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DISCLOSURE OF CHILD SEXUAL ABUSE
What Does the Research Tell Us About the Ways That
Children Tell?
Kamala London and Maggie Bruck
Johns Hopkins University
Stephen J. Ceci
Cornell University
Daniel W. Shuman
Southern Methodist University
The empirical basis for the child sexual abuse accommodation syndrome (CSAAS),
a theoretical model that posits that sexually abused children frequently display
secrecy, tentative disclosures, and retractions of abuse statements was reviewed.
Two data sources were evaluated: retrospective studies of adults’ reports of having
been abused as children and concurrent or chart-review studies of children under-
going evaluation or treatment for sexual abuse. The evidence indicates that the
majority of abused children do not reveal abuse during childhood. However, the
evidence fails to support the notion that denials, tentative disclosures, and recanta-
tions characterize the disclosure patterns of children with validated histories of
sexual abuse. These results are discussed in terms of their implications governing
the admissibility of expert testimony on CSAAS.
Although it is widely acknowledged that the sexual assault of children is a
major societal concern, it is not known how many children are victims of sexual
abuse in the United States (Ceci & Friedman, 2000). There are two major reasons
for this lack of data. First, present estimates of the incidence of child sexual abuse
(CSA) are primarily based on reports received and validated by child protection
agencies. These figures, however, do not reflect the number of unreported cases
or the number of cases reported to other types of agencies (e.g., sheriff’s offices)
and professionals (e.g., mental health diversion programs). Second, the accuracy
of diagnosis of CSA is often difficult because definitive medical or physical
evidence is lacking or inconclusive in the vast majority of cases (Bays &
Chadwick, 1993; Berenson, Heger, & Andrews, 1991), and because there are no
gold standard psychological symptoms specific to sexual abuse (Kendall-Tacket,
Williams, & Finkelhor, 1993; Poole & Lindsay, 1998; J. M. Wood & Wright,
1995). Given these limitations of medical and psychological evidence, children’s
statements typically represent the central evidence for judging the occurrence of
Kamala London, Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical
Institutions, Johns Hopkins University; Maggie Bruck, Division of Child and Adolescent Psychiatry,
Johns Hopkins Medical Institutions, Johns Hopkins University; Stephen J. Ceci, Department of
Psychology, Cornell University; Daniel W. Shuman, Department of Psychology, Southern Meth-
odist University.
Correspondence concerning this article should be addressed to Kamala London, Department of
Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, 600 N. Wolfe Street,
Baltimore, MD 21287-4346, or to Maggie Bruck, Division of Child and Adolescent Psychiatry,
Johns Hopkins Medical Institutions, 600 N. Wolfe Street, Baltimore, MD 21287-4346. E-mail:
klondon1@jhmi.edu or bruck@welch.jhu.edu
Psychology, Public Policy, and Law
2005, Vol. 11, No. 1, 194 –226
Copyright 2005 by the American Psychological Association
1076-8971/05/$12.00 DOI: 10.1037/1076-8971.11.1.194
194
CSA. In making these judgments, professionals must often address the delicate
issue concerning how children disclose abuse.
According to some experts, a major problem with relying on children’s
statements in forensic investigations is that many sexually abused children remain
silent about abuse; they may deny that abuse ever occurred, or they may produce
a series of disclosures of abuse followed by recantations of these disclosures. In
1983, Roland Summit, a psychiatrist, published a formal description of how
sexually abused children disclose abuse. The purpose of this model, termed child
sexual abuse accommodation syndrome (CSAAS),
1
was to outline for clinicians
why child victims of intrafamilial abuse may be reluctant to disclose abuse.
2
Summit’s model included five components: (a) secrecy; (b) helplessness; (c)
entrapment and accommodation; (d) delayed, conflicted, and unconvincing dis-
closures; and (e) retraction of disclosure. Summit argued that children who have
been sexually abused may respond with self-blame and self-doubt. They may fear
the perpetrator and the possible consequences of disclosure. Hence, in order to
survive sexual abuse by a trusted family member, children make accommodating
efforts to accept the abuse and to keep the abuse secret. Furthermore, according
to Summit (1983), when children do reveal their abuse, disclosure will be
incremental over time, a process that often includes outright denials and recan-
tations of prior disclosures, and then reinstatements of the abuse. It is important
to keep in mind that there are two separate aspects of this model, each with its own
components. The first stipulates the psychological consequences of abuse (fear,
blame, and accommodation). The second aspect, the focus of this article, stipu-
lates the consequences that these psychological states have on behavior (secrecy,
denial, and recantation).
Summit’s (1983) model has received much attention and has had a significant
impact in the area of child sexual abuse. His 1983 article was rated by profes-
sionals as one of particular influence in the area of child sexual abuse (Oates &
Donnelly, 1997). The components of his CSAAS model have been endorsed by
many clinicians and scholars who continue to base clinical and forensic judgments
on its tenets (e.g., Adams, 1994; Browne, 1991; Carnes, 2000; Elias, 1992; Ford,
Schindler, & Medway, 2001; Kelley, Brant, & Waterman, 1993; King Mize,
Bentley, Helms, Ledbetter, & Neblett, 1995; Leonard, 1996; MacFarlane, 1992;
Reichard, 1992; Reiser, 1991; Waterman, Kelly, Oliveri, & McCord, 1993; see
also Conte, Sorenson, Fogarty, & Rosa, 1991, for a survey of professionals’
beliefs). For example, Browne (1991) stated, “Disclosure is almost always an
ongoing process. It may begin with an initial quite dramatic first step, or it may
manifest itself as a series of tentative revelations, hints, and explorations” (p.
153). Similarly, Kelley et al. (1993) wrote, “Disclosures are often delayed and
gradual” (p. 82). Salter (1995) declared, “The child is viewed as having betrayed
the family by telling ‘strangers,’ and such children are frequently pressured to
recant” (p. 231). Salter also stated, “Denial is not a door that victims exit; it is a
1
A similar model posited by Sgroi (1982), child sexual abuse accommodation (CSAA),
provided a checklist of 20 hypothesized behavioral indicators of CSA. MacFarlane and Krebs (1986)
also proposed a model of reluctant disclosure, one that they termed “no-maybe-sometimes
syndrome.”
2
In 1992, Summit (1992) expanded the model to include victims of extrafamilial abuse.
195DISCLOSURE OF CHILD SEXUAL ABUSE
line that victims walk back and forth many times before moving forward” (Salter,
1995, p. 243).
Today these beliefs are echoed in guidelines for assessment and diagnosis of
CSA. For example, Children’s Institute International,
3
a California-based child
abuse assessment and treatment center that has trained over 40,000 professionals
worldwide, recommends training and offers a course on CSAAS for all profes-
sionals and paraprofessionals who work with children. Another influential orga-
nization, the National Children’s Advocacy Center (Carnes, 2000), states in one
of its publications, “Forensic evaluation is a process of extended assessment of a
child when that child is too frightened or young to be able to fully disclose their
experiences on an initial forensic interview” (p. 14). “For many children, abuse
disclosure is a process, not an event” (Carnes, 2000, p. 21). “Reluctance is
commonplace and difficult to overcome in suspected child sexual abuse cases”
(Carnes, 2000, p. 42).
Some professionals have gone as far as suggesting that children who readily
disclose abuse should be considered suspect. Rather, only those children who
initially deny abuse, then make a sexual abuse allegation, then recant it, and later
re-disclose, should be considered reliable cases of sexual abuse. For example,
Summit (1983) states, “The more illogical and incredible the initiation scene [of
the abuse] might seem to adults, the more likely it is that the child’s plaintive
description is valid” (p. 183). These beliefs are echoed in the courtroom, as
demonstrated in the following examples.
Finally, the majority of children who are sexually abused underreport the extent
and severity of the abuse. If I would have heard about lengthy disclosures with a
specific beginning, middle, and end to the story, I would have been less impressed
since that type of recounting is not likely with sexually abused children, particu-
larly preschoolers. The two most common types of reports that I hear from a
sexually abused child of this age are either flat denials or fragmented segments of
an incident. (Expert testimony in Lillie v. Newcastle City Council, 2002, p. 42)
In the following, a prosecutor questions his expert witness:
Q: Doctor, you mentioned earlier that with respect to child victims, it is not
unusual that they would fully describe all of the events in your first interview.
A: No.
Q: And if they do, is it suspicious to you?
A: To me, yes. (People v. Carroll, 2001, p. 70)
Although Summit (1992) wrote that he did not intend to imply that CSAAS
is present in all abused children, or that it should be treated as diagnostic of abuse,
many professionals have adopted CSAAS as a template by which to diagnose
sexual abuse (Fisher, 1995; Kovera & Borgida, 1998; Robin, 1991; Summit,
1992). Perhaps the best example of this practice is reflected in State v. Michaels
(1993). Margaret Kelly Michaels was accused and convicted of 115 counts of
sexual abuse involving 20 children from the Wee Care Day Nursery in Maple-
3
See http://childrensinstitute.org/ for Children’s Institute International’s description of their
contemporary interview training procedures.
196 LONDON, BRUCK, CECI, AND SHUMAN
wood, New Jersey. Expert testimony was presented at trial by Eileen Treacy, who
stated that children in the case showed behavior consistent with CSAAS and thus
their testimony and conduct was consistent with CSA. After 5 years in prison,
Michaels’ conviction was overturned for reasons including the inadmissibility of
testimony that uses CSAAS as a tool to diagnose abuse.
In keeping with the legal rule of excluding expert testimony that seeks to tell
the jury to believe a witness (i.e., that the child witness is being truthful, or in
general that children are truthful), the courts have uniformly excluded CSAAS
evidence that is used to persuade the jury that a child’s testimony about sexual
abuse is truthful or diagnostic of abuse (e.g., People v. Duell, 1990; Snowden v.
Singletary, 1998; State v.Gokey, 1990; State v. JQ, 1993; State v. Jones, 1993;
State v. Myers, 1984; see also Freckelton, 1997, for a review of New Zealand and
Australian rulings). When a child’s inconsistency has been the subject of an attack
on credibility during cross-examination, however, most courts have assumed that
CSAAS rests on a reliable scientific foundation and have permitted the prosecu-
tion to introduce evidence of CSAAS to explain “what would be expected of, or
what would be consistent with, facts surrounding other victims of childhood
sexual abuse” (State v. Huntington, 1998, p. 698).
Given the widespread appeal and currency of CSAAS in the mental health
community and its acceptance in the forensic arena, especially when used to
rehabilitate an inconsistent child witness on redirect, it is important to examine the
empirical basis for this syndrome. In his original article, Summit (1983) stated
that the CSAAS model was based on an empirical foundation:
This study draws in part from statistically validated assumptions regarding prev-
alence, age, relationships and role characteristics of child sexual abuse and in part
from correlations and observations that have emerged as self-evident within an
extended network of child abuse treatment programs and self-help organizations.
(Summit, 1983, p. 180)
Despite this claim, however, Summit’s (1983) article contained no data and
seemed to be predicated solely on clinical intuition. Almost a decade later,
Summit (1992) clarified, “It should be understood without apology that the
CSAAS is a clinical opinion, not a scientific instrument” (p. 156).
In the rest of this article, we review and evaluate the existing empirical data
to assess the scientific support for the behavioral components of CSAAS—
secrecy/silence, denial, and recantation. We draw on two major sources of
empirical data on children’s disclosure patterns, each with its own limitations: (a)
retrospective accounts from adults who claimed to have been abused as children
and (b) examinations of children undergoing sexual abuse evaluations. To fore-
shadow the results of this review, we conclude that although a substantial
proportion of children delay reporting or altogether fail to report incidents of CSA
(the secrecy stage), there is little evidence to suggest that denials, recantations,
and re-disclosures are typical when abused children are directly asked about
abuse. As is seen later in the present article, this emerges as an important
distinction on both scientific and applied grounds.
197DISCLOSURE OF CHILD SEXUAL ABUSE
Patterns of Disclosure Among Adults in Retrospective Surveys
Disclosure Rates
The studies discussed in this section include those in which adults with
self-reported histories of CSA were asked in a survey whether and at what age
they first disclosed their abuse. Table 1 lists 11 studies that yielded rates of
childhood disclosure of CSA. Studies that did not provide relevant statistics are
not listed in the table but are cited when relevant for related topics (e.g., predictors
of disclosure patterns). Finally, we focused on studies that were conducted since
1990 in order to control for cohort effects; in other words, the rates obtained in
older studies might reflect practices of several decades ago that are no longer
current because of changes in education, advocacy, increased sensitivity, and legal
procedures.
As shown in Table 1, the modal childhood disclosure rate (in 6 of the 11
studies) is just over 33%. Three other studies (7, 8, 9) reported slightly higher
rates of disclosure that are still low and are consistent with the claims of the
CSAAS model that nondisclosure of sexual abuse (silence) in childhood is very
common. The disclosure rate of 87% reported by Fergusson, Lynskey, and
Horwood (1996) is much higher than those found in other studies, an issue to
which we later return. In summary, these data indicate that two thirds of adults
who claimed in retrospective surveys to have been abused as children reported
that they did not disclose the abuse during childhood.
Disclosure rates were similar for studies that specifically recruited adults with
childhood histories of CSA (see Table 1; Studies 3, 4, 5, 8, and 9) and for studies
that recruited adults from the general population (Studies 1, 2, 6, and 10). For
example, Somer and Szwarcberg (2001) questioned 41 Israeli women who re-
ported that they were sexually abused as children and who at the time of the
interview were attending rape crisis centers. (It is unclear whether the women
were seeking treatment at the centers for the childhood abuse incident or for some
more recent incident.) Less than half (45%) reported that they had disclosed abuse
by age 17, and the average delay between abuse onset and disclosure was 15
years. Lamb and Edgar-Smith (1994) questioned 48 women and 12 men who
responded to a city newspaper advertisement seeking research participants who
had been sexually assaulted during childhood. Although a high proportion of these
respondents reported severe intrafamilial abuse, only 36% of the participants
disclosed the abuse during childhood (defined in this study as before age 14). The
same childhood disclosure rate of 36% was obtained from a sample of women
who reported sexual abuse by a relative before the age of 16 (Roesler & Wind,
1994). In another study (Roesler, 1994), 37% of adults with childhood histories of
abuse involving genital contact disclosed abuse during childhood. Finally, a
slightly higher rate of childhood disclosure was obtained in Ussher and Dewber-
ry’s (1995) survey of 775 women who responded to a questionnaire published in
a women’s magazine. Approximately 54% of these participants disclosed CSA
during childhood. These women reported a range of abuse severity, from un-
wanted sexual attention to severe and repeated abuse from family members. The
mean age at disclosure for this group was 26 years, 12 years after the average time
when the abuse had ended.
198 LONDON, BRUCK, CECI, AND SHUMAN
Table 1
Childhood Disclosures of Sexual Abuse: Retrospective Studies
Study nSample source
a
Definition of CSA
Reports
abuse at
survey
Childhood
disclosure
Report
to
authorities
Avg.
age at
time of
abuse
(yrs.)
Avg. age
of sample
(yrs.)
1. Arata (1998) 860 (f) College sample Unwanted contact
before 14 yrs.
24.0% 31% (at time of abuse) 10% 8.50 23
2. Smith et al. (2000) 3,220 (f) National probability
sample
Rape 9.0% 34% (within 6 months
of abuse)
12% 10.90 45
3. Roesler & Wind
(1994)
286 (f) CSA hotline callers Intrafamilial before
16 yrs.
100% 36% 6 41
4. Lamb & Edgar-
Smith (1994)
48 (f)
12 (m)
Newspaper ad Not specified 100% 36% (by age 13) 8.15 30
5. Roesler (1994) 168 (f)
20 (m)
Abuse center Genital contact
before 16 yrs.
100% 37% ⬍16.00 41
6. Tang (2002) 1,151 (f)
887 (m)
Hong Kong Chinese
college students
Unwanted sexual
experiences before
18 yrs.
6.0% 38% 11.00 21
7. Finkelhor et al.
(1990)
1,481 (f)
1,145 (m)
National probability
sample
Before 18 yrs. 27.0%
(f)
16.0%
(m)
42% within 1 yr. of
abuse
9.70 30
39
8. Somer &
Szwarcberg (2001)
41 (f) Israeli abuse center CSA survivors 100% 45% (by age 17) 7.11 32
9. Ussher & Dewberry
(1995)
775 (f) Magazine survey Unwanted sexual
attention
100% 54% 18% 8.50 38
10. Fergusson et al.
(1996)
1,019
(m&f)
New Zealand
longitudinal study
Unwanted experience
before 16 yrs.
10.0% 87% (by age 18) ⬍16.00 18
11. Hanson et al. (1999) 4,008 (f) National probability
sample
Nonconsensual
penetration assaults
before 18 yrs.
8.5% 13% ⬍18.00 38
Note. CSA ⫽child sexual abuse; Avg. ⫽average; yrs. ⫽years; f ⫽female; m ⫽male.
a
Unless noted, all studies were conducted in the United States.
One might argue that the rates of childhood disclosure obtained in these five
studies may not be reliable population estimates because they were obtained from
samples of participants who had to declare before study enrollment that they had
been abused as children. Perhaps such procedures draw victims with very late
disclosures and exclude those who had disclosed at much earlier ages. Alterna-
tively, it could be argued that these rates underestimate the failure to disclose
because those who never told anyone may be less likely to respond to such
advertisements. Notwithstanding these competing suggestions, however, similar
findings have been obtained in studies that included convenience samples of
college students as well as national probability samples that were not selected on
the basis of childhood histories. For example, Smith et al. (2000) examined data
from a nationally representative telephone survey on women’s experiences with
trauma and mental health (Resnick, Kilpatrick, Dansky, Saunders, & Best, 1993).
In this study, 9% of the women retrospectively reported at least one incident of
rape (i.e., vaginal, oral, and/or anal penetration by a penis, finger, or object) prior
to their 18th birthday. Approximately 27% of these abused women remembered
disclosing the rape to someone within 1 month of the sexual abuse; another 34%
said they had disclosed within 6 months of the abuse; an additional 18% were not
sure when they had first disclosed the abuse. Thus, a considerable number of
women delayed or altogether failed to disclose the childhood rape; 47% waited
more than 5 years to report the abuse, and 28% said that they had never told
anyone about the incident prior to the telephone interview.
Similar rates of nondisclosure were obtained by Finkelhor, Hotaling, Lewis,
and Smith (1990) in their national telephone survey of 2,626 American men and
women. In that study, 27% of women and 16% of men reported a history of CSA.
Of those with histories of CSA, 42% reported having disclosed abuse within 1
year of the incident, 20% told someone of the event later, and 38% had never told
anyone of the abuse prior to the telephone interview. Abused men were more apt
than abused women never to have disclosed the abuse (42% vs. 33%).
Low rates of disclosure also characterized two college student samples. Arata
(1998) found that 24% of female undergraduate students attending a southeastern
university reported unwanted sexual contact before age 14 by someone 5 or more
years older. Of those with CSA histories, 31% reported having disclosed the abuse
to someone around the time of the abuse. Tang (2002) found that in a sample of
Hong Kong Chinese college students who reported abuse, 38% disclosed abuse in
childhood.
Only 1 of the 11 studies in Table 1 reported high rates of disclosure. The study
was carried out in New Zealand by Fergusson et al. (1996) and involved a
longitudinal study of 1,265 children. Sexual abuse was defined broadly in this
study, ranging from noncontact activities, such as indecent exposure or lewd
suggestions (including experiences with same-aged peers), to rape before age 16.
At 18 years old, 87% of the abused subsample reported having told someone
about the abuse. There are several factors that may account for Fergusson et al.’s
finding of high disclosure rates relative to the other studies. As the authors noted,
such high rates of disclosure may partially reflect the young age of the adults in
their sample: possibly some were still denying the abuse, thus producing lower
rates of CSA with concomitantly inflated rates of disclosure. Another factor that
could explain high rates of disclosure is that many of their participants reported
200 LONDON, BRUCK, CECI, AND SHUMAN
noncontact activities such as lewd suggestions, which reportedly the participants
did not consider as incidents of CSA. This could also explain why many of these
participants denied abuse history 3 years later, during a follow-up interview
(Fergusson, Horwood, & Woodward, 2000).
In summary, although one study yielded extremely high disclosure rates
(Fergusson et al., 1996), the results of the 10 other retrospective studies indicated
that only one third of adults who suffered CSA revealed the abuse to anyone
during childhood. Given the differences in methodology, definitions of abuse, and
sample characteristics, the general consistency of these findings across these
studies is noteworthy.
Predictors of Nondisclosure
In addition to providing overall disclosure rates, some studies also examined
predictors of disclosure rates. In this section, we examine associations of some of
these predictors from data within studies and, when possible, across studies.
Summit’s (1983) original model was based on disclosure patterns of children
who were victims of familial abuse. Thus, one would expect that such children
would be less likely to disclose than children who were abused by nonfamilial
perpetrators. The results of two studies (Hanson, Resnick, Saunders, Kilpatrick, &
Best, 1999; Smith et al., 2000) are consistent with these claims; CSA disclosure
was more likely when the perpetrator was a stranger rather than a family member.
Consistent with these findings, Ussher and Dewberry (1995) reported longer
delays to disclosure among intra- versus nonfamilial abuse. In contrast to these
three supporting studies, five studies failed to find an association between rela-
tionship to perpetrator and CSA disclosure (Arata, 1998; Kellogg & Hoffman,
1995; Kellogg & Huston, 1995; Lamb & Edgar-Smith, 1994; Roesler, 1994).
These are surprising findings given the fact that Summit (1983) originally con-
structed his model to account for nondisclosure in the context of intrafamilial
abuse.
Age at time of abuse has not been consistently associated with failure to
disclose. Although Smith et al. (2000) found that younger victims were more
likely to delay disclosure than older child victims, other researchers (e.g., Arata,
1998; Kellogg & Hoffman, 1995) failed to find any relationship between age and
delay of disclosure. There is one important caveat to this conclusion. When study
participants reported experiencing CSA during adolescence, this was consistently
accompanied by high disclosure rates (Everill & Waller, 1995; Kellogg &
Hoffman, 1995; Kellogg & Huston, 1995). For example, in the Everill and Waller
(1995) study, in which the mean age at time of abuse was 14 years, 69% of this
female sample reported having disclosed to a friend, most around the time of the
incident. Kellogg and Huston (1995) found that 85% of their sample of young
adults (mean current age ⫽19.5 years, mean age of abuse ⫽14 years) had also
disclosed at some point in the past. In these cases, the most common confidant
was another adolescent (Lamb & Edgar-Smith, 1994; Tang, 2002). In contrast,
adults reporting that they revealed CSA as school-aged children did so to a parent
rather than to a peer (Arata, 1998; Lamb & Edgar-Smith, 1994; Palmer, Brown,
Rae-Grant, & Loughlin, 1999; Roesler, 1994; Roesler & Wind, 1994; but see
Smith et al., 2000; Somer & Szwarcberg, 2001). These studies, taken together,
201DISCLOSURE OF CHILD SEXUAL ABUSE
imply that disclosure rates may vary as a function of age at CSA onset, which in
turn is associated with the availability of a same-aged confidante.
Finally, no systematic relationships have been reported between demographic
variables, such as race and ethnicity, and childhood disclosure rates (e.g., Arata,
1998; Hanson et al., 1999; Kellogg & Hoffman, 1995; Kellogg & Huston, 1995;
Smith et al., 2000). However, most of the retrospective studies have too little
variability in their sample’s demographic composition to test for differences. (For
discussions on how demographic variables—race and gender—may be related to
CSA disclosure, see Fontes, 1993; Kazarian & Kazarian, 1998; Kenny &
McEachern, 2000; Levesque, 1994; Toukmanian & Brouwers, 1998.)
We examined the existing data to determine its support for one of the major
assumptions of the CSAAS model; that is, disclosure is related to the amount of
fear or violence associated with the abuse. According to the model, children do
not disclose because they are afraid of the perpetrator who physically coerced or
harmed them. In addition, children also do not disclose because they are threat-
ened with consequences of disclosure that involve harm to family members or to
the self. On the basis of these assumptions, it is predictable that the more severe
or frightening the abuse or the more the child is threatened postabuse, the less
likely the child would be to disclose.
In general, the data do not support the hypothesis that disclosure rates are
related to severity of abuse. Although Arata (1998) found lower disclosure rates
for contact versus noncontact abuse, there was no relationship between disclosure
and method of coercion (e.g., threat, gift, curiosity, appeal to authority, or physical
force). To further call into question the validity of this assumption of the CSAAS
model, most researchers have either found the opposite pattern—that is, higher
disclosure rates are associated with incidents that are life threatening and involve
physical injury (Hanson et al., 1999; Kellogg & Hoffman, 1995)— or have not
found any significant relationship between severity and method of coercion and
disclosure (Lamb & Edgar-Smith, 1994; Roesler, 1994; Smith et al., 2000).
Another method to examine the relationship between severity/coercion/phys-
ical harm and disclosure is to compare the rates among studies in Table 1 in terms
of the types of abuse that were included in the study. Some experimenters defined
CSA broadly (i.e., unwanted sexual attention by anyone), and some defined it
more narrowly (e.g., forcible penetration). Despite the differences in definitions
(excluding the outlier study by Fergusson et al., 1996), disclosure rates reported
across studies were very similar. In summary, the data indicate no consistent
association between severity or method of coercion and disclosure.
Next, we searched for studies that examined the relationship between threats
that were used to secure the child’s silence (“Don’t tell or else. . . .”) and
disclosure. The major problem encountered was that the few studies that reported
threat data did not stipulate whether the measure of “threat” referred to statements
or actions during the commission of the assault to engender physical compliance
or to threats used to engender silence (see, e.g., Arata, 1998; Hanson et al., 1999;
Roesler, 1994; Smith et al., 2000). This failure to provide operational definitions
of threats is problematic on methodological grounds (How did the study partic-
ipant interpret the question?) and on interpretational grounds (How does the
consumer of the literature interpret the statistics?). Hence, the extant retrospective
202 LONDON, BRUCK, CECI, AND SHUMAN
data are insufficient to examine whether childhood disclosure rates vary as a
function of whether the child was threatened to remain silent.
Summary
The results of the retrospective studies make two important contributions to
our knowledge about the patterns of children’s disclosure of abuse. First, these
data, when taken at face value, reveal that approximately 60%–70% of adults do
not recall ever disclosing their abuse as children, and only a small minority of
participants (10%–18%) recalled that their cases were reported to the authorities
(see Table 1, Column 7). Furthermore, to underscore the results of nondisclosure,
many of the adults reported that their first disclosure was during the study survey.
Thus, the retrospective studies provide evidence to support the assumption that
many incidents of CSA go unreported and that the stage of silence in the CSAAS
model has a strong empirical foundation. Second, analyses of predictor variables
in these retrospective studies provide few insights into the factors associated with
disclosure. They do suggest, however, that commonly held assumptions, such as
fewer disclosures among more severe cases of CSA, or in cases of intrafamilial
abuse, lack empirical support. We must await further data to examine these issues
definitively.
There are two limiting aspects, however, of the adult retrospective literature.
The first is common to all retrospective studies; namely, the design raises
concerns about the accuracy of the informants’ reports. Specifically, it is possible
that some adults in these retrospective studies had been abused but continued to
deny abuse. Such false denials would work to reduce the overall CSA prevalence
rates and inflate the disclosure rates. Alternatively, it is possible that some adults
in these retrospective studies had not been abused but claimed to have been. Such
false allegations would inflate the incidence of CSA and render the data on
disclosure nonmeaningful. Finally, some adults may have disclosed abuse in
childhood, despite their reports to the contrary. In some cases, participants may
have misdated their disclosure, placing it much further from their victimization
than was the actual case. In a related vein, they may in fact have told someone but
failed to remember having done so. A rich cognitive psychology literature
demonstrates the myriad of retrospective biases, even when the events in question
are highly emotional (e.g., Freyd, 1996; Neisser, 1997; Read & Lindsay, 1997;
Ross, 1989). In their investigation of flashbulb memories, Schooler and colleagues
(Schooler, Ambadar, & Bendiksen, 1997; Schooler, Bendiksen, & Ambadar,
1997) coined the term “forgot-it-all-along-effect” to describe the finding that
people sometimes inaccurately recall to whom, when, and whether they reported
an important life event. Adults’ denial of CSA reports that were actually made
during childhood would not affect prevalence rates of CSA but would lead to an
underestimation of childhood disclosure rates.
A second constraint in the interpretation of the adult retrospective literature is
that although the studies indicate that delayed disclosure or silence is common
among sexually abused children, these studies are uninformative as to the fre-
quency that abused children deny or recant abuse reports. This is because
participants in these retrospective surveys were not asked if as children anyone
had ever asked them about abuse, and, if so, what they had replied. Thus, it is not
203DISCLOSURE OF CHILD SEXUAL ABUSE
known whether the high rates of childhood silence reflected the fact that survey
participants had never been asked about abuse, or whether it reflected denial to
abuse-related questions. In order to examine the probability of this latter outcome,
the literature on children’s patterns of disclosure must be examined.
Patterns of Disclosure Among Children Treated or Evaluated for Sexual
Abuse
In this section, we review studies of disclosure patterns of children who were
specifically assessed or treated for sexual abuse. We examine studies that yielded
data on (a) delay of disclosure, (b) denial, and (c) recantation. We also searched
for studies that reported data on the correlates of delay, denial, and recantation. As
with the retrospective studies reported above, we excluded studies published prior
to 1990 because of possible cohort effects that could be due to the changes in
interviewing practices and prevention programs (for children) that have occurred
in the decade of the 1990s.
Delay of Disclosure (Silence)
The results of the studies using child samples echo the adult retrospective
finding regarding delay of abuse disclosure; namely, when children do disclose, it
often takes them a long time to do so. For example, disclosure rates of children
whose cases were referred for prosecution were examined by Goodman et al.
(1992) and by Sas and Cunningham (1995). Although 37%– 42% of the children
had disclosed within 48 hr of the abuse, it took more than 6 months or even 1 year
for many of the children to make a disclosure. Even higher rates of delayed
disclosure were obtained in Elliott and Briere’s (1994) study, in which 75% of
children did not disclose CSA within the first year following the abuse, and 18%
waited more than 5 years to disclose the abuse. Similarly, Henry (1997) found
that, among 89 criminal CSA records, there was an average 2-year delay between
abuse and disclosure. Some of the variability in the length of delay in the child
studies may reflect the settings in which the data were collected. Shorter periods
of delay may show up in surveys of children in criminal trials simply because
delayed disclosure cases might be excluded from consideration because of the
inherent difficulty in obtaining convictions. Therefore, it may be that cases in the
prosecutor’s office are unrepresentative of those that never reach the courtroom.
Few of the studies on delay of disclosure examined individual differences.
Nonetheless, there are some data on gender differences, suggesting that boys may
be more reluctant to disclose than girls (e.g., DeVoe & Faller, 1999; Goodman-
Brown, Edelstein, Goodman, Jones, & Gordon, 2003; Gries, Goh, & Cavanaugh,
1996; Sas & Cunningham, 1995; Stroud, Martens, & Barker, 2000; but see
DiPietro, Runyan, & Fredrickson, 1997; Keary & Fitzpatrick, 1994, who report
null gender findings). However, as Goodman-Brown et al. (2003) discuss, gender
differences in disclosure rates may be suppressed by other abuse-related variables
associated with gender (e.g., prior disclosure or relationship to perpetrator).
With regard to empirical findings on disclosure and ethnicity or race, Shaw,
Lewis, Loeb, Rosado, and Rodriguez (2001) found that Hispanic girls waited
longer to disclose (average delay ⫽19 months) than African American girls
(average delay ⫽9 months). This finding is consistent with the report that African
204 LONDON, BRUCK, CECI, AND SHUMAN
American children received more maternal support to disclose abuse than did
Hispanic children (Rao, DiClemente, & Ponton, 1992). Although it has been
suggested that children raised with values typifying Eastern cultures (e.g., col-
lectivist values, preservation of family, etc.) may be more apt to conceal abuse
than children raised in Western cultures (e.g., Futa, Hsu, & Hansen, 2001; Rao et
al., 1992; Toukmanian & Brouwers, 1998; Wong, 1987), data are needed to
address this hypothesis. In short, there are reasons to suspect that members of
certain ethnic groups, as well as boys, may face additional and culture-specific
barriers to CSA disclosure. However, the studies that have examined children’s
disclosure patterns to date do not present a coherent canvas of the effects of
demographic variables on abuse disclosure.
Some researchers have examined the association of the abuse characteristics
and delay of disclosure. At times, when associations between abuse variables and
disclosure are reported, the researchers fail to provide adequate operational
definitions of the abuse variables. For example, as was the case with the retro-
spective studies, the data on “threats” are difficult to interpret because researchers
do not specify whether threats are defined tactics to gain the child’s compliance
during the commission of the assault or as tactics to scare the child into not
revealing the abuse. When clearly defined data on abuse characteristics do exist,
they are sparse and do not consistently support assumptions underlying the
CSAAS model. For example, Sas and Cunningham (1995) found that children
waited longer to disclose abuse when the perpetrator “groomed” them and
established a close relationship than if the perpetrator used force. Some research-
ers have found that children who are victims of familial abuse tend to delay
disclosure longer than those experiencing extrafamilial abuse (Goodman-Brown
et al., 2003; Sjo¨berg & Lindblad, 2002). However, these studies are exceptional
because the majority of studies we examined either failed to find such an
association or failed to report an association.
As the analyses of Goodman-Brown et al. (2003) demonstrated, the relation-
ship between delayed disclosure and abuse characteristics is mediated by a
complex interplay of variables. These researchers found that in a sample of 218
CSA cases referred for prosecution, older children and victims of familial abuse
tended to perceive that more negative consequences would result from disclosure,
which in turn was associated with the time taken to disclose. Goodman-Brown et
al. (2003) also found increased delays among children feeling responsible for the
abuse; additionally, older children were more apt than younger children to feel
responsible for the abuse. It is clear from the results of this study that future work
must focus on a multivariate model that attempts to provide a causal explanation
for the timing of disclosure. Note that none of the studies covered in this section
addressed issues concerning denial of abuse. These are addressed in the next
section.
Rates of Disclosure (Denial)
In this section, we review 16 articles that were published since 1990 that
contained statistics on the frequency of denial. These are listed in Table 2,
Column 4, in ascending order of disclosures. When relevant, we cite other studies
205DISCLOSURE OF CHILD SEXUAL ABUSE
Table 2
Disclosure and Recantation Rates From Child Clinic Studies
Study nAge (range) Disclosing Recantations
No. SSI
citations Type of interview
Gonzalez et al. (1993) 63 (2–12) 24% 27.0% 9 Therapy
Sorenson & Snow (1991) 116 Mode ⫽6–9 (3–17) 25% 22.0% 70 Therapy
Lawson & Chaffin (1992) 28 M⫽7.00 43% 31 Social worker
Carnes et al. (2001) 147 M⫽6.00 (2–17) 45% not listed CSA team
B. Wood et al. (1996) 55 M⫽5.70 (6–11) 49% 2 CSA team
Bybee & Mowbray (1993) 106 M⫽5.60 (2–11) 58% 11.0% 5 CPS and therapy records
Cantlon et al. (1996) 1,535 Mode ⫽4.00 (2–17) 61% 3 CSA team
Gries et al. (1996) 96 M⫽8.30 (3–17) 64% 15.0% 2 CSA clinic
Stroud et al. (2000) 1,043 M⫽8.40 (2–18) 65% 1 CSA clinic
Gordon & Jaudes (1996)
a
141 M⫽6.40 (3–14) 74
b
4 CSA team
DiPietro et al. (1997) 179 M⫽7.50 (1.4–22) 76% (47%)
c
4 CSA team
Dubowitz et al. (1992) 132 M⫽6.00 (⬍12) 83% (59%)
c
22 CSA clinic
Elliott & Briere (1994) 399 M⫽11.03 (8–15) 85% (57%)
c
9.0% 31 Clinician
DeVoe & Faller (1999) 76 M⫽6.80 (5–10) 87% (62%)
c
7 Social worker
Keary & Fitzpatrick (1994) 251 Mode ⫽6–10 91% (50%)
c
16 CSA team
Bradley & Wood (1996) 234 M⫽10.00 (1–18) 96%
c
4.0% 16 CPS
Faller & Henry (2000) 323 M⫽11.70 (3–21) 6.5% 1 CPS/police
Note. SSI ⫽Social Sciences Citation Index; CSA ⫽child sexual abuse; CPS ⫽Child Protective Services.
a
We do not report Gordon and Jaudes’s (1996) “recantation” rate because the child was not interviewed under the same clinical watch, but
rather the first interview was a brief medical screening. Also, the authors include parents’ disclosures (i.e., as historian) in the base rate.
b
This
rate is the percentage of children from the total sample disclosing during the investigative interview. The authors do not report the percentage
of disclosing during the investigative interview for substantiated cases.
c
Denotes studies based on cases classified as probable abuse cases;
the first disclosure rate is that of children classified as substantiated, high probability, and so forth, the second disclosure rate is for all children
examined, regardless of classification of abuse likelihood.
206 LONDON, BRUCK, CECI, AND SHUMAN
that did not provide data on the rate of disclosure in their sample but that do shed
light on the correlates of disclosure.
Most of the studies listed in Table 2 involved “chart reviews” of children who
were interviewed by child protective services (CPS), mental health, or medical
professionals specializing in the assessment and treatment of sexual abuse (see
Table 2, Column 7, for the type of assessment in each study). Children presented
at these various settings for a variety of reasons that included a prior disclosure to
an adult, a suspicion of abuse by an adult or an agency, or the need for a second
opinion or more extensive interviewing. Thus, across and within studies, there is
often great variability in the methods by which children were interviewed, in the
information collected, and in the procedures of diagnosing CSA. Furthermore, in
some studies, as is later noted, researchers categorized the children according to
the likelihood of abuse (e.g., highly probable, unclear, or not abused); in other
studies, only children who met some prespecified criteria for abuse were included;
and in still other studies, the certainty of abuse status was not specified. For those
studies that categorized children by likelihood of abuse, the rates for substantiated
cases are presented first in Column 4 of Table 2.
The pooled mean of disclosures for studies listed in Table 2 is 64% (range ⫽
24%–96%), or the mean of denials is 36%. For reasons discussed below, however,
these figures should not be viewed as the best estimate of central tendency. We
focus on four factors that account for the enormous between-study variability in
disclosure/denial rates in order to highlight methodological and design factors that
need to be considered in evaluating the generalizability, validity, and reliability of
the findings in Table 2. These factors are age of the child, previous disclosure of
abuse, substantiation of abuse, and representativeness of the selected sample. We
conclude that when such factors are considered, mean denial rates are quite low
when children are explicitly asked about sexual abuse.
Developmental differences. The wide variation in the ages of the children,
both within and between studies (see Table 2, Column 3), could account for
differences in the rates of disclosure across studies. In order to examine this
hypothesis, age– denial associations were examined within studies. Although no
significant relationships between age and denial were found in two studies
(Bradley & Wood, 1996; DeVoe & Faller, 1999), the more common finding was
that school-aged children are more apt than preschoolers to disclose abuse during
formal evaluation. For example, B. Wood, Orsak, Murphy, and Cross (1996)
found that older children made more credible disclosures of abuse than younger
children.
4
Similarly, DiPietro, Runyan, and Fredrickson (1997) found that older
children were more likely to disclose than younger children and that children
generally became more likely to disclose abuse after age 4. Keary and Fitzpatrick
(1994) conducted a chart review of 251 children assessed by a multidisciplinary
team at a CSA unit. Only 29% of children younger than 5 years disclosed during
the assessment, compared with 51%, 64%, and 67% of 6- to 10-year-olds, 11- to
4
B. Wood et al. (1996) defined a credible disclosure as one that “was adequate for use as
evidence in a future legal and/or child protection proceedings” (p. 84). The “not credible” category
included cases “where the child did not disclose, denied sexual abuse, refused to cooperate, provided
insufficient detail or was not believable” (p. 84). The authors did not cite the number of children
falling into each of the not credible subcategories.
207DISCLOSURE OF CHILD SEXUAL ABUSE
15-year-olds, and 16⫹years, respectively. And finally, among foster children
receiving therapy for suspected CSA, children who disclosed abuse in the first
interview were likely to be older (M⫽9.3 years) than were children who took two
sessions to disclose (M⫽5.8 years) (Gries, Goh, & Cavanaugh, 1996). Thus, it
appears that different rates of disclosure/denial will be obtained depending on the
age levels of the children in the sample (see also Cantlon, Payne, & Erbaugh,
1996; Sas & Cunningham, 1995). Of course, these rates are only meaningful if all
the children in the sample were actually sexually abused—an issue that we
address later in this article.
There are several possible explanations to account for these developmental
differences in children’s abuse disclosures. They could reflect the single influence
or combined influences of linguistic, cognitive, and social– emotional factors.
Thus, younger children may not have the same linguistic skills to convey their
abuse experience, or younger children may not understand the “meaning” of
abusive acts and thus fail to make explicit disclosures. Studies that examine the
intent of children’s disclosing statements provide some data for this developmen-
tal hypothesis. These studies show that younger children are more likely to make
accidental disclosures, whereas older children are more likely to make purposeful
disclosures (Campis, Hebden-Curtis, & DeMaso, 1993; Fontanella, Harrington, &
Zuravin, 2000; Nagel, Putnam, Noll, & Trickett, 1997). That is, younger children
are more likely to make spontaneous statements about abuse that are not consis-
tent with the topic of conversation or of the ongoing activity (e.g., stating, while
watching TV, “Uncle Bob hurt my bottom”). In contrast, older children are more
likely to report the abuse to an adult when asked. Although the conclusions are
consistent across studies, the ages of the “younger” and “older” children are not
the same across studies. Thus, there is no objective age cutoff that can be inferred
from the literature.
A second possible explanation for developmental differences in rates of denial
is that there may be higher rates of true denials among younger than older
children. This hypothesis is based on several interrelated findings. Younger
children may be more likely than older children to be brought for assessment
because of their caregivers’ concerns about behaviors (rather than an abuse
disclosure) that often are ambiguous and do not necessarily reflect CSA (see
Campis et al., 1993; Fontanella et al., 2000; Levy, Markovic, Kalinowski, Ahart,
& Torres, 1995; Nagel et al., 1997). Thus, in any sample there may be a greater
proportion of younger nonabused children than of older nonabused children, and
the higher denial rates by younger children would then reflect a higher rate of
denial that are true negatives. For example, Keary and Fitzpatrick (1994) were
less likely to categorize younger children’s presentation as diagnostic of CSA
compared with that of the older children; in addition, the younger children were
less likely to disclose abuse. Unfortunately, these researchers did not present data
on age differences in denial rates among older versus younger children who were
classified as “founded” by the assessment team.
Although most of the data indicate that younger children may be less likely
to disclose than older children, upon closer investigation, there may also be
patterns specific to adolescents. At least among cases that reach authorities,
children are most likely to reveal the abuse to their primary caregiver (Campis et
al., 1992; Faller & Henry, 2000; Fontanella et al., 2000; Gray, 1993; Henry, 1997;
208 LONDON, BRUCK, CECI, AND SHUMAN
Sas & Cunningham, 1995). However, adolescents may have a greater appreciation
of the consequences of disclosing intrafamilial abuse and thus withhold informa-
tion. It is also possible that they may not readily disclose extrafamilial abuse to
family members or to investigators because they feel it is a personal matter, or
they have already disclosed to peers, as noted in the retrospective studies reviewed
in the first part of this article. Hence, the rate of CSA disclosure to parents and
authorities may resemble an inverted U-pattern, with an increase in disclosure as
one moves from preschoolers to school-aged children, followed by an apparent
decrease as one moves into adolescence. There are, however, few data on
disclosure patterns in adolescence, and we must await these before drawing any
definite conclusions. In addition, regardless of potential developmental differ-
ences in disclosure patterns, it is highly likely (although not yet researched) that
different factors account for denial or disclosure at different age levels.
Prior disclosure of abuse predicts disclosure during formal assessment. The
studies included in Table 2 focus on children’s reports during forensic interviews
and psychotherapy. That is, the children in these studies were specifically brought
to a clinic, mental health professional, or law enforcement agency either because
they had previously made a claim of abuse or because there was a suspicion of
abuse that required further investigation. Thus, most of the children in each study
had been questioned by someone (e.g., teacher, parent) about abuse prior to the
formal interviews or therapy sessions. This fact is important because, as shown in
Table 3, the most significant predictor of disclosure in the formal interview is
whether the child had disclosed before (e.g., to a parent, a teacher, a CPS worker,
etc.). For example, Keary and Fitzpatrick (1994) reported that of the 123 children
who had made a prior disclosure, 86% disclosed again during the formal inter-
view; in contrast, only 14% of the 128 children with no prior disclosures disclosed
at interview.
5
Similar patterns of results were found by Gries et al. (1996),
DiPietro et al. (1997), and DeVoe and Faller (1999).
This pattern of consistency of disclosure is most common in older children.
Among children who had disclosed prior to formal assessment, older children
were more likely than younger children to disclose again during formal assess-
ment (Keary & Fitzpatrick, 1994; see also Ghetti, Goodman, & Eisen, 2002).
In summary, several studies suggest that once children have made an abuse
disclosure, they are likely to maintain their allegations during formal assessments.
This finding suggests that if children have already told a professional or a
caretaker about an abusive event, then they are likely to repeat the disclosure in
a formal investigation. Discrepant cases (in which a child discloses before the
formal interview but denies at the time of the formal interview) represent a small
minority and may occur most commonly among very young children.
Abuse substantiation. The third and perhaps most important methodological
factor that accounts for variation in disclosure patterns across studies concerns the
validity of the diagnosis of CSA. In conducting studies of CSA disclosure
5
When children have made a prior allegation but do not repeat it during a formal investigation,
this should not be categorized as a recantation because it is possible that the child’s first allegation
was incorrect or misinterpreted, and the report during the formal investigation is accurate. In this
article, recantations are defined as statements that are made to the same assessment team who heard
the disclosure.
209DISCLOSURE OF CHILD SEXUAL ABUSE
patterns, it is of utmost importance to ensure that the group under study had in fact
experienced CSA; otherwise, counts of frequency of delay to disclosure, denials,
recantations, and restatements are meaningless. That is, children may deny be-
cause they in fact never were abused; children may take a long time to disclose
because it is only with repeated suggestive interviewing that they will make
disclosures that are false; and children may recant in order to correct their prior
false disclosures.
In order to address problems of substantiation of abuse, some researchers
have classified children in the sample in terms of the likelihood of abuse having
occurred. Cases of suspected abuse that meet one or more of the following criteria
(depending on the study) are classified as substantiated abuse cases: perpetrator
convictions, plea bargains or confessions, medical evidence, other physical evi-
dence, and children’s statements. Although the use of such criteria is a good start,
it should be noted that there are problems with each. First, the accused may be
persuaded to accept a plea bargain because of the stress, financial burden, and
uncertain outcome of facing trial. Also, there are some accused who have been
falsely convicted despite the absence of direct evidence to prove child abuse, and
on appeal, their convictions have been overturned (Ceci & Bruck, 1995). Al-
though this may not be common, it does happen. Next, medical evidence is not
always an accurate indicator of abuse. In the statistically rare case in which genital
or anal abnormalities are found, similar abnormalities can sometimes be found
among nonabused children (Berenson et al., 1991). Finally, in terms of the studies
that are included in this article, the children’s statements at the time of formal
interview are used as indicators of abuse. But this is a circular exercise whereby
children who make spontaneous disclosures with much elaboration, for example,
are categorized in the “high-certainty” abuse group. The analysis of the disclosure
patterns of the high-certainty group indicates that the children disclosed sponta-
neously and/or with much elaboration (or did not deny).
Notwithstanding these problems with the use of certainty criteria, there must
be some reliable basis to categorize the children in studies of CSA disclosure, lest
the disclosure rates obtained merely reflect the overall responses of children
(abused and nonabused alike) who are assessed for sexual abuse. Keeping these
reservations in mind, we now review those studies that have examined disclosure
patterns as a function of the certainty of abuse diagnosis. We argue that, with a
few exceptions, high disclosure rates characterize those samples that contain
sexually abused children with high-certainty diagnoses, and low disclosure rates
Table 3
Rates of Disclosure During Forensic Interviews as a Function of Prior
Disclosure
Study
% of children disclosing at
formal interviews with
prior disclosure
% of children disclosing at
formal interviews with no
prior disclosure
DeVoe & Faller (1999) 74 25
DiPietro et al. (1997) 77 7
Keary & Fitzpatrick (1994) 86 14
Gries et al. (1996) 93 40
210 LONDON, BRUCK, CECI, AND SHUMAN
are associated with samples for which the diagnoses of abuse are either unknown
or questionable. If correct, then this conclusion bypasses the sundry assumptions
of models, such as the CSAAS, and in their place posits that children are found
to disclose least when their history of sexual abuse is least certain.
Referring to the studies listed in Table 2, the highest disclosure rates (76%–
96%) were obtained from those studies that focused on children with high-
certainty diagnoses of sexual abuse. Disclosure rates are greatly lowered in these
same studies when the data from the unsubstantiated or unclear cases are averaged
with the substantiated cases (see data in parentheses in Table 2, Column 4). Thus,
although only 62% of DeVoe and Faller’s (1999) entire sample of 5- to 10-year-
olds disclosed abuse, when only substantiated cases are included, the disclosure
rate rises to 87%. The overall rate of disclosure in the Keary and Fitzpatrick
(1994) study was 50%; however, when only the substantiated cases are included,
the rate was 95%. DiPietro et al. (1997) classified each of the children in their
sample who were assessed because of suspicions of CSA as unfounded, possible,
probable, or definitive abuse. Rates of disclosure during the first visit increased as
a function of abuse certainty, with 7%, 8%, 59%, and 76%, respectively, disclos-
ing. The overall disclosure rate in Dubowitz, Black, and Harrington (1992) was
58%; however, among their cases rated by an interdisciplinary team as holding
low to possible likelihood, the disclosure rate was only 19%, compared with the
disclosure rate of 83% for the moderate to high likelihood cases. Elliott and Briere
(1994) examined the case records of 399 8- to 15-year-olds who were seen at a
child sexual assault assessment center. Overall, 57% of the 399 cases disclosed
abuse, with 20 of these children later recanting. When only the 248 children who
were in the “abused” category were included in the calculation, the rate of
disclosure increased to 84%. It is interesting to compare the profiles of these
children with the 20% of the sample who were categorized as “unclear.” The latter
sample all made noncredible disclosures or noncredible denials of abuse. These
unclear children were more likely to be referred by a mandated reporter because
of a suspicion of abuse, more likely to be male, and more likely to exhibit
increased sexual acting-out behavior.
Returning to Table 2, studies that include cases without providing information
on their diagnostic certainty (in ascending order, Gordon & Jaudes, 1996; Stroud
et al., 2000; Gries et al., 1996) yield disclosure rates (61%–74%) that are lower
than those of the studies just discussed. In these studies, there is no other evidence
to confirm the abuse status of these children, and hence the disclosure rates of true
positive abuse cases are not ascertainable from the data.
Table 2 shows that the lowest rates of disclosure are provided by Sorensen
and Snow (1991) and Gonzalez et al. (1993). On the basis of our analysis of the
cases included in these studies, we conclude that these low rates reflect the
unreliable diagnoses of sexual abuse in these two studies. Because the Sorensen
and Snow study is most frequently cited as supporting the notion that sexually
abused children deny and recant (see Table 2, Column 6), it is important to
carefully review this study and the characteristics of the sample.
Sorensen and Snow (1991) selected 116 cases of confirmed CSA from a larger
sample of 633 children who were involved in CSA allegations from 1985 to 1989.
Sorensen and Snow reported that 72% of children denied abuse when first
questioned by either a parent or an investigative interviewer; only 7% of these
211DISCLOSURE OF CHILD SEXUAL ABUSE
deniers immediately moved into an “active disclosure” stage, which involved
detailed, coherent, first-person descriptions of the abuse. Seventy-eight percent
moved into a “tentative disclosure” stage, with partial, vague, or vacillating
disclosures of sexual abuse. Eventually, 96% of children made an active
disclosure.
There are several factors to be considered in interpreting these data. First, the
authors do not state the criteria by which they selected the 116 cases out of the
larger sample of 633. One needs some reassurance that the disclosure patterns of
this group were similar to that of the larger sample, assuming that the larger
sample also contained “confirmed” cases. Second, the children in this study were
selected from the private psychological practice of the two authors, and most had
been in therapy with Dr. Snow. Sorensen and Snow (1991) did not note how long
the children were in therapy or what type of therapeutic methods were used to
elicit these eventual disclosures, recantations, and re-disclosures. (For example, it
is unclear how forensically based these therapeutic interviews were, compared
with, say, the use of play therapy, empowerment enactments with dolls and props,
visualization exercises, or other techniques that have been shown to reduce a
child’s report accuracy.) This raises the issue that the reported patterns of
disclosure were consequences of the specific therapeutic practices (of the authors)
rather than of reflections of the manner in which children disclose abuse under
formal interviewing conditions. This raises the hypothesis that many of the
children in their sample may not have been abused (see Ceci & Bruck, 1995).
A glimpse of the authors’ clinical practices and cases can be gleaned from a
review of the social science and legal records. First, in 1990, Snow and Sorensen
(1990) published an article entitled “Ritualistic Child Abuse in a Neighborhood
Setting,” in which ritualistic abuse was defined as repetitive, bizarre sexual,
physical, and psychological abuse of children that included supernatural themes
and/or religious activities. Of the 575 cases of alleged child abuse in which the
authors served as therapists and/or evaluators between 1985 and 1988, 52 were
identified as ritualistic child abuse. Of the 52 children, 39 were allegedly abused
in a neighborhood setting. In a number of these cases, the children were first
brought in for therapy because of allegations of ritualistic abuse by a nonfamily
member; during the course of therapy, the children came to make the following
types of disclosures:
Cross-dressing, masks, and costumes (31%) included red and black robes, men’s
wearing of women’s erotic underwear and dresses, clowns and devil’s masks,
capes, and costumes such as a lion, bear, snake, witch, devil, Darth Vader,
vampires, skeleton, and leather loin cloths. The killing of children and infants was
identified by six children in four neighborhoods (15%). Thirteen percent of the
children said that they had participated in eating flesh. (Snow & Sorensen, 1990,
p. 483)
The disclosures resulted in trials and convictions of two adults. One of the
cases, State v. Hadfield (1990), was successfully appealed. In addition, five
adolescents from other neighborhoods were accused, three of whom were acquit-
ted, and two pleaded guilty.
There is a high probability that a number of the children classified as ritually
abused were included in Sorensen and Snow’s (1991) study, which sampled from
212 LONDON, BRUCK, CECI, AND SHUMAN
the same but slightly smaller population that was described in their 1990 study. In
addition, because the accused in their neighborhood cases either made pleas or
were convicted, these cases met criteria for substantiated cases of abuse.
The problem with the inclusion of these types of cases into studies of
disclosure patterns is that there is no evidence to support the once popular belief
that ritualistic sexual abuse is common (see Nathan & Snedekor, 1995, for
examples). Numerous authorities have failed to find any physical evidence to
support the many allegations that have been made and that were the basis of many
of the multivictim, multiperpetrator criminal trials of the 1980s and early 1990s
(e.g., Lanning, 1991). Furthermore, it appears that the large proportion of reported
cases of ritualistic abuse can be accounted for by the practices of a small minority
of clinicians (Bottoms, Shaver, & Goodman, 1996; Lanning, 1991). Because
Sorensen and Snow diagnosed so many “ritually abused” children in their prac-
tice, this, by inference, leads to the possibility that these children’s allegations
were a product of the practices and beliefs of these clinicians. This information
would undermine the reliability of the results of the Sorensen and Snow (1991)
disclosure study, rendering them scientifically doubtful.
Reviews of the court records for two trials in which patients of Snow testified
about allegations of sexual abuse provide support for the view that the children’s
allegations were associated with biased suggestive interviewing practices:
Defendant offered several witnesses at trial who described the suggestive and
coercive interviewing techniques allegedly utilized by Dr. Snow and one police
officer who described how the children in Dr. Snow’s care were able to reproduce
specific information after he had suggested to Dr. Snow that such information
should be presented in their statements. (State v. Hadfield, 1990, p. 508)
On the basis of Snow’s testimony in State v. Bullock (1989), one of the judges in
the case concluded,
Indeed, Dr. Snow herself admitted that she used interrogation procedures that were
not intended to sift truth from error. She forthrightly admitted she was not a neutral
interviewer; rather she was “an ally for the child”, “biased”, and not a fact collector
like the police. . . . She also testified in effect that there was nothing in her methods
that served as a standard for determining the truthfulness of the stories she
produced by her interrogation. . . . But since she starts an interrogation with the
assumption that abuse occurred, she then proceeds to prove that point. . . . In short,
any claim that scientific principles or Dr. Snow’s own expertise and experience
validated her conclusions and procedures is devastatingly refuted by her own
statement, “I didn’t believe any of those kids when they told me it didn’t happen.”
(State v. Bullock, 1989, p. 175)
Given the nature of the “validated” cases in the Sorensen and Snow (1991)
sample, as well as in the apparently biased and suggestive interviewing/therapeu-
tic techniques, the results of the study are uninterpretable. The patterns of
disclosure may merely be characteristic of children who come to make false
allegations as a result of suggestion. This would explain why these children
originally denied having been abused (because they were telling the truth), why
they eventually disclosed (because they were pressured into making allegations),
and why they recanted (they wanted to restate the truth).
213DISCLOSURE OF CHILD SEXUAL ABUSE
The Gonzalez et al. (1993) study suffers from many of the same problems.
These authors examined the disclosure and recantation patterns of 63 children in
therapy for sexual and ritualistic abuse in day care facilities. Gonzalez et al.’s
source of data was the therapists’ retrospective accounts of the behavior they
reportedly saw in their child patients. They found that within the first 4 weeks of
therapy, 76% of the children had made vague disclosures (“bad things had
happened”)
6
; that by 8 weeks, 45% of the children had disclosed highly specific
terrorizing acts (killing of adults, children, and animals); and that by 20 weeks,
43% of the children had reported aspects of ritualistic abuse (organized cults).
However, for the same reasons that apply to the Snow and Sorensen (1990)
article, the findings of this study are scientifically problematic. First, the children
in this study were from the McMartin Preschool case and other cases that arose
in the community at the same time. The allegations in this case, which involved
claims of ritualistic abuse, arose after multiple highly suggestive interviews with
evaluators and therapists (see Nathan & Snedekor, 1995). At the time of their
study, the children had been in therapy on average for over 1 year. There was no
physical or corroborative evidence of abuse, and the charges in these cases were
eventually all dropped. The interviewing methods used by the children’s thera-
pists and evaluators have been documented elsewhere (e.g., Garven, Wood,
Malpass, & Shaw, 1998), and the scientific evidence now shows that these
methods can produce erroneous reports when used in interviews with children.
Thus, the patterns of disclosures made by children in the Gonzalez et al. study
may represent those of children who make false disclosures as a result of
suggestive interviewing practices.
Finally, the results of the Bybee and Mowbray (1993) study may be open to
the same criticism as detailed above. The participants in this study were all
involved in a Michigan day care case that involved multiple perpetrators. The case
eventually resulted in only one conviction, which was overturned on appeal.
Compared with the other studies in Table 2, disclosure rates were quite low; of the
106 children, 58% disclosed abuse.
Representativeness of selected sample. In order to examine the rates of
disclosure among sexually abused children who are questioned about abuse, the
sample in question not only should have substantiated diagnoses of sexual abuse
but also should not be selected on the basis of their preinterview disclosure
patterns. For example, it would be meaningless to examine disclosure patterns in
a sample of children who were selected because they had already disclosed abuse;
the results of this type of study would merely indicate the consistency of
children’s responses across time. Similarly, one would not want to study disclo-
sure rates of children who were selected for study because they had previously
denied abuse. The results of the latter type of study would only address the issue
of the degree to which deniers disclose sexual abuse with repeated interviewing.
Three studies in Table 2 (Carnes, Nelson-Gardell, Wilson, & Orgassa, 2001;
Lawson & Chaffin, 1992; B. Wood et al., 1996) reported the disclosure rates of
6
We present a disclosure rate of 24% in Table 2 because it seems that 76% of the children
merely said that “bad things had happened,” thus not making any claims of abuse. But the denial rate
could be higher if the remaining 24% clearly denied any wrongdoing.
214 LONDON, BRUCK, CECI, AND SHUMAN
children who had not disclosed abuse during an initial interview. The Lawson and
Chaffin (1992) study is used to illustrate the point because this sample included
children with medical substantiations of sexual abuse; thus, the degree of abuse
certainty is high in this study. From a sample of over 800 children who tested
positive for a sexually transmitted disease (STD) at a large pediatric hospital,
cases that met the following criteria were selected: The presenting complaint was
solely physical; there was no prior disclosure or suspicion of abuse; the child was
older than 3 and premenarcheal. A sample of 28 girls met these criteria; their
mean age was 7 years, and most of the children were from minority households
without a father. These 28 children and their mothers were called back to the
hospital after they tested positive for an STD. During this interview, the mothers
were given the diagnosis for the first time and then were interviewed about sexual
abuse. Next, their daughters were interviewed by a trained social worker. Only
43% of the girls made an abuse disclosure during this initial interview.
7
This rate,
however, is based on a very different population than sampled in other studies, in
which children were brought in either because of a suspicion or disclosure of
abuse. Rather, in the Lawson and Chaffin study, children were selected because
of their medical history and because they had not disclosed abuse. Because it is
not known how many of the 800 children in the larger sample had already
disclosed abuse, this subgroup of 28 children with no prior disclosure might
compose an unusual sample; that is, they may represent the small hard core of
children who do not disclose abuse when directly asked. If they are a small
minority, then these results are not generalizable to the entire population of
children with STDs. In addition, it should be remembered that very few children
who have been sexually abused have any physical symptoms or STDs, and thus
this sample again is not representative of the CSA population. There is a second
factor that is important to consider. In this study, when the children were called
back to the hospital, their mothers were first informed of the STD diagnosis of
their children. Children whose mothers accepted the possibility of abuse (the
parents were labeled as supportive) were more likely to disclose (63% of this
group disclosed), compared with children whose parents were not supportive and
did not believe their child had been abused (only 17% of these children disclosed).
Elliott and Briere (1994) also found a similar pattern of higher disclosure rates for
children with supportive mothers. Among children who disclosed abuse in their
sample, 78% had supportive mothers, whereas only 40% of nondisclosers had
supportive mothers. Thus, differences among studies might reflect the role of
parental support, which might be quite low when parents are first confronted with
the fact that their children were abused, as was the case in the Lawson and Chaffin
study.
8
B. Wood et al. (1996) examined 55 videotaped interviews of children referred
7
In a follow-up study, Chaffin, Lawson, Selby, and Wherry (1997) located 5 of these 28
participants. Though not specifically asked about their children’s disclosure, four out of five mothers
spontaneously mentioned that the child disclosed CSA subsequent to this initial evaluation.
8
Although many mothers do not support their children’s disclosures of abuse, many are
supportive, especially if the defendant is an estranged husband or partner rather than a current one.
In many studies, the support rate is between 50% and 85% (see Lyon, 1999, notes 238 –239, for
details).
215DISCLOSURE OF CHILD SEXUAL ABUSE
by CPS to a multidisciplinary assessment center. All 55 children had been
interviewed previously by CPS or law enforcement officials and were included in
the study because they had not disclosed. Thus, the disclosure rate of 49% in
Table 2 is based on the percentage of children disclosing out of these 55 children
who had not previously disclosed during police or CPS interviews. Finally,
Carnes et al. (2001) reported that their sample of children undergoing extended
CSA assessment because of failure to initially disclose represented approximately
10%–15% of the total population presenting for assessment to the clinics in their
study. Thus, the results of this study, as well as the results of the B. Wood et al.
study, merely indicate the response patterns of children who had previously failed
to disclose abuse during an initial assessment. Furthermore, although this is not
the case for the Lawson and Chaffin (1992) study, there are no data on the number
of children in both the B. Wood et al. and the Carnes study who met acceptable
criteria for diagnosis of sexual abuse. Thus, children who did or did not disclose
with extra assessment may or may not have been abused.
Recantations. There are fewer studies on recantations than on denials or
disclosures of sexual abuse. All but one of eight studies that have examined this
issue (see Table 2, Column 5) also included information on disclosure rates. For
the one exception, Faller and Henry (2000) examined the recantation rates of
children who testified at trial about their sexual abuse. Thus, all these children had
made prior disclosures that were judged as credible by the prosecutors’ office.
Before reviewing the actual data of the studies, it is important to point out that
there could be two different interpretations of recantation. The first is that the
child is withdrawing a true statement of abuse. The second is that the child is
withdrawing a false allegation of abuse. The child’s underlying motivation for a
statement is unknowable in each study.
The recantation rates of the studies listed in Table 2 range from 4% to 27%.
Our analysis of the variability is very similar to that just carried out with respect
to the disclosure rates; namely, the highest rates of recantation are obtained for
studies that have the least certain diagnoses of sexual abuse. The two studies with
the highest recantation rates were those of Gonzalez et al. (1993) and Sorensen
and Snow (1991), in which the recantation rates were 27% and 22%, respectively.
Because of concerns about the actual abuse status of the children in these studies,
one might argue that these recantation rates reflect the number of children who
attempt to discredit their own previous false allegations by setting the record
straight.
9
(In the Gonzalez et al. [1993] and Sorensen and Snow [1991] studies,
these attempts appeared to have failed, however, as the authors of both studies
reported that most of the children reinstated their earlier accusations.)
The lowest rates of recantation are obtained from samples that have the most
certain diagnoses of sexual abuse (4%: Bradley & Wood, 1996; 6.5%: Faller &
Henry, 2000; 9%: Elliott & Briere, 1994). The slightly higher rate of 15% reported
by Gries et al. (1996) is difficult to interpret because there is no information on
the number of children who were diagnosed as clear or unclear cases of abuse.
9
There were also issues concerning the validity of the sexually abused sample in Bybee and
Mowbray (1993), who reported a much lower recantation rate of 11%. Thus, recantation rates do not
necessarily have to be high for doubtful cases.
216 LONDON, BRUCK, CECI, AND SHUMAN
Although our analysis shows that some children recant sexual abuse, the
results of this analysis show that recantation is uncommon among sexually abused
children. In fact, it shows just the opposite; that is, only a small percentage of
children in these studies recant.
Conclusions
We began this article by describing the popular view that sexually abused
children do not readily disclose their abuse and that even when they disclose, they
commonly recant such disclosures. Given how frequently these claims are made
in the literature (as well as in proffered expert testimony), we sought to examine
their scientific basis. A review of retrospective studies showed that most adults
with histories of CSA recall that they never told anyone about the abuse during
childhood. This pattern confirms the view that failure to disclose is common
among sexually abused children. However, these findings do not address the issue
of whether children will deny abuse or recant their disclosures when interviewed.
In order to examine these issues, it is necessary to study how sexually abused
children disclose abuse when asked directly. Because it is difficult if not impos-
sible to obtain accurate information if the first disclosure is made outside a formal
setting (e.g., to a parent, friend, or teacher), we have to rely on studies in which
children are questioned in formal investigative interviews. We identified 17
studies that contained relevant data and found that, when the analysis focused on
children with substantiated diagnoses of abuse and on children who have not been
subjected to the potentially suggestive techniques, most children do disclose abuse
within the first or second interview. Only a small minority of these children recant
their abuse reports. Even if analyses were broadened to include children with less
certain CSA diagnoses, in all but two studies, the majority of children disclosed
abuse when directly asked, and only a minority of them recanted their previous
disclosures.
One of the basic problems in interpreting the literature on children’s disclo-
sures of sexual abuse involves the issue of the validity of sexual abuse diagnosis.
As we stated above, in many of the cited studies, classification of abuse was often
based in part on children’s disclosures; consequently, the conclusion that abused
children do disclose abuse during formal interviews may be circular. However,
there is some evidence that shows that when children are classified as abused on
the basis of medical evidence or other nonchild factors (confession, material
evidence), most of these children do disclose abuse. For example, in the Elliott
and Briere (1994) study, there were 118 children involved in cases with external
evidence: 84% of these 118 children at one point disclosed abuse. In Dubowitz et
al. (1992), the finding that 83% of children disclosed abuse was based on the
calculation of the number of children with medical findings (but see Gordon &
Jaudes, 1996).
Although there are a number of studies to address issues of patterns of
disclosure, several overriding issues remain to be addressed. These issues focus
on the central theme of individual differences in rates of secrecy, denial, and
recantation. Specifically, although the data clearly demonstrate that most children
who are interviewed about sexual abuse do disclose and do not later recant, there
does exist a minority of children who fit the behavioral pattern that is put forth in
217DISCLOSURE OF CHILD SEXUAL ABUSE
the CSAAS model. The outstanding issues thus focus on the characteristics of
these children, and whether these children fit the psychological profiles of the
CSAAS model. For example, although Summit’s (1983) CSAAS model was
developed to explain why children may not disclose intrafamilial abuse, there are
few data on potential differences in disclosure patterns when the alleged abuse is
intrafamilial versus extrafamilial. Next, there needs to be a greater focus on
developmental differences in disclosure patterns. In many of the studies we
reviewed, children ranged in age from early preschool to late adolescence.
Clearly, it is not very informative to provide group means when age ranges are so
great. Studies are needed to examine potential developmental trends in loyalty to
family and peers, reactions to fear, need for privacy, choice of confidants, and
then to relate these factors to disclosure patterns in children of various ages.
Another important area concerns the potential role of threats, which plays a
central role in the CSAAS model. In this future research venture, it is crucial to
distinguish threats that were used to coerce the child into molestation from threats
that were used to secure the child’s silence. Finally, in most of the studies cited
in this article, there was little if any detailed information about how the children
were interviewed and the degree to which standardized and validated protocols
were used. In future studies, it would be important to compare the disclosure
patterns of children interviewed with current standardized interviews (e.g.,
Hunter, Yuille, & Harvey, 1990; Sternberg, Lamb, Esplin, Orbach, & Hershkow-
itz, 2002). If these protocols do in fact optimize the elicitation of reliable
statements from children, then the disclosure patterns produced by these instru-
ments would provide the most reliable data to test various hypotheses about the
disclosure patterns of sexually abused children and to explore the factors that
distinguish disclosers from nondisclosers.
The status of the scientific findings of disclosure patterns is of importance, not
only for diagnostic and assessment purposes but also for issues regarding the
interviewing of children. As mentioned above, the CSAAS has provided a basis
for experts to advocate that when children deny abuse when directly asked, then
they should be questioned further and even should be questioned suggestively
(e.g., Carnes, 2000; Faller & Toth, 1995; MacFarlane & Krebs, 1986). In order for
such practices to be empirically grounded, it is important to demonstrate first that
children will commonly deny abuse when questioned (thus calling forth the need
for special strategies), and, second, that the use of special strategies will lead to
accurate reports of abuse. The findings presented in this article address the first
issue only. The second issue has been addressed by a multitude of researchers in
the past decade (e.g., Ceci & Bruck, 1995; Ghetti & Goodman, 2001; Poole &
Lindsay, 2002; J. M. Wood & Garven, 2000). Professionals need to be aware that
although suggestive techniques may produce correct reports from otherwise silent
children, these same techniques, especially when used by biased interviewers,
entail a risk of producing false allegations (e.g., Bruck, Ceci, & Hembrooke,
2002; Poole & Lamb, 1998). Part of the bias may include the notion that when
children deny abuse, they must be pursued until they disclose their abuse;
however, as we demonstrated in this present article, the need for suggestive
interviewing is probably overestimated because denial of sexual abuse to profes-
sionals is not as rampant as previously suspected. Our analysis clearly shows that
218 LONDON, BRUCK, CECI, AND SHUMAN
when children who have been abused are questioned in formal settings, they will
usually tell, obviating the need for suggestive questioning strategies.
We have provided a host of studies that fail to support the view that children
who are sexually abused most commonly deny abuse and frequently recant
disclosures. Nonetheless, we find that the strong and unqualified assertions
regarding the frequency of denials and recantations continue and are supported by
the most scientifically problematic of the many studies we examined (e.g.,
Gonzalez et al., 1993; Sorensen & Snow, 1991). For example, in some recent
reviews of the literature, we find the following statements: “It is appropriate to tell
the jury that accommodation frequently occurs among abused children, in order to
disabuse the jury of misconceptions regarding about how children ought to
behave” (Lyon, 2002, p. 110); “A review of the research on CSAAS clearly
supports the conclusion that a substantial proportion of abused children exhibit
accommodation” (Lyon, 2002, p. 132)
10
; “Furthermore, research reveals that
disturbing numbers of children deny their sexual victimization even in the face of
compelling evidence to the contrary” (Paine & Hansen, 2002, p. 290); and
“Investigations of abuse have frequently been impeded when children fail to
disclose abuse, deny abuse that has occurred, or recant a prior disclosure” (Paine
& Hansen, 2002, p. 272).
Moreover, even when researchers themselves find low rates of denials or
recantations, they still maintain that these are consistent with the popular view.
For example, although Elliott and Briere (1994) found high rates of disclosure and
low rates of recantation, they concluded their article with the following: “Con-
sistent with Sorensen and Snow’s (1991) data, the present results suggest that
disclosing sexual abuse is more an ongoing process than a single event” (Elliott
& Briere, 1994, p. 274).
The courts have a long history of grappling with how to handle expert
testimony regarding characteristics of sexually abused children. In most cases,
when courts have permitted expert testimony concerning CSAAS, they have not
carefully scrutinized its scientific basis. Instead, they have relied on the unsub-
stantiated assurances of the proffering expert (as exemplified in the above quo-
tations) or the acceptance of CSAAS by other courts (e.g., State v. Edelman,
1999). As shown above, this reliance can result in experts providing incorrect
opinions. In recognizing that it makes no sense to accept that an assertion is
scientifically grounded “just because somebody with a diploma says it is so”
(United States v. Ingham, 1995, p. 226), Daubert v. Merrell Dow Pharmaceuti-
cals, Inc. (1993) and its progeny in the federal and state courts have directed trial
judges to assume the role of gatekeeper and, as such, to examine the relevance and
reliability of all proffers of expert testimony. In this role, trial judges are directed
to consider falsifiability, error rates, publication, peer review, and general accep-
tance. In other words, the expert testimony must “rest on a reliable foundation . . .”
(Daubert v. Merrell Dow Pharmaceuticals, Inc., 1993, p. 2799; see also General
Electric Co. v. Joiner, 1997). Daubert standards hold for scientific as well as
nonscientific experts (Kumho Tire Company Ltd. v. Carmichael, 1999).
10
See Lyon, 2002, p. 109, for Lyon’s operational definition of child sexual abuse
accommodation.
219DISCLOSURE OF CHILD SEXUAL ABUSE
According to these testimonial standards, the only component of the CSAAS
that has empirical support is that delay of abuse disclosure is very common.
However, the probative value of expert testimony on delayed disclosure, whether
for evidentiary or rehabilitative reasons, is undetermined; some evidence suggests
that knowledge about delay of disclosure is within the ken of the jury, perhaps
therefore obviating the need for expert evidence on the issue of delay. Gray (1993)
surveyed a sample of adults from the general public and a sample of jurors
regarding whether they agreed that delayed disclosure was common among
abused children ranging from 1 (strongly agree that delay is common)to6
(strongly disagree). They found that the general public had a mean rating of 2.3,
and jurors had a mean rating of 1.7, suggesting that laypeople tend to believe that
delayed disclosure is common. Presently, there is insufficient evidence to con-
clude whether expert testimony on delayed disclosure meets the Daubert standard
of possessing probative value for jurors.
The research on denial and recantation shows that when directly questioned
in a formal setting, only a small percentage of abused children demonstrate these
behaviors. In terms of Daubert’s concern with error rate, our review of the
literature revealed that there was high variability in specific behaviors across
studies and that in some cases, the reported rates were inaccurate, reflecting
methodological flaws of the study. In summary, there is no convincing evidence
that CSAAS testimony on denial or recantation provides relevant or reliable
assistance to the fact finder to assess allegations of CSA.
Our intention in writing this article was to examine the empirical basis of
professional and lay opinions about disclosure patterns of CSA. In so doing, we
found that, although there was much support for the silence/secrecy stage of the
accommodation syndrome, most of the evidence failed to provide empirical
support for the rest of the model. In order to clearly present these conclusions, it
was necessary to dissect the methodological sections of each study and to point
out major problems when these occurred. It was also our intent to provide the
readers with a host of other studies that provided relevant data that were not prone
to the same or as many methodological weaknesses. We believe that child abuse
professionals should be aware of this information and incorporate it into their
clinical practice as well as into their expert courtroom testimony. If the field is to
be guided by scientifically validated concepts, then this must be predicated on the
literature that comes closest to the standards of science.
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