Ted Cross, Michael Johnson, and Meera Kypta

As a detective for the Plano (TX) Police Department, Michael Johnson investigated hundreds of child sexual abuse cases for 24-years. He is the founder of one of the first co-housed Children’s Advocacy Centers in the nation and trained thousands of MDT professionals nationally and internationally on the multidisciplinary response to this heinous crime. Ted Cross of the Children and Family Research Center has studied the investigation and prosecution of child sexual abuse for more than three decades. In this workshop, they teamed up with UIUC political science student Meera Kypta to present an evidence-based, best practice, multidisciplinary framework for implementing effective and trauma-informed child sexual abuse investigations.

Theodore P. Cross, Debra Whitcomb, and Emi Maren

Children’s Advocacy Centers (CACs) are central to the response to child sexual abuse and other child maltreatment in the United States. CACs coordinate the investigative and service response to child victimization, and support child survivors and their families to reduce the stress that follows a child maltreatment allegation. Multidisciplinary teams (MDTs) are the mechanism CACs use to coordinate investigation and service delivery in a centralized, child-friendly setting. CACs use forensic interviewers specially trained to work with children; and offer children and families medical, therapeutic, advocacy services, and other services. Presenting results from a U.S. survey of CAC directors, this research brief focuses on the composition of MDTs and the forms of assistance CACs provide. Compared to previous studies, this brief provides more detailed information on the kinds of help that CACs provide and the range of agencies that participate in CACs

Ted Cross, Megan Alderden, Alex Wagner, Lisa Sampson, Brittany Peters, and Kaitlin Lounsbury

This study examined the timing of the crime laboratory report relative to arrests in sexual assault cases and explored the relationship between biological evidence and arrest in those cases in which the crime laboratory report came first and thus could have influenced the arrest decision. A random sample (N = 528) of cases that occurred between 2008 and 2010 and included a report to police was drawn from a Massachusetts statewide database of medical reports on sexual assault cases. Data from medical providers were merged with data abstracted from crime laboratory reports and with data requested from police departments. The vast majority (91.5%) of arrests took place before crime laboratory analysis could be conducted. The crime laboratory report was available before or near in time to the arrest in 11 cases. These cases were significantly more likely than other cases to have DNA profiles of the assailant, DNA matches to the suspect, and a match to another investigation in the FBI’s CODIS DNA database. Given that the probable cause needed to make an arrest in these cases was presumably established only after crime laboratory analysis was available, DNA may have helped lead to the arrest in these cases. However, these results should be interpreted very cautiously, because statistically significant results in early, small studies can have inflated effect sizes and often do not replicate in future studies. Because most arrests occur well before biological evidence is available, improvements in recovering biological evidence may have modest effects on arrest rates, though they may impact arrest rates by identifying more serial offenders. Future research on the relationship of biological evidence to arrest should use methods to increase sample size of relevant cases, such as oversampling cases with later arrests and using case control study designs. Future studies should also use case abstraction and interview methods to explore how police use biological evidence to make arrests.

Cross, T.P., Alderden, M.A, Wagner, A., Sampson, L., Peters, B. & Lounsbury, K. (2020). Biological evidence in adult and adolescent sexual assault cases: Timing and relationship to arrest. Journal of Interpersonal Violence, 7/8, 1828-1939.

J. Helton, M. Vaughn, J. Carbone, and Ted Cross

For children who have been sexually abused, emergency department (ED) professionals provide immediate medical care, including testing and treatment for sexually transmitted infections, prophylaxis for potential HIV exposure, and emergency contraception.¹ In some cases, ED clinicians conduct forensic examinations to assist with child protection and criminal investigations.² Physicians and nurses in EDs are among the first to recognize the signs of sexual abuse and identify patients who are currently being abused, such as children being exploited in sex trafficking.³ Despite the medical, criminal justice, and protective roles that ED professionals serve in caring for vulnerable children, few data are available regarding the frequency with which children are admitted to the ED for sexual abuse. Therefore, this analysis observed patterns among children admitted to the ED for sexual abuse across the United States and examined important subgroup characteristics based on demographic and primary payer data.

Helton, J., Vaughn, M., Carbone, J. & Cross T.P. (2019). Emergency department admissions of child sexual abuse: Recent national trends and correlates. JAMA Pediatrics. Nov 04, 1-3

Ted Cross and Thaddeus Schmitt

In sexual assault cases, little research has examined differences in forensic medical findings and law enforcement response by victim age across the entire age range. This study addressed this gap by comparing four victim age groups: adults, adolescents over the age of consent, adolescents under the age of consent, and children under 12. Cases were randomly sampled from a statewide database of medical reports on sexual assault examinations conducted in hospital emergency departments, including only cases reported to law enforcement.

Cross, T. & Schmitt, T. (2019). Forensic medical results and law enforcement Actions following sexual assault: a comparison of child, adolescent and adult cases. Child Abuse & Neglect, 93, 103-110

Ted Cross and Megan Alderden

Presented in Urbana at the Carle Hospital SANE Seminar, March 11, 2019.

Wendy Walsh, Ted Cross, and Kaitlin Lounsbury

Presented at the 34th Annual San Diego International Conference on Child and Family Maltreatment, January 29, 2019.

