Assessment of sexually abused children with anatomically detailed dolls: A critical review

The use of anatomically detailed (AD) dolls is widespread, especially with young children who have been, or may have been, sexually abused. A number of empirical studies have compared the responses of sexually abused and non-abused children to AD dolls. Additional research has assessed AD doll play among non-abused children only. Methodological limitations notwithstanding, virtually all empirical data support the use of AD dolls for data gathering in cases of sexual abuse.     

The use of anatomically detailed dolls in sexual abuse evaluations: The state of the science

In child sexual abuse investigations, anatomically detailed dolls (ADDs) are used frequently with the intention of facilitating expression or demonstration in children who do not disclose abuse verbally. We review and critique research that examines the play of nonabused children with ADDs, compares the ADD play of abused children with that of nonabused children, or compares ADD-aided interviews with interviews using other data-gathering methods. We conclude that the APA Council of Representatives' recent statement (February 8, 1991) endorsing the use of ADDs by certain examiners and the current research on this topic are incompatible.     

Child Sexual Abuse

Summary

Children who are recent victims of sexual abuse may initially present to their primary care health provider. Often, the outward manifestations of sexual abuse are somatic complaints or nonspecific behavioral changes. Retrospective reports of adults suggest that about 20-30% of women were sexually abused as children, with figures for men ranging from 10-15%. Interview guidelines for children and adolescents emphasize the need for sensitivity to cognitive development and emotional issues while simultaneously being focused on eliciting specific behavioral data. The use of anatomically detailed dolls, in the context of a comprehensive assessment, is discussed. Health care providers are mandated reporters and must disclose suspected child sexual abuse to the state's child protective service department. Guidelines for reporting as well as addressing this issue with parents are discussed.     

Assumptions and beliefs about the role of AD dolls in child sexual abuse validation interviews: are they supported empirically?

The use of anatomically detailed dolls in child sexual abuse validation interviews is based on a number of underlying assumptions and beliefs. However, only over the last 12 years have researchers begun to evaluate the validity of these assumptions and beliefs systematically. This consideration of the existing AD doll empirical literature reveals that the support for some of the assumptions underlying the use of the dolls, as well as the surrounding beliefs, is available. However, for other assumptions and beliefs support is less firm, frequently contradictory, and sometimes absent. The evidence of support for these assumptions and beliefs is discussed and future research needs are identified.     

Strengths and Limitations of Forensic Child Sexual Abuse Interviews with Anatomical Dolls: An Empirical Review

A comprehensive review of the use of anatomical dolls reveals three areas of research: (1) normative studies (with no known history of sexual abuse) of children's interactions with anatomical dolls; (2) comparative studies of children suspected of being victims of sexual abuse, and those believed not to be; and (3) the role anatomical dolls play in the identification of a child who has been sexually abused. The results of empirical studies in each area are mixed and inconsistent. However, there is general clinical support for the use of the anatomical doll as a demonstration aid during forensic interviewing with children over 3 years of age.     

Possession is not always the law: With age, preschoolers increasingly use verbal information to identify who owns what

Children can identify owners either by seeing a person in possession of an object (a visual cue) and inferring that they are the owner or by hearing testimony about a claim of ownership (a verbal cue). A total of 391 children between 2.5 and 6years of age were tested in three experiments assessing how children identify owners when these two cues are in conflict. Children were presented with stories using two dolls and a toy. One doll possessed the toy, and children were told that the toy was either the possessor's or the nonpossessor's. Two forms of ownership statement were used: a third-person statement, "That is Billy's ball", and a first-person statement by one of the dolls, "That is my ball". The results show that by 4years of age, children prioritize the verbal statements as a more reliable cue to ownership than physical possession. Younger children did not prioritize possession over the verbal cue to ownership but rather gave mixed responses. These results are discussed in terms of children's social experience outside of the home and their acceptance of testimony in other domains.     

Child sexual abuse evaluations: the scientist–practitioner model

The scientist-practitioner model is presented as a format for conducting child sexual abuse evaluations. This model bases conclusions on empirically established relationships between data and the behavior of interest, rather than on subjective opinions. Using empirically derived evidence, the scientist-practitioner defines child sexual abuse as a life event rather than a clinical syndrome, relies on base rates of behavior for distinguishing and understanding differences between nonsexually abused and sexually abused children, and considers issues of instrument sensitivity and specificity when utilizing assessment tools in child sexual abuse evaluations. This model enlists safeguards to keep the evaluator from inappropriately forming cause and effect associations between a child's single response (e.g., behavioral and emotional symptoms, interactions with anatomically detailed dolls, drawing genitalia) and the occurrence of an event (e.g., sexual abuse). © 1998 John Wiley & Sons, Ltd.     

