Child Sexual Abuse Prosecutions Research Articles

Child Sexual Abuse: How Is the Victim Represented in Portuguese Sentences

ABSTRACT Child sexual abuse (CSA) is a global problem with severe consequences for victims and their development, with various resulting consequences. Sentences regarding CSA crimes can be unconsciously influenced by extralegal factors. This study aimed to understand how Portuguese CSA victims are represented in judges’ sentencing of offenders. Twenty-seven sentences of CSA, from a Portuguese database, were thoroughly analyzed through thematic analysis. Six main themes pertaining to the victim, emerged from the sentences’ analysis: (i) emotional response during statements; (ii) reported details and reactions; (iii) credibility and reliability of statements; (iv) revelation and secret-keeping; (v) victim’s trajectory; and (vi) impact on the victim. The assessment of the credibility of the victim’s statements proved to be central across all sentences. Data related to external sources, namely judges’ personal beliefs, physical evidence, and witnesses, emerged. Legal and psychosocial factors were identified, with the latter consisting of victim-blaming and legitimization of sexual violence. As for the practical implications of these findings, we argue that a fair exercise of justice, and improvement of the efficacy of prosecution of CSA is only possible through identification of these sensitive issues and adequate addressal of them during magistrates’ training.

Child Sexual Assault Nurse Examinations and Prosecutorial Decisions to Accept or Reject Cases of Child Sexual Abuse

Prosecution of child sexual abuse (CSA) cases provides safety for communities and justice for victims. Prosecutorial decisions are multifactorial and include the presence of a structured coordinated community response to outcries and access to skilled healthcare providers. This study examines the impact forensic nurse sexual assault examinations (SAEs) have on prosecution in a population of children seen at a child advocacy center (CAC). The authors examined case data from 553 cases of reported CSA, seen by a forensic nurse in a CAC. Statistical analysis focused on prosecution decisions with and without SAE, with and without physical findings. Logistic regression determined prosecution occurred more often when SAE had been conducted (p = 0.026, OR = 1.732, 95% CI [1.068, 2.808]), regardless of examination findings. The limitations include a single location for data and the multifactorial reasons for prosecution of cases. The multifactorial elements contributing to prosecutorial decisions are diverse. The formalized approaches in CACs historically show increased prosecution. Teasing out the impact of an SAE in a CAC may be reflective of positive CAC approaches. Regardless, a statistically significant finding of association uniquely with the SAE, with or without findings, implies more studies are needed to support the role of the forensic nurse in successful prosecutions of CSA cases.

‘No action required’: A historical pattern of inaction and discretion towards child sexual abuse in Queensland policing

Throughout much of the 20th century, the Queensland Police Force were led by an administration of senior officers more engaged with corrupt practices than with the prosecution of child sexual abuse. An unwillingness within the police force to take action against suspected child sex offenders on many occasions could be perceived to obstruct investigations and provide a layer of protection to this kind of criminal behaviour. Examination of archival material suggests that Queensland police were motivated by an anomic condition within the force that led to deviance from established social norms governing attitudes towards child sexual abuse cases.

Trauma and the Construction of Suffering in Irish Historical Child Sexual Abuse Prosecutions

Adopting the special issue’s broad definition of criminal law reform, this article explores some of the ways the Irish criminal process is grappling with the demands for justice of adults who report childhood sexual abuse. In particular, it shows how the cultural notion of trauma is bound up with the construction of victims’ suffering. In historical child sexual abuse prosecutions, trauma is shown to be an effect of the abuse on the victim/survivor; a site of mediation of the relationship between the state and victims; and a site of mediation of the relationship between the state and its past. The article first explores these insights in relation to the law’s approach to questions of alleged procedural unfairness to defendants flowing from the passage of time. Trauma is exposed as both legitimating some forms of suffering, and disqualifying others. The article then employs the trope of trauma to expose the problems with current approaches to cross-examination of vulnerable victims and recent reforms of the rules on disclosure of victims’ counselling records. Finally, the article explores the possibilities of trauma discourse in thinking anew about how to address the suffering of victims of historical child sexual abuse.

Challenges facing East Asian immigrant children in sexual abuse cases.