Ted Cross and Wendy Walsh

Presented at the 34th Annual San Diego International Conference on Child and Family Maltreatment, January 29, 2019.

Laura Siller, Ted Cross, and Megan Alderden

Presented November, 2018 at the American Society of Criminology Meeting in Atlanta.

Ted Cross, Thaddeus Schmitt, and Megan Alderden

Presented November, 2018 at the American Society of Criminology Meeting in Atlanta.

Ted Cross, Wendy Walsh, Elizabeth Cross

This final report presents results from a program evaluation of the National TeleNursing  Center, a pilot project funded by the federal Office for Victims of Crime that uses telemedicine to support clinicians doing forensic medical examinations following sexual assault. Experienced Sexual Assault Nurse Examiners (SANEs) are linked by video technology to nurses in underserved communities who lack the training and experience to do effective exams. SANEs participate virtually in the examination to guide clinicians to provide quality medical care while also collecting biological evidence that may help identify and prosecute the offender.

Megan Alderden, Theodore Cross, Maja Vlajnic, and Laura Siller

Little prior research has explored how prosecutors perceive and utilize biological and injury evidences in sexual assault cases. In this qualitative study, semistructured interviews were conducted with assistant district attorneys (ADAs) working in an urban district attorney’s office in the northeastern United States. ADAs were asked to describe how biological and injury evidences could be probative and their strategies for using this evidence. The interviews suggest that prosecutors perceive the probative value of biological and injury evidences on a continuum, varying based on case characteristics. Prosecutors felt that undergoing a forensic medical examination in itself supported victims’ credibility. Biological evidence bolstered victims’ credibility if it matched the victim’s account better than the defendant’s. They perceived DNA evidence as helpful when it identified unknown suspects, confirmed identification of suspects by other means, or rebutted defendants’ denial of sexual contact. DNA evidence was also helpful when victims were incapacitated, too traumatized to recall or talk about the assault, or too young to identify assailants, and when police used the information in interrogating suspects. The biggest limitation to biological evidence prosecutors cited was overcoming the consent defense. The ADAs reported they used DNA evidence even when it was not particularly probative, because it confirms the correct person is being prosecuted, it communicates the victim’s and prosecution’s seriousness, and it meets jury expectations in trials. Prosecutors found injury evidence useful because it corroborated victims’ accounts and helped refute defendant claims of consensual sex. The findings may assist in educating others about biological and injury evidences in these cases, and could inspire professionals and advocates to work to develop and support a broad range of investigative methods.

Alderden, M., Cross, T., Vlajnic, M., & Siller, L. (2018). Prosecutors’ perspectives on biological evidence and injury evidence in sexual assault cases. Journal of Interpersonal Violence, 1–23

Wendy Walsh and Ted Cross

Ted Cross of CFRC is leading a research team conducting a program evaluation of the National TeleNursing Center, a pilot project funded by the federal Office for Victims of Crime that uses telemedicine to support clinicians doing forensic medical examinations following sexual assault. Experienced Sexual Assault Nurse Examiners (SANEs) are linked by video technology to nurses in underserved communities who lack the training and experience to do effective exams. SANEs participate virtually in the examination to guide clinicians to provide quality medical care while also collecting biological evidence that may help identify and prosecute the offender. Drs. Cross and Walsh presented interim results gathered from interviews with the teleSANEs and the clinicians they support. This was a presentation at the conference of the International Association of Forensic Nurses in Toronto in October 2017 and was reprised in November 2017 at the New England Rural Health Conference in Bartlett, NH.

Alex Wagner, Ted Cross, Rosa Mazzeo and Dan Bibel

This presentation at the annual American Society of Criminology meeting reports final results on a study of the quality of data on arrests in the FBI’s National Incident-Based Reporting System (NIBRS). NIBRS is one of the prime sources for research on arrests in the United States, but this study of data on four crimes suggests that NIBRS may be undercounting arrests, particularly for sexual assault cases. This an update of a May 2017 presentation (i.e., Bibel, et al., The Importance of the Quality of Arrest Data in NIBRS) also listed in CFRC’s publication webpages. These findings suggest ways to improve the recording of arrest data that may increase the accuracy of crime data and research on arrests.

Theodore Cross, Wendy Walsh

Research has made significant contributions to the development of the CAC model, but much remains to be learned and stronger empirical support is needed to develop the model further. This workshop first reviews CAC research to date, including an assessment of previous published CAC research reviews. The workshop then discusses significant research gaps in areas such as criminal investigation and prosecution, victim advocacy, service delivery and MDT functioning. The workshop concludes by discussing steps for moving CAC research forward, and reviews the development of a new NCA Research Advisory Committee formed in 2016.

Cross, T., Goulet, B., Evans, S. & Tittle, G.

The Child Protection Training Academy at the University of Illinois at Springfield (UIS) is collaborating with the Illinois Department of Children and Family Services (DCFS) to add an innovative experiential component to the training of new DCFS investigators. The program supplements the classroom-based Foundations Training that every new investigator receives with experiential training days in a Residential Simulation Laboratory and a Courtroom Simulation Laboratory. The Children and Family Research at University of Illinois at Urbana-Champaign is conducting the program evaluation for simulation training. This presentation describes the program, discusses its first year of development, and presents preliminary program evaluation results.

