Die identifisering van seksuele molestering by kinders: 'n kruis-kulturele studie

Abstract

English: The identification of child sexual abuse is a challenging task, particularly as erroneous decisions could have far-reaching implications - not only for the alleged victim, but also for the accused. The task is especially impeded it there are no concrete indicators such as medical proof, evidence of an eyewitness, or confession of the perpetrator. Sexually abused children are also not a heterogeneous group. The implication is that the disclosure of sexual abuse could be influenced by a variety of factors. In this regard the most important variables are the context of abuse (e.g. relationship with the perpetrator, frequency of the offence, and support systems), the competencies of the child (e.g. cognitive skills and suggestibility), as well as the characteristics of the evaluation process itself (e.g. questioning techniques and emotional contexts). These complexities have increasingly compelled forensic evaluators to find methods and techniques to differentiate between abused and non-abused children. The dilemma, however, is that there is no single existing psychometric instrument that meets these requirements. Psychologists and other forensic evaluators are therefore inclined to use miscellaneous measuring instruments and techniques for this task. Mostly these techniques have not been empirically validated for child sexual abuse assessment. The primary goal of this study was to investigate the suitability of a number of measuring instruments that are widely used by South African forensic evaluators in the assessment of sexual abuse. A second goal was to investigate the applicability of these instruments in the South African multi-cultural context. The participants were 150 children of whom 83 were abused and 67 non-abused. There were 52 white and 31 black children in the abused group, and 41 white and 26 black children in the non-abused group. The ages varied between 7 and 16 (the average of the abused and nonabused children were 11,6 and 12,02 years respectively.) The children were assessed on both indirect and direct levels. On the indirect level projective techniques such as drawing techniques (HTP/DAP) and picture tests (CAT,TAT, RATC and PST-C) were used. On the direct level, techniques to explore touching (anatomical drawings and anatomical dolls) and a self-report inventory (TSCC) were administered. Collateral information was also obtained from the parents (via the CSBI and CBCL, parent form) and teachers (CBCL, teacher form). The results indicate that no single measuring instrument can differentiate between abused and non-abused children. A multi-dimensional model is proposed to assess the child on various levels. This will not only present a total picture of the child, but also facilitate the decisionmaking process regarding the status of abuse. More specifically: • Standardised and structured projective techniques such as the House- Tree-Person/Drawa- person (HTP/DAP) and the Roberts Apperception Test for Children (RATC) present more objective measures than, for example, the CAT and TAT. • The Projective Story Telling Cards (PST-C) could be considered to mainly explore themes regarding sexuality. However, due to the potential sexual nature of this technique, the results should be interpreted with the necessary caution. • The use of anatomical drawings and anatomical dolls as techniques to explore touching is also recommended. However, it should be used according to the recommended procedure. These drawings and dolls are especially valuable as anatomical models, and as methods to explore touching. Additionally, the dolls are also suitable as a demonstration technique. • Self-report inventories such as the Trauma Symptom Checklist for Children (TSCC) could be used to assess sexual trauma, as well as other clinically relevant symptomatology. • Behaviour checklists, specifically the Child Sexual Behavior Inventory (CSBI) and the Child Behavior Checklists (CBCL) (parent and teacher forms), could be used to obtain information regarding problems of a sexual nature as well as the child's general functioning. • Assessment techniques should be used in a specific sequence: From the least threatening (i.e. non-sexual content) to the more threatening (more sexual content) techniques. This procedure does not only put the child at ease, but could also facilitate disclosure. Cl The afore-mentioned techniques should, however, not be administered in a vacuum but should form an integral part of the interviewing process. It is therefore necessary that forensic evaluators should not only be trained in the relevant psychometric techniques, but also in the correct forensic interviewing procedure. It seems that especially the TSCC, CSBI and CBCL could be applied in a cross-cultural setting. The reliability of these techniques also seems to be satisfactory. Regarding the projective techniques, the PST-C, the HTP/DAP and RATC (and to a lesser degree the CAT and TAT) are recommended. The anatomical drawings and dolls appear to be cross-culturally applicable. However, it should be taken into account that, although certain responses are more prevalent in abused than non-abused children, they are also present in non-abused children. Furthermore, some sexually abused children are asymptomatic. Concentrating only on certain responses or problems as indicators of sexual abuse, could lead to either an overinterpretation or under-interpretation of the child's abuse status.

