Introduction 1 Improving Training at the Undergraduate and Graduate Level 5



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The View from the Trenches

Table of Contents



Introduction 1

Improving Training at the Undergraduate and Graduate Level 5
Undergraduate Reforms 10
Seminaries 13
Law Schools 13
Medical Schools 15

Improving Training in the Field 17
Minimal Initial and Ongoing Training Standards 20
Emphasis on Experiential Learning 22
Training Facility 22
Training Portal 23
Unique Needs 24
Next Steps 24

Improving the Collection of Evidence 25
Increase the Collection of Evidence 29
Conduct Forensic Interviews within Two Hours 31
Solicitors Should Increase their Role 33

Resolving Cases More Quickly 34
CSA Cases should come to trial within 6 months 36

Improving the ARS System 37
Public Policy Makers Must Engage in the Debate 49
Review of ARS Cases and Screening Instruments by the MDT 49

Developing Partnerships Between Faith and Child Protection Communities 54
Training at the Seminary Level 62
Mandated Reporter Training for Churches 65
MDT and Faith Leader Collaboration 66
Implement “Chaplains for Children” within One Year 67
Implement “Chaplains for Child Protection Professionals” within Three Years 68
Replication of the HALOS Program 69

Improving the Mandated Reporting System in South Carolina 71
MDTs Must Increase Community Awareness of MR Training 77
MDTs Should Target Faith Communities for MR Training 77
Implement a “Two Plus Ten” Plan 78
Parents Should Raise their Voices 79
Prosecute Egregious Cases of Failure to Report 80

Expanding Prevention Initiatives in South Carolina 81
Prevention Resource Guide 82
Prevention Planning 83
Prevention Scouting 84
Color South Carolina Blue 85

Improving South Carolina’s Juvenile Sex Offender Registry 85
Recommendations 88

Reducing Vicarious Trauma 90
MDTs Should Have a Written Plan to Address Vicarious Trauma 91

Silent Tears Task Force Must Continue 97

Conclusion 97

Exhibit A: Onsite Survey Instrument 100

Exhibit B: Silent Tears Survey Analysis 111

Exhibit C: Silent Tears Speedy Trial 141

Exhibit D: Chaplains for Children 241

Exhibit E: CVs 252

The View from the Trenches:

Recommendations for Improving South Carolina’s Response to Child Sexual Abuse Based on Insights from Frontline Child Protection Professionals

“It’s not hearing the kids’ stories that kill you,

[it is] coming in every day and deciding which kids I can’t help.”

--South Carolina Law Enforcement Officer1



Introduction

The National Child Protection Training Center (NCPTC) has worked with child protection professionals from South Carolina in myriad capacities over the past ten years. For instance, we worked with the Children’s Law Center at the University of South Carolina and the Assessment and Resource Center (ARC) in Columbia in developing the very first ChildFirst2 forensic interview training program—a model that has been replicated in eighteen states and two countries.3 We also worked with the University of South Carolina Upstate and area child protection professionals in implementing an intensive undergraduate child protection minor entitled “Child Advocacy Studies” or CAST. We have worked with many South Carolina children’s advocacy centers (CACs) in providing training and otherwise collaborating to meet the needs of maltreated children. From these and other experiences, we have come to realize the extraordinary heart and dedication of South Carolina child protection professionals.

Perhaps the greatest example of the heart of these child protection professionals is the Silent Tears project. Two years ago, community leaders and child protection professionals from South Carolina approached NCPTC about conducting a large-scale study of the response of South Carolina professionals to cases of child sexual abuse (CSA) and to make recommendations for improving the system. In the ensuing months, it became clear to NCPTC that hundreds of child protection professionals were eager to assess the state’s strengths and weaknesses and to move to an even higher level in protecting children. It was clear from the outset that these professionals had something to say—and they wanted a vehicle in which to express their hopes for the children for whom they labor.

To this end, NCPTC implemented a five stage process for evaluating South Carolina’s response to instances of child sexual abuse. In the first stage, we held in person meetings in Columbia, Spartanburg, and Greenville with various child protection leaders to discuss the scope of the project and to receive their input. We also had a conference call with leaders assembled in Charleston.

In the second stage, we surveyed all of the CACs in South Carolina to help us select seven counties that would be representative of the state as a whole. With this input, we selected the following counties:


  1. Greenville (population 451,225) (CAC in county)

  2. Aiken (population 162,099) (CAC in county)

  3. Spartanburg (population 284,307) (CAC in county)

  4. Richland (population 384,504) (CAC in County)

  5. Charleston (population 350,209) (CAC in county)

  6. Dillon (population 32,062) (served by Florence CAC)

  7. Allendale (population 10,419) (served by Beaufort CAC)

In selecting these counties, NCPTC attempted to include both urban and rural communities and counties from each region of the state.

In the third stage, NCPTC worked with the CACs located in or serving the seven counties to assist in identifying local child protection professionals and assisting us in arranging for onsite interviews. As a result of the leadership of these CACs, we were able to arrange onsite interviews with 166 front line solicitors, child protection workers, law enforcement officers, doctors, nurses, victim advocates, sex offender treatment providers and other professionals who work directly with sexually abused children.

In the fourth stage, NCPTC selected three teams4 that would spend a total of six weeks in the selected counties conducting literally hundreds of hours of interviews with front line professionals. To increase the chance for candor, we agreed not to record the interviews and to keep confidential the names of those interviewed. However, two NCPTC employees were taking detailed notes during each interview and these notes were cross-compared to ensure accuracy. When completed, the final type written notes exceeded 1,000 pages.

In conducting the interviews, NCPTC employees used a survey instrument consisting of 90 questions divided into 21 categories that would aid in determining the background of the interviewee and his or her thoughts on South Carolina’s mandated reporting system, the local multi-disciplinary team (MDT) response to cases of child sexual abuse, the collection of physical evidence, the handling of cases involving juvenile offenders, the delivery of services to victims, the effectiveness of South Carolina’s appropriate response system (ARS), the length of time it takes to get to trial, and the role of faith in responding to abuse.

The professionals interviewed were asked to respond only to the questions they felt they had enough knowledge to speak substantively. Accordingly, none of the 166 professionals interviewed answered all the questions. The instrument used in the on-site questioning is included in this report as Exhibit A.

In the fifth stage, the Metropolitan Studies Institute (MSI) at the University of South Carolina Upstate reviewed the notes of all the team interviews and developed an online survey that would assist the team in determining if the information gathered in the onsite interviews was representative of the state as a whole. The survey was online for several weeks in March and April of 2013 and was taken by 404 respondents. Once completed, MSI prepared a “Silent Tears Survey Analysis” report. This report is attached as Exhibit B.



Themes Emerging from the interviews and surveys

In both the onsite interviews and the online surveys, a number of themes were repeated across disciplines and geographical location. These themes included inadequate training at the undergraduate and graduate level, a lack of “experiential training” in the field, the length of time it takes for a child sexual abuse case to come to trial, the lack of corroborating evidence and confessions, and both the positive and negative roles of faith in responding to CSA cases.

In South Carolina, there is broad consensus supporting the efficacy of children’s advocacy centers and the importance of responding to CSA cases as part of a multi-disciplinary team (MDT). There is strong support for the state’s forensic interview training program, and a clear recognition that forensic interviews played before jurors increase the chance for a conviction.

There are also areas in which the child protection professionals we queried were divided. We found mixed reviews on the state’s mandated reporting system and the willingness of at least some professionals to report. The greatest divide, though, occurs when asking South Carolina’s child protection professionals for their views of the state’s Appropriate Response System (ARS). Generally speaking, the Department of Social Services (DSS) is strongly supportive of the emerging system while many in the criminal justice field expressed strong reservations and even outright hostility to the program.

These and other themes, as well as our recommendations, are detailed below.

Improving training at the undergraduate and graduate level

In the 166 field interviews, the vast majority of respondents indicated very little undergraduate or graduate training on child sexual abuse. In fact, most respondents indicated they had no training on CSA cases before entering the field. For example, one law enforcement officer told us he had “no college training on child sexual abuse cases” and no training at the police academy. Indeed, the officer told us the “the academy didn’t really talk about children at all.”

A sheriff’s deputy with a bachelor’s degree in criminal justice told us he has handled more than 600 CSA cases in his career but his entire training was “on the job.” Similar sentiments were expressed by child protection professionals with graduate degrees. When asked about law school training on CSA, a solicitor told us he received “none.” A pediatrician told us there were a “couple of lectures in medical school” and in her residency training on child abuse but her formal schooling on the subject could best be described as “very little.”

The results of the online survey echo the onsite interviews. Although 85% of the respondents had a bachelor’s degree or higher, only 16% had “some” undergraduate training on CSA cases and only 17% had “some” graduate training.5 Although the online survey did not ask if the training received was adequate, the onsite interviewers did ask this of the professionals we spoke to and nearly all of the professionals said the training they received was insufficient.



Inadequate undergraduate and graduate training is the national norm

These findings are not unique to South Carolina. There is a significant and growing body of research documenting that judges, prosecutors, child protection attorneys, doctors, nurses, psychologists, social workers, law enforcement officers, clergy, teachers, and other child protection professionals or mandated reporters are inadequately trained at the undergraduate and graduate level.6

In a 2006 study, Winona State University analyzed the web sites of 1,416 universities and colleges. These universities offered baccalaureate degrees in criminal justice/law enforcement (393), social work (340), human services (113), nursing (390), medicine (96), psychology (794), sociology (639), and education (105). WSU professors searched these sites using the terms “child maltreatment,” “child abuse and neglect,” “child protection,” “child welfare,” and “child advocacy.” Only 29% (410) of these web sites had any course work addressing issues of child maltreatment. Moreover, when course work was offered, it was typically in fields of sociology or psychology—thus leaving the vast majority of child protection professionals with no training at the undergraduate level.7

Even when universities had some undergraduate coursework on child maltreatment, the coverage was often cursory. Indeed, not one of the 1,416 universities analyzed had a concentration, much less a minor on child maltreatment.8 This research echoes findings by other researchers and commentators.


Reporter Anna Quindlen describes a child protection worker’s obstacles as follows:

Their training is inadequate, and the number of workers is too small for the number of families in trouble. Some of the cases would require a battalion of cops, doctors, and social workers to handle; instead there are two kids fresh out of college with good intentions and a handful of forms.9

Commenting on his lack of training, social worker Marc Parent said he received “two weeks of solemn discussion on child protective issues, but little on getting a drug dealer to let you into an abandoned building or talking a restless police officer into sticking around until you get through with a case and back into your car.”10

The problem extends to graduate schools as well. A study of American Psychological Association (APA) accredited graduate programs found that many of the programs “fall far short” of guidelines proposed by the APA for minimal levels of competence in handling child maltreatment cases.11 The study finds the lack of graduate training for psychology students “contradicts the rapidly expanding literature on responding to maltreatment and the demands of this interdisciplinary, professional endeavor.”12

Discussing her educational background, psychologist Anna Salter writes:

In the two years I spent at Tufts getting a Masters degree in Child Study and the five years I spent at Harvard getting a Ph.D. in Psychology and Public Practice, there was virtually nothing on child sexual and physical abuse in any course I took. I had one lecture on the victims of child abuse, but not a single lecture anywhere on offenders. Ironically, many of the lectures were on maladies so rare I’ve yet to see them in twenty years of practice.13
The training provided to medical professionals is similarly inadequate. When it comes to medical schools, the reality is that “more than 40 years after the diagnosis of battered child syndrome entered the literature, our pediatric residency programs do not have a significant education requirement for preventing, recognizing, or managing child abuse.”14 As a result, egregious errors occur. In one study, for example, researchers found that 31% of abusive head trauma cases were not recognized by the physicians who first evaluated these victims.15

In a study published last year, researchers concluded the ability of medical professionals to “correctly identify genital and anal findings and interpret medical findings” in possible instances of child sexual abuse was “significantly associated” with “(t)raining, discipline, and clinical experience….”16 In a national survey of pediatricians, researchers found “(t)hose who had received some child abuse” training in the field “expressed more confidence in their ability to identify and manage child abuse.”17 However, 22% of the pediatricians who had received field training did not feel adequately trained.18 The researchers concluded “(g)reat variability in self-reported training and experience were noted in the current study, suggesting these variations may be partially responsible for previously observed problems in identification and reporting of child abuse” from pediatricians.19



U.S. Attorney General’s Task Force Recommendations for undergraduate/graduate reform

The United States Attorney General’s Task Force on Children Exposed to Violence has recognized the need to improve undergraduate and graduate training in this area and has called for a “national initiative to promote professional education and training on the issue of children exposed to violence.”20 The task force specifically urges academic institutions to “include curricula in all university undergraduate and graduate programs to ensure that every child and family serving professional receives training in multiple evidence-based methods for identifying and screening children for exposure to violence.”21 The Attorney General’s Task Force included sexual abuse of children in its definition of violence.22



Addressing inadequate undergraduate and graduate training in South Carolina

South Carolina is one of at least fifteen states making meaningful progress in improving undergraduate and graduate training of future child protection professionals. The University of South Carolina Upstate has implemented an intensive, inter-disciplinary twenty-one credit minor entitled Child Advocacy Studies or CAST. The minor provides practical, experiential training for students studying social work, criminal justice, psychology, nursing or other disciplines likely to encounter child abuse cases. Preliminary research on CAST is positive with students more likely to recognize instances of abuse and respond appropriately and thoroughly.23

Although not exclusively focused on child abuse, the University of South Carolina Law School has implemented a course entitled Children and the Law that directly addresses a number of issues related to child abuse. We applaud and urge the expansion of reforms of this kind.

At the same time, there is more to do. In the summer of 2012, NCPTC reviewed the course catalogues of 45 South Carolina colleges and universities and could find little evidence of courses, much less concentrations in responding to cases of child maltreatment.



Recommendations

Reflecting the concerns of the nearly 600 South Carolina child protection professionals who participated in this study, as well as the numerous other studies on this issue, we have three recommendations.



  1. All universities and colleges in South Carolina should scrutinize existing curricula on child maltreatment and, if need be, implement undergraduate and graduate reforms

  1. Undergraduate reforms

In 2003, Winona State University (WSU) received funding from the United States Department of Justice to develop an inter-disciplinary child protection minor to better prepare future social workers, law enforcement officers, mental health professionals, and nurses to respond to instances of child abuse. WSU contracted with the National District Attorneys Association to create the National Child Protection Training Center (NCPTC), a national entity that would assist in developing the curriculum and disseminating it to other interested universities.