A substantial portion of immigrants to Canada comes from East Asia (e.g., Mainland China, Taiwan, Hong Kong, and Korea). In this article, we discuss how culture shapes the way that children recall autobiographical events, how language differences can affect prosecutions of child sexual abuse, and why cultural differences (between East Asia and North America) may affect the likelihood that children disclose abuse. These three factors closely interplay with each other, which can lead child abuse victims who are from East Asian cultures to be underrepresented and disadvantaged in the Canadian legal system.In this article, we discuss the severe consequences that may face East Asian immigrant families when their children try to disclose alleged sexual abuse. In particular, we refer to Mandarin Chinese speakers. We first discuss the role of children in investigations of abuse in Canada and then outline some cultural differences between Euro-Canadian and Asian cultures. We then present our argument about how cultural and language differences may impact the investigation and prosecution of abuse.Child sexual abuse investigations can take place in two ways: Children could directly voice the allegations (known as disclosure) or a concerned adult might suspect abuse and report it to authorities. In both Canada and the United States, there is mandatory reporting of abuse (i.e., adults must report suspected abuse to the authorities or risk being accessories to the abuse). A common sequence of events after a disclosure/suspicion of abuse is for the relevant child welfare and legal authorities to proceed with an investigation to determine, first, if the child is in imminent danger and, second, whether there is information of sufficient quality to proceed with an investigation (Brubacher, Bala, Roberts, & Price, 2016). Although there are sometimes witnesses who can give first-hand accounts, sexual abuse often takes place in private and so the only testimony can come from the child and/or the perpetrator. Suspected perpetrators commonly deny the abuse unless there is a credible, quality statement from the alleged victim (Pipe, Orbach, Lamb, Abbott, & Stewart, 2013). Thus, what children say in investigative (forensic) interviews is critical to decisions about whether to prosecute or not.It is our argument that East Asian immigrant children are particularly disadvantaged and, potentially, at-risk, compared to Westernized children. As illustrated in Figure 1, we focus specifically on three areas of concern: (1) cultural differences that can shape children's memory recall, (2) cultural differences that can impact the path of disclosure of sexual abuse, and (3) language differences which reduce the chances that perpetrators will be prosecuted for sexual abuse. Before discussing these cultural differences, we outline the role of memory in a forensic interview given the importance of children's role as victim witnesses. This provides the reader with a clear idea of what is involved in Canadian investigations of child abuse.Children's Memory and the Forensic InterviewGood forensic interviewers allow children to freely recall what happened to them. This means that children are free to choose what information they report. There are no hints or suggestions at this stage as to what sort of details are needed. When we recall, one memory reminds us of another memory and so on. In more visual terms, picture a web of neuronal pathways each connected to another. Each pathway produces a memory and links to the next piece of information. Thus, we can recall many details about an experienced event.Recalling memories requires a larger cognitive load than recognizing pieces of information. An interviewer who asks, Was your mum there? is asking the child to recognize whether mum was present. Although recognition is easier than recall, it is not a forensically valid technique in child sexual abuse interviews. By describing a piece of information, the interviewer is suggesting information that may or may not be true. …

Taking the incidence of false child sexual abuse allegations more seriously

Taking the incidence of false child sexual abuse allegations more seriously

Australian prosecutors’ perceptions of the utility of child investigative interview protocols

Investigative interviews with alleged victims form the central plank of evidence in the prosecution of child sexual abuse. Despite interviewers being provided with a guiding framework, child sexual abuse cases are often not prosecuted because of poor-quality evidence. The purpose of this study was to elicit feedback from prosecutors about the structure and format of current interview protocols and the ways in which these could potentially be improved from an evidential perspective. Focus group discussions (ranging in length from 180 to 190 minutes) were conducted with 13 Crown prosecutors representing every jurisdiction of Australia. Thematic analysis of the focus group discussions revealed that prosecutors were supportive of the structure of interview protocols, however, concerns were raised about four of the interview elements. These elements were the oath and truth–lie competency test, the ground rules, the practice narrative and eliciting a disclosure. The prosecutors’ concerns and their implications for protocol developers and trainers are discussed.

BEHAVIOURAL SCIENCE EVIDENCE IN CHILD SEXUAL ABUSE PROSECUTIONS IN SOUTH AFRICA: A JURISPRUDENTIAL AND COMPARATIVE INSIGHT

The role of behavioural science (BSE) in proving the occurrence of child sexual abuse (CSA) is well documented. Equally, its role in placing the evidence of the CSA victim into proper perspective is undisputable. South Africa stands out as one of the very few or perhaps the only criminal justice system in Africa which has over the years admitted BSE in CSA prosecutions. This potentially makes it a source of good practice for many criminal justice systems in Africa and the world over. Despite the many years of admitting BSE in CSA prosecutions, little is known about the critical role it has played thus far, the gaps in the courts’ current approach to BSE and how these gaps can be addressed. The present article, with reference to selected recent case law from South Africa and comparative case law from America, analyses the critical role of BSE in affording broader redress to CSA victims. The article identifies the gaps in the current approach of the courts in South Africa. Drawing from the approach of selected courts in America, it suggests additional reforms which may be relevant if the potential of BSE in CSA prosecutions is to be fully and appropriately exploited.