Afrikaans: Die identifisering van seksuele molestering by die kind is meestal 'n uitdagende taak, veral vanweë die verreikende implikasies wat 'n verkeerde beslissing kan hê - nie net vir die beweerde slagoffer nie, maar ook vir die beweerde molesteerder. Die taak word veral bemoeilik indien daar nie konkrete aanduiders soos mediese bewyse, getuienis van 'n ooggetuie, of erkentenis van die oortreder is nie. Seksueel-gemolesteerde kinders is ook nie 'n heterogene groep nie, wat impliseer dat onthullings van seksuele molestering al dan nie deur 'n verskeidenheid faktore beïnvloed kan word. Hier word veral verwys na die konteks van die molestering (bv. verwantskap met die molesteerder, frekwensie van die daad, en ondersteuningstrukture), die bevoegdhede van die kind (bv. kognitiewe vaardighede, en vatbaarheid vir suggesties), asook die kenmerke van die evalueringsproses self (bv. vraagstellingstegnieke en emosionele kontekste).Hierdie kompleksiteite het forensiese evalueerders toenemend genoodsaak om metodes en tegnieke te vind om die gemolesteerde van die nie-gemolesteerde kind te onderskei. Die dilemma is egter dat daar tot op hede geen enkele meetinstrument bestaan wat aan hierdie vereiste beantwoord nie. Sielkundiges en ander forensiese evalueerders is dus geneig om van allerlei bestaande meetinstrumente en tegnieke gebruik te maak om hierdie taak te verrig, sonder dat die geldigheid van hierdie metodes empiries geverifieer is. Die primêre doel van hierdie studie was om ondersoek in te stel na die toepaslikheid van 'n aantal meetinstrumente wat algemeen deur Suid-Afrikaanse forensiese evalueerders gebruik word in die assessering van seksuele molestering. 'n Tweede doelwit was om die bruikbaarheid van hierdie instrumente in die Suid-Afrikaanse multikulturele samestelling te ondersoek. Die ondersoekgroep het bestaan uit 150 kinders waarvan 83 gemolesteer en 67 I1Ie gemolesteer was. Daar was 52 wit en 31 swart kinders in die gemolesteerde groep, en 41 wit en 26 swart kinders in die nie-gemolesteerde groep. Die ouderdomme het tussen 7 en 16 jaar gewissel (X van gemolesteerd en nie-gemolesteerd was onderskeidelik 11,6 en 12,02 jaar).Die kinders is op indirekte sowel as direkte vlakke geassesseer. Op indirekte vlak is van projektiewe tegnieke soos tekentegnieke (HBM/MFT en kinetiese gesinstekeninge) en prenttoetse (CAT, TAT, RATC en PST-C) gebruik gemaak. Op direkte vlak IS aanrakingseksplorasie-tegnieke (anatomiese tekeninge en anatomiese poppe) en 'n selfrapporteringsvraelys (TSCC) toegepas. Kollaterale inligting is ook van die ouers (via die CSBI en CBCL-ouervorm) en onderwysers (m.b.v. die CBCL-onderwyservorm) verkry. Volgens die resultate kan geen enkele meetinstrument tussen gemolesteerde en niegemolesteerde kinders onderskei nie. 'n Multidimensionele model word voorgestel waardeur die kind op verskeie vlakke geassesseer word. Hierdeur word sowel 'n geheelbeeld van die kind verkry, as die besluitnemingsproses oor die molesteringstatus gefasiliteer. Meer spesifiek: • Gestandaardiseerde en gestruktureerde projektiewe tegnieke soos die Huis-Boom- Menstekening/Mensfiguurtekening (HBM/MFT) en die Roberts Apperception Test for Children (RATC) verskaf meer objektiewe metings as byvoorbeeld die CAT en TAT. G Die Projective Story Telling Cards (PST-C) kan oorweeg word om veral temas rondom seksualiteit te eksploreer. Weens die potensieel seksuele aard van dié tegniek, moet die resultate egter met die nodige omsigtigheid hanteer word. • Die gebruik van anatomiese tekeninge en anatomiese poppe as aanrakingseksplorasietegnieke word ook aanbeveel, mits dit volgens die aanbevole prosedure gebruik word. Hierdie tekeninge en poppe is veral waardevol as anatomiese modelle en om aanraking te eksploreer. Die poppe is bykomend ook bruikbaar as demonstrasietegniek. • 'n Selfrapporteringsvraelys soos die Trauma Symptom Checklist for Children (TSCC) kan nie net seksuele trauma nie, maar ook ander klinies-relevante simptomatologie ondervang. • Met gedragsmerklyste soos spesifiek die opname van seksuele gedrag (CSBI) en gedragsmerklyste vir ouers en onderwysers (CBCL) word nie net inligting oor moontlike seksuele problematiek bekom nie, maar ook oor die kind se algehele funksionering. o Assesseringstegnieke moet in 'n spesifieke volgorde aangebied word en wel van die mins bedreigende (m.a.w. nie-seksuele inhoud) na die meer bedreigende (meer seksuele inhoud) tegnieke. Hierdie prosedure stel nie alleen die kind op sy of haar gemak nie, maar kan ook die onthullingsproses fasiliteer. o Die voorafgenoemde tegnieke kan egter nie in 'n vakuum aangebied word nie, maar vorm 'n integrale deel van die onderhoudproses. Dit is daarom noodsaaklik dat forensiese evalueerders nie net met die psigometriese tegnieke vertroud is nie, maar ook met die korrekte forensiese onderhoudprosedure. Wat kruiskulturele toepaslikheid betref, is veral die TSCC, CSBI en CBCL bruikbaar. Die betroubaarheid van hierdie meetinstrumente blyk ook bevredigend te wees. Rakende projektiewe tegnieke, kan die PST-C, die HBM/MFT en RATC (en in 'n mindere mate die CAT en TAT) aanbeveel word. As aanrakingseksplorasietegnieke blyk sowel die anatomiese tekeninge as poppe kruiskultureel toepaslik te wees. Daar dien egter op gelet te word dat hoewel sekere response meer by gemolesteerde kinders as by nie-gemolesteerde kinders voorkom, is dit ook by sekere nie-gemolesteerde kinders teenwoordig. Hierbenewens is sommige seksueel-gemolesteerde kinders asimptomaties. Om dus slegs op sekere response of problematiek as aanduiders van seksuele molestering te konsentreer, kan tot óf oorinterpretasie, óf onderinterpretasie van die kind se molesteringstatus aanleiding gee.