Daniel Bibel, Alex Wagner, Theodore Cross, Rosa Mazzeo

This presentation explores the quality of data on arrests in the FBI’s National Incident-Based Reporting System (NIBRS). Hundreds of police departments across the United States contribute data on crime incidents to the NIBRS system, which is one of the chief tools nationally for monitoring and researching crime. Over one quarter of studies published using NIBRS focus on arrest issues, but recent research suggests reasons to be concerned about the reliability of arrest data in NIBRS. Ted Cross of the CFRC led a research team studying the quality of NIBRS arrest data. NIBRS arrest data were compared to data from local law enforcement agencies for a sample of 348 crime incidents that occurred in Massachusetts between 2011 and 2013. The sample focused on four crimes: sexual assault, simple assault, aggravated assault, and intimidation. A preliminary analysis suggests that NIBRS may “undercount” arrests, since 24.9% of incidents that should have been counted as arrests in NIBRS were not recorded as arrests in NIBRS data files. Additional analysis not reported in this presentation suggest two reasons for this: 1) law enforcement agencies do not always update NIBRS data files if an arrest was made after initial data were entered, and 2) contrary to instructions in the NIBRS manual, law enforcement agencies did not always record one method of apprehending suspects (issuing a summons) as an arrest. These findings have implications for crime data specialist entering NIBRS data and for researchers using NIBRS data files. A final analysis of these data will be conducted in the summer of 2017.

Ted Cross

A presentation by Dr. Ted Cross from the eighth annual Conference of Upstate Child Advocacy Studies held on March 31, 2017.

Theodore P. Cross and Debra Whitcomb

Despite efforts by advocates, practitioners, and legislators to alleviate the burden on child maltreatment victims in the criminal justice system, many challenges remain for prosecutors as they seek to hold offenders accountable while minimizing the emotional impact on children. More than 200 state and local prosecutors in 37 states responded to an online survey to share their perspectives on current challenges, procedures to support children in the adjudication process, and the impact of the U.S. Supreme Court opinion in Crawford v. Washington (2004), sex offender registries, and "Safe Harbor" legislation to protect child sexual exploitation victims. Respondents' most pressing challenges were obtaining evidence to corroborate children's statements and the difficulties of working with child victims. Child testimony was ranked as more frequent than any other type of evidence, and least frequent were DNA, photos or videos of criminal acts, and other physical evidence. Prosecutors rely primarily on victim/witness assistants and courtroom tours to prepare children for testimony; technological alternatives are seldom used. Results suggest a real but limited impact of the Crawford opinion on the need for child testimony and on the decision to prosecute. Survey findings indicate a need for greater attention to thorough investigations with particular attention to corroboration. Doing so may strengthen the child's credibility, which is especially critical in cases lacking physical or medical evidence of maltreatment.

Cross, T.P & Whitcomb, D. (2017). The practice of prosecuting child maltreatment: Results of an online survey of prosecutors. Child Abuse & Neglect. Advance online publication. doi: 10.1016/j.chiabu.2017.04.007

Ted Cross

This presentation provided useful findings on forensic evidence and on sexual assault to both unit leaders and first responders in the United States Air Force, drawing from Dr. Ted Cross’ National Institute of Justices-funded research. Results from an initial study suggest that crime laboratory evidence plays a role in only a small number of arrests in sexual assault cases, because the vast majority of arrests take place soon after the reported incident, well before crime laboratory analysis. But DNA evidence was significantly more likely in the small number of arrests that took place later, after the crime laboratory analysis was completed. This suggests the potential impact of DNA in making arrests that occur well after the incident. In the second study, DNA matches were significantly related to obtaining convictions in sexual assault cases, though the DNA match could be both a cause and effect. A DNA match can identify an unknown suspect and strengthen the evidence against a known offender. But DNA matches can also be an effect of pursuing convictions, since prosecutors who were interviewed reported that, to be thorough, they always try to introduce DNA evidence in cases they carry forward, even if the case rests mostly on other evidence. Juries expect it. (Read more about Dr. Cross’ presentation in a news release here.)

Debra Whitcomb and Theodore Cross

Prosecution of child abuse often depends on the ability of children to testify in court, but this places enormous demands on children and risks exacerbating the effects of the abuse. This presentation provides an overview of research and legal and practice development on child abuse victims in the courtroom in recent decades, and presents new survey data from prosecutors and Children's Advocacy Centers about current challenges of prosecuting child abuse and what steps professionals are taking to protect and support children in court. It was originally presented at annual conference of the Institute of Violence, Abuse and Trauma in San Diego, CA in September 2015.

Ted Cross

This presentation compares child, adolescent and adult cases receiving forensic medical examinations following sexual assault. Data come from a National Institute of Justice-funded study of 563 medical examinations conducted across Massachusetts from 2008 to 2010, which included data from medical, crime laboratory and police reports. Results suggest that adolescent victims present severe challenges that are different from those of younger victims, challenges similar to those faced by adults. Adolescents were at higher risk for injury than younger children, and for cases being dropped by police. Biological evidence was more prevalent too, which can enhance opportunities for pursuing justice but also places a premium on adolescents undergoing medical examination. The needs of the adolescents, who were as young as 12, are different from both younger children and adults, and systems and practice models have not been developed that are specifically tailored to this age group. These results could help inspire the development of enhanced models of care specifically aimed at adolescent victims of sexual assault.