Factors Associated with Delays of Days to Decades to Criminal Prosecutions of Child Sexual Abuse.

Until the latter part of the 20th century, legal doctrines made it almost impossible to successfully prosecute in criminal court a case involving child sexual abuse (CSA), whether the complaint was timely or delayed. Many English-speaking countries have abrogated most formal legal barriers to prosecuting CSA cases, and courts are faced with the singular challenge of adjudicating sexual offenses against children that are reported to have happened years or decades earlier. We conducted analyses of 4,237 criminal complaints of CSA heard in Canadian criminal courts. There were several differences between timely and delayed prosecutions that led us to conclude that delayed prosecutions of CSA are common and due, in part, to the nature of the offense. Offense duration was associated with longer delays to prosecution. When the accused had access to the child through his position in the community, length of delay to prosecution was very long, particularly for male complainants. More research is needed on delayed CSA prosecutions, particularly given an apparent trend for jurisdictions to abolish barriers to criminal prosecutions of CSA that occurred years or decades earlier.

Factors Impacting Prosecution of Child Sexual Abuse, Physical Abuse, and Neglect Cases Processed Through a Children’s Advocacy Center

This study examined the impact of victim, offender, and case characteristics on the decision to accept cases of child maltreatment for prosecution. Data were collected over a 2-year period from a large southern Children’s Advocacy Center, and the final sample consisted of 467 substantiated cases of child sexual abuse, physical abuse, and neglect. Logistic regression results indicated that sexual abuse cases were significantly more likely to be accepted for prosecution compared to physical abuse and neglect. Additionally, cases involving female victims and male offenders were more likely to be moved forward. When each type of maltreatment was examined separately, logistic regression results indicated that victim and offender age significantly impacted the decision to prosecute sexual abuse cases. Offender gender and age, as well as availability of medical evidence predicted physical abuse case acceptance, and offender gender and frequency of maltreatment significantly impacted prosecutorial decision making for cases of neglect.

Due Process and the Admission of Expert Evidence on Recovered Memory in Historic Child Sexual Abuse Cases: Lessons from America

This article reviews the decisions of the US state courts on the admissibility of expert testimony on recovered memory in historic child sexual abuse prosecutions. Unlike their English and Irish counterparts, most US courts scrutinise the reliability of expert evidence on recovered memory. In examining the US decisions the article explores the challenges posed to the criminal process by the contested scientific status of recovered memory theory. It sets out due process arguments why expert evidence on the topic should not be admitted in a criminal trial.

Children's Rights, Family Rights

In this article I explore the intersections of children's human rights, social policy, and qualitative inquiry from a social work perspective. First, I consider the relationship between human rights work and social work. Second, I argue that children add complexity to the human rights debate. In doing so, I briefly examine the conflict between children's rights as developed in the United States and that of the United Nation's Convention on the Rights of the Child. Third, I turn to a specific qualitative research project in which a team of researchers conducted an in-depth study of the prosecution of child sexual abuse in one U.S. jurisdiction. I argue that the findings from this study illustrate how qualitative inquiry can reveal conflicting and often hidden value trade-offs that must be addressed when enacting and enforcing children's human rights. This study demonstrates what qualitative inquiry has to offer policy advocates who seek to promote children's human rights.

Predators and Propensity: The Proper Approach for Determining the Admissibility of Prior Bad Acts Evidence in Child Sexual Abuse Prosecutions