In developing the curriculum, WSU and NCPTC examined 56 child protection training programs developed through federal funds to ascertain what content is being taught in the field that could be taught in the undergraduate level. The committee also worked from a curriculum outline originally published in the Journal of Aggression, Maltreatment and Trauma.24

Once developed, the minor was reviewed by panels of front line professionals as a check on the suitability of the training to prepare a student for work in the field of child protection.25 The curriculum, entitled Child Advocacy Studies (CAST) has now been implemented at twenty-four colleges or universities26 in fifteen different states with some universities implementing the curriculum as a certificate, minor, major or even graduate program.27 Preliminary research on CAST is promising.28

The University of South Carolina Upstate is one the universities that has adopted the CAST minor and at least one other South Carolina university has attended the annual CAST conference to learn more about the curriculum.29

Although other institutions may choose a curriculum other than CAST, all institutions of higher education must assess their current courses (if any) on child abuse and make necessary reforms. At a minimum, though, there must be inter-disciplinary training of future child protection professionals that adequately, if not fully prepares them to work with families impacted by child sexual abuse and other forms of trauma. Undergraduate institutions may wish to go beyond the twenty-one credit hours offered at USC-Upstate but they should not go below this standard.

Although NCPTC’s long standing work in implementing this reform may pre-dispose us to making this recommendation, other organizations have also recognized the need for this reform. In addition to the United States Attorney General’s Task force on Children Exposed to Violence, the Academy on Violence and Abuse has said that a requirement for “institutional competence” in this area is to “adopt an interdisciplinary approach to (training on) violence and abuse.”30



  1. Law schools, medical schools and seminaries should develop or expand child protection curricula

Given the low percentage of South Carolina child protection professionals claiming any child sexual abuse training at the graduate level, and the small numbers reporting the training received was adequate, we urge all graduate institutions to examine their existing curricula and consider making improvements.

  1. Seminaries

We recommend that seminaries provide a minimum of ten hours on child abuse training. The specific content of this training is detailed later in this report.31

  1. Law schools

As noted earlier, the USC law school offers a two credit course entitled “Children and the Courts” that addresses “issues related to children in the courts, with particular attention to children who are in criminal or family court as witnesses (including as victims of abuse and neglect) and to children who are in family court as delinquents. Specific issues covered will include an overview of legal systems, the role of counsel in representing children, evidentiary rules, and systemic issues involving children and the courts.”32

The law school also offers an externship in which students work 6-8 hours a week on child welfare and juvenile matters in family court as well as a Child Advocacy Law Clinic in which students, under supervision, handle child protection cases for the Department of Social Services

The Charleston School of Law also has a course entitled “Children and the Law” which “explores the shifting and balancing relationship between the State, parents, and children while also examining dependency and delinquency issues facing children, their parents, and the State. Particular attention is paid to South Carolina law.”33

We applaud these and other efforts by South Carolina’s law schools to prepare students for child protection careers. We also encourage graduates of South Carolina law schools to be proactive in communicating what additional information, if any, would have better prepared them for their work. Should the schools determine a need to expand their course offerings related to child maltreatment there are at least three options.

First, explore the value of a course focused exclusively on child abuse that is specifically designed for students interested in a career as a child abuse prosecutor or child protection attorney. Some schools have taken this route and there are existing curricula which may be worth considering. Even if a course devoted exclusively to child abuse is not feasible, there may be topics taught at other law schools worthy of inclusion in South Carolina’s schools as well.34

Second, if this is not done already, law schools may wish to incorporate child abuse topics into courses on ethics, criminal law, criminal procedure, constitutional law, family law, evidence and other subjects which have a direct bearing on child maltreatment cases. In this way, all students, even those who do not take a course on children and the law will have some exposure to the issue.

Third, schools may want to survey interest among South Carolina solicitors for an LLM in child protection law. If there is an interest in such a program, law schools may want to work with interested solicitors and child protection attorneys in developing and implementing the program. In order to be accessible to professionals in the field, the LLM should be offered on weekends or online. At least one law school in the United States is pursuing such a program.35


  1. Medical Schools

The Council on Medical Student Education in Pediatrics (COMSEP) suggests the following competencies for medical students in the area of child abuse:

  • list characteristics of the history and physical examination that should trigger concern for possible physical, sexual, and psychological abuse and neglect such as inconsistency in the history, unexplained delays in seeking care, injuries with specific patterns or distributions on the body, or injuries incompatible with the child's development;

  • describe the medical-legal importance of a full, detailed, carefully documented history and physical examination in the evaluation of child abuse;

  • discuss the concurrence of domestic violence and child abuse and describe markers that suggest the occurrence of family violence;

  • describe the unique communication skills required to work with families around issues of maltreatment;

  • summarize the responsibilities of the "mandatory reporter" to identify and report suspected child abuse; and know to whom a child abuse report should be made.36

Although these standards provide important guidance on what medical education in maltreatment should address, such training remains scarce and inconsistent. According to a survey of medical students and deans, 21% of medical students had no instruction on child abuse, and the median amount of child abuse instruction during medical training was just two hours.37 When medical school training does take place, it is often a single offering, separated from the medical curriculum, rather than a coordinated, multifaceted, multidisciplinary approach.38

To address this issue, the University of Toledo College of Medicine and Life Sciences has implemented a nine month medical school curriculum on child maltreatment. The course is taught by a multi-disciplinary group of child protection professionals and addresses prevention, identification, reporting and responding to all forms of child and adolescent maltreatment. When compared to students not taking the elective, the medical school students completing the child maltreatment course were “significantly more prepared” to:



  • identify signs of maltreatment;

  • report a case of suspected maltreatment (even if they were not 100% certain abuse occurred);

  • recommend or secure services for a maltreated child or adolescent; and

  • demonstrate improved knowledge in the areas of maltreatment identification and reporting.39

Although the medical school curriculum at the University of Toledo may not be optimal, we believe it represents a minimal standard all medical schools should meet.

  1. Child protection employers should actively recruit candidates with adequate undergraduate and graduate training

Many of the front line professionals who spoke to us about inadequate training at the undergraduate and graduate level are also in supervisory positions or otherwise play a role in hiring child protection professionals. To the extent these professionals believe undergraduate and graduate training on child sexual abuse is important, they should actively seek candidates who have graduated from institutions that provide this training. As more academic institutions move in this direction, finding suitable candidates will become easier. In the meantime, all advertisements for open jobs should express a strong preference for students who have been trained in the core competencies required for the field of child protection. In doing this, these agencies will assist academic institutions in understanding that reform is necessary if their graduates hope to obtain jobs in the field of child protection. There is some indication this may already be happening in South Carolina, with many of the graduates of the CAST program at USC Upstate quickly finding jobs in the child protection field or admission to MSW programs.40

Improving Training in the Field

Nearly all of the 166 child protection professionals interviewed onsite indicated they had received training on child sexual abuse cases once in the field. However, the professionals had numerous suggestions for additional training for themselves or other team members. A consistent theme from these interviews was the preference for “hands on” training in which skills are not simply presented in a lecture but the students are required to conduct mock forensic interviews, suspect interrogations, crime scene investigations, or mock trials. Although training of this nature is available in South Carolina—such as the state’s ChildFirst forensic interview training program—there is a clear desire for more experiential learning opportunities.

In the online survey, a majority of solicitors, law enforcement officers and clinicians/therapists noted at least some barriers to receiving ongoing training including lack of funding, lack of time and, in some instances, the unavailability of training.41 Although 64% of DSS workers noted “no barriers” to accessing ongoing training, only 37% considered themselves sufficiently trained to work with victims of child sexual abuse.42 Sixty-one percent of DSS workers who took the survey received no undergraduate or graduate training on child sexual abuse and 18% had not received any training on child sexual abuse once in the field.43 Only 31% of DSS respondents have received training through the South Carolina’s ChildFirst forensic interview training program, a number that is considerably lower than the percentage of attendees from law enforcement (46%) and clinicians/therapists (41%).44

The impact of inadequate training generally—what other studies suggest

A number of studies illustrate the danger of inadequate training of child protection professionals at the undergraduate or graduate level or once these professionals are in the field. The greatest danger, of course, is that clear instances of abuse will be missed or that important evidence will not be collected.

According to the Fourth National Incidence Study of Child Abuse and Neglect (NIS-4), a large percentage of maltreated children identified by mandated reporting professionals did not receive child protection investigation.45 Specifically, only 50% of the nation’s identified abused children received a child protection investigation and only 30% of the children suffering “serious harm” received child protection investigation.46 The NIS-4 researchers labeled “serious harm” cases as those child abuse or neglect cases in which “an act or omission result in demonstrable harm.”47

The NIS-4 data are summarized in the following graph taken from the report to congress:



This is not a recent or isolated finding but, rather, a finding that has been found repeatedly over a period of decades. Indeed, researchers note “Throughout its history, the NIS has consistently found that child protective services agencies (CPS) investigate maltreatment of only a minority of the children the NIS identifies.”48

Although the NIS research is broader than simply inadequate training, other studies highlight the danger of limited training and experience. For example, a recent study of medical professionals found that “training, discipline and clinical experience were significantly associated with the ability to correctly identify medical findings and apply medical knowledge to correctly interpret findings” in cases of possible sexual abuse.49

In 1996, Richard Gelles, a pioneer in the field of child protection, wrote “If the current child welfare system is to be improved it will require three things: (1) training, (2) training, and (3) training.”50 More than twenty years later, national child protection experts continue to echo this refrain.51



Recommendations for improving training in South Carolina

Improving training in South Carolina may be as simple as developing minimal training standards on child sexual abuse, emphasizing experiential training, locating or developing facilities ideal for hands on training, and developing cross-jurisdictional resources to free up professionals for training. These suggestions are explored more fully below.



  1. Minimal initial and ongoing training standards.

The National Children’s Alliance has minimal training standards for forensic interviewers working in accredited CACs. These standards include at least 40 hours of initial training as well as ongoing training in the field of child abuse. We believe these standards should apply to each member of the MDT including law enforcement, DSS, and solicitors assigned to prosecute child sexual abuse cases. Specifically, we recommend a minimum of 40 hours of training on child sexual abuse that includes child development, the dynamics present in most CSA cases, and the process of disclosure. This standard can be easily met by attending the state’s ChildFirst forensic interview training course or any number of trainings offered by professionals in the state. Indeed, of the professionals taking the online survey, 46% of the law enforcement officers, 31% of DSS workers, and 41% of the clinicians have already taken this course—with 82% of the law enforcement officers, 73% of the DSS workers, and 74% of the clinicians rating the investigative protocol taught at the course as a 4 or 5 out of scale of 1-5 (five being the highest).52

We also recommend core MDT members receive a minimum of 10 hours of additional training each year on child abuse cases. With the proliferation of high quality online child protection training initiatives,53 this standard can be met with little or no additional expense to the MDT. This is simply a matter of educating MDTs about the availability of the training and for MDT supervisors to require a minimal base of ongoing training.



The critical importance of ongoing training on child sexual abuse was reflected in the comments of many of the front line professionals with whom we spoke. One law enforcement officer told us “these cases are worse than murder. When you’re dead you’re dead. These children die a little every day. You should have to work your ass off to be a child abuse investigator just like a homicide detective.” Accordingly, this officer suggested that any child abuse detective be required to have 40 hours of training in forensic interviewing and specific training on child abuse crime scene investigation, corroborating evidence, and interrogation of sex offenders. One solicitor told us he had observed a direct correlation between the level of training of various officers and the amount of corroborating evidence obtained and percentage of offenders from whom they received confessions or incriminating statements. One of the better trained officers we interviewed told us she had some corroborating evidence in 100% of the cases she worked and obtained incriminating statements from offenders in over 60% of the child sexual abuse cases she worked.

  1. Emphasis on experiential learning

Many of the professionals interviewed expressed a strong desire for hands on training courses such as mock trials, mock crime scene investigations, or mock forensic interviews. As one law enforcement officer told us “I don’t need any more PowerPoint presentations—I don’t remember what’s on the slides. I need trench training.” According to this officer, “trench training” is experiential learning in which the MDT is processing a mock crime scene, testifying in a mock trial, conducting mock forensic interviews or suspect interrogations. To this end, every institution in South Carolina providing training to child protection professionals, and every department or supervisor sending staff to training should emphasize experiential training as the first resort. Only when “trench training” is unavailable, should traditional lecture training be considered.

  1. A training facility

Trench training is best conducted in mock houses, courtrooms or forensic interview rooms that enable participants to practice skills or techniques. Accordingly, child protection professionals may want to combine resources and work with public and private funders to develop a state child protection training facility ideal for experiential learning. In the meantime, law schools, police academies and other institutions may have mock courtrooms, houses or other facilities available for trial advocacy or other laboratory training environments. We suggest that South Carolina child protection professionals have available to them at least 15 “hands on” child abuse courses of 2.5 to five days that are offered annually.

  1. Training portal

There are some basic child abuse workshops every solicitor, law enforcement officer, DSS worker, forensic interviewer and other members of the MDT should take and that do not change very much, if at all, over the years. For example, every child abuse solicitor needs to know how to cross examine a suspect in a child sexual abuse case, how to prepare a child for court, and how to give an effective closing argument. Every law enforcement officer needs to know how to search for and collect corroborating evidence and to interrogate a suspected sex offender. Rather than offer these workshops sporadically as part of state or regional conferences, South Carolina should have a training portal that can be accessed 24 hours a day, seven days a week. Within that portal, there should be sub-portals appropriate for each discipline from the team. Accordingly, a law enforcement officer could go into the criminal justice portal and watch a training on suspect interrogation.

Once developed and fully functional, this would be a low cost, efficient manner for ensuring that all child protection professionals have immediate and permanent access to basic training. The portals can be used to supplement more intensive, experiential learning programs. For example, certain portal workshops could be a pre-requisite for attending more intensive, crime scene courses.

The National District Attorneys Association and the Midwest Regional Children’s Advocacy Center have already developed a number of online, on demand workshops on basic investigation
and prosecution topics. Simply providing a link to these already existing online programs could be immensely helpful.54

There should be a centralized body that controls and maintains the portals and a passcode should be required. For obvious reasons, it would not be appropriate for sex offenders or child abusers to be able to access information they could use to avoid detection or apprehension.



  1. The unique needs of rural child protection professionals

In rural communities and counties, the MDT faces unique challenges. Child protection professionals, by necessity, may not be able to specialize in child abuse but must handle everything from cases of speeding to murder. Distance may make it more difficult to attend an MDT meeting or get a child to a CAC in a timely manner. With a limited number of employees, attending a multi-day training can be particularly burdensome to rural practitioners. In light of these and other challenges, resource guides and training programs should consistently take into account the unique factors of smaller communities and tailor their recommendations accordingly. When this is done, history shows that rural communities can do as well if not better than their metropolitan counterparts in responding to child maltreatment.55

  1. The next steps

In order to carry out these recommendations, we recommend that the Silent Tears Task Force develop a working committee of representatives from the CACs, solicitor’s offices, DSS, medical and mental health professionals, as well as statewide training organizations such as the Children’s Law Center, to develop a plan for making sure training is in place that will enable all child protection professionals to meet the minimal standards and that will move toward an emphasis on experiential learning. This committee should also recommend one or more options for providing experiential training in a mock house, courtrooms, hospital and other “laboratory” settings. In selecting such a site, factors should not only include accessibility but the willingness of a community to contribute funding and otherwise support such a facility.