Theodore Cross and Wendy Walsh

Children’s Advocacy Centers (CACs) are multidisciplinary centers designed to coordinate all professionals involved in the investigative and service response to child abuse. They provide forensic child interviews with interviewers trained in best practice and a multidisciplinary team to coordinate the work of child protection, law enforcement, prosecution, health, mental health and other professionals. Over 700 CACs are providing services across all 50 states and in several foreign countries. This presentation presents an overview of research involving CACs. Several studies suggest the efficacy of CACs for improving several aspects of the response to children, and a number of important studies expanding knowledge on child maltreatment have been conducted in CACs. Several opportunities and challenges of doing research in CACs are discussed, and new results from a survey of CAC directors on Center practice are presented. This presentation was originally given at the One Child, Many Hands Multidisciplinary Conference on Child Welfare in Philadelphia in June 2015.

Theodore Cross, Megan Alderden, Alex Wagner, Lisa Sampson, Brittany Peters, Kaitlin Lounsbury, Laura Siller

The use of forensic evidence in sexual assault cases is prominent in TV crime dramas, but no studies have examined how prosecutors actually use forensic evidence in these cases and what impact it has in trials. This presentation provides preliminary qualitative results from a mixed methods study of the role of forensic evidence in sexual assault cases in an urban district attorney's office. Assistant district attorneys were interviewed about their experience in using forensic evidence on sexual assault and their observations about when and how it can be employed to effectively prosecute these crimes. They reported that forensic evidence can be effective in a variety of ways as part of a prosecution strategy with multiple forms of evidence.

Theodore P. Cross, Megan Alderden, Alexander Wagner, Lisa Sampson, Brittany Peters, Meredith Spencer, and Kaitlin Lounsbury

Biological evidence like DNA can be central to the investigation and prosecution of sexual assault, as can evaluation and documentation of injuries. But data are lacking on the actual impact of these forms of forensic evidence on the criminal justice system. Through a grant from the National Institute of Justice (NIJ), CFRC researcher Theodore Cross headed a team that examined the frequency and timing of forensic evidence and its relationship to arrest in a statewide sample of cases. Most arrests took place well before crime laboratory analysis could be conducted, but DNA profiles and matches to suspects were prominent in a small set of cases in which police had access to crime laboratory results prior to arrest. The final report to NIJ that we link to here highlights these results and many others on how often and when forensic evidence is available is a wide array of different types of sexual assault cases.

Alexander Wagner, Theodore Cross, Megan Alderden, Lisa Sampson, Brittany Peters, and Meredith Spencer

Promising methods have emerged in the last tweny years for using DNA and other biological evidence in the investigation and prosecution of sexual assault, but there is little research on how often this type of evidence is available and what role it plays in the criminal justice response to sexual research. This presentation to the Massachusetts Association of Crime Analysts is one of a series reporting findings from of a National Institute Justice-funded study on the frequeny, use and impact of forensic evidence in criminal investigations of sexual assault. Results suggests that biological evidence and DNA does not play a role in the vast majority of arrests, which are typically made soon after the incident. But DNA is very prominent in a small number of cases in which arrests are made later, after crime laboratory analysis has been conducted.

Theodore P. Cross, Megan Alderden, Alex Wagner, A., Daniel Bibel, Lisa Sampson, Brittany Peters, Saijun Zhang, and Meridith Spencer

This presentation reports on a study of the relationship between injury evidence and crime laboratory evidence and police unfounding and arrest in a statewide sample of Massachusetts sexual assault csaes. Most arrests took place rapidly--before crime laboratory analysis was conducted, but in the small number of cases in which arrests took place afterwards DNA evidence was common--suggesting the importance of DNA when probable cause cannot immediately be established. Arrests were more likely when there were injuries, though the causal relationship is unclear. Additional predictors of unfounding and arrest were identified.

Ted Cross, Joan Meunier-Sham, and L. Zuniga

This article describes a systematic approach used by a statewide pediatric sexual assault nurse examiner program to ensure the quality of forensic medical examinations it provides in child sexual abuse investigations. Seven strategies for enhancing quality are described: (a) hiring experienced professionals, (b) effective training, (c) comprehensive protocols, (d) ample support for pediatric sexual assault nurses, (e) management oversight, (f) a clinical coordinator to provide ongoing training and technical assistance, and (g) a quality assurance process in which expert child abuse pediatricians review each statewide pediatric sexual assault nurse examination. To show the evolution of quality care over time, the program's experience from 2004 to 2010 is reviewed, and quality assurance data are analyzed.

Sham, J.M., Cross, T.P. & Zuniga, L. (2013). The seven pillars of quality care in a statewide pediatric sexual assault nurse examiner program. Journal of Child Sexual Abuse, 22,722-739.

Theodore P. Cross, Joan Meunier-Sham and Cynthia L. Moore

This brief presents data on statewide implementation of the Massachusetts Pediatric Sexual Assault Evidence Collection Kit, a specially designed non-invasive kit for victims of child sexual abuse receiving acute forensic medical examinations. The kit yielded biological evidence in 33% of 283 cases, a rate that was comparable or higher than previous studies using traditional, more invasive methods.