The admissibility of prior bad act evidence in child sexual abuse prosecutions oftentimes makes the difference between a guilty and not guilty verdict. Recently, jurisdictions have growingly embraced the admission of such evidence for the purpose of establishing the defendant’s propensity to sexually victimize children. Due to the potentially high prejudicial effect of admitting propensity evidence, it is more critical than ever that courts carefully apply the decisive evidentiary gatekeeper, the probative value balancing test of Federal Rule of Evidence 403 and its state equivalents. Over the years, courts and legislators have attempted to develop analytical frameworks to be used by trial judges when evaluating the probative value of prior bad acts propensity evidence in child sexual abuse cases. Unfortunately, the framework most often applied by the courts in these cases has minimal correlation to the determination of propensity, but instead is premised upon the traditional Rule 404(b) basis of establishing proof of motive, opportunity, intent, preparation, plan, knowledge, identity, or absence of mistake, or accident. As a result, courts end up applying differing, and sometimes inconsistent frameworks that bear no rational relationship to one’s propensity to commit a child sexual offense. Without such a relationship, it is virtually impossible to meaningfully engage in a Rule 403 balancing test to determine the probative value of prior bad acts evidence being offered to establish propensity. This Article proposes a new analytical framework (the “403 Propensity Proposal”) to be applied by courts when evaluating the admissibility of prior bad acts evidence in child sexual abuse prosecutions that directly correlates to the issue of propensity. If such evidence is to be admissible, courts must ensure that it be directly probative of researched behavioral patterns of those who sexually victimize children. The heart of this proposal is the consideration, evaluation, and application of three methods commonly employed by those who sexually victimize children. The 403 Propensity Proposal applies these three methods — trust, authority, and instrumental force/threats as factors in establishing a rational and consistent analysis for evaluating the probative weight of such propensity evidence. This Article culminates with the application of the 403 Propensity Proposal to a fictional case study involving a child sexual abuse prosecution where the prosecutor seeks to introduce the testimonies of three witnesses who allege prior sexual abuse by the defendant. The case study application demonstrates that the proposed propensity factors will better ensure that prosecutions for these types of crimes are based upon relevant and probative evidence that directly relates to one’s propensity to sexually victimize children. Both defendants and complainants are entitled to nothing less.

Judicial decision making in timely and delayed prosecutions of child sexual abuse in Canada: A study of honesty and cognitive ability in assessments of credibility.

Child sexual abuse is an alarmingly common criminal offense. Whether prosecutions occur shortly after the alleged offense or after a lengthy delay, complainant credibility is often the central issue at trial. In both law and in psychology, credibility is said to be a function of two relatively distinct factors: honesty and cognitive ability. Complainant age informs evaluations of both such that younger children are seen as more honest but less cognitively competent than older children and adults. When a complainant describes a recent event, current age may be used to assess honesty and cognitive ability. However, when a complainant describes an event that occurred in the distant past, we argue that current age is most informative in evaluations of honesty, whereas age at the time of the alleged offense should inform evaluations of cognitive ability. In this research, we analyzed judicial assessments of complainants’ credibility in 52 timely (child complainant) and 49 delayed (adult complainant) criminal prosecutions of child sexual abuse. Judicial comments concerning cognitive ability suggest that adults were viewed more positively than children, despite the fact that all complainants were children when the alleged offense occurred. As expected, comments related to honesty suggested that children were seen to be more honest than adults unless they had been exposed to suggestive influences.

The contribution of children's advocacy centers to felony prosecutions of child sexual abuse

Objective To describe trends of felony sexual abuse prosecutions between 1992 and 2002 for two districts of a large urban city that differed primarily in their use of children's advocacy centers (CACs) for sexual abuse evaluations in children. Methods Aggregate data for two districts of a large urban city were provided from 1992 to 2002 from the district attorney's office, child protective services (CPS) agency, and all CACs serving both districts. Summary statistics were calculated over time and compared between both districts for ecologic trends using negative binomial regression. Results Over the time period of the study, substantiated reports of child sexual abuse declined: District 1 experienced a 59% decrease in the incidence of reports, while District 2 experienced a 49% decrease in the incidence of reports. Despite this decrease, felony prosecutions of child sexual abuse increased in District 1 (from 56.6 to 93.0 prosecutions/100,000 children, rate ratio 1.64, 95% CI 1.38–1.95), but did not significantly increase in District 2 (from 58.0 to 54.9 prosecutions/100,000 children, rate ratio 0.94, 95% CI 0.73–1.23); by 2002, the rate of felony prosecutions in District 1 was 69% greater (95% CI 37–109%) than the rate in District 2. In 1992, CACs in District 1 evaluated approximately 400 children, increasing to 1,187 children by 2002. The number of children evaluated by CACs in District 2 increased modestly from nearly 800 in 1992 to 1,000 in 2002. Conclusion Felony prosecutions of child sexual abuse doubled in a district where the use of CACs nearly tripled, while no increase in felony prosecutions of child sexual abuse was found in a neighboring district, where the use of CACs remained fairly constant over time. Practice implications Though many limitations exist when bringing together ecological data from different agencies, the strength of the association we observed between increased CAC use and increased felony prosecutions, and the stepwise fashion in which it occurred should support future research to confirm our findings and to delineate which attributes of CAC performance might impact the likelihood of prosecution of child sexual abuse.

