Stories given by children, when to take it with a pinch of salt?

Abstract

The history given by a child is very important in child abuse investigations. This is especially relevant in cases of child sexual abuse as in some forms of sexual abuse injuries may be absent. The only evidence to prove the case sometimes is the evidence given by the child. The law presumes that the statements given by the child are true. To what extent can a doctor believe a child’s history? This case report describes a situation where a child gave a history of being kidnapped and in the child’s own words, “cared for” twice, by an unknown person. There was a suspicion that the child may have been sexually abused. The child gave a similar detailed history to the judicial medical officer (JMO), police, and the psychiatrist. Based on the information received from the child, various investigatory procedures were initiated by the police. But the detailed examination of this “victim” by the child psychiatrist revealed that the child was having a significant and very prominent fantasy life of a romantic/sexual nature. It was also detected that the child was not very bright intellectually. It appeared that a big proportion of the story given by the child was coloured by her experiences and fantasies. This case reveals the importance of suspecting the possibility of fantasy, when an unusual story without supporting evidence is given by a child. Medico-Legal Journal of Sri Lanka 2013; 1(3) : 17-19