Megan Alderden, Theodore P. Cross, Alexander Wagner, Daniel Bibel, Marjorie Bernadeau, Lisa Sampson, Saijun Zhang, Kaitlin Lounsbury and Brittany Peters

This presentation reports preliminary results from a study of forensic evidence in 587 adult sexual assault cases (victim age 12 and older) seen by medical providers in Massachusetts from 2008 to 2010.Non-genital injuries were found in 53% of victims, genital injuries in 41.1% of victims, and biological evidence in 86.9% of cases (the last included semen, blood, a saliva enzyme and/or other biological evidence). Over two thirds of medical examinations were conducted by nurses from the statewide Sexual Assault Nurse Examiners (SANE) program, who are specially trained to conduct forensic medical examinations in sexual assault cases, and less than one-third by other medical providers, primarily emergency department physicians. Black and Hispanic victims were significantly less likely to have non-genital injuries identified, which may relate to the contrast in color between the injury and skin. SANE nurses were significantly more likely to identify genital injuries; there was no significant difference on non-genital injuries. In 40.9% of cases in which some biological evidence was found, the crime labs were able to extract a DNA profile. In 37.9% of the cases with DNA profiles generated, the DNA matched the suspect in the case, in 8.3% the DNA matched the DNA in another investigation in a national DNA database, and in 17.5% the DNA matched a convicted offender in that database. There were no significant differences between SANE nurses and other medical providers on likelihood of forensic evidence, even though the SANEs, whose philosophy stresses empowering patient choices, were significantly less likely to use certain procedures such as pubic hair combings.

Joan Meunier-Sham, Theodore Cross, and Cynthia Moore

This presentation reports research on Massachusetts Pediatric Forensic Evidence Collection Kit, the first evidence kit in the country specially created to collect forensic medical evidence in acute child sexual assault cases. The kit is designed to follow a set of "first do no harm" principles that make use of the kit less invasive and more supportive of children than traditional methods of medical examination. Statistical results are presented that show that the kits yield biological evidence following crime lab analysis at rates that are comparable to previous studies even while following the "do no harm" principles.

Theodore Cross, Jesse Helton, and Emmeline Chuang

Some advocates argue that police too rarely conduct criminal investigations in Child Protective Services sexual abuse cases, while policy regarding police involvement in CPS physical abuse and neglect cases is not well developed. However, little research has examined how often police investigate in CPS cases and what factors predict involvement. Using two cohorts of cases (1999-2001 and 2008-2009) from the National Survey of Child and Adolescent Well-Being, a national probability study of children involved in CPS investigations, this presentation examines the frequency of criminal investigations in CPS cases and the factors predicting criminal investigation. Across cohorts, criminal investigations took place in 21% to 24% of all cases, 47% to 49% of sexual abuse cases, 24% to 27% of physical abuse cases and 15% to 18% of neglect cases. Police investigated more often when caseworkers reported greater risk and harm to the child and greater evidence, but variables like child age and relationship to perpetrator were not significant. Which county was involved, however, was a major predictor, with enormous variation in rates of police investigation across counties. Thus the likelihood of a criminal investigation depends on severity but also agency differences in practice. Equity suggests the need to discuss these differences.

Theodore Cross

This day-long workshop presents a more comprehensive overview of 25 years of research on the criminal justice response to child maltreatment. Topics include the progress of child abuse cases through the criminal justice system, the effect of multidisciplinary teams, the impact of the court experience and testifying on child victims, factors associated with prosecution, and research on evidence and offender confession.

Theodore Cross

This 90 minute workshop presents a brief overview of 25 years of research on the criminal justice response to child abuse. Topics include the progress of child abuse cases through the criminal justice system, the effect of multidisciplinary teams, the impact of the court experience and testifying on child victims, factors associated with prosecution, and research on evidence and offender confession.

Theodore Cross, Janet Fine, Lisa Jones and Wendy Walsh

Children's Advocacy Centers (CACs) are specialized multidisciplinary programs that respond to child abuse in over 700 communities across the U.S. This article is a response to two recent chapters in professional books that have criticized CACs for creating role conflict for mental health professionals, because of their work with criminal justice and child protection professionals in CACs as part of a coordinated response to child abuse. The article argues that these authors overestimate the risk of role conflict. CACs set a boundary between forensic interviewing and therapy. Many mental health professionals in CACs serve as consultants with no clinical responsibility and all are rarely involved in investigation. Participation in multidisciplinary teams focuses on children’s interests and well-being.

Cross, T.P., Fine, J., Jones, L.M. & Walsh, W.A. (2012). Mental health professionals in children’s advocacy centers: Is there role conflict? Journal of Child Sexual Abuse, 21, 91-108.

Wendy Walsh, Theodore Cross and Lisa Jones

This study examined factors explaining parental doubt and blame of their child in 161 child sexual abuse cases. Parental blame and doubt was higher when youths were older, when youths were Black and non-Hispanic, and when alleged perpetrators were adolescents (versus adults). Practitioners need to recognize that adolescent victims may be at risk for parental doubt and blame, as may be victims of adolescent perpetrators.

