Forensic Interviewing Skills for use with Child Abuse Victims with DisAbilities By Nora J. Baladerian, Ph.D.
Nora J. Baladerian, Ph.D. Licensed Clinical Psychologist Practicing Forensic Psychologist Other designations: LMFT, Diplomate Sex Therapist‑ABS, Diplomate Forensic Examiner‑ACFE, Former AASECT Certified Sex Educator & Therapist, Forensic Interviewing Trainer for OCJP programs.
Purpose of Training To expand the knowledge and skills of the participants to more effectively intervene with individuals with cognitive and/or communication issues.
Learning Objectives Students will be able to describe at least 5 different types disability list at least 3 Pre/During/Post strategies that are particular to interviewing with children with disabilities discuss the importance of including a disability specialist on the team for all interviews identify 2 situations for which an interpreter may be needed
Barriers to Effective & Sensitive Interviewing… • Lack of information about mental retardation & other (developmental) DisAbilities, and thus • Cultural and informational differences due to to segregation, exclusion, and the disability. • Unexamined myths and stereotypes that result in prejudice and fear & negative attitudes. …of individuals with Intellectual and/or Communication Impairments/Differences
Barriers to Effective & Sensitive Interviewing • Devaluing, dehumanizing and distancing. • Limited or lack of personal contact with individuals with similar backgrounds. • Belief that individuals with mental illness, impairment or communication differences cannot be effectively or reliably interviewed.
Common Preconceptions about Individuals with Developmental DisAbilities • Cannot remember • Make up stories to get attention • Will never be a credible witness • Cannot understand enough • Cannot be understood by the interviewer • Are not really necessary as a witness • Will later change their story & are therefore unreliable...they were lying then or now.
Favorite Myths & Stereotype Concept • Innocence • Wildness • Shame • Spread • Deviancy & Evil • Contagion • Cannot distinguish the truth from a lie • Cannot understand the consequences for lying • Don’t have a sufficient or correct vocabulary to describe the abuse. • Alternative methods of communication cannot be used. • Not bright enough to repeat their story.
Why Training is Important • So similarities and differences won’t get overlooked • To improve the experience of abuse victims with DisAbilities, • Will expand their skills, knowledge, and cultural understanding of members of this population • And can recognize or avoid “Crazy Thinking”
Brief Overview of DisAbilities Characteristics of Disability • Congenital OR Adventitious • Hidden OR Overt • Chronic OR Temporary • Progressive & Degenerative OR Static • May have episodes of presence OR remission.
Related & Non-Related DisAbilities An overview of conditions that occur alone, but may co‑exist with a developmental disability • Sensory • Communication • Mobility Impairment • Intellectual • Social (Personality Disability or Autism Spectrum) • Psychiatric (Bio‑Medical, thought disorders) • Medical including Neurological, Endocrine, etc. • Orthopaedic • Respiratory
DisAbilities as defined in Law & Medicine Legal definition of DisAbilities: Developmental Disability is a legal term, to define those who are eligible for supportive services from infancy throughout the lifetime. (This is not a medical definition.)
Developmental Disability in Federal Law Section 504 of the 1973 Rehabilitation Actand theDevelopmental DisAbilities Act define a “Developmental Disability as a condition which results in significant deficits on 3 or more major life activities. These are… Self care Receptive and expressive language Learning Mobility Self‑direction Capacity for independent living Economic self sufficiency
Developmental Disability in Federal Law cont. …and Reflect a need for a combination & sequence of special, interdisciplinary or generic care, treatment or other services which are of lifelong or extended duration and are individually planned or coordinated.”
Developmental DisAbilities as defined in California To be eligible for services funded by the California Department of Developmental Services, individuals must have a developmental disability as defined in Section 4512 of the California Welfare and Institutions Code.
Developmental DisAbilities as defined in California cont. The disability must begin before the 18th birthday, be expected to continue indefinitely and present a significant disability. Also, the disability must be due to one of the following conditions: • Mental Retardation • Cerebral Palsy • Epilepsy • Autism • A disability condition closely related to mental retardation or requiring similar treatment.