Judging the credibility of historic child sexual abuse complainants: How judges describe their decisions.

Criminal prosecutions of child sexual abuse alleged to have occurred in the distant past raise myriad challenges. One significant challenge involves assessing the credibility of complainants. In the present study, 51 bench trials involving 87 complainants were coded into categories related to complainants’ memory for the offense, as well as credibility of the complainant, reliability of the evidence, and judicial inferences. A total of 4,827 judicial comments were identified and categorized. Judges were more likely to describe the allegations specifically than generally; however, they were sensitive to the predictably impoverished nature of memory after such a long delay. Consistent with psychological evidence, there were more judicial comments about inconsistencies in acquit cases than in convict cases and more comments about corroboration in convict than in acquit cases, although neither inconsistencies nor corroboration were strongly associated with verdict. Of some concern was the apparent and considerable judicial interest in complainants’ behavior and emotions around the time of the alleged abuse and around the time of disclosure.

Delayed Complaints in Childhood Sexual Abuse Prosecutions—A Comparative Evaluation of Admissibility Determinations and Judicial Warnings

This article reviews legal responses to delayed complaints in child sexual abuse prosecutions in Australia, Canada, the United States, Ireland, and England and Wales, focusing on recent legislative and judicial modifications to the historical common law requirement for early or recent complaint. Consideration is given to three legal mechanisms regulating the jury's access to information about delayed complaints: cross-examination of the complainant on the issue of delay, the admissibility of a late complaint for the prosecution, and judicial warnings indicating how, if at all, jurors should incorporate the fact of late complaint into their deliberations.

Delayed Prosecutions of Historic Child Sexual Abuse: Analyses of 2064 Canadian Criminal Complaints.

Recently, in many English-speaking countries, legal principles that had the effect of barring delayed criminal prosecutions have been abrogated. In these jurisdictions, criminal prosecutions of child sexual abuse that is alleged to have occurred in the distant past (historic child sexual abuse or HCSA) are a growing legal challenge. These cases raise myriad issues relevant to research and the development of public policy that would benefit from a considered exchange of ideas that is informed by a clear understanding of the phenomenon. Based on 2064 judicial decisions of Canadian criminal complaints of HCSA we describe the trial, the complainant, the accused, and the offence. In the context of these legal cases, we raise some of the germane issues as well as suggestions for future research and discussion that we believe are particularly current and pressing.

Child Witness Policy: Law Interfacing with Social Science

Dorothy F. Marsil (*) Jean Montoya (**) David Ross (***) Louise Graham (****) I INTRODUCTION The number of children testifying in court has posed serious practical and legal problems for the judicial system. One problem confronting the courts is how to protect children from experiencing the psychological trauma resulting from a face-to-face confrontation with a defendant who may have physically harmed the child or threatened future harm to the child. Another concern is that this trauma may impair children's memory performance and their willingness to disclose the truth. In response to these concerns, child witness innovations proliferated throughout the United States in the 1980s and 1990s. (1) Among the innovations were: placing a screen between child witnesses and the defendant during children's testimony; (2) transmitting children's testimony into the courtroom by closed-circuit television; (3) and admitting children's otherwise inadmissible hearsay, (4) including children's videotaped interviews. (5) These innovations spawned a fair amount of appellate litigation regarding their constitutionality . Much of the litigation focused on whether a given innovation violated the Confrontation Clause, (6) but questions about due process arose as well. Court decisions regarding the constitutionality of child witness innovations rest on a number of assumptions that are subject to empirical testing. This article examines many of these assumptions and evaluates whether they are supported by social science evidence. Part II of the article examines the use of shielding procedures in child sexual abuse prosecutions. It begins by exploring the Supreme Court's analysis of state laws providing protection by shielding the child witness from the defendant. Next, it explores various questions: Do child witnesses need protection from confrontational stress? Does shielding prejudice the defendant? Does it impact juror perception of the proceedings' fairness? Does shielding impact juror perception of the child witness? How reliable is children's shielded testimony? Does shielding impair juror ability to detect deception in the child witness? Part III examines the use of hearsay testimony in child sexual abuse prosecutions. As with Part II, it begins by painting a picture of the legal landscape. Specifically, it considers the evidentiary and constitutional implications of using hearsay when children are witnesses. Part III then addresses various questions: Does admitting hearsay testimony protect the child witness? Does admitting hearsay testimony prejudice the defendant? How reliable is hearsay testimony offered in trials involving child witnesses? How accurate are the hearsay witnesses? Are they able to reconstruct details of their out-of-court exchange with the child witness? Does the eyewitness report deteriorate as it is transmitted down the hearsay chain from the child to the hearsay witness? Part IV concludes the article. It highlights the insights gained from the interface of law and social science and makes suggestions for legal practice and future social science research. II CHILDREN'S SHIELDED TESTIMONY Using shielding procedures is distinct from admitting hearsay statements. With shielding procedures, the child's view of the defendant is obstructed during the child's testimony at trial. When a screen is used, the child testifies from behind a screen placed between the child and the defendant. When one-way closed-circuit television is used, the child testifies from a separate testimonial room, and the child's testimony is transmitted into the courtroom where the defendant, jury, and judge are able to view the testimony. (7) In either case, the child witness testifies under oath and is subject to cross-examination. In contrast, when hearsay is admitted in lieu of the child's testimony, not only does the child avoid physical confrontation with the defendant, but the child witness is also not subject to cross-examination, because the prosecution relies on the testimony of a hearsay witness who reports the child's out-of-court statements. …

The Maturation and Disintegration of the Hearsay Exception for Statements for Medical Examination in Child Sexual Abuse Cases

Robert P. Mosteller (*) I Introduction The purpose of this symposium is to examine the treatment of children as victims and witnesses in criminal trials, most frequently involving sexual abuse, over the last quarter of the twentieth century and, from that experience, to draw lessons. In this essay, I examine what we have learned about the hearsay exception for for purposes of diagnosis or (1) Earlier, I studied this exception as applied in child sexual abuse prosecutions and found being stretched beyond the bounds of its theoretical justification. (2) In this essay, I reexamine our national experience with the exception over the past decade and find both a maturation of the exception and at least a partial disintegration. Briefly, the hearsay exception admits statements made by a person for the purpose of either receiving treatment or allowing a doctor to diagnose without any expectation of treatment. (3) The statements may concern the individual's present symptoms, history, or the general character of the condition or injury that prompted the visit. To be admissible, the statements must be reasonably pertinent to diagnosis or treatment, apparently from the perspective of either the declarant or the expert. Although central to the no definition of the term is provided in the rule itself or in the accompanying commentary. Finally, the availability or unavailability of the person who made the statement is irrelevant to admissibility. The exception is applied in a relatively straightforward and uncontroversial manner in typical civil cases involving accidents, injuries, sickness, and treatment. Its use is far more debatable as applied in child sexual abuse cases when one of the key issues is whether a child's statements describing sexual abuse, particularly statements identifying the abuser, are admissible. To illustrate how the use of the exception can, in my judgment, be very troubling, consider the following hypothetical case: A four-year-old female child, in the care of a single mother and her current live-in boyfriend, is found by social workers to be malnourished and poorly clothed. She is also apparently emotionally withdrawn. A physical examination reveals irritation in the genital area that is suggestive of sexual abuse several days earlier, but could also be fully explained in other ways. When asked by the examining pediatrician about her genital area, the child responds with very little information and the best that can be determined is that it hurt. Because of the conditions of her care, the child is temporarily taken from her mother's custody. While in emergency care, the child is interviewed several times by social workers trying to determine whether sexual abuse occurred. She provides no additional information that would suggest sexual abuse. The interviews are not recorded. Investigators continue to suspect abuse because of an unproven but reported incident of sexual abuse of a child two years earlier by Buddy, the mother's live-in boyfriend. The child is sent to a pediatrician who works regularly with the Department of Social Services in detecting and treating sexual abuse. The doctor is briefed on all the information in the case and the suspicions regarding Buddy. He conducts no physical exam, because the symptoms are no longer present. Without any witness present or any recording made, and with very few notes, the doctor interviews the child. He reports that the child told him that hurt her bottom with his pee pee, writing this quotation in his notes. The child never repeats a statement of this sort in later interviews. Buddy is charged with child sexual abuse. The child is not called as a witness by the state; she is found incompetent to testify because she does not understand the oath. The trial judge rejects the defense's objection based on hearsay and Confrontation Clause grounds, and allows the pediatrician to testify to the child's statement to him under the medical examination exception, the doctor explaining that the inquiry was pertinent to the child's placement in foster care, away from Buddy. …