Walsh, W.A., Cross, T.P. & Jones, L.M. (2012). Do parents blame or doubt their child more when sexually abused by adolescents versus adults?. Journal of Interpersonal Violence, 27, 453-470.

Ted Cross, Jesse Helton & Emmeline Chuang

Some advocates argue that police too rarely conduct criminal investigations in Child Protective Services sexual abuse cases, while policy regarding police involvement in CPS physical abuse and neglect cases is not well developed. However, little research has examined how often police investigate in CPS cases and what factors predict involvement. Using two cohorts of cases (1999-2001 and 2008-2009) from the National Survey of Child and Adolescent Well-Being, a national probability study of children involved in CPS investigations, this presentation examines the frequency of criminal investigations in CPS cases and the factors predicting criminal investigation. Across cohorts, criminal investigations took place in 21% to 24% of all cases, 47% to 49% of sexual abuse cases, 24% to 27% of physical abuse cases and 15% to 18% of neglect cases. Police investigated more often when caseworkers reported greater risk and harm to the child and greater evidence, but variables like child age and relationship to perpetrator were not significant. Which county was involved, however, was a major predictor, with enormous variation in rates of police investigation across counties. Thus the likelihood of a criminal investigation depends on severity but also agency differences in practice. Equity suggests the need to discuss these differences.

Daniel Smith, Genelle Sawyer, Lisa Jones, Theodore Cross, Michael McCart, and M. Elizabeth Ralston

Maternal support is an important factor in predicting outcomes following disclosure of child sexual abuse; however, definition of the construct has been unclear and existing measures of maternal support are utilized inconsistently and have limited psychometric data. The purpose of this study was to develop a reliable and valid mother-report measure for assessing maternal support following the disclosure of child sexual abuse.

Smith D. W., Sawyer, G. K., Jones, L. M., Cross, T. P., McCart, M. R., and Ralston M. E. (2010). Mother reports of maternal support following child sexual abuse: Preliminary psychometric data on the Maternal Self-Report Support Questionnaire (MSSQ). Child Abuse & Neglect, 34, 784-792.

Theodore P. Cross, Tonya Lippert, Lisa M. Jones & Wendy A. Walsh

Suspect confessions in child sexual abuse investigations help establish the veracity of children's disclosures and empower a speedy, just and healing response. But little is known about the frequency of confessions and what influences suspects to confess. Using data from the Multi-Site Evaluation of Children's Advocacy Centers, this study examines these aspects of confession in a sample of 282 cases in which investigators believed abuse had occurred across four communities. (Presented at the American Professional Society on the Abuse of Children 18th Annual National Colloquium, New Orleans, LA.)

Lisa M. Jones, Kathryn E. Atoro, Wendy A. Walsh, Theodore P. Cross, Amy L. Shadoin, Suzanne Magnuson

Qualitative responses by caregivers (n = 203) and youth (aged 8 and older; n = 65) about their experiences with sexual abuse investigations were analyzed in conjunction with quantitative ratings of satisfaction. Respondents described mostly high levels of satisfaction, although dissatisfaction was reported with some key aspects of investigations. The features cited as worse than expected by caregivers were the investigators' commitment to prosecuting the alleged offender and the absence of clear and regular communication about the status of the case. The features mentioned most often by caregivers as better than expected were the emotional support and interviewing skills of investigators. Youth focused both praise and criticism on investigators' interviewing skills. There were relatively few complaints by either caregivers or youth about the duration of the investigation, medical exams, lack of services, or failures of interagency communication, areas of considerable reform in the past several decades. Implications for investigator training and reform initiatives are discussed.

Jones, L. M., Atoro, K. E., Walsh, W. A., Cross, T. P., Shadoin, A. L., & Magnuson, S. (2010). Nonoffending caregiver and youth experiences with child sexual abuse investigations. Journal of Interpersonal Violence, 25, 291-314.

Tonya Lippert, Theodore Cross, Lisa Jones, & Wendy Walsh

Increasing the number of suspects who give true confessions of sexual abuse serves justice and reduces the burden of the criminal justice process on child victims. With data from four communities, this study examined confession rates and predictors of confession of child sexual abuse over the course of criminal investigations (final N = 282). Overall, 30% of suspects confessed partially or fully to the crime. This rate was consistent across the communities and is very similar to the rates of suspect confession of child sexual abuse found by previous research, although lower than that from a study focused on a community with a vigorous practice of polygraph testing. In a multivariate analysis, confession was more likely when suspects were younger and when more evidence of abuse was available, particularly child disclosure and corroborative evidence. These results suggest the difficulty of obtaining confession but also the value of methods that facilitate child disclosure and seek corroborative evidence, for increasing the odds of confession.

Lippert, T., Cross, T. P., Jones, L., & Walsh, W. (2010). Suspect confession of child sexual abuse to investigators. Child Maltreatment, 15, 161-170.

Wendy A. Walsh, Lisa M. Jones, Theodore P. Cross, Tonya Lippert

Corroborating evidence has been associated with a decrease in children's distress during the court process, yet few studies have empirically examined the impact of evidence type on prosecution rates. This study examined the types of evidence and whether charges were filed in a sample of child sexual abuse cases (n = 329). Cases with a child disclosure, a corroborating witness, an offender confession, or an additional report against the offender were more likely to have charges filed, controlling for case characteristics. When cases were lacking strong evidence (confession, physical evidence, eyewitness), cases with a corroborating witness were nearly twice as likely to be charged. Charged cases tended to have at least two types of evidence, regardless of whether there was a child disclosure or not.