Comparison of behaviors of suspected sexually abused and nonsexually abused preschool children using anatomical dolls

Using anatomical dolls, the play behaviors of nine sexually abused preschool children (five males, four females), ranging in age from 3 to 5 years, were compared with nine preschool children for whom there was no suspicion of sexual abuse and who were matched on the basis of age, gender, race, family status, and socioeconomic status. There was no significant difference between the two groups on explicit sexual behavior (vaginal, oral, and anal intercourse with thrusting motions between the dolls or between the child and the dolls and masturbation by the child). The groups were significantly [t(8)=2.19, p <.05; Wilcoxon W=6, p <.05) different when behaviors with suspicious sexual implication were combined with explicit sexual behaviors. There were no differences between the groups on measures of nonsexual behavior. The occurrence of the suspicious sexual behaviors is discussed and reviews of previous doll research and physical evidence of child sexual abuse are provided.This project was supported in part by a grant from The Graduate College of Western Michigan University, Kalamazoo, Michigan.     

Child’s Play: Anatomically Correct Dolls and Embodiment

Anatomically detailed dolls have been used to elicit testimony from children in sex abuse cases. However, studies have shown they often provide false accounts in young, preschool-age children. Typically this problem is seen as a cognitive one: with age, children can correctly map their bodies onto a doll due to greater intellectual ability to represent themselves. I argue, along with the work of Maurice Merleau-Ponty, that although cognitive developments aid in the ability to represent one’s own body, a discussion of embodiment is required in order to understand the use and abuse of anatomical dolls in forensic interviews. This paper examines these issues and maintains that a better understanding of embodied perception in both adults and children helps show how phenomenology can provide a more nuanced understanding to a troubling ethical and legal problem.

Children's preference for body or external object on a task requiring transposition and discrimination of right-left relations.

First graders were tested on trials requiring the discrimination and transposition of right-left relations, with stimuli similar to (dolls) or different from (toy planes) the body. On an initial series of training and practice trials children were allowed to respond to body and external objects as referents providing right-left cues. A later series of test trials was then used to determine the referent the child actually preferred. Results of the test trials indicated that 24 children tested with the dolls preferred the body as referent, while 24 children tested with planes preferred the external referent. The results were interpreted as suggesting two alternative systems through which children develop an understanding of right-left relations and possibly other concepts as well.     

Memories of Mickey Mouse: Young children recount their trip to disneyworld

What young children remember and how long they retain such information are crucial issues for the study of young children's memory. In this research, these issues were examined by asking children who visited Disneyworld at 37 or 49 months of age to recall their experience. Half of the children were interviewed 6 months after their trip, and the remaining children were interviewed after 18 months. Surprisingly, there were no effects for age or retention interval on the amount children recalled; all children recounted a great deal of accurate information about their Disneyworld experience. However, older children's reports were more detailed than younger children's, and older children tended to recall more information spontaneously than did younger children. Finally, there is some suggestion that children who talked about their Disneyworld experience more frequently with their families subsequently recounted more information during the memory interview. Implications for these findings are discussed.     

Behavioral Variability in the Play of Children With Autism and Their Typically Developing Peers

Invariable or repetitive behavior is a defining feature of autism and can limit a child's exposure to varying consequences and subsequent learning opportunities. We compared the variability in play material selection between 30 children with autism and 30 typically developing children, aged 2‐8 years, across three different activities: selecting paper outfits to dress dolls, selecting beads to place on a string, and choosing marker colors for coloring shapes. Selections of materials could be varied or identical to previous selections within the session. Although there was some overlap between the two groups, children with autism were more likely to respond invariably than typically developing children. Two‐year‐old children in both groups tended to display invariable play material selection, but variability increased across increasing age groups for typical children and remained relatively stable across increasing age groups for children with autism. Implications regarding the divergence in variable behavior across children with autism and typically developing children as a function of age are discussed. Copyright © 2015 John Wiley & Sons, Ltd.     

Parent Toddler Play with Feminine Toys: Are All Dolls the Same?