Improving the Collection of Evidence

A recurrent theme in our onsite interviews of South Carolina’s child protection professionals is the rarity of collecting corroborating evidence in child sexual abuse cases. Many MDT members said that crime scene photographs are rarely taken and that corroborating evidence of any kind is seldom collected. This sentiment was echoed in the online survey wherein 66% of the responding solicitors and law enforcement officers reported that crime scene photographs were taken in no more than half the cases.56

In terms of corroborating evidence, 86% of the solicitors and law enforcement officers agreed “there is usually not much corroborating evidence.”57 One MDT member told us “in the past three years, I’ve worked with 375-425 child sexual abuse cases and it’s pretty rare there was corroborating evidence collected.” However, this low rate of obtaining corroborating evidence was not universal. For example, one law enforcement officer told us he obtains some corroborating evidence in at least 75% of his cases. Another officer told us she obtains corroborating evidence in 100% of the cases, noting “you can always find it if you dig.” This same officer said that, in most cases, she collects 3-4 pieces of corroborating evidence per case.

With respect to obtaining incriminating statements from suspects, many officers told us that incriminating statements are rare and outright confessions are even more rare. One experienced officer said confessions occur in only about 3% of the cases he has worked. When incriminating statements are collected in South Carolina, it is often the result of a failed polygraph examination. Indeed, 57% of the law enforcement officers and solicitors taking the online survey noted that polygraphs are “routinely used” in child sexual abuse cases. Although polygraphs can be an effective tool in obtaining incriminating statements, research suggests this tool may only lead to confessions in about 25% of CSA cases.58

As is the case with corroborating evidence, low confession rates are not uniform in South Carolina. One officer reported obtaining incriminating statements or confessions in as many as 95% of the cases worked and noted the effectiveness of obtaining and using corroborating evidence in the interrogations. Another officer reported obtaining incriminating statements from at least 60% of the suspects interrogated and an outright confession in at least 20% of the cases investigated. The same officer told us her success with interrogating offenders was directly attributable to training, noting that other officers “can’t play the game” of getting in the suspect’s head because they have not specifically been trained on interrogating sex offenders.

There is a growing body of research documenting the critical role that corroborating evidence and suspect interrogations play in convincing prosecutors to file charges and in convicting suspects of child sexual abuse. For example, child sexual abuse cases involving at least one corroborating witness are “nearly twice as likely” to result in a conviction.59 If, for instance, a child says he was molested on a fishing trip, a witness who corroborates the boy and the offender went fishing together can have a significant impact. This same study suggests that evidence of this kind is more commonly present than many believe. Specifically, the researchers concluded “these results suggest that police and prosecutors are indeed finding evidence in many cases and that evidence has a bearing on the decision to file charges and on the conviction rate of offenders.”60

There is also a predictable correlation between corroborating evidence and confessions. Generally speaking, the more corroborating evidence obtained, the greater the chance a suspect will confess or at least make incriminating statements.61

Inadequate training on interrogation and corroborating evidence clearly plays a role in the relatively low collection of this evidence. One officer, for example, told us that in 80% of the cases, the victim’s statement is all that is necessary and that crime scene photographs are only important in the “big cases.” We believe training on corroborating evidence and suspect interrogation in child sexual abuse cases would dramatically change the landscape in South Carolina.

Inadequate training, though, is only one factor leading to a low rate of collecting this evidence. The delay in South Carolina of conducting a forensic interview of alleged victims also contributes to a loss of evidence. Many onsite interviewees told us it may take two or more weeks to conduct a forensic interview. Although actions are taken to protect the child in the interim, this delay in conducting the forensic interview gives the suspect time to destroy evidence or pressure the child into recanting.

One law enforcement officer told us:

I think we have a pretty good working relationship [with the CAC]. I know in other states, if a report comes in they have a forensic interview immediately. That could be an improvement [here]…A lot of times you interview a child, they disclose, and by the time the forensic [interview is completed] a few weeks later the child has recanted or doesn’t know the details. A more timely…interview could help.

Although the MDT may take steps to preserve a crime scene or other potential evidence, until the forensic interview is completed, it is likely the team has insufficient information to determine the location or locations of the crime or sources of potential corroborating evidence.

According to the forensic interviewing guidelines of the American Professional Society on the Abuse of Children (APSAC), interviewers are, when developmentally appropriate, to obtain “as many details as possible” during the investigative interview.62 The APSAC guidelines also note the forensic interview “should occur as close in time to the event in question as feasible….The possible impact of delays on the child’s ability to recall and willingness to report an experience should also be taken into account.”63

The APSAC forensic interviewing guidelines also note the critical importance of corroborating the forensic interview:

No interview is perfect. The child interview is only a part of a complete child protection or criminal investigation. Further investigation should be conducted to confirm or refute the allegations, and to see if details supplied by the child can be corroborated. Interviewers should always attempt to elicit information about specific facts that can be verified later—during a search of the scene as well as during interviews with other witnesses and the suspect. Additional investigation may corroborate facts elicited during the interview and thus prove the reliability of those facts, even at times when the interview was not conducted in a manner consistent with these Guidelines.64

Another difficulty in obtaining corroborating evidence is that many team members we spoke with see this as only the obligation of law enforcement when, in reality, DSS, mental health providers, medical providers, and other team members may have access to corroborating evidence.



Recommendations to increase the collection of evidence

  1. MDTs should set a goal of taking crime scene photographs in every case of child sexual abuse

We suggest that, within a year, the taking of crime scene photos should be the norm. The sexual abuse of children always occurs in a physical location. Even when the abuse happened years ago, that physical location is often still present or, if it is not, family photo albums or other documentation of the crime scene may still be available. In speaking with solicitors in South Carolina, they routinely expressed the value of crime scene photographs in court. One solicitor said his investigators produce crime scene photographs in 80% of his cases and that “jurors love the crime scene photographs.” The solicitor spoke of a case in which a child described items in her closet that the offender used in the abuse and told us the photographing of the closet and the seizure of the items proved critical in demonstrating the child’s credibility to the trier of fact.

  1. MDTs should set a goal of at least five items of corroborating evidence in every case

At first blush, this may seem to be an unrealistic or unobtainable goal. In reality, though, many experts have argued there is corroborating evidence in all child sexual abuse cases and that collecting “multiple pieces of corroborating evidence” should be routine.65 Indeed, we encountered MDT members in South Carolina who said they were always able to collect some corroborating evidence and, in many cases, multiple items of corroborating evidence.

To achieve this goal, team members must be taught that corroborating evidence is more than semen, saliva or blood.66 Corroborating evidence includes crime scene photographs documenting the child’s description of the scene, finding witnesses that place the child and offender in a particular location, and documenting unusual sexual positions or preferences of the suspect. In one South Carolina case, for example, a child told the interviewer that the offender made a “whinny” or “horsey” sound when reaching orgasm. In speaking with other sexual partners of the suspect, the officer was able to confirm the offender made unusual sounds during climax. In most cases, the child loves the offender. When this happens, documenting letters, gifts or artwork the child has made for the offender illustrates the child has no motive to lie. These are the sort of things that should be gathered routinely and, if they are, research suggests the confession, charging and conviction rates will increase in South Carolina.

It is important to note that this recommendation is not limited only to law enforcement officers. DSS, victim advocates, therapists, solicitors and others who work with child sexual abuse victims and will often learn of or even encounter evidence that should be seized or otherwise documented. We suggest that a routine question in all case review teams should be whether the team has looked for and in fact obtained corroborating evidence.


  1. Within five years, CACs/MDTs should have the ability of conducting forensic interviews within two hours of a report to the authorities

The MDT members we spoke with were nearly unanimous in praising South Carolina’s children’s advocacy centers and the profound impact they have had in bringing communities together, in establishing MDTs, in helping families access medical and mental health care, and in conducting quality forensic interviews.67 These sentiments were also reflected in the online survey. Online respondents said the vast majority of the interviews are recorded, are conducted by well-trained interviewers and are helpful to the case.68 However, only 26% of the forensic interviews in metropolitan communities are conducted within a week and only 33% of the interviews overall are conducted within a week.69 In fact, 41% of forensic interviews in metropolitan communities take more than two weeks and 34% of all forensic interviews take more than two weeks.70 This is problematic because, as noted earlier in this report, a delay in conducting the forensic interview makes it more difficult to collect corroborating evidence and obtain incriminating statements.

The delay in conducting forensic interviews was noted by some of the CAC personnel we spoke with as well. Unfortunately, the number of highly skilled interviewers does not currently match the demand for this service. Accordingly, this is not a problem that can be fixed overnight nor is it possible to develop a solution that will work for every community.

Instead, we urge each CAC to establish a goal of being able to conduct a forensic interview within one week and to meet this standard within two years. Within five years, the goal of each CAC should be to have the resources to conduct a forensic interview within two hours of the time a report is made to the authorities. The timeliness of forensic interviews is urged by APSAC71 and by many leading child protection professionals.72

This is not simply a responsibility of the CACs, but the MDT as a whole must work together to make sure forensic interviews are expedited and, when they are, that the team is following up quickly to seize corroborating evidence and otherwise complete the investigation in a timely manner.

To achieve this goal, each CAC should assess their annual volume of cases and determine what additional resources would be needed to have interviewed all these children in a more timely manner. To expedite the delivery of interviews, CACs should consider not only the possibility of adding additional full time interviewers, but also part time interviewers who can help fill the need. Finally, CACs may want to consider the possibility of using well-trained law enforcement officers or DSS workers to conduct forensic interviews when a CAC interviewer is not available. Private and public funders should work closely with CACs in developing the financial resources necessary to expedite the delivery of forensic interviewing services.

Having the ability to conduct an interview within two hours does not mean the team will always choose this option. There may be any number of exceptions to the rule of a timely interview, but these exceptions should be well thought out and reduced to writing so that all team members are on the same page. For example, if there are five reports of child sexual abuse in a matter of hours, it may be necessary to select the cases involving recent or ongoing abuse, as opposed to a case involving an offender no longer in the home. If a child is physically or emotionally injured to such an extent that a prompt interview cannot be completed, there may be justification for the delay. If a report is made late at night and there is no reason to believe lives are in danger or critical evidence will be lost, it may be prudent to wait until a child has a good night’s sleep. Although these and other exceptions may be appropriate, the goal of the team should be to expedite interviews whenever possible and appropriate and to make delays the exception and not the rule.



  1. Solicitors should increase their role in MDT meetings

In both the onsite interviews as well as the online interviews, it became apparent that solicitors are often not present at forensic interviews or MDT case review meetings.73 Although some CACs have worked with solicitors to set up separate meetings at the prosecutor’s office, we believe the presence of at least one solicitor at forensic interviews, MDT case review or other critical MDT meetings will increase the chance that critical evidence is collected. Simply stated, the prosecutor understands better than any other team member what evidence may help him or her make the case in court. Accordingly, a solicitor present at forensic interviews74 and at MDT case review can help medical, mental health, law enforcement officers, forensic interviewers and other MDT members function in such a way as to maximize the amount of evidence collected.

According to the National Center for Prosecution of Child Abuse, a program of the National District Attorneys’ Association,

“(c)ommunities in which the prosecutor has taken a leadership role in designing the investigation process tend to be the same communities that have demonstrated the greatest success prosecuting child abusers…The prosecutor must develop policies requiring prompt, thorough, objective, sensitive, and coordinated investigation despite the initial drain of such planning on time and personnel….Because of prosecutors’ prominence in the charging process they are in the best position to ensure the success of a coordinated approach.”75

We realize there is a tremendous burden on the state’s child abuse solicitors and greater involvement in interviews, MDT meetings, or the investigation as a whole may be burdensome for some departments. In the long run, though, we believe greater involvement in the interviews and MDT meetings will build stronger cases and save time.76 Most cases are won or lost during the investigation stage, and thus it is important for the prosecutor to be involved in the case as early as possible.



From Crime Scene to Trial: Resolving Cases more Quickly

Another recurring theme in both the onsite interviews and online surveys is the frustration many South Carolina child protection professionals have with the time it takes to resolve a child sexual abuse case. Many professionals told us it often takes more than two years for a case to come to trial with some professionals reporting instances in which a case was delayed for three or more years. One law enforcement officer described these delays as “the biggest problem South Carolina faces” and causes “children and families to be beaten down” which, in turn, results in more lenient plea agreements and longer periods of time in which sex offenders are free to offend again.

The National Center for Prosecution of Child Abuse, a program of the National District Attorneys Association, echoes these sentiments:

Continuances are a plague of the criminal justice system—exasperating to the courts and frustrating to victims and their families. Continuances are especially detrimental to the success of child abuse prosecutions. Pressures on the child and child’s supporters are magnified when accompanied by the emotional rollercoaster of repeated changes in schedule…Once a determination has been made that enough evidence exists to file a child abuse case, most prosecutors find that the typical case only becomes weaker as time passes. When the prosecutor and child are prepared for trial, delays can decrease the likelihood of conviction by discouraging victims from cooperating, causing all witnesses to remember less, and reducing any sense of urgency by putting more time between the offense and the trial. Defense attorneys are well aware of this and often seek continuances in child abuse cases for these reasons.77

In recognition of these issues, the federal Victims of Child Abuse Act allows federal courts to give scheduling priority in cases of child abuse and to take into account the child’s age and the impact of any delay in the proceedings on the child’s well-being.78 Although failing to specify a minimum time period in which a case must come to trial, at least 13 states have enacted “speedy trial” provisions related to cases of child abuse.79 The American Bar Association notes that “long periods of uncertainty and judicial indecision can put pressure on children and families.” The ABA proposes that 99% of all felony cases be resolved within 180 days from the date of arrest.80

South Carolina has not adopted a speedy trial statute with respect to child abuse cases and, at least with respect to child sexual abuse cases, the court system is scheduling trials well outside the guidelines proposed by the ABA. According to the child protection professionals responding to the online survey, less than 6% of CSA trials take place within 6 months of arrest and less than 4% of CSA cases in metropolitan communities come to trial within 6 months.81



Recommendations to improve timely resolution of CSA cases in criminal court

  1. All CSA cases should come to trial within 6 months of arrest or charging

To accomplish this goal, we suggest the governor of South Carolina appoint a bi-partisan commission of legislators, court administrators, appellate and trial judges, solicitors specializing in child abuse cases, defense attorneys, medical and mental health professionals and, most importantly, child abuse survivors or their families impacted by lengthy court delays. The commission should be charged to develop concrete recommendations to resolve CSA cases within the ABA guidelines. The recommendations may include:

  1. Speedy trial legislation;

  2. Court rules designed to expedite child abuse cases;

  3. Required training of judges and other court personnel pertaining to the impact of lengthy delays in the court process on abused children and their families;

  4. Standards for granting a continuance and requiring courts to make specific findings as to the likely impact of a continuance on the alleged victim;

  5. Giving victims and their families the right to submit affidavits or other evidence concerning the impact of delays on their well-being;

  6. Clearly enunciated ethical standards prohibiting any attorney from requesting a continuance merely to intimidate a child witness—and permitting sanctions against any attorney shown to abuse the court system in this manner; and

  7. Funding research to show the efficacy of any enacted court reforms

In order for this to be successful, the governor must make it clear to the commission that South Carolina is making child abuse cases a top priority and that reform is coming. Accordingly, the commission should freely discuss barriers to speedy resolution of child abuse cases but the discussion should focus on overcoming these barriers. Simply stated, excuses will not be tolerated. In appointing members to the commission, the governor should actively seek those who believe this problem can be addressed and who are fully committed to making sure it is addressed.

