EXPLAINING CONTROVERSIES OF CHILD SEXUAL ABUSE ACCOMMODATION SYNDROME (CSAAS) TO A JURY- DR. CHARLES HELLER, REBUTTAL EXPERT WITNESS

Child Sexual Abuse Accommodation Syndrome (CSAAS) is a framework developed by Dr. Roland C. Summit in 1983 to explain the behaviors and reactions of children who have experienced sexual abuse. He later regretted calling his idea a syndrome and said it should have been called a pattern (Summit, 1992). He posits that children often respond to sexual abuse in predictable ways, which can include secrecy, helplessness, entrapment, delayed disclosure, and retraction of allegations. CSAAS seeks to explain why some children may not immediately disclose abuse or may even recant their accusations later on. However, there has been much criticism of his work, with some referring to it as “junk science” that has been weaponized by prosecutors to convince a trial jury that if any of the elements of CSAAS are present, then the syndrome must be present and causally related to actual sexual abuse perpetrated against the accuser. Criticisms of Summit’s ideas point to the great variability in children’s responses to abuse. Additionally, the theory does not take into account the possibility that children can make false allegations for various reasons. In fact, the U.S. Supreme Court overturned a death penalty case (Kennedy v. Louisiana, 128 S. Ct. 2641-2008) citing problems with children’s testimony related to sexual abuse. It should be emphasized that CSAAS is not an official DSM-5 diagnostic term. In response to controversial uses of the theory, Dr. Summit later clarified that he never intended for CSAAS to diagnose child sexual abuse and should not be used as evidence of a defendant’s guilt. Summit (1992) stated, “It should be understood without apology that the CSAAS is a clinical opinion. not a scientific instrument” (p. 156). With these precautions in mind, let's review the elements of CSAAS.

The Stages of CSAAS

1. Secrecy: The child may keep the abuse a secret due to fear, shame, or confusion.
2. Helplessness: Children may feel powerless to stop the abuse, especially if the perpetrator is someone they trust or depend upon.
3. Entrapment and Accommodation: This stage suggests that children may comply with the abuser's demands to avoid further harm.
4. Delayed Disclosure: Many children do not immediately disclose abuse, often waiting until they feel safe or able to articulate their experiences.
5. Retraction or Recantation: In some cases, children may retract their allegations due to pressure, fear of consequences, or doubts about being believed.

Controversies Surrounding CSAAS

While CSAAS has been used in legal and psychological contexts to understand the complexities of child sexual abuse, it remains controversial for several reasons:

1. Generalization and Stereotyping: Critics argue that CSAAS can lead to stereotyping children's responses to abuse, potentially undermining the credibility of victims whose reactions do not fit this framework.
2. Impact on Reporting Rates: There is concern that overemphasis on CSAAS may deter victims from coming forward or receiving appropriate support if their reactions deviate from the expected theoretical stages.
3. Cultural and Contextual Variations: Responses to abuse can vary widely based on cultural norms, family dynamics, and individual personalities. CSAAS may not adequately account for these variations, potentially misinterpreting children's behaviors.
4. Research has not shown that children with true histories of sexual abuse manifest the disclosure patterns described in CSAAS: Researchers London, Bruck, Ceci & Shuman (2005) concluded, “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 recantations characterize the disclosure patterns of children with validated histories of sexual abuse,” [Abstract] page 194.

5. Misinterpretation and use of circular logic leading to bias against an accused in legal settings: There is a concern that prosecutors may use experts that describe CSAAS theory to explain child behaviors, implying the truth of allegations if behaviors like delayed accusation and other elements of CSAAS are present. This unscientific expert testimony suggests guilt based on fitting CSAAS criteria. In these cases, to provide fairness to the justice process, the defense utilizes a CSAAS rebuttal expert to explain its potential misuse.

Evolving Perspectives and Recommendations

In recent years, professionals have advocated for a more nuanced approach to understanding children's responses to sexual abuse. This includes:

• Trauma-Informed Care: Recognizing that each child's response to abuse is unique and influenced by their developmental stage, personality, and support systems.
• Multi-disciplinary Collaboration: Bringing together psychologists, social workers, medical professionals, and legal experts to provide comprehensive support to child victims without relying solely on CSAAS for interpretation.
• Education and Training: Increasing awareness among professionals and the public about diverse responses to abuse and the importance of believing and supporting children who disclose abuse, regardless of their reactions and at the same time exploring alternative hypotheses that could account for false allegations based on “secondary gain” (the numerous underlying motivations for making these false allegations).

Conclusion

Child Sexual Abuse Accommodation Syndrome has played a controversial role in shaping our understanding of how children may react to sexual abuse. It is not based on science and major problems with CSAAS exist. Most importantly, it was never developed to diagnose child sexual abuse or to imply guilt, yet it is often used by prosecutors and the experts they bring to court, as part of an inherently biased trial strategy against a defendant. In response to its use by prosecutors in criminal court, Summit (1992) stated, “Prosecutors saw the CSAAS as a potential offer of proof that an inconsistent victim is truthful” (p. 157).” Its application remains contentious due to its potential for oversimplification and misinterpretation in legal and therapeutic settings. Weiss & Alexander (2013) addressed the problem of inappropriate use of Summit’s work,

"The New Jersey Supreme Court ruled recently that statistical evidence about CSAAS implying the probability that a child is truthful runs the risk of confusing jury members and biasing them against the defendant. We review the parameters of expert testimony and its admissibility in this area, concluding that statistics about CSAAS should not be used to draw inferences about the victim’s credibility or the defendant’s guilt (Abstract, page 412)."

Moving forward, a balanced approach that acknowledges the diversity of children's responses to trauma is crucial for effectively supporting victims and holding perpetrators accountable. By promoting awareness, sensitivity, and informed practices, we can better serve the needs of child survivors and foster a culture of safety and trust. However, CSAAS is still considered very controversial for the reasons described above.  In a court situation, a forensic psychologist expert witness such as myself and other experts, testify as rebuttal witnesses for the defense to explain these controversial aspects of CSAAS. Ultimately there’s no scientific way to show if a child is accurately relaying real abuse or whether they are making it up absent any physical manifestation-it’s up to the trier of fact, the Judge and Jury. Different children respond differently to abuse.  Rebuttal testimony is extremely important in order to bring fairness and balance to trial by educating and increasing the awareness of a jury.

References:

London, K., Bruck, M., Ceci, S. J., & Shuman, D. W. (2005). Disclosure of child sexual abuse: What does the research tell us about the ways that children tell? Psychology, Public Policy, and Law, 11*(1), 194-226. https://doi.org/10.1037/1076-8971.11.1.194

Summit, R. C. (1983). The child sexual abuse accommodation syndrome. Child Abuse & Neglect, 7(2), 177-193. https://doi.org/10.1016/0145-2134(83)90070-4

Summit, R. C. (1993). Abuse of the Child Sexual Abuse Accommodation Syndrome. Journal of Child Sexual Abuse, 1(4), 153–164. https://doi.org/10.1300/J070v01n04_13

Weiss, K. J., & Alexander, J. C. (2013). Sex, lies, and statistics: Inferences from the child sexual abuse accommodation syndrome [Abstract]. Journal of the American Academy of Psychiatry and the Law, 41(3), 412-420. https://jaapl.org/content/41/3/412