Walsh, W.A., L.M. Jones, Cross, T.P., & Lippert, T. (2010). Prosecuting child sexual abuse: The importance of evidence type. Crime & Delinquency, 56, 436-454.

Tonya Lippert, Theodore Cross, Lisa Jones, & Wendy Walsh

This study aims to identify characteristics that predict full disclosure by victims of sexual abuse during a forensic interview. Data came from agency files for 987 cases of sexual abuse between December 2001 and December 2003 from Children's Advocacy Centers (CACs) and comparison communities within four U.S. states. Cases of children fully disclosing abuse when interviewed were compared to cases of children believed to be victims who gave no or partial disclosures. The likelihood of disclosure increased when victims were girls, a primary caregiver was supportive, and a child's disclosure instigated the investigation. The likelihood of disclosure was higher for children who were older at abuse onset and at forensic interview (each age variable having an independent effect). Communities differed on disclosure rate, with no difference associated with having a CAC. Findings suggest factors deserving consideration prior to a forensic interview, including organizational and community factors affecting disclosure rates.

Lippert, T., Cross,T.P., Jones, L. & Walsh, W. (2009). Telling interviewers about sexual abuse: Predictors of disclosure at forensic interviews. Child Maltreatment, 14, 100-113.

Tonya Lippert, Tricia Favre, Cindy Alexander, and Ted Cross

The objective of this study was to identify child characteristics, factors related to the therapy referral, and caregivers’ psychological and social variables that predict sexually abused children’s beginning therapy following a therapy referral.

Lippert, T., Favre, T., Alexander, C. & Cross, T.P. (2008). Families who begin versus decline therapy for children who are sexually abused. Child Abuse & Neglect, 32, 859-868

Theodore P. Cross, Lisa M. Jones, Wendy A. Walsh, MoniqueSimone, David J. Kolko, Joyce Szczepanski, Tonya Lippert, Karen Davison, Arthur Cryns, Polly Sosnowski, Amy Shadoin, and Suzanne Magnuson

This bulletin reports results from a multi-site quasi-experimental evaluation of the impact of Children's Advocacy Centers (CACs). CACs are multidisciplinary organizations designed to provide a coordinated, child-friendly investigation and service response in cases of alleged child sexual abuse or other serious abuse. Compared to non-CAC comparison communities, non-offending caregivers in CACs reported greater satisfaction with the investigation, and children were more likely to receive forensic medical examinations and referrals for mental health services. The bulletin provides a comprehensive overview of study results and discusses the implications for practice in the response to serious child abuse.

Wendy A. Walsh, Tonya Lippert, Theodore P. Cross, Danielle M. Maurice and Karen S. Davison

This article explores the length of time between key events in the criminal prosecution of child sexual abuse cases (charging decision, case resolution process, and total case-processing time), which previous research suggests is related to victims' recovery. The sample included 160 cases in three communities served by the Dallas County District Attorney. Most cases (69%) took at least 60 days for the charging decision, with cases investigated at the Children's Advocacy Center having a quicker time than either comparison community. Only 20% of cases had a case resolution time within the 180-day target suggested by the American Bar Association standard for felonies. Controlling for case characteristics, one of the three communities and cases with an initial arrest had a significantly quicker case resolution time. Total case processing generally took more than 2 years. Implications include the need to better monitor and shorten case resolution time.

Walsh, W., Lippert, T., Cross, T., Maurice, D. & Davison, K. (2008). How long to prosecute child sexual abuse for a community using a children’s advocacy center and two comparison communities? Child Maltreatment, 13, 3-13.

Lisa M. Jones, Theodore P. Cross, Wendy A. Walsh & Monique Simone

The Children's Advocacy Center (CAC) model of child abuse investigation is designed to be more child and family-friendly than traditional methods, but there have been no rigorous studies of their effect on children's and caregivers' experience. Data collected as part of the Multi-Site Evaluation of Children's Advocacy Centers were used to examine whether CACs improve caregivers' and children's satisfaction with investigations. Nonoffending caregiver and child satisfaction were assessed during research interviews, including the administration of a 14-item Investigation Satisfaction Scale (ISS) for caregivers. Two hundred and twenty-nine sexual abuse cases investigated through a CAC were compared to 55 cases investigated in communities with no CAC. Hierarchical linear regression results indicated that caregivers in CAC cases were more satisfied with the investigation than those from comparison sites, even after controlling for a number of relevant variables. There were few differences between CAC and comparison samples on children's satisfaction. Children described moderate to high satisfaction with the investigation, while a minority expressed concerns about their experience. The CAC model shows promise for improving families' experiences, but to build upon this promise, agencies will need to systematize procedures for refining and adapting the model as new research becomes available.

Jones, L.M., Cross, T.P., Walsh, W. & Simone, M. (2007). Do Children's Advocacy Centers improve families' experiences of child sexual abuse investigations? Child Abuse & Neglect, 31, 1069-1085.