In terms of a timeline, we suggest the commission complete its work within a year of its formation, that the proposed reforms be enacted within two years, and that research on the efficacy of the reforms be conducted and published within four years.

To assist in considering the possibilities, NCPTC reviewed the statutes in all 50 states to determining what, if any, speedy trial provisions exist and how, if at all, these laws address the needs to expedite cases of child abuse. This summary of these state statutes is attached to this report as “exhibit c.”

Improving the Alternative or Appropriate Response System (ARS)

The South Carolina Department of Social Services is unfolding an alternative or “appropriate response system” to provide services to families reported as possible cases of abuse but that are screened out as low risk. Cases screened out are referred to professionals employed with a contracted program entitled Specialized Alternatives for Families and Youth (SAFY).82

In our onsite interviews with DSS workers, supervisors, and SAFY workers, numerous advantages of the program were explained. Most of these workers believed the SAFY program was allowing DSS to focus its efforts on the families at highest risk for abuse while providing services to low risk families in the hopes of preventing abuse. Prior to SAFY, many of these cases would have been screened out with no intervention at all and may have returned to the system months or years later involving a much greater risk.83

One DSS worker told us “I love it. I’m a huge advocate of this. I think it is great.” This same worker went on to explain:

In the past [the intake screener] would decide if they would accept for DSS investigation or screen it out in which case nothing is done. Now with the differential response system we still have those choices but now we can send it to SAFY. It’s a great system. DSS now works with more severe cases of abuse and neglect. SAFY can skip the issue of investigating for abuse and start with services from the get go. I think it is huge that we can just give [the family] services rather than dragging it out. It’s less accusatory. People have developed a stigma around DSS—thinking we are just taking kids away and not here to help. It’s not true, our goal is to help. SAFY’s strength is that they are not DSS, they aren’t affiliated with DSS and they are here to help….I’m a huge advocate….I think it is working extremely well and I only wish they would have implemented it sooner.

A DSS supervisor explained the benefits of the program in this way:

The strength [of ARS] is that families are more apt to engage with a private provider than they are DSS. The cases referred to [SAFY] are low risk. If they [SAFY] get in there and see it isn’t low risk, they can send it back to us. It’s a two way street. The other strength that I see is that up until July 1st, there were 65-70 cases [SAFY] had taken. That is 70 cases our case workers didn’t have to take on. That lessened the treatment loads. Some people had 42 cases involving 148-160 children being seen in a month. Now they are down to 25. It has impacted case load size. [DSS workers] can actually do some work [with families] instead of [only] seeing children. They used to only have time to see the children.

However, a number of medical, criminal justice, and CAC professionals expressed strong reservations about the appropriate response system. A CAC employee told us she was working with a family she considered high risk because a child had been sexually abused but that DSS labeled the case low risk because the perpetrator was no longer in the child’s home. Another worker told us that although SAFY can refer a case back to DSS or the MDT for a traditional investigation, they are not fully aware how to do this. According to this worker, she has had requests from SAFY workers to conduct forensic interviews of children suspected of being physically or sexually abused without realizing the CAC provides this service only as part of an investigation—and thus the case should be referred back to DSS or law enforcement.

A pediatrician expressed her reservations this way:

I think it is very scary. I am having a problem with a computer generated risk assessment. I have seen children fall through the cracks already. I had three cases of children with sexually transmitted diseases [that were screened out]….We recently had a child death where there was a call to DSS for neglect but the case was screened out—the child was hit by a car. I’m not confident in the system we have in place at this time. The other problem is that it was rolled out without any education to community partners.

A law enforcement officer bluntly said the alternative response system “stinks” and that he had little confidence in any computer screening system being fool-proof. The officer said he was involved in a case in which a woman had been sexually exploiting her daughter by selling her to men in exchange for drugs. The officer said the abuse began when the child was 11 and continued until she was 16. In the interim, the officer claimed there were 23-24 reports to DSS but all of them were screened out.

Another law enforcement officer told us:

It worries me. The experiences I have had with it, they said we aren’t sending kids to [ARS] that are sex abuse cases, but that has happened…[DSS] says ‘we didn’t send it to SAFY for sex abuse, we sent it for something else.’ But SAFY gets involved.

This same officer told us “when you talk to the folks {SAFY] working these cases, you hear them say ‘I shouldn’t do that.’ They aren’t trained at the level they should be if they are going to have involvement with some of these families.”

Some of the SAFY workers we spoke to also expressed concerns. One SAFY worker told us they had as many case referrals in three months as they had been led to believe they would have in a year. A SAFY worker told us that once a case is referred to them, they can’t refer it back to DSS without closing out the case and that this has created an obstacle in having a true multi-disciplinary response to a family’s needs. Another SAFY worker expressed concern regarding the voluntary nature of ARS. Even though there is some level of risk that lead to the SAFY referral in the first place, families can choose whether they participate with the services offered. This worker expressed concern that once services were refused, it was unlikely that DSS would subsequently become engaged with the family to alleviate the risk factors for which the family was initially referred.84

A DSS supervisor supportive of the ARS system also expressed the need to make sure cases were properly screened. According to this DSS official, “We get really good at dumping in the child welfare system and we had to work with our [DSS] workers on this [to make sure they understand] this isn’t how to get rid of cases. If it doesn’t work well, it will come back.”

Although most interviewees commenting on ARS were strongly supportive or strongly critical, we also encountered more moderate voices. For example, one SAFY worker said the concept of alternative response is great but “we have a lot of work to do in educating the community of who we are and what we do.” The same worker said the advantage of not being DSS increases the level of cooperation from families and enables the provision of immediate services. At the same time, this worker observed that SAFY has limited powers, noting, for example, the inability to access a parent in prison or access a child in school. This worker said the contract with SAFY extends over a five year period and she is hopeful that, at the end of that period, there will be clear evidence that low risk families were not only served better but that SAFY played a meaningful role in preventing future abuse.

The disparate, often strong opinions about the appropriate response system expressed in the onsite interviews was also apparent among the child protection professionals who took the online survey. For example, more than 60% of DSS workers consider the Appropriate Response System as enabling them to work with high risk families more quickly, but less than 10% of the solicitors and law enforcement officers considered this to be the case.85 Clinicians, law enforcement officers and solicitors were also much more likely to claim that the Appropriate Response System sometimes improperly screens cases.86

Although bridging the divide among MDT members over the ARS system is challenging, there is reason for hope. When asked to rate the quality of ARS on a scale of 1-5 with 5 being the highest, the largest percentage of respondents labeled ARS as a 3—meaning it was “somewhat hopeful.”87 Specifically, 44% of law enforcement officers/solicitors, 49% of clinicians/therapists, and 36% of DSS workers used this label. The fact that a large percentage of MDT members see hope in the ARS system may enable the system to succeed at the level it hopes to. To do this, though, we believe DSS must not only educate other team members about ARS but also work with these same team members to address concerns that some cases are improperly screened or inappropriately handled in the ARS system.

ARS in the context of child protection history

In the past 40 years, there have been numerous shifts in federal child welfare policies which, in turn, have influenced the response of child protection agencies to instances of child maltreatment. The Child Abuse Prevention and Treatment Act of 1974 “set the tone for more frequent use of intrusive intervention in CPS.”88 As a result, child protection agencies removed “many at-risk children from their families and placed them in foster care.”89 However, research subsequently documented that “foster care placements were often unstable and were inherently traumatic for children”90 Accordingly, there was a “national permanency planning movement” that “sought to elevate permanence for maltreated children to a level of importance equal to that of child safety.”91 The federal government enacted legislation requiring states to make “reasonable efforts” to prevent removal of children from their families and to quickly reunify families when removal was necessary.92 Unfortunately, this over-emphasis of keeping families together resulted in some children continuing to endure egregious abuse. In 1997, the federal government enacted the Adoption and Safe Families Act “which reaffirmed and expanded programs to preserve and support families but which also clarified the reasonable efforts provisions….to ensure that children’s health and safety would be the foremost criteria when making decisions to remove or reunify children.”93

The need to balance child safety while also promoting family support structures made the concept of “alternative” (AR) or “differential” response (DR) attractive in that it allowed social service agencies to place “low risk” families in a supportive, engaging environment while utilizing the more traditional child protection investigation and court processes for families at higher risk to abuse. The “eventual development of a national advocacy team and access to significant federal and foundation resources to support the initiative together made DR one of the more widely replicated child welfare reform efforts in recent history.”94

The national debate over alternative, differential or appropriate response systems

The strong feelings about ARS expressed by many South Carolina child protection professionals, reflects a national debate over this emerging system which also involves strong views. In January of this year, a team of researchers headed by Ronald Hughes of the North American Resource Center for Child Welfare, published a strong critique of the differential response system.95 Hughes and his colleagues made five critiques of the differential response system.

First, Hughes concluded “there is considerable variation in how DR programs have been defined, designed, and implemented across states and agencies and over time.”96 Hughes finds this problematic because “(w)ithout a consistent program model which is implemented with fidelity across jurisdictions and comparably evaluated, it is impossible to draw valid conclusions about the effectiveness, benefits and limitations of DR.”97

Second, Hughes concluded there were significant “methodological problems” in the DR research “thereby calling into question the reliability and accuracy of many of the claims and conclusions made in these studies.”98

Third, Hughes found there is “insufficient data” to conclude that children are, in fact, safe. Hughes says “this does not necessarily mean that children in AR tracks are unsafe. It does mean that child safety is not being uniformly assessed, accurately measured, or fully addressed in either DR programming or research.”99 Hughes also cautioned that “the principles that underlie DR programming may prevent a thorough assessment of risk and safety from occurring in alternative tracks. DR’s stated preference that workers focus on family needs rather than incidents of maltreatment could clearly discourage practitioners from having the sometimes difficult conversations with families that are necessary to fully assess risk and to address safety concerns.”100

Fourth, Hughes found some evidence that scarce social service resources were being shifted to families in alternative response systems as opposed to families in the traditional CPS system. Hughes and his colleagues cautioned “in an environment of chronically limited resources, CPS agencies should carefully consider the consequences of diverting their resources to serve lower risk families in alternative tracks, when families in traditional tracks cannot be adequately served because of insufficient fiscal, staffing, and community resource resources.”101

Finally, Hughes concluded that “DR literature” misrepresents traditional CPS investigations in an effort to “enhance the alternative track.”102 Specifically, Hughes found “unprofessional and negative” stereotypes of the traditional CPS system as being inflexible, adversarial, judgmental, and “unable to provide sufficient services.”103 Hughes found this distortion to be inaccurate and lamented that “accepting the distortion as fact prevents a legitimate, balanced assessment of the real strengths and limitations.”104

In the past three months, Hughes’ critique of the differential response system has drawn strong and varied reactions. Viola Vaughan-Eden, the president of the American Professional Society on the Abuse of Children, co-authored a commentary in which she contends the Hughes’ paper “may be the most important article in the child welfare arena in the past 15 years.”105 Vaughan-Eden concludes the literature and research supporting differential or alternative response is “deeply flawed methodologically and riddled with bias. In some instances, what has been presented as empirical research is, but thinly veiled advocacy…one must ask how a program with so little empirical support gained such favor—at least 35 states utilize some form of differential response—in this era of evidence based practice.”106

Vaughan-Eden answers her own question, in part, by suggesting the differential response system is “politically popular” in that it “speaks to the concerns” of liberals “who see much of child welfare as unwarranted attacks on the poor, minorities, and otherwise disadvantaged” and to the needs of conservatives who “often for religious reasons promote a ‘hands off’ approach to family life.”107

L. Anthony Loman and Gary Siegel from the Institute of Applied Research in St. Louis, Missouri, concluded the Hughes paper was full of “misunderstandings, misinterpretations and errors” and is thus a “flawed vehicle” for assessing differential response.108 Indeed, Loman and Seigel contend “(t)he only good we see coming out of the Hughes et al, paper is that readers may decide to read for themselves the reports referenced in it.”109

Brett Drake from the Brown School of Social Work similarly objected to the Hughes paper, finding the “tone of the article to be unrealistically critical, casting one of the most well-researched areas in child welfare practice in undeservedly negative terms. Both the rigor of the research and the validity of the findings in DR are, in my view, considerably stronger than the authors of the current article suggest.”110

Bryan Samuels and Brett Vaughn Brown from the Administration on Children, Youth, and Families of the United States Department of Health and Human Services responded to the Hughes critique by stating they have a “more favorable view of the more recent and rigorously designed evaluations of DR, which, while certainly not perfect—as no field-based research can be—are overall of good quality and establish DR as promising practice.”111

As reflected in the Hughes critique of differential response, and in the responses to the critique, the ARS system being implemented in South Carolina is part of a national movement for which there is both strong support and criticism.

Recommendations

Some national experts, such as Viola Vaughan-Eden, have argued that “(p)olicy makers and child welfare staff on the frontlines should impose a moratorium” on the use of differential response “until the program is better defined and its utility is rigorously and honestly studied.”112 According to Vaughan-Eden, “(f)ailure to do so runs too high a risk of violating the fundamental commitment of child welfare practice: keeping children safe.”113

Other experts claim the “notion that DR or any other systems level reform should not be implemented until the highest standard of research is conducted is unrealistic. The logical outcome of this perspective would have us suspending or eliminating many aspects of our approach to child protection, including training programs, judicial review procedures, and perhaps the entirety of the CPS system.”114

We do not agree with Vaughan-Eden that there should be a “moratorium” on the implementation of differential response since there is some research to support the model even though, as Hughes points out, that research may be “overstated” or exaggerated. We also note that many child protection professionals in South Carolina, including those outside the field of DSS find the program at least “somewhat helpful” to the children in this state. It is also our impression that if differential response in South Carolina were scrapped or temporarily stopped, the children in the ARS system would not receive any services—they would simply be screened out.

Although the issue of improperly screening children into the ARS system is of real concern, it should be noted that screening children in or out of the traditional child protection system is also concerning—with national data suggesting that a majority of identified instances of child abuse are never investigated.115

As we see it, then, the primary concern with the ARS system is ensuring the initial screening is conducted in the most rigorous manner possible and that SAFY or other professionals working with these families are fully equipped to conduct ongoing screening to ensure child safety. As noted in the recommendations below, there is solid research suggesting that MDT involvement in child maltreatment cases is critical to increasing the accuracy of screening decisions and child abuse assessments. We believe this research may be a basis for improving the ARS system in South Carolina and increasing the confidence of other team members in the screening decisions.