Play with toys provides children with theopportunity to practice behaviors that have relevance togender role development. By 18 months, toddlersconsistently choose to play with sex-appropriate toys. This study was designed to investigate parents'and toddlers' initiation of play with baby dolls and astuffed clown to determine whether boys are providedwith the same opportunity for feminine play as girls are when playing with the same type oftoys. 42 parent toddler dyads from Caucasianmiddle-class families were observed playing with twobaby dolls and a soft stuffed clown for four minutes.Parent toddler play was coded for doll appropriate andinanimate object-type play. The baby dolls and the clownelicited different play behaviors from both the parentsand the toddlers. Same-sex dyads engaged in different types of play than opposite-sexparent toddler dyads. Findings of this study lendevidence that not all dolls are alike. Consequently,parents who provide their toddlers with baby dolls are providing different experiences from parentswho provide soft stuffed toys. Implications for genderrole development are discussed.     

Autobiographical memory in middle childhood: recollections of the recent and distant past

To address the question of whether memories from early childhood survive into later childhood, participants visited the laboratory at age 3 and again at 7, 8, or 9. At age 3, each talked with a parent about six events; at the later age each child talked with a researcher about four of these distant events as well as two more recent events. School-aged children recalled fewer than half of the distant events introduced. Further, the proportion of distant events recalled was negatively correlated with age. Those distant events that were recalled, however, were recounted in an accurate, detailed manner. Importantly, reports of distant events did not reflect the full extent of children's narrative ability. Reports of recent events were more coherent and included twice the detail. Implications for existing interpretations of autobiographical memory and childhood amnesia are discussed, and the need for further research employing innovative methods is emphasised.     

Autobiographical memory in middle childhood: Recollections of the recent and distant past

To address the question of whether memories from early childhood survive into later childhood, participants visited the laboratory at age 3 and again at 7, 8, or 9. At age 3, each talked with a parent about six events; at the later age each child talked with a researcher about four of these distant events as well as two more recent events. School-aged children recalled fewer than half of the distant events introduced. Further, the proportion of distant events recalled was negatively correlated with age. Those distant events that were recalled, however, were recounted in an accurate, detailed manner. Importantly, reports of distant events did not reflect the full extent of children's narrative ability. Reports of recent events were more coherent and included twice the detail. Implications for existing interpretations of autobiographical memory and childhood amnesia are discussed, and the need for further research employing innovative methods is emphasised.     

Co‐Witness Influence on Children's Memory Reports: The Difference is in the Details1

This study examined the effect of social influence on children's witness reports, with respect to a number of details varying in centrality. Children (N = 115; age = 10 years, 4 months to 13 years, 8 months) were interviewed about a personally experienced event. Half of the children were interviewed together with a confederate who answered the interview questions before the child did, while the other half were interviewed alone. Children were influenced by the confederate's answers to withhold some critical details observed (omission errors), but not to add details not observed (commission errors). When the children were asked to follow up on their reports, truthful reports contained more information than did false reports.     

Does Barbie make girls want to be thin? The effect of experimental exposure to images of dolls on the body image of 5- to 8-year-old girls

The ubiquitous Barbie doll was examined in the present study as a possible cause for young girls' body dissatisfaction. A total of 162 girls, from age 5 to age 8, were exposed to images of either Barbie dolls, Emme dolls (U.S. size 16), or no dolls (baseline control) and then completed assessments of body image. Girls exposed to Barbie reported lower body esteem and greater desire for a thinner body shape than girls in the other exposure conditions. However, this immediate negative impact of Barbie doll was no longer evident in the oldest girls. These findings imply that, even if dolls cease to function as aspirational role models for older girls, early exposure to dolls epitomizing an unrealistically thin body ideal may damage girls' body image, which would contribute to an increased risk of disordered eating and weight cycling.     

Forensic Interviewing Aids: Do Props Help Children Answer Questions About Touching?

The belief that props help children report abuse has fostered the widespread use of anatomical dolls and body diagrams in forensic interviews. Yet studies involving alleged abuse victims, children who have experienced medical examinations, and children who have participated in staged events have failed to find consistent evidence that props improve young children's ability to report key information related to bodily contact. Because props elevate the risk of erroneous touch reports, interviewers need to reconsider the belief that props are developmentally appropriate in forensic interviews, and researchers need to explore new approaches for eliciting disclosures of inappropriate touching.