Developmental DisAbilities as defined in California cont. Infants and toddlers (age 0 to 36 months) who are at risk of becoming developmentally disabled or who have a developmental delay may also qualify for services. The criteria for determining the eligibility of infants and toddlers is specified inSection 95014 of the California Government Code. A developmental disability does not include other disability conditions that are solely physical in nature.
ADA ‑ Americans with DisAbilities Act The term “Qualified Individual with a Disability” means an individual who... • Has a physical or mental impairment that substantially limits one or more life activities; • Has a record of such an impairment; or • Is regarded as having such an impairment.
Medical Definitions: Mental Health Psychiatric (a.k.a. mental illness) conditions: • Schizophrenias • Bi‑Polar Disorders • Personality Disorders • Mood Disorders All mental conditions are defined in the Diagnostic And Standards Manual.
Medical Definitions: Mental Health Cognitive function diagnoses: • Mental Retardation • Learning DisAbilities • Pervasive Developmental Delays • Autism
Medical Definitions: Mental Health Interpersonal conflict problems • Parent‑child conflict • Marital/partner conflict • Inter‑personal conflicts • Occupational conflicts and • Substance use related problems of dependence or abuse.
Medical Conditions: Physical Health • Cerebral palsy • Epilepsy • Neurological conditions that impact cognition and communication Medical Conditions traditionally included as “Developmental DisAbilities” are:
Understanding Psychological Evaluations The diagnosis requires information on 5 “Axes. • Axis I: Clinical conditions • Axis II: Neurobiological, Personality Disorders, and Mental Retardation • Axis III: Medical Conditions • Axis IV: Specific stressor • Axis V: Global Assessment of Functioning(GAF)
Brief Disability Overview – Mental Illness Foundational concept: Perception of reality is impaired. • Neurobiological conditions: psychosis, bi‑polar disorder • Affective Disorders: depression, anxiety, Post Traumatic Stress Disorder • Consciousness: Coma, Semi‑coma • Acute/chronic ‑ temporary due to illness or toxicity
Autism • No known cause • No known cures • Wide Spectrum of conditions (from Asperger’s, ADD to Schizophrenia) • Diagnosed by age 5, usually by age 3 (600% ^ 10 yrs) • Language may be extremely limited, not related to the topic at hand OR more extensive than yours! • Social interactions typified by objectification • IQ’s range from severe impairment to very bright • Treatment: Behavioral rehearsal; Behavior Modification, 1:1 assistance.
Autism Stereotypical behaviors may/may not be present: • Rocking, vocalizing (grunts, tics, humming) • Hand wringing • Hyperactive, fidgety • Dislike eye contact • Interactional synchrony • Touch toxic • Require sameness in environment (furniture) • Require explicit and repeated instruction and information transfers. May require concrete demonstrations.
Autism These are new to you, not the child When any of these stereotypical behaviors are present, note if they increase as a possible result of stress. If so, ‘BACK UP’ the interview. Refrain from telling the person to stop any stereotypical conduct Assure that there is plenty of room for the individual Allow the person to stand or walk around if needed. Refrain from physically touching the child Do remain calm, interested, and focused.
Cerebral Palsy • A neuromuscular impairment resulting from brain injury either through head trauma or anoxia. • Characterized by lack of control of body movement • May impair speech production • May or may not effect intellectual function • Frequently mistaken & treated as low IQ • May be able to communicate best using non‑verbal options such as Facilitated Communication or other computer assisted technology.
Cerebral Palsy • You may need extra time to get used to the child’s accent that is a function of mechanical speech differences…take your time, but if you find it too hard to understand, exchange interviewers with a team mate. • Assure plenty of space for the child • Make sure you are aware ahead of time of their communication styles • You may find that you will need additional time to accommodate for the amount of time required for each conversational interchange.
Epilepsy • A neurological impairment which may have onset at any time and also may recede at anytime. • Can be managed with medication (but not cured). In some cases, seizures cannot be eliminated. • Usually a result of brain trauma such as fever, meningitis or other illness. Can run in families.
Epilepsy • Make sure that you have an understanding of how to respond if the individual has a seizure during the interview. • If it is a small seizure, the person may simply need time to recover, about 10 minutes. • If it is a grand mal seizure, do not put anything in their mouth, make sure they do not hit their head on anything, and let them rest. You may need to call for medical assistance.