Within this context, we have several suggestions:


  1. Public policy makers must engage in the debate

The differential or alternative response system is one of the most important public policy debates in the history of child protection and will, for good or ill, impact the lives of millions of children in South Carolina and throughout the United States. Accordingly, it is critical for the governor, congressional delegation, and state legislators to make sure they are fully apprised of this issue and that these policy makers ask concrete questions of federal and state leaders advocating for ARS and implementing the system nationally and locally. This includes hard questions about the research supporting this model. These same policy makers should support funding for rigorous, impartial review of the ARS system and insist that any research neither over nor understate the positive and negative features of the system. South Carolina is implementing ARS under a five year contract with SAFY and, at the end of that contract, policy makers must insist on rigorous, reliable data to measure the program and to determine its future course.

  1. The ARS screening instrument should be reviewed by multi-disciplinary team members and ARS cases should be subjected to MDT case review

There is strong research suggesting that any screening or case assessment conducted by a limited number of professionals, particularly professionals from the same agency, may be prone to human error and bias. Dr. Mark Everson from the University of North Carolina at Chapel Hill notes there are seven studies documenting “substantial unreliability in professional judgments about abuse allegations” but that these studies had several limitations including sample size.116 To this end, Dr. Everson and Jose Miguel Sandoval117 developed the Child Forensic Attitude Scale (CFAS), an instrument that was administered to 1,613 child abuse professionals, including over 500 child protective service workers, over a six year period.118 What Everson and Sandoval found is that all professionals have different subjective biases that can play a role in our evaluation of various child sexual abuse case scenarios.119 Indeed, depending on an individual’s biases, he or she may be 6-7 times less likely than his or her peers to view a case of child sexual abuse as credible.120

In their research on bias, Everson and Sandoval include a finding that may help understand the disagreement among some South Carolina MDT members about screening and assessment decisions and, at the same time, offer a possible solution. Specifically, Everson and Sandoval found that child protective service (CPS) workers “exhibited an overall attitude profile…associated with a higher probability of disbelieving sexual abuse allegations.”121

Everson and Sandoval conclude:

This finding is troubling in light of the role of CPS as one of the primary gatekeepers for sexual abuse cases entering the system. Other players in the system include law enforcement, prosecuting attorneys, judges, juries and various mental health professionals. Ideally, these other players, in combinations that vary with case characteristics, function as checks and balances for CPS substantiation decisions. However, in most cases, there are no checks and balances for CPS decisions against substantiating allegations of abuse. As a result, if CPS sets standards for accepting or substantiating allegations that are too high, there is a risk of many true cases of child sexual abuse being screened out or unsubstantiated, leaving little recourse for abuse victims.122

One of the remedies to individual or agency bias, is a “‘team’ approach to assessment that emphasizes diversity in professional position or discipline, gender, and experience level…”123 Everson and Sandoval contend a team approach to assessment is “likely to be useful in providing alternative perspectives to counterbalance individual biases.”124

Consistent with Everson and Sandoval’s research, we have two recommendations for reducing the possibility of screening or assessment errors and otherwise increasing MDT confidence in the ARS system.

First, the DSS screening instrument and process should be reviewed with solicitors, law enforcement officers, medical and mental health professionals and other pertinent MDT members. The background and experience of these individuals may provide valuable information for improving the initial screening of these cases and possible referral of some cases to law enforcement or other agencies.

Second, ARS cases should be part of MDT case review. A number of MDT members we spoke with reported instances in which they believed an egregious case of child abuse was inappropriately referred to SAFY or inappropriately retained by SAFY even though there were concerns the family may be at higher risk than originally suspected. Since we did not review individual case files, we are unable to conclude whether or not errors of this kind occur and, if they do, the extent of the problem. However, each MDT should make it clear that when concerns of this nature arise, the case in question should be discussed at the MDT case review and the appropriate DSS or SAFY personnel should be present to discuss the case with the team. In this way, DSS/SAFY will be able to alleviate any misunderstandings or, if there are real issues present, work with the team to address them.

In addition to allowing team members to raise concerns about individual children or families, each case review meeting should include a review of a limited number of randomly selected SAFY cases for discussion with the team. In this way, the team will gain a deeper appreciation that many SAFY cases are appropriately handled and DSS/SAFY workers may be able to access more services for families in the ARS system. Simply stated, the benefits of the MDT case review process should not be limited only to children whose cases have resulted in criminal or civil child protection filings but should also include some work with and assistance for families in the ARS system. Other national experts have also recommended this as a common sense reform that would improve the country’s emerging differential response systems.125

There is one more critical factor warranting greater involvement of the MDT in ARS cases. In South Carolina, as is the case nationally, DSS workers experience the highest rate of turnover of any discipline represented on the MDT. This fact was mentioned repeatedly in our onsite interviews and was also apparent in the online survey with 72% of MDT members in metropolitan communities and 70% of all South Carolina communities agreeing that DSS turnover in their jurisdiction is “very high.”126

The Children’s Bureau of the United States Department of Health and Human Services calls DSS turnover a “major concern in many child welfare agencies” and the president of the American Professional Society on the Abuse of Children recently wrote:

Unfortunately, one result of high turnover is that child welfare professionals with the least amount of experience receive the most difficult cases. They lack the experience and training necessary to identify risk factors, differentiate severity of cases, distinguish their own biases, and make objective assessments of the children and families they are assigned, and are often left feeling overwhelmed and unappreciated.127

Although better training, beginning at the undergraduate level is part of the long term solution to this issue, getting more MDT members involved in developing screening tools and otherwise adding their own resources to the DSS system will reduce some of the concerns referenced above.

We believe that many DSS and other frontline professionals will be receptive to the above referenced reforms as well as any additional reforms consistent with this proposal. After all, these are the very professionals who raised these concerns and are in the best position to work toward a solution. The professionals supportive or concerned about ARS are compassionate child protection professionals genuinely striving to help children in their communities. We believe this concern for children is the common denominator that will enable MDTs to reach a consensus on moving forward with ARS.

If this can’t be done, the governor and legislature may need to intervene and work with front line professionals in developing a process in which MDTs are involved in reviewing screening policies and serve as an additional check on the system by reviewing randomly selected cases referred to ARS.

Developing Partnerships between Faith and Child Protection Communities

Faith is an important part of American culture. More than 90% of Americans believe in God,128 55% of Americans say religion is “very important” in their life,129 40% of Americans attend church weekly and 85% attend religious services at least sometimes.130 Contrary to popular myth, church membership today is “far higher than it was in colonial times, and…the membership rate has been rising for more than 200 years.”131 Sociologists predict a rise in religious involvement in the years ahead fueled partly by our aging population, the rise in minorities (who tend to be more religious), and a migration to more religious regions of the United States.132

Faith is a particularly important aspect of the culture of South Carolina. South Carolina has the third highest percentage of weekly church attendance in the nation.133 In 2009-2010, Gallup measured the “net religiousness” of all 50 states and South Carolina was deemed the fourth most religious state in the country.134 Although 54% of Americans are protestant, this is not true in South Carolina and eight other southern states with protestant populations exceeding 71%.135 This is a significant demographic because, as measured by Gallup’s “net religious” index, protestants are “more religious than the national average.”136

In our meetings with stakeholders, in our interviews with front line child protection professionals, and in the online survey results we consistently saw evidence of the impact faith has in South Carolina. On a scale of 1-10, we asked on site interviewees to rate the importance of involving the faith community in child abuse prevention efforts. Of the 37 child protection professionals asked this question, 24 rated this importance a 10, two respondents rated the importance 9-10, two respondents didn’t give a number but said it was “very important” or “extremely important” to engage the faith community. Seven professionals rated the importance of engaging the faith community as an 8. One respondent was “neutral” on the issue and one respondent rated the importance as a 5.

Typical responses from South Carolina child protection professionals include:


  • “Religion is a very important factor in the lives of South Carolina’s families. Engaging them would be helpful because their members rely so much on the church for guidance.”

  • “A lot of church members have problems and they would feel more comfortable if they thought their church was open to discussing these issues and trained in how to respond.”

  • “A HUGE need to educate the faith community about reporting and how to work with families in these situations.”

  • “Faith community is already involved in the family’s life so they are a natural place for services to be accessed. They need training on recognizing child sexual abuse and working with families in these types of situations.”

  • “The churches can be most effective in prevention because they are already doing outreach and they can engage those who attend their church in a different way and be accepted. Churches are part of the community and it helps people be involved and have ownership in the well-being of the community.”

  • “I think it is very important as many families are not connected to any other organization but are connected to a church. Having the church leaders informed and involved can help the families. They [the churches] need education because they can also be a barrier when they are not informed.”

  • “This is the Bible belt. There [are] more churches here than fast food restaurants.”

Although the South Carolina child protection professionals we spoke with recognized the critical role the faith community can play in helping maltreated children, many lamented that such assistance is often rare. Many of these professionals shared with us instances in which a church was supportive primarily of an offender and was, at best, insensitive to the needs of the victim. A solicitor told us he has seen “lots of instances” in which children have had their faith impacted by abuse and questioning the existing of God because they “begged” God to make it stop but their prayers were not addressed. Unfortunately, this solicitor reported, pastors are not aware of or simply ignore these issues and instead testify on behalf of or otherwise support the offender. When this happens, the solicitor says he always asks the pastor “Didn’t the child attend your church, too?”

Other examples child protection professionals gave of inappropriate church responses include:



  • A child protection professional told us of a mother charged with force feeding her child. Rather than support the child, the pastor and various members of the church rallied around the allegedly abusive mother. According to this child protection professional, child abusers “use the church. They speak the language and use the church.”

  • Another child protection professional told us of a Sunday school teacher charged with sexually abusing a child. Church leaders supported the teacher, resulting in the victim and her mother changing churches. The offender was convicted and is serving a prison sentence.

  • One child protection professional lamented “I don’t know why but the preacher is always behind the suspect.” In one case a pastor “kicked the girl” victim out of church “and stood behind the dad.” According to this professional, clergy “are so vocal for the person [charged with sexual abuse] because they want to say how good he is. I want to say ‘you weren’t there. You are on the wrong side of the aisle [in the courtroom]. They just need to be educated.”

  • A number of child protection professionals lamented that church leaders often keep instances of child abuse “in house.” One professional told us “Many perpetrators seek their victims through religious affiliations. Here at the center, we see so many cases where churches cover it up. The minister, the faith community has covered up what has happened [by] encouraging families to forgive and forget and not make reports.”

  • A clinician told us of a child sexual abuse victim she was working with who was excommunicated from her church because she “couldn’t forgive immediately.” This same clinician commented “We all know how important spirituality and religion can be in a child’s recovery. [I came] from a state where religion was not a huge focus as it is here—here it is a daily part of children’s lives. It can be such a part of their healing process. Many of the children I work with wonder if God blames them or they ask how God views them.”

  • A clinician told of a victim who called for six months pertaining to her sexual abuse but was afraid to give her name because “you don’t go against the church or God.” Reflecting the theology of her offender and her church, the victim said “Pure children aren’t abused” and that her victimization was the result of the fact she had “unholy thoughts.” According to the child’s provider, “her faith is destroyed.”

Concern that the faith community frequently shields offenders and fails to protect children was also expressed in the online survey. When asked which professionals were least likely to report cases of child sexual abuse, 66% of child protection workers, 44% of law enforcement officers/solicitors, and 49% of clinicians said pastors were the least likely to report.137

The importance of working with faith communities: a summary of spiritual injury research

The views expressed by child protection professionals in South Carolina are consistent with a large and growing body of research concerning the use of religion in sexual or other acts of child abuse, the impact this has on a child’s sense of spirituality, and the frequency with which child sexual abusers manipulate the faith community into shielding an offender and further harming the victim. This research is summarized below.



The use of religion in sexual abuse

There is evidence that most sex offenders are religious and that many of them use religion to their advantage. In a study of 3,952 male sex offenders, 93% of these perpetrators described themselves as “religious.”138 Research suggests that “religious” sex offenders may be the most dangerous category of offenders. One study found that sex offenders maintaining significant involvement with religious institutions “had more sexual offense convictions, more victims, and younger victims.”139 According to another study, clergy sex offenders share the same characteristics of non-clergy sex offenders with the exception that clergy are more likely to use force.140

The vast majority of these offenders use religious or spiritual themes in the abuse of their victims. For example, an offender may point to a child’s biological reaction to sexual touching and comment “You had an erection, just like me. You enjoy the sexual contact as much as I do and you are as much to blame as me.”

The frequency with which sex offenders manipulate church leaders

Child molesters, particularly those meeting the diagnostic criteria of pedophilia, are extremely manipulative not only of their victims but also the church as a whole. According to one treatment provider, “If children can be silenced and the average person is easy to fool, many offenders report that religious people are even easier to fool than most people.”141

In the words of one convicted child molester:

I consider church people easy to fool…they have a trust that comes from being Christians…They tend to be better folks all around. And they seem to want to believe in the good that exists in all people…I think they want to believe in people. And because of that, you can easily convince, with or without convincing words.142

Child molesters are skilled at deception because, in part, they have considerable practice at lying to their families, their victims, their friends, and to themselves. Sex offender treatment provider Anna Salter describes the abilities of molesters to lie convincingly in this way:

Very few of us have ever been suspected of a crime, and fewer still have been interviewed by the police about one. Under such circumstances, detection apprehension would be very high for most of us…But that would change had we practiced lying over serious matters every day, had we lived a double life, had we been questioned by upset parents or by police numerous times in the past. You are never going to run into a child molester who is not a practiced liar, even if he is not a natural one.143

Not only are child molesters skilled at lying to pastors and parishioners alike, they are often proud of their abilities to fool the leaders and members of their congregations. In the words of one convicted child molester:

(T)here was a great amount of pride. Well, I pulled this one off again. You’re a good one…There were times when little old ladies would pat me on the back and say, ‘You’re one of the best young men that I have ever known.’ I would think back and think ‘If you really knew me, you wouldn’t think that.’144



The impact of child abuse on spirituality

Whether or not a child is abused in the name of God, many children have profound spiritual damage as a result of maltreatment. For example, a study of 527 victims of child abuse (physical, sexual or emotional) found a significant “spiritual injury” such as feelings of guilt, anger, grief, despair, doubt, fear of death, and belief that God is unfair.145

In a review of 34 studies reporting on a total of 19,090 adult survivors of child maltreatment, scholars noted that most studies found abuse damaged the faith of children, often by damaging the victim’s view of and relationship with God.146

When the perpetrator is a member of the clergy, the impact on the victim’s spirituality may be even more pronounced. Clergy abusers often use their religion to justify or excuse their sexual abuse of children. According to one study, clergy in treatment for sexually abusing children believed that God would particularly look after the children they had victimized and otherwise keep them from harm.147 Through their religious role, these offenders also engaged in “compensatory behavior” and believed that their good works in the community would result in God excusing their moral lapses with children.148

The religious cover used by clergy abusers is often communicated to the victims in a manner that irreparably damages their spirituality. Specifically, church attendance of these survivors decreases, they are less likely to trust God, and their relationship with God often ceases to grow.149

The importance of spirituality for many abused children

Spirituality is of critical importance to most children. Indeed, a “growing body of theoretical and research literature suggests that spiritual development is an intrinsic part of being human.”150 Research from UCLA’s Higher Education Research institute found that 77% of college freshman believed “we are all spiritual beings.”151 Eighty percent of these freshmen said they had an “interest” in spirituality.152 Some studies suggest spirituality may be particularly important to vulnerable children. In a study of 149 youth in an institutional care setting, 86% of these children considered themselves spiritual or somewhat spiritual.153 As an example of the importance spirituality plays for some vulnerable youth, a teenage survivor of the sex industry told a journalist “I admit that I’m still struggling, even after six months away from the business…Because I dropped out of school I have few career options…Yet I know what God wants for me. I need to be healed.”154

With respect to victims of child abuse, research consistently shows that abuse victims “who maintained some connection to their personal faith (even if it was damaged as a result of abuse) experienced better mental health outcomes compared to adult survivors of abuse who did not.”155 Many victims turn to their sense of spirituality to cope with one study noting that many survivors of childhood abuse report praying more frequently and having a “spiritual experience.”156

Recommendations for developing child protection and faith partnerships

Given the importance of faith to many families in South Carolina, it is critical to improve the ability of the faith community to meet the needs of children impacted by abuse and to work collaboratively with child protection professionals. To this end, we suggest seven reforms.