Theodore P. Cross , Lisa M. Jones, Wendy A. Walsh, Monique Simone, David Kolko

Children's Advocacy Centers (CACs) aim to improve child forensic interviewing following allegations of child abuse by coordinating multiple investigations, providing child-friendly interviewing locations, and limiting redundant interviewing. This analysis presents one of the first rigorous evaluations of CACs' implementation of these methods. This analysis is part of a quasi-experimental study, the Multi-Site Evaluation of Children's Advocacy Centers, which evaluated four CACs relative to within-state non-CAC comparison communities. Case abstractors collected data on investigation methods in 1,069 child sexual abuse cases with forensic interviews by reviewing case records from multiple agencies. CAC cases were more likely than comparison cases to feature police involvement in CPS cases (41% vs. 15%), multidisciplinary team (MDT) interviews (28% vs. 6%), case reviews (56% vs. 7%), joint police/child protective services (CPS) investigations (81% vs. 52%) and video/audiotaping of interviews (52% vs. 17%, all these comparisons p < .001). CACs varied in which coordination methods they used, and some comparison communities also used certain coordination methods more than the CAC with which they were paired. Eighty-five percent of CAC interviews took place in child-friendly CAC facilities, while notable proportions of comparison interviews took place at CPS offices (22%), police facilities (18%), home (16%), or school (19%). Ninety-five percent of children had no more than two forensic interviews, and CAC and comparison differences on number of interviews were mostly non-significant. Relative to the comparison communities, these CACs appear to have increased coordination on investigations and child forensic interviewing. The CAC setting was the location for the vast majority of CAC child interviews, while comparison communities often used settings that many consider undesirable. CACs showed no advantage on reducing the number of forensic interviews, which was consistently small across the sample.

Cross, T.P., Jones, L., Walsh, W., Simone, M. & Kolko, D. (2007). Child forensic interviewing in children's advocacy centers: Empirical data on a practice model. Child Abuse & Neglect, 31, 1031-1052.

Wendy Walsh, Theodore Cross, Lisa Jones, Monique Simone, & David Kolko

This study examines the impact of Children's Advocacy Centers (CAC) and other factors, such as the child's age, alleged penetration, and injury on the use of forensic medical examinations as part of the response to reported child sexual abuse. This analysis is part of a quasi-experimental study, the Multi-Site Evaluation of Children's Advocacy Centers, which evaluated four CACs relative to within-state non-CAC comparison communities. Case abstractors collected data on forensic medical exams in 1,220 child sexual abuse cases through review of case records. Suspected sexual abuse victims at CACs were two times more likely to have forensic medical examinations than those seen at comparison communities, controlling for other variables. Girls, children with reported penetration, victims who were physically injured while being abused, White victims, and younger children were more likely to have exams, controlling for other variables. Non-penetration cases at CACs were four times more likely to receive exams as compared to those in comparison communities. About half of exams were conducted the same day as the reported abuse in both CAC and comparison communities. The majority of caregivers were very satisfied with the medical professional. Receipt of a medical exam was not associated with offenders being charged. Results of this study suggest that CACs are an effective tool for furthering access to forensic medical examinations for child sexual abuse victims.

Walsh, W., Cross, T.P. , Jones, L., Simone, M. & Kolko, D. (2007). Which sexual abuse victims receive a forensic medical examination? The impact of children's advocacy centers. Child Abuse & Neglect, 31, 1053-1068.

Lisa M. Jones, Theodore P. Cross, Wendy A. Walsh & Monique Simone

This article reviews the research relevant to seven practices considered by many to be among the most progressive approaches to criminal child abuse investigations: multidisciplinary team investigations, trained child forensic interviewers, videotaped interviews, specialized forensic medical examiners, victim advocacy programs, improved access to mental health treatment for victims, and Children's Advocacy Centers (CACs). The review finds that despite the popularity of these practices, little outcome research is currently available documenting their success. However, preliminary research supports many of these practices or has influenced their development. Knowledge of this research can assist investigators and policy makers who want to improve the response to victims, understand the effectiveness of particular programs, or identify where assumptions about effectiveness are not empirically supported.

Jones, L.M., Cross, T.P., Walsh, W., & Simone, M. (2005). Criminal investigations of child abuse: The research behind best practices. Trauma, Violence and Abuse: A Review Journal, 6, 254-268.

Theodore P. Cross & Leonard Saxe

Polygraph tests to assess veracity are widely promoted for application in sexual abuse matters. The use of polygraph tests is advocated despite substantial differences in professional and scientific opinion about the validity of such techniques. Polygraph diagnoses of an individual's deception are inferences made by an examiner who compares physiological reactions to a set of questions. The test situation, however, is also used to induce examinees to admit crimes. In addition to their use in investigations, polygraph tests are used by defendants seeking exculpatory evidence and by treatment and probation programs to assess and monitor sexual offenders. Although there are dissenters, most knowledgeable scientists consider polygraph testing as unvalidated. Professionals need to access the literature on polygraph testing, evaluate the efficacy and ethics of polygraph tests in their community, and further develop standards for their use.

Cross, T.P. & L. Saxe (2001). Polygraph testing and sexual abuse: The lure of the magic lasso. Child Maltreatment, 6, 195-206.