Characteristics of Mental Retardation Levels of impairment are classified as: • Borderline 70‑85 • Mild 55‑69 • Moderate 40‑54 • Severe 21‑39 • Profound 5‑20 The use of “mental age” ignores one’s life style, self esteem and history.
Mental Retardation Know that the child may have a more limited vocabulary than other children The child may know a lot but may require a sense of permission to talk and your patience for their pacing and word searching. Make sure that your questions are concrete not abstract Do not repeat questions unless you truly did not understand their answer.
Sensory Impairments: Hearing • Must identify how individual normally communicates • Use standard rules for interpreters • Make sure they are State Certified, • NEVER use a family member or care provider, • Best if trained in working forensically in trauma issues
Sensory Impairment: Vision • Learn how the individual gets around • Learn how they deal with written materials • Learn when vision became impaired
Abuse Victims with DisAbilities in the Legal System • Cases of individuals with cognitive and/or communication impairments are rarely moved forward in the legal system due to... • A belief that a report will not result in any positive benefit for the victim. • A belief that a report may result in a more negative situation for the victim and for the reporter. • A belief that the victim will make a bad witness.
Abuse Victims with DisAbilities are less likely to be prosecuted • Due to interviewing and attributed credibility problems • Due to failing to take enough time or failing to use available consultation and expertise in interviewing the victim and investigating the case.
These Victims of Abuse are less likely… • if prosecuted to result in a conviction or reasonable sentence • to be referred for psychotherapy • if referred for psychotherapy to receive effective and experienced provider.
Crazy Thinking • Although one may feel inept, new to a situation, just keep in mind the usual procedures and protocols that you always use. • Try not to create new procedures, but make slight modifications in your • Vocabulary, syntax, grammer, • Pacing, • Touching and space considerations Just add the word “DISABILITY” to any discussion and things change in a hurry.
Avoid infantalizing the victim • Do not touch • Do not use terms of endearment • Do not use baby talk or “kiddy” words • Do not use items for illustration that are meant for much younger children. • Do not pretend you do not remember or understand when in fact you do...ie. Don’t lie.
Pre-Interview • What you will need to do and know • Planning for the interview
Language: PC… or RESPECT • Use “People First” language. • Avoid any permutation of the word retarded. Even in casual conversation avoid saying , “Oh, that was so retarded.” • Don’t say handicapped, cripples, lame, deaf and dumb, wacked, loosely wrapped. • Use powerful images: “uses a wheelchair” NOT “wheelchair bound” or “the wheelchair guy”.
Pre-Interview Information “Musts Knows” • If the victim has any type of disability • If the person takes medication for the disability, make sure the person has had their proper dose of medication timely • Know the best communication style for the individual • Know the victims primary contacts.
Setting for the Interview • Location. • Who present: Decided by MDIT. • Videotape: should be unobtrusive.
Adapted Techniques • Large Type for documents you may use • Be aware of individual’s educational/cultural levels & exposure to protective services • Use Plain English • Consult with specialists as needed
Facilitated Communication Use of a communication board with physical assistance from a trained facilitator. Use “Famous Baladerian FC Protocol” for these interviews: • Use a trained FC facilitator who does not know victim or case • Repeat interview with another trained FC facilitator, same conditions • Compare results. • Apologize to victim for having to repeat interview, explain precarious status of FC
Conducting the Interview • What you need to know • How to best acquire the information • Conduct during the interview… • Do’s and Don’ts
Questions that need to have an answer…you all know these… • Did a crime occur? • Who done it? (May be multiple perps, multiple types of crime) • Who else? What else? • How many times? Any other known victims? • When did it happen? • Where? Did victim understand what was happening? • Was victim threatened? How did victim meet the perp? What didn’t I ask that you’d like to tell me or that I should know? What else?
Getting the “right” answer • Ask if the victim has told others about this. • What was their response? • Did things change after that? In what way? • Has this changed the victim’s ideas about what to say or not say? • Does the victim believe this interview is due to “being in trouble”. • Make sure they know they are not going to jail.
Vocabulary Tips • Use Plain English • Match the victim’s sentence length and vocabulary. • Use simple sentences. • Avoid double negatives, • Do not hesitate to refrain from asking a simple question. WHAT??