  1. Training at the seminary level

As is true of most child protection professionals, clergy are poorly trained to address any aspect of child abuse. As an illustration of the need for training, the pastoral care department of the Children’s Hospital Medical Center of Akron, Ohio surveyed 143 clergy of numerous faiths and found that 29% believed that actual evidence of abuse, as opposed to suspicion was necessary before a report could be made. The same study found that only 22% of the respondents were required by their denomination/faith group to receive child abuse training. This study also documented an under-reporting of suspected abuse cases.157 The 143 clergy responding to this survey impact, at some level, the lives of 23,841 children.158

To address this gap in training, we believe that existing and future seminaries in South Carolina should include ten hours of instruction on child abuse as a pre-requisite to graduation. Since it is impossible to oversee a congregation for any extended period of time without encountering families impacted by child abuse, and given the manipulation of so many offenders of the faith community, it is critical to improve the skills of clergy. We believe the acquisition of these skills should begin at the seminary level with additional training throughout a minister’s career.

Seminaries choosing to move in this direction do not need to start from scratch. The National Child Protection Training Center has developed such a curricula and at least one seminary in South Carolina has attended coursework in Minnesota to consider the possibility of implementing the program.

Six hours of the curriculum developed by NCPTC address these topics:



  • The prevalence of child abuse

  • How children disclose sexual abuse

  • The impact of sexual abuse on spirituality

  • Behaviors indicative of sexual abuse

  • What can be done to keep children safe in our faith institutions

  • The interest sexual offenders have in faith based camps and schools and the methods often used in selecting children to be abused

  • Effective policies for deterring sexual offenders

  • Effective policies should a sexual offender nonetheless become active in a faith institution

  • Helpful rules and lessons from youth-serving organizations

  • Physical abuse signs (students learn to distinguish unusual bruising patterns, understand the meaning of a “patterned injury”, and to recognize a potential hand slap)

  • The five types of emotional abuse

  • The role of background checks and worker interviews

  • Correlation between animal abuse and child abuse

  • Research on the effects of corporal punishment, the present status of state and international law on this issue, and suggestions for discussing this issue in our seminaries, churches, and other faith institutions.

  • How to respond when the church, seminary or other faith institution is sued by a victim or group of victims

  • Case study of child sexual abuse (students look at a case of child sexual abuse arising in the church and, applying all the knowledge gained in course, walk through possible approaches to responding to the case)

  • Suggestions for speaking with:

    • An adult survivor disclosing childhood maltreatment

    • An adult confessing child sexual abuse

In addition, each participating seminary is expected to develop at least four hours of instruction on addressing spiritual injuries resulting from abuse. Seminary students receive actual cases of child abuse in which survivors ask profound spiritual questions. The students are asked to write papers or give presentations addressing these issues. For example, one of the questions students are asked to address is:

I am a police officer and a Christian. I’ve been baptized, confirmed, and have faithfully attended church all my life. I am, though, deeply troubled. When I was a boy, my father cruelly abused me. One of his favorite things to do was to take me into the barn (we lived on a farm), strip me naked, bind my hands together with a rope and then toss the other end of the same rope over the rafters in the barn so that I would hang naked in the barn as he beat me with a stick. The sound of that stick, the smell of that barn, and the sight of my blood are never far from my memory. I am a good person, and I believe Jesus is my savior. At the same time, though, I know I’m going to hell. I recall the Sunday School lesson of Jesus scolding Peter that our obligation is not to forgive seven times but seventy times seven—meaning an infinite number of times. I recall Jesus saying that if we can’t forgive others, we won’t be forgiven. Try as I might, I cannot forgive my father. Why should I have to go to hell because I can’t forgive the man who tortured me?159

Obviously, seminaries can choose to develop their own curriculum. In doing so, though, it must be rigorous in design and implementation, and it must adequately prepare future clergy to recognize and respond competently—if not with excellence to instances of abuse.


  1. Mandated reporter training for churches

All clergy and other church workers involved with youth should receive high quality mandated reporter training. Once completed, those involved with youth should receive refresher training at least once every two years. South Carolina has many high quality mandated reporter training programs which local CACs can help churches access. As one example, the Children’s Law Center at the University of South Carolina Law School provides both online and in person mandated reporter training and, in the past nine months alone, has trained 3,708 mandated reporters.

Parishioners, particularly those who are parents, should insist that churches have in place minimal training standards for those working with youth. Martin Luther said “It is to the little children we must preach, it is for them that the entire ministry exists.”160 Churches in agreement with Luther’s sentiments will develop minimal standards of training on child abuse for workers and volunteers interacting with youth.



  1. MDTs and faith leaders should collaborate on church policies

Although many churches have child protection policies, and many insurance companies require these policies, the writers of these policies are oftentimes not child abuse experts.161 One area for collaboration between child protection and faith leaders is for clergy and other church leaders to consult with child abuse solicitors, DSS, and law enforcement officers in their community and ask for feedback on individual policies. In turn, these other agencies should be willing to provide this collaborative service to churches in the hope of preventing instances of child abuse in faith settings.

  1. CAC/MDTs should have a chaplain specially trained in child abuse assisting the team

Given the large amount of research on the use of religious themes in the sexual abuse of children, as well as the large body of research about the profound impact of child sexual abuse on a child’s sense of spirituality, MDTs should begin to discuss this aspect as part of case review processes and, in appropriate instances, assist children in accessing culturally appropriate spiritual care. To assist in this dialogue, it may be wise for each CAC to select a chaplain specially trained in child abuse to participate in case review processes under the same levels of confidentiality that would be required of any team member. The selected chaplain must pass a background check, be recommended by at least two members of the MDT, and must complete at least 40 hours of training on child abuse with the training being approved by the participating CAC. If the Chaplains for Children program contemplated in this report162 becomes a reality, the participating chaplain must also participate and complete that training program successfully.

In addition to serving the MDT in this way, the CAC/MDT may find other roles for clergy to add resources to the team and otherwise serve the needs of maltreated children. Attached to this report as “Exhibit C” is an article co-authored by child protection leaders from NPCTC, APSAC, NDAA and the University of North Carolina-Chapel Hill proposing 12 possible roles for clergy on the MDT. At the discretion of local MDTs, one or more of these additional roles may also be appropriate.



  1. Implement a “Chaplains for Children” training program within one year

We suggest that South Carolina develop and implement a five day training program entitled Chaplains for Children. This intensive program will be designed for police chaplains, hospital pastoral care workers, and clergy seeking to improve their skills in providing spiritual counseling to survivors of child abuse and in working with MDTs providing mental health and other services to maltreated children and their families. The course should cover all of the topics suggested in the seminary curriculum and also provide hands on experience in speaking with survivors of abuse who are asking spiritual questions about their victimization. The “survivors” would be portrayed by professional actors (similar to the concept used in South Carolina’s ChildFirst forensic interview training program) and be critiqued by a team of pastoral care and mental health professionals assisting with the course. The students must also complete a written or oral examination demonstrating knowledge of pertinent child abuse literature, mandated reporting laws, and other subjects covered in the course.

In looking for an agency ideal for hosting this training and promoting it throughout the state, we suggest the South Carolina Law Enforcement Assistance Program and Chaplaincy Service (SCLEAP). This chaplaincy service is part of the South Carolina Law Enforcement Division and is modeled on a concept currently used by the FBI. The SCLEAP program has staff and volunteers that currently serve over 2,500 South Carolina law enforcement officers and their families. The services provided by SCLEAP include “regular training for staff and volunteers in those areas where SCLEAP provides services.”163 We believe a “Chaplains for Children” training program would be a natural extension of the current work of SCLEAP and could become a model replicated nationally.

We discussed this concept with a number of front line child protection professionals with the vast majority expressing support provided there were appropriates checks and balances on who was admitted to the program or what they may eventually do as part of an MDT. In the online survey, 57% of clinicians, 47% of DSS workers and 43% of law enforcement officers/solicitors said involving chaplains in cases of child sexual abuse was a “good idea.”164 Only 4% of DSS workers, 7% of clinicians and 23% of law enforcement officers said it was not a good idea—with large percentages unsure.165 We suspect the large number of “unsure” respondents indicate that the online survey did not fully explain the concept in the manner that was done in the onsite interviews.


  1. Within 3 years implement a “Chaplains for Child Protection Professionals” training program

In addition to the chaplaincy programs offered through SLED, South Carolina has a great many law enforcement chaplains, pastoral care workers and other spiritual counselors assisting MDT members cope with the stressors of their work and lives. We suggest a 2.5 day course specifically focusing on addressing the spiritual needs of child protection professionals. Chaplains attending this course must have completed the five day Chaplains for Children course and must be approved by a law enforcement agency, pastoral care department, or other program affiliated with an MDT. We suggest that this course also be provided under the auspices of SCLEAP.

  1. The HALOS program in Charleston should be replicated throughout the state

One of the most creative programs in the country for involving faith communities with child protection professionals is located in Charleston, South Carolina. In 1997, a pediatrician by the name of Eve Spratt worked with local churches, synagogues, public policy makers and DSS workers in creating a program called HALOS which stands for Helping and Lending Outreach Support.

The concept behind HALOS is simple. Local DSS workers articulate the unmet needs of children and families they are working with and participating churches provide financial or other resources to meet the need. In Charleston County alone, there are more than 1,800 open case files on abused and neglected children.166

The needs met by HALOS can be as simple as helping cover registration fees for summer camp, or assisting a child in foster care in acquiring a prom dress. A posting on the HALOS website tells of a case involving “a woman on a fixed income who took in two young grandchildren while their mother struggled with drug addiction. When the children outgrew their cribs, she needed beds to keep the children out of a foster home, but she could not afford new furniture. HALOS stepped in to provide a lightly used bunk bed donated by a local family.”167

In 2004, HALOS received a federal grant from the Office for Victims of Crime to duplicate the program in three other locations including Dillon and Lancaster counties in South Carolina. The program has also been replicated in Greene County, Missouri and a similar program, called Care in Action operates in Minnesota.168

We applaud the HALOS program for its work in three South Carolina counties, as well as other states. We suggest that ministerial and other associations of faith leaders in every county in South Carolina form a working group to consider the feasibility of a HALOS program in their communities. In turn, these working groups will need to work closely with local DSS workers and officials to make sure the program is adding meaningful resources to families served by DSS and SAFY.

From our interviews with South Carolina professionals working with children, including children who have offended, we learned of many needs that are not being met. For example, a group home worker told us:

We have a child now who has pulled out all his teeth…he is 11, he needs teeth. The system doesn’t pay for teeth. He is going to go through life without teeth. The child [also] needs a specific medication [but] we are told he can’t get it because it is too expensive. It is those kinds of things you have to bring to everyone’s attention. I think talk is cheap.

It is cases like this, cases in which a child needs the simple dignity of having teeth, that we believe the South Carolina faith community can help.



Improving the Mandated Reporting System in South Carolina

In the wake of the child sexual abuse scandal at Penn State University, many in the nation were shocked that so many men, many of them well educated, failed to report even clear instances of sexual abuse to the authorities.169 As a result of public outrage, there has been a great deal of work at federal and state levels to expand the list of professionals mandated to report and to increase the penalties for failing to report abuse. South Carolina is one of many states in which legislators are considering these reforms.

Although some South Carolina child protection professionals we spoke with expressed support for expanding the state’s mandated reporting law, the vast majority of the professionals did not see the current mandated reporting law as the primary problem in South Carolina. One law enforcement officer told us simply “It is a pretty air tight law. If you are one of those people, you have to report…I can’t think of any weaknesses off the top of my head.”

However, these same professionals did see instances of under-reporting (failing to report clear suspicions of abuse) as well as over-reporting (reporting instances not suspicious of abuse) and suggested that both problems are rooted in inadequate training. Examples from the frontlines include these comments:



  • “I think it [the law] is written very clear. I think it is unfortunate that [some] people don’t know about it. I see teachers, resource officers, and others who aren’t aware of mandated reporting. We had a school official who said [to a teacher he suspected of sexually abusing a child] ‘if you don’t tell on yourself then I will tell someone.’”

  • “I deal a lot with cases in schools. I feel like our schools need a lot of help. Their concerns tend to be more superficial…They do report a lot of our cases [but] there is nit-picking…”

  • “Schools do the best job of reporting. Medical professionals struggle with reporting because they don’t want to go to court.”

  • “Teachers and therapists do the best job of reporting. Medical staff struggles with this….Many people are afraid of having their name revealed during the investigation even though that is not supposed to happen.”

  • “Mental health professionals and doctors do the best job of reporting. The school is the least likely to report [in our community].”

  • “Doctors and pediatricians [in my community] have been hard. You have to show up with a SWAT team to find out what the kid told them.”

  • “I feel like knowledge is power. I feel there aren’t enough people who have knowledge about it [mandated reporting]. I have pediatricians calling and second guessing themselves. Teachers and guidance counselors [are] calling over here and their questions are no brainers to me. Of course you have to report. There is a lot of handholding. I worry about those who don’t call us. Education needs to be out there.”

One of the mandated reporters we spoke to said she knows of people who have stopped reporting suspicions of abuse because so many cases are screened out. Specifically, this reporter told us:

I don’t think it [mandated reporting] is working….[Our] attitude became ‘why report when they [DSS and law enforcement] won’t do anything. Does he have a bruise on him now? No. He has been here a month. If he doesn’t have a bruise on him now I can’t do anything. If his mom isn’t smoking weed with him [but] is only smoking in the house you get laughed at for calling.

