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Guidelines
by
American Academy of
Child and Adolescent Psychiatry


         
                                                                                



The American Academy of Child and Adolescent Psychiatry has prepared a standard set of guidelines that sets forth the elements which in AACAP's view must be part of an evaluation in order to ensure maximum reliability.

If conclusions are drawn on the basis of inadequate or insufficient information, children might be harmed, parent-child relationships might be seriously damaged, and these cases might be contaminated to the point that courts and other professionals would have great difficulty sorting out what did or did not occur.

Persons doing evaluations must be professionals with special skills and experience in child and adolescent sexual abuse and trained in diagnostic evaluation of both children and adults.  And ideally evaluations should be performed under the direction of an experienced child and adolescent psychiatrist or psychologist.

The child should be seen for the minimum number of times necessary and by the fewest number of people necessary.

Gathering a history on the child or adolescent from parents or caregivers is an important part of the evaluation and should include developmental history, cognitive assessment, history of prior abuse or other traumas, relevant medical history, behavioral changes, history of the parents abuse as children, and the families attitudes toward sex and modesty, prior psychiatric disorders in the child or parents, impressions of the child's credibility, and allegiances to respective parents are also relevant.

Part of that information should be obtained by interviewing both parents.  It is important to obtain a history from the perspective of each parent.  The clinician needs to be able to consider all sides of the story and any other stresses besides sexual abuse that could account for the child's symptoms.

Sufficient time should be spent with each parent alone.  This should include a psychiatric assessment of each parent especially if there is concern that the allegations may be false or when a parent was abused as a child.

A guardian ad litem for the child should be appointed to represent the child's best interests, preventing the parents from subjecting the child to multiple evaluations in the hope of finding an expert who will support one or another's contentions.

The possibility of false allegations needs to be considered particularly if allegations are coming from the parent rather than the child, if parents are engaged in a dispute over custody or visitation, and/or if the child is a preschooler.

Under such circumstances the clinician should consider observing the child separately with each parent.  Before these observations, the clinician should meet alone with the child to establish trust and ensure that the child will feel some degree of control over the interview with the alleged offender.

False allegations may arise in other situations as well, such as the misinterpretation of a child's statement or behavior by relatives or caretakers.