TreeTop Child Advocacy Center logoChildren’s Advocacy Centers (CACs) play a significant role in the response to child abuse allegations. First developed in the 1980s, CACs are designed to reduce the stress on child abuse victims that can be created by traditional investigation and prosecution procedures, and to improve the effectiveness of the response.

Before CACs, child victims were subjected to multiple, redundant interviews about their abuse by different agencies, and were questioned by professionals without knowledge of children’s developmental limitations nor experience working with children. Child interviews possibly took place in settings like police stations, further stressing already frightened children.

Moreover, an effective response could be hampered if multiple agencies involved did not coordinate investigations, and the child’s need for services could be neglected. CACs aim to coordinate multidisciplinary teams (MDTs) in a centralized, child-friendly setting; employing forensic interviewers specially trained to work with children’ and assisting children and families in obtaining medical, therapeutic, and advocacy services.

The CAC movement is based on the belief that the response system should focus on the needs of the child, and is most effective when the skills of multiple agencies are coordinated. (1)

Children’s and Adolescents’ Brains are Different

Children’s cognitive and verbal abilities develop in stages as they mature. Questions must be related to a child’s knowledge base and reasoning ability, and answers must be interpreted according to the child’s stage of cognitive development. Children at different ages and developmental stages display a range of abilities to communicate and understand concepts such as concrete and abstract operations, linear time sequencing, awareness of self and others, source monitoring, and suggestibility, among others.

When children are questioned as if they were adults, misunderstanding and avoidable errors can undermine children’s credibility and contaminate their statements. Problems arise when questions are asked in language too complex for young children to comprehend, about concepts too abstract for them to understand. Children will try to answer questions they do not fully understand, and adults misinterpret the meaning of children’s responses. (2) Additionally, if an investigator is not completely comfortable talking about sexual abuse and body parts, that discomfort may reinforce the victim’s shame and embarrassment, further limiting disclosure.

Older Children and Teenagers

The brain’s prefrontal cortex, responsible for higher thinking, judgment and impulse control, matures last, in the early 20s — sometimes later in males. The lag between emotional and cognitive parts of the brain means young teens are prone to (mis)read emotion into interaction and to miss content. (3) Because the human brain undergoes radical changes in adolescence, it’s essential that alleged victims are able to be interviews by a specialist in child and adolescent forensic interviewing.

Many investigators may believe that teenage victims may be too “old” for a child advocacy center environment and choose to interview them at the local police department, school or other location. Environment is critical for victims of any age, and the environment provided by a child advocacy center greatly benefits all minors, increasing their comfort level and reducing anxiety. The judicial scrutiny given to forensic interviews often includes the potential influence, suggestiveness or possible coercive nature of the environment. (4)

The shock, shame and stigma attached to being a victim of crime make it difficult for even adults to report their victimization. Teens face many additional obstacles; they are more aware (than younger children) of potential consequences of reporting abuse; many fear no one will believe them; fear of being blamed or punished; have feelings of shame or self-blame; fear retaliation; believe nothing will be done; lack knowledge about available services; and have concerns about perceived and real limits of confidentiality. (5)

Medical Care & Evidence Collection

CACs are effective in increasing access to forensic medical examinations for child sexual abuse victims. Children seen at CACs were two times more likely to have forensic medical examinations than those seen at comparison communities. Non-penetration cases at CACs were four times more likely to receive exams as compared to those in comparison communities. (6)

Mental Health Services

Sexual Abuse victims are at high risk for emotional and behavioral problems, and CACs improve victim access to mental health services. CACs refer a higher proportion of victims to mental health services than comparison communities (72% vs. 31%). (7)

Satisfaction and Comfort for Children and Parents

Caregivers whose children were evaluated and interviewed at a CAC expressed more satisfaction with the investigation than those from comparison sites. (8)

Children are often moderately to highly stressed at interviews, sometimes presenting as silent, resistant, depressed, and/or avoidant. Emotional states divert attention, disorganize mental operations, or reduce successful memory retrieval, interfering with the memory process itself. The CAC staff and child-friendly environment are aimed at reducing a child’s anxiety, supporting their ability to function cognitively at an optimal level. (9)

A prolonged criminal court experience is another stressor for child abuse victims that can be detrimental to the child’s mental health. There is research indicating that cases seen at a CAC have a significantly quicker charging decision time than cases at comparison communities. (10)

  1. Cross et al. (Aug 2008) Evaluating Children’s Advocacy Centers’ Response to Child Sexual Abuse. Juvenile Justice Bulletin.
  2. Saywitz & Comparo. (1998) Interviewing Child Witnesses: A Developmental Perspective. Child Abuse & Neglect, 22, 8, pp 825-843.
  3. Shute. (2009) The Amazing Teen Brain; Science suggests ways to promote growth while preventing disaster. US News & World Report. 146, 1.
  4. Johnson. (Spring 2011) Talking with Teens… Really? Is that in my job description? ChildFirst. National Child Protection Training Center.
  5. Whitman et al. (2003) Reaching and Serving Teens Victims: A Practical Handbook. Office for Victims of Crime.
  6. Walsh et al. (2007) Which sexual abuse victims receive a forensic medical examination? The impact of Children’s Advocacy Centers. Child Abuse and Neglect, 31, pp 1031-1068.
  7. Cross et al. (Aug 2008) Evaluating Children’s Advocacy Centers’ Response to Child Sexual Abuse. Juvenile Justice Bulletin.
  8. Jones et al. (2007) Do Children’s Advocacy Centers improve families experiences of child sexual abuse investigations? Child Abuse & Neglect, 31, pp 1069-1085.
  9. Saywitz & Comparo. (1998) Interviewing Child Witnesses: A Developmental Perspective. Child Abuse & Neglect, 22, 8, pp 825-843.
  10. Walsh et al. (2008) Home Long to Prosecute Child Sexual Abuse for a Community Using a Children’s Advocacy Center and Two Comparison Communities? Child Maltreatment, 13, 3.