In the online survey, we asked frontline professionals to rate the effectiveness of the mandated reporting system on a scale of 1-5 with five being the highest. Nearly half of the professionals working in metropolitan communities (49%) and the state as a whole (46%) rated the system as a 4 or a 5. A large number (42% in metropolitan communities and 43% overall) rated the system “somewhat effective.”170

As stated previously, when asked what professionals were least likely to report suspicions of child sexual abuse, law enforcement officers/solicitors, DSS workers and clinicians all said pastors were the least likely to report sexual abuse.171



Putting the South Carolina findings in the context of other research

The contention of South Carolina professionals that at least some reporters fail to report instances of abuse, and the stated reasons for these failures, is consistent with other studies over the past several decades.

A 1990 study found that only 40% of maltreatment cases and 35% of the most serious cases known to professionals mandated to report were in fact reported or otherwise getting into the child protection system (CPS).172 A study published one decade later found that 65% of social workers, 53% of physicians and 58% of physician assistants were not reporting all cases of suspected abuse.173

In a survey of 197 teachers, these educators were given two hypothetical cases of abuse. In the first hypothetical, the teachers were asked if they would make a report when a student tells them a stepfather has been touching their genitals. In the second hypothetical, the teachers were asked if they would make a report when a student tells them that another teacher was touching their genitals. Only 26% of the teachers said they would report the first instance to the authorities and only 11% said they would report the second incident to the authorities.174

According to this same study, 73% of teachers reported they had never made a report of child abuse and those who had a made a report averaged only one report.175 This is true even though the teachers in this study averaged 10 years of experience.176 When reports are made, it is typically only to a supervisor.177

Reasons some mandated reporters fail to report: what other studies tell us

The reasons offered to us for the failure of some South Carolina reporters to call in suspicions of abuse mirrors other research. In other studies, insufficient evidence, lack of certainty that abuse has occurred, the belief a report will cause additional harm, and the need to maintain a good relationship with patients and clients are some of the reasons cited by reporters failing to comply with the law.178

Physicians often worry about the effects of an unfounded report on their private practice.179 In small towns, patients may be reluctant to visit a physician who has previously reported abuse, particularly if the report is viewed as frivolous.180 Although the identity of a reporter is to be handled in confidence, small-town life is such that the identity of the reporter can often be detected.181

Some skilled reporters recognize that child protection investigators must prioritize the reports received and may be able to respond to only the most serious. Recognizing this, some reporters may not call in a suspicion of abuse because it is believed no action can be taken.182



The correlation between reporting and training: a review of other studies

A lack of training may explain the ignorance of some mandated reporters about their obligations. In a 1989 survey of 480 elementary school teachers, 50% said they had not received any in-service training on mandated reporting and most of the teachers were not fully aware of their school’s policies as to the handling of child abuse cases.183 In a 1999 survey of 382 master's level social workers, pediatricians, physicians, and physician assistants, researchers found that 57% of the respondents had received less than ten hours of training on their obligations as mandated reporters.184 In a 2001 study of 197 teachers, 74% said they received “minimal” or “inadequate” preparation in college to prepare them for the work of being a mandated reporter and 58% said they were receiving minimal or inadequate training on child abuse once they entered the field.185

In the case of the Penn State scandal, inadequate training of mandated reporters may have played a role in the failure of many adults to disclose evidence of abuse to the authorities. In a survey of 1,400 mandated professionals from 54 counties in Pennsylvania, 14% said they had never received mandated reporter training.186 Another 24% said they had not received mandated reporter training in the past five years.187 The professionals that had received training on their obligations as mandated reporters, may not have received quality training. Approximately 80% of the respondents to the survey said the training was not approved for continuing education units or they were uncertain.188

A number of researchers have recognized the urgent need to improve the training of mandated reporters at both the undergraduate and graduate level as well as when these reporters are in the field.

Commenting on three decades of studies, one team of researchers concluded:

Failure of professionals to report child maltreatment may leave hundreds of thousands of children and their families without needed interventions and at increased risk of further maltreatment. During the past 30 years, several reasons have been consistently found to influence professionals to ignore legal mandates to report suspected child abuse and neglect, including inability to recognize signs and symptoms of child abuse and neglect, misunderstanding State child abuse and neglect reporting laws, and fear of negative consequences resulting from the report. These concerns may be easily allayed through increased availability of training programs, implementing educational programs that emphasize potential consequences of reporting, and improving the working relationship with CPS (emphasis added).189



Recommendations for improving mandated reporting in South Carolina

The vast majority of child protection professionals responding to the online survey rated the South Carolina system as somewhat effective or very effective.190 This may be attributable to the fact that most professionals (53%) said mandated reporter training was available in their community, although some of the onsite interviewees lamented that available training was not always taken advantage of by local reporters. A consistent theme throughout the onsite interviews was that most, if not all problems with mandated reporting could be rectified with training. This view is supported by other research studies.

From this information, we have the following recommendations:


  1. MDTs must increase community awareness of mandated reporter training

Every CAC, solicitor’s office, law enforcement agency, hospital or other agency working as part of an MDT should list on their respective websites and other social media outlets available mandated reporter trainings in their community or state. At a minimum, this should include mandated reporter training offered through the Children’s Law Center at the University of South Carolina School of Law which, from our review, has a sophisticated mandated reporter training program that has been well received throughout the state.

  1. MDTs should target faith communities for MR training

Given the striking percentages of MDT members claiming clergy are the least likely to report instances of child sexual abuse, we suggest that South Carolina’s multi-disciplinary teams make a concerted effort to reach out to faith communities and offer training on child abuse and mandated reporting.

We suggest this training also provide an overview of the impact of child abuse on spirituality. To this end, mandated reporter trainers working with churches may want to supplement their training with the DVD Hear their Cries, a 48 minute DVD and training packet produced by Faith Trust Institute that includes comments from survivors abused in the name of religion or whose abuse was ignored by church leaders.191 The National Child Protection Training Center has also produced a number of articles and presentations appropriate for the faith community which local trainers can use free of charge.



  1. Implement a “two plus ten” plan

Nearly all of the available data on mandated reporting suggests that the success or failure of the system is largely dependent on training. Accordingly, the state should focus most of its efforts in this area.

We suggest the state adopt as its goal a minimum of two hours of in person training each year for mandated reporters. Through the Children’s Law Center, South Carolina already has a 7.5 hour course in which law enforcement officers and other members of the MDT can be trained to provide mandated reporter instruction. Although every county can decide the number of trainers it may need, fully utilizing this vehicle can quickly expand the number of qualified instructors available in each community.

We also suggest that the two hours of annual training be supplemented with an additional ten hours of training that mandated reporters can access 24/7 online but must complete every three years. These courses can be included on a training portal accessed with a password provided through the Children’s Law Center or another statewide entity overseeing the project.

The online courses should supplement the onsite training by covering topics not commonly discussed with mandated reporting professionals including recognizing cases of emotional maltreatment, the impact exposure to domestic violence has on children, adverse childhood experience research,192 the impact of child abuse on spirituality, and the role of youth serving organizations in building resiliency factors that assist maltreated children in overcoming their trauma.



  1. Parents should raise their voices

Child protection is not simply the responsibility of mandated reporters and child protection professionals—it is first, and foremost, the job of parents. Simply put, parents and other caretakers who enroll their children in school, day care, little league, church or other youth serving organizations should inquire what child protection policies, if any, the organization has in place. Moreover, parents should inquire as to what training the organization provides its employees in recognizing and responding to instances of abuse. CACs should educate parents on the type of questions consumers should ask before enrolling their children in various community activities. If parents have a choice in which organizations to enroll their children, they should consistently choose schools, day cares, churches and other organizations that take child protection seriously. If even a small percentage of parents demand this change, change will come.

  1. Prosecute egregious cases of failure to report child sexual abuse

In onsite interviews, child protection professionals told us there have been some consequences for failure to report instances of child abuse—such as reporters losing their jobs. However, some professionals told us the prosecution of reporters, even in egregious instances of failing to report child abuse, is rare. A 13 year child protection veteran told us “Failure to report is not taken seriously” and added “I don’t know of one person who has been prosecuted for not reporting.”

We did, though, find instances wherein charges were filed against mandated reporters who failed to contact the authorities even when they had clear evidence of sexual abuse.193 Although prosecutors should exercise discretion in filing any criminal charges, in cases when a reporter has clear evidence of sexual abuse—such as a child making a clear disclosure or a reporter walking in on abuse—prosecution for failing to report should be routine.

The reason South Carolina and other states have mandated reporting laws is because children are often unable physically and emotionally to protect themselves. Accordingly, it is primarily the responsibility of adults to protect children and when reporters willfully fail to fulfill this function in clear violation of South Carolina law, they should be held accountable.

Expanding Prevention Initiatives in South Carolina

South Carolina is one of only nine states that does not collect, or at least report data to the United States Department of Health and Human Services on the level of preventative services implemented throughout the state.194 Accordingly, it is challenging to assess the actual level of, much less impact of prevention programming in the state.

It is clear, though, that there are prevention programs in South Carolina. For example, the prevention program Darkness2Light began in Charleston, South Carolina and has been utilized in communities throughout the United States.195 The program is evidence based and has resulted in a much greater awareness of child sexual abuse among those participating in the program.196

In the onsite interviews, we asked several questions to determine the existence of prevention programs and policies that may be present in the state.197 In some instances, child protection professionals told us they were not aware of any prevention programs in their communities. A veteran child protection professional of 20 years said “there are no prevention programs I am aware of.”

Others spoke of personal safety and dating violence workshops in public schools. A number of professionals mentioned Darkness2Light. To the extent prevention programming and policies were in place, a number of professionals commented that these practices have not extended to the faith community. One child protection worker commented “They don’t understand it at my small church. They don’t do screenings for Sunday School teachers or anything.”

A law enforcement officer told us she does child protection policy training for community groups. In her experience, the officer told us most churches don’t have child protection policies and, when they contact her for training or other assistance, the “vast majority” of the time it is “reactionary” to a case of sexual abuse having occurred as opposed to being proactive in preventing the abuse at the outset.

In the online survey, we asked child protection professionals if they were aware of child safety programs in their community that were targeted to adults, to children generally, or to children in high risk populations. In metropolitan communities, 38% of respondents were unaware or were not sure of any such program and, overall, 44% were not aware of such programs in their communities.198

Recommendations


  1. A prevention resource guide

A number of frontline professionals expressed an interest in promoting prevention but were unaware of available programs—sometimes even programs that were operating in their communities. Some of these professionals suggested the utility of a resource guide listing all the available programs in their jurisdiction so they could easily refer families in need or advocate for programming in the schools, day cares, churches and other institutions with which they interact professionally or personally.

We suggest the CACs ask their MDTs to list all of the prevention programs operating in their communities and develop a comprehensive list of these programs complete with contact information, websites, etc. To this list should be added state or even national prevention programs—such as Darkness2Light--that could be implemented in interested communities.

Once developed, the resource guide should be on the website of every CAC and agency participating in the MDT. Simply put, every team member has a responsibility to educate themselves about prevention programming and to promote these efforts at every opportunity. This can’t happen, though, until everyone is aware of existing programs and programs that could be implemented.


  1. Prevention planning

The prevention of sexual abuse is more than simply adopting cookie cutter programming and putting it in place throughout a state or country. The reality is that not only is child abuse complex, but so are the communities in which child abuse exists. Accordingly, it is incumbent on child protection professionals, those closest to the children and families impacted by abuse, to periodically step back and analyze what, if any, prevention programs would actually make a difference in their communities.

To this end, we suggest that, once a year, an agency in each MDT agrees to host a “prevention planning” day or, if need be, two days. During this event, the MDT would look at typical cases handled in the previous year and ask what, if anything, could have been done to prevent abuse? Perhaps the team noticed an increase in teenage pregnancies and observed that many of these young parents were lacking in parenting skills and ended up physically hurting their children. In such a scenario, teenage pregnancy prevention programming or, where pregnancy cannot be averted, public health nurses or parenting classes for young mothers may have made all the difference.

There should also be an open discussion in which MDT members can share their observations over the years and offer thoughts on available programs that may have prevented at least some instances of abuse. From this discussion, the team should select 1-2 prevention initiatives they would like to implement (more than 2 likely becomes too much). A sub-committee should be formed to implement the program within a year.

There should also be an open discussion about prevention programming that is currently operating in a community but for which the team believes there is little evidence it is making a difference. Simply put, every program, no matter how popular, should be put under the radar of the local MDT.

If at all possible, MDTs should invite local colleges or universities to be part of the discussion and to consider helping the team research the efficacy of any new program being implemented or to research the efficacy of old programs the team is not sure are working.

The prevention planning contemplated in this report should become an annual event for every MDT in South Carolina.



  1. Prevention scouting

Each year, every MDT should assign one or more team members to be prevention scouts. Those assigned this honor agree to attend at least one national and as many state conferences as possible with the specific task of looking for evidence based prevention programs that might be a good fit for their communities. Once discovered, the job of the scout is to share these ideas with the local team and community. In this way, the team is constantly being invigorated with fresh ideas for taking prevention to a continually higher plane.

  1. Color South Carolina Blue

Within 5 years, every MDT in South Carolina should be able to claim that the counties in which they operate have at least five evidence-based child abuse prevention programs. The CAC chapter website should have a state map and, once the MDTs in a particular county can list the five prevention programs they have up and running—and also cite the research or other evidence to support the models--the county should be shaded blue on the state map.

Within five years, then, every county in South Carolina should be colored blue. If policy makers are so inclined, counties meeting this standard should be able to post road signs at their borders announcing they are so dedicated to preventing child abuse that they have met the state standard necessary for being deemed a “blue county.” It would be breathtaking to drive through every county in South Carolina and, with the crossing of each border, read a sign proclaiming “you are entering a blue county.”

Because child sexual abuse often exists with other forms of abuse, the prevention programs should not focus only on sexual abuse. We also suggest that at least one of the five prevention programs focuses on physical abuse, one on neglect, and one on emotional abuse.

Improving South Carolina’s Juvenile Sex Offender registry

A consistent theme in our interviews with front line solicitors, law enforcement officers, DSS workers and treatment providers, is that South Carolina’s sex offender registry, at least with respect to juveniles, is too harsh and may be increasing the risk these children will not be able to function in society as adults and may, as a result, offend again. Simply stated, most child protection professionals we spoke with articulated an understanding that juveniles do not necessarily offend for the same reasons as adults and that their developing brains make them very different from most adult offenders. This is not to say that some juveniles should not have to register, and register for life, but that there is a need to recognize that a “one size fits all” approach contradicts research, practice, and common sense.

