Interdisciplinary Evaluations Research Articles

Evaluations of Children Who Have Disclosed Sexual Abuse via Facilitated Communication

To review the findings of interdisciplinary team evaluations of children who disclosed sexual abuse via facilitated communication.Case series.Tertiary care hospital outpatient child sexual abuse program in central New York.Between January 1990 and March 1993, 13 children who disclosed sexual abuse via facilitated communication and were referred to a university hospital child abuse referral and evaluation center. The range of previously determined developmental diagnosis included mental retardation, speech delay, and autism.None.Medical records were reviewed for (1) disclosure, (2) physical evidence, (3) child's behavioral and medical history, (4) disclosures by siblings, (5) perpetrator's confession, (6) child protective services determinations, and (7) court findings.Four children had evidence of sexual abuse: two had physical findings consistent with sexual abuse, one also disclosed the allegation verbally, and one perpetrator confessed.These results neither support nor refute validation of facilitated communication. However, many children had other evidence of sexual abuse, suggesting that each child's case should be evaluated without bias.

Evaluations of Children Who Have Disclosed Sexual Abuse via Facilitated Communication

Objective: To review the findings of interdisciplinary team evaluations of children who disclosed sexual abuse via facilitated communication. Design: Case series. Setting: Tertiary care hospital outpatient child sexual abuse program in central New York. Patients: Between January 1990 and March 1993, 13 children who disclosed sexual abuse via facilitated communication and were referred to a university hospital child abuse referral and evaluation center. The range of previously determined developmental diagnoses included mental retardation, speech delay, and autism. Interventions: None. Main Outcome Measures: Medical records were reviewed for (1) disclosure, (2) physical evidence, (3) child's behavioral and medical history, (4) disclosures by siblings, (5) perpetrator's confession, (6) child protective services determinations, and (7) court findings. Results: Four children had evidence of sexual abuse: two had physical findings consistent with sexual abuse, one also disclosed the allegation verbally, and one perpetrator confessed. Conclusions: These results neither support nor refute validation of facilitated communication. However, many children had other evidence of sexual abuse, suggesting that each child's case should be evaluated without bias. (Arch Pediatr Adolesc Med. 1994;148:1282-1287)

Interdisciplinary Evaluations of Alleged Sexual Abuse Cases

Children who are alleged to have been sexually abused often go through gruelling interrogations to relate their experiences to adults and, even then, most are not viewed as reliable sources of information. The Victim Sensitive Interviewing Program (VSIP) was initiated to decrease the number of interviews endured by a child who allegedly had been sexually abused. The program brought together the disciplines involved in the evaluation of these cases: hospital-based social worker and pediatrician, state child protective agency worker, police, and assistant state's attorney. This team established a protocol for an investigative interview to be conducted by a team member. Pre-VSIP sexual abuse evaluations from 1985 and 1986 (38) were compared with VSIP evaluations (226) from 1987 and 1988. There was no significant difference between the two groups in relation to gender or age of victim, physical symptoms, physical findings, sexually transmitted diseases present, age of perpetrator, or length of stay in hospital. However, there were significant differences between the two groups in (1) number of interviews, 11% pre-VSIP vs 79% VSIP receiving only one interview (P less than .001); (2) number of interviewers, 24% pre-VSIP vs 88% VSIP were interviewed by only one interviewer (P less than .001); (3) indicated cases of sexual abuse, 68% pre-VSIP vs 88% VSIP (P less than .006); (4) identification of the perpetrator, 71% pre-VSIP vs 85% VSIP (P less than .035); and (5) charges pressed if perpetrator identified, 33% pre-VSIP vs 60% VSIP (P less than .010). It is concluded that interdisciplinary evaluations of alleged sexual abuse in children not only decreased the number of interviews a child must undergo but also increased the likelihood of indicated cases, identification of the perpetrator, and charges being pressed. Therefore, it is strongly recommended that interdisciplinary teams be formed to assess alleged sexual abuse in children.

Public school satisfaction with interdisciplinary services.

Representatives from local, regional, and state educational agencies throughout the country were surveyed to determine their satisfaction with services provided by University Affiliated Programs (UAPs). Sixty-eight respondents from 26 states and the District of Columbia returned questionnaires indicating their assessment of UAP services. Overall results showed highly positive ratings regarding access to UAP services, interdisciplinary evaluations, comprehensiveness, and relevancy of written reports and in-service training activities.

Interdisciplinary evaluations for guardianships and conservatorships.

The adequacy of forensic evaluations by an individual expert representing one discipline has increasingly been questioned. A growing awareness has developed that such evaluations can best be conducted by an interdisciplinary team of health-related professionals pooling their respective expertises. Nevertheless, a review of state laws pertaining to evaluations in connection with guardianship and/or conservatorship proceedings show that in most states little provision is made for the utilization of such interdisciplinary teams. In light of the grave risks resulting from an inappropriate evaluation in these proceedings. support is given to a model guardianship and conservatorship statute proposed by the Developmental Disabilities State Legislative Project of the American Bar Association's Commission on the Mentally Disabled which incorporates an interdisciplinary approach for such evaluations (Sales, Powell, Van Duizend, and Associates, 1982).