A professional working with South Carolina’s juvenile sex offenders told us “if you treat a child as a prisoner, you get a prisoner…(The) community gets the difference between the adult pedophiles and the children.” With respect to the registration of juveniles as sex offenders, particularly registration for life, this provider said:

It [registration of juveniles] prevents them from getting jobs, housing or being on campus. It is very negative. We have children leave [treatment] and do well and [then] someone finds them on the registry and [makes] their life a living hell. I don’t see any benefit for the sex offender registry for children…If they are adjudicated as an adult and believed to be a risk then I’m all for it…juvenile family court judges look at these 12 and 13 year olds and plead them down…They are trying to keep them off the registry. People think the numbers are going down because it [registration] worked. I think family court judges have to sleep at night and that is why the numbers are down.

In the online survey conducted as part of this research project, a majority of law enforcement officers/solicitors (52%), DSS workers (55%), and clinicians (53%) agreed with the statement that “juvenile offenders need special consideration as they are often victims themselves and shouldn’t be on the registry for life.”199 Only 22% of law enforcement officers/solicitors, 14% of DSS workers and 10% of clinicians/therapists disagreed with this statement with the remainder of respondents unsure.200

The National Center for Prosecution of Child Abuse (NCPCA), a program of the National District Attorneys’ Association, recently published a “cheat sheet” for prosecutors trying to determine the danger juvenile offenders pose to society and otherwise offering some guidance to MDTs confronted with these cases. The article, entitled Juvenile Sex Offenses: Finding Justice, is authored by Ann Ratnayake and was peer reviewed by nationally recognized sex offender treatment experts Anna Salter and Barbara Bonner as well as former child abuse detective Mike Johnson, who is currently serving as the director of youth protection for the Boy Scouts of America. The article is available online.201

As noted in the NCPCA article, children below the age of 12 initiating sexual contact fall into a “special subgroup” and the younger the child is “the more likely he or she is only mimicking behaviors seen or repeating behaviors the child has experienced.”202 Accordingly, NCPCA proposes an “initial step” of “screening these children for possible sexual abuse.” Although each case is different, NCPCA suggests that the best course for many of these children is “applying for a child protection petition to ensure the child gets treatment.…”203

With respect to children 12-18, NCPCA notes the following factors have been linked in research to an increased risk of sexual recidivism:



  • Reporting deviant sexual fantasies with an interest in prepubescent children and/or sexual violence;

  • Committing sexual offenses despite prior charges or conviction of a sexual offense;

  • Targeting a stranger as a victim;

  • Unwillingness/inability to form peer relationships, or social isolation for other reasons; and

  • Unwillingness/inability to participate in treatment.204

Recommendations

  1. Give South Carolina’s judges the option of not requiring juveniles below the age of 12 to register as sex offenders for life

Unless a juvenile court judge finds unusual circumstances, juveniles below the age of 12 should be screened as possible victims and receive appropriate treatment. As noted by a number of experts, “Among preteen children with sexual behavior problems, a history of sexual abuse is particularly prevalent.”205 This proposal is consistent with research that only a small fraction of this population will re-offend after treatment but still allows the trial court to make an exception for juveniles for whom there is evidence suggesting a higher risk.

  1. Children 12-14 should be required to register as sex offenders for life only when the court finds specific evidence of an increased risk of recidivism

As the NCPCA article points out, there is no magic “litmus test” for determining recidivism but there are a number of common sense factors that make recidivism more likely including deviant arousal, interest in pre-pubescent children, multiple victims and unwillingness or inability to undergo treatment. Judges should be given discretion to apply these and other relevant factors in determining the child’s sentence, including registration for life.

  1. Children 14 and older should face registration consistent with federal law

With respect to children 14 and older, South Carolina, like all states, must comply with the Adam Walsh Child Protection and Safety Act (AWA). To this extent, the issue of registering offenders in this age range may be more of a federal than state issue. There is every reason to believe the issue will continue to be debated at the federal level and that proposed changes to the law will be advanced.206 Accordingly, it is critical for survivors of abuse, for child protection professionals, and for those working directly with juvenile offenders to communicate their thoughts and suggestions to their elected leaders. It is also critical for these leaders to ask hard questions of those advocating for reform or the status quo. With studies suggesting that juvenile offenders constitute more than one-third of sexual offenses committed against minors,207 it is also important to consider what, if any, additional resources can be committed in our communities to preventing offenses in this age range.

  1. DSS should consider accepting cases of inappropriate sexual acting out in children below the age of 10

As noted above, the younger the child is who is initiating inappropriate sexual conduct, the greater the likelihood the child is mimicking behaviors seen or repeating behaviors experienced. From our interviews with MDT members, including DSS workers, we were consistently told that these cases would not be considered a child protection issue unless there was evidence a parent knew of the sexual offenses committed by a child in his or her home and failed to protect.

Many sexual acts by young children are perfectly normal and should be screened out. It may also be appropriate to work voluntarily with many parents to address even troubling behaviors. However, when the behaviors are violent or otherwise far outside the norm for a young child, we discourage a bright line rule that uniformly screens out such cases—at least without any sort of assessment by the MDT.



Reducing Vicarious Trauma

A significant body of research documents that law enforcement officers, prosecutors, forensic interviewers, therapists, DSS workers and other child protection professionals working daily with cases of child abuse can experience “vicarious trauma” as a result of hearing about these events or in otherwise aiding someone who has endured trauma.208 The symptoms of vicarious trauma may resemble the symptoms of post-traumatic stress disorder including avoiding reminders of traumatic reports, withdrawal and isolation from others, anxiety and depression.209

A consistent theme throughout our interviews with South Carolina’s front line child protection professionals was a concern about burnout. Indeed, many of the child protection professionals were poignant in describing their own pain and the emotional pain of their colleagues.

Comments we heard included:



  • “One of the things I noticed about doing this work, you don’t have memory anymore. I can hardly even remember. It is a self-preservation mechanism, because it is gone. I can’t be really specific.”

  • “It’s not hearing the kids’ stories that kill you, but it is truly coming in every day and deciding which kids I can’t help. They all deserve help and it is gut wrenching and nearly inhumane. [Lowering our case load] would go a long way in stopping vicarious trauma.”

  • “Well our agency isn’t very good at [dealing with vicarious trauma]. We don’t have a lot of resources to handle burnout. We have a lot of time off and you can take that whenever you want. That’s how I handle it, [if] I feel like I’m getting burned out I take a few days off and not think about work and do something else.”

  • “The sheriff brought in a therapist to meet with us…I haven’t used her because she is the therapist for the kids I [work with] so it seems creepy. I work with her professionally. As a team we are pretty good checking in when people have a problem. We are conscious of each other…Honestly, our biggest issue would just be if they would properly staff us.”

  • “I feel like from team member to team member we are all very good at supporting each other. We are good at recognizing when we need someone to talk to and when we need to talk before we go home. As an agency we need to do a whole lot more—white water trips or other ridiculous things. I would love a week to audit charts and not have new clients so I could feel really good about where my work is [at].”

  • “How do you win a war when soldiers are dying on the battle field? We need for our leaders to have creative ways to provide [emotional support]. Not just make us feel better…When we get desensitized we can’t serve. We need to be upset about what is happening. We need to be attentive, not taking it home all the time. Specific therapists that could see staff that we don’t work with all the time. A debriefing meeting where people can support each other [would also help].”

Recommendations

  1. Within 12 months, every agency represented on South Carolina MDTs should have a written plan to address vicarious trauma

Although many child protection professionals acknowledged their supervisors and agencies are aware of vicarious trauma and are generally sympathetic, it is critical to develop a concrete plan to ensure workers are exercising self-care. Given the volume of cases many agencies see, and the dire consequences for any error, many employees will not, or cannot take care of themselves without strong leadership from within their organizations.

Although the specifics of the plan will vary from organization to organization, common features may include:



  1. Training. When workers feel lacking in the skills necessary to help children, their anxiety levels predictably increase. Accordingly, supervisors should ask employees what additional training, if any, they would like that can help with their work. The supervisor should make every effort to help the worker secure the training requested. In addition to increasing skills, training often “energizes child abuse professionals and gives…important contacts that can assist in the handling of difficult cases.”210

  2. Mandated vacations. Some workers we spoke with recognized the importance of vacations in reducing vicarious trauma. However, this is not true for every child protection professional we encountered. Child protection professionals in South Carolina, as is true around the country, sometimes worry that any leave of absence will hurt a child and they feel personally responsible for all the children whose cases are on their desk. When this happens, supervisors must intervene and remind the worker that the entire agency, indeed the entire team is responsible for the children and it is necessary for each member to practice self-care. Doing so is in the best interests of the MDT and the children for whom this is all about. Supervisors may want to remind workers of the instructions provided by flight attendants in case of an emergency—that it is critical to put on our own oxygen masks before assisting others.

  3. Encourage, if not require workers to have a “self-care” list. Lisa Yazdanni, a child psychologist from Mississippi suggests that each child protection professional have a “self-care list” that is “specific, measurable, achievable, rewarded and time limited.”211 Yazdani suggests that each worker develop an annual list of things he or she will do to exercise self-care. The list must be concrete and include things that are easily achievable. For example, if a worker has always wanted to visit Paris but doesn’t have the funds to do so, that should not be on the list. If, though, the worker has always wanted to canoe a nearby river, that can be on the list. To enforce the self-care plan, each worker can have a buddy whose job it is to periodically check in and see how you are doing and how much of the list has been checked off. To some extent, there is already an informal “buddy system” in place at many agencies in South Carolina. Many of the MDT members we spoke with told us that child protection professionals look out for one another. We believe making this informal system more formal through the creation of a “buddy system” may help ensure that no professional falls through the cracks.

  4. Social events. It is important for MDT members to get together in informal events and unwind. We suggest agencies host such an event at least once a month. It can be as simple as an ice cream social or more involved such as white water rafting (the suggestion we received from one of the professionals with whom we spoke). If at all possible, these events should be held during office hours. It does not alleviate stress to require workers to come in for a social event that simply takes them away from their families. If community members or public policy leaders object to such events taking place on “company time,” supervisors should strongly—and bluntly--explain that workers who spends months or years interacting with children who have been beaten, bludgeoned, burned, raped, starved, tortured and, in some cases murdered need some “company time” breaks in order to survive. Simply stated, the lives of the children depend on our ability to keep these workers emotionally healthy.

  5. Encourage and create opportunities for workers to vent. As one worker told us, “(w)e need to be upset about what is happening. We need to be attentive, not taking it home all the time.” Simply stated, workers need to be able to express their frustrations and their feelings about children who have died, cases that have been lost, or even cases that have been successfully handled but the child’s outcry has emotionally impacted one or more members of the team. Supervisors must be vigilant in asking workers how they are feeling, in organizing de-briefing sessions after particularly traumatic cases, and otherwise inviting honest expression of feelings, including worker frustrations with management. In the field of child protection, it is our work that inflicts the most pain and, if at all possible, it is at work where we should leave the pain.

  6. Mental health support. Every child protection agency must have an employee assistance plan that allows employees to access mental health care. As noted by some of the professionals with whom we spoke, the mental health provider must be someone other than a psychologist working on the team. As one law enforcement officer told us, it is “creepy” to speak to a psychologist who is also serving the children with whom you are working. Since a child protection professional may need to express frustration he or she has with other team members, it is critical that the therapist be someone who is not in any way connected to the MDT.

  7. Spiritual care. Many hospitals, police departments, fire departments and branches of the military provide pastoral care or chaplains for their employees. Many of the child protection professionals we spoke with told us of the importance of their faith in coping with trauma. Accordingly, we support chaplaincy programs for child protection professionals. To make these programs as effective as possible, though, we also encourage the development of training programs to assist these professionals in understanding the unique form of vicarious trauma experienced by so many child protection professionals.

  8. Manageable case loads. Although managers and supervisors may currently lack the funding to reduce the case loads of their workers, they should get input from their workers to assist in determining reasonable case-loads as well as look at any recommended standards for a given profession. Supervisors should be visibly active in working to reduce case loads. Even if they are not successful, managers seen fighting the good fight for the child protection professionals they supervise will aid in reducing the feeling of aloneness that some professionals experience.

  9. Rotation. From time to time, a child protection worker may need to rotate out of a child protection unit. For example, a solicitor may need to take a break from sexual abuse cases and, for a year or more, simply be assigned to prosecute crimes not involving children. If this happens, though, the supervisor must make sure it is a clean break. Other workers should not be calling or e-mailing the prosecutor rotated out of the unit for his or her advice on incoming child protection cases.

  10. In-house training. Every year, every agency should have an in-house training on vicarious trauma. Simply stated, if there is not an open discussion about this issue, and management does not make it clear that addressing vicarious trauma is a top priority, every other effort will fall by the wayside.

  11. Getting out of the office. There may be times a worker has to work through lunch or otherwise forego any break. This, though, should not be routine. All team members, including supervisors, should model self-care by getting out of their office for lunch—even if this simply means going to the break room and interacting with colleagues.

  12. Thank you files. Workers should be encouraged to have a “thank you file” in their file cabinets or on their computer. Whenever children, parents or fellow child protection professionals send a note of thanks, particularly in egregious cases in which a worker excelled, the note of gratitude should be maintained. When days are gray and the worker feels he or she has not made a difference, a supervisor or colleague may want to remind the worker to pull out the thank you file and remind herself of all the cases, and all the children to whom she made a world of difference.

  13. Community service. Many professionals told us they like getting out in the community to teach a class or otherwise interact with the public in a manner that doesn’t involve asking children where they were touched or looking for semen on bed covers. Simply stated, being proactive in teaching a prevention class or educating a local youth serving group about child protection efforts in the community is a welcome change of pace for many professionals. Whenever possible, supervisors should encourage these sort of activities.

  14. Public recognition. Given the high stress, high burnout nature of this field, it is critical for child protection managers and supervisors to frequently and publicly praise the workers who have dedicated their lives to serving maltreated children. There should also be opportunities at staff meetings or other gatherings for colleagues to single out someone who excelled in handling a difficult case or who has otherwise assisted the team.

The Silent Tears Task Force Must Continue

If any of the recommendations in this report, much less most or all of them are to be enacted, it is crucial that the Silent Tears Task Force remain in place and assist in aiding individuals and agencies in taking next steps. Most of the proposals will not take very much money, but they will likely involve some expense. To this end, the Task Force should take a leadership role in finding philanthropists willing to fund entities engaging in activities consistent with this report. Silent Tears was not a project designed to generate paper—it was designed to make a difference in the lives of children. Until this goal is reached, the Task Force needs to remain engaged.



Conclusion: Making a Very Good System Even Better

In reviewing this report, readers should keep in mind that, in many respects, the child protection system in South Carolina is among the best in the nation. South Carolina has a nationally recognized child sexual abuse prevention program (Darkness2Light), a nationally recognized program for bringing child protection and faith communities together (HALOS), was among the first states to develop a forensic interview training program (ChildFirst), and is one of only 15 states to have begun the process of dramatically improving undergraduate training of child protection professionals (the CAST program at USC Upstate). The state offers a number of high quality training programs and the ability of the Children’s Law Center to provide technical and other assistance to child protection MDTs is an invaluable resource many states lack.

As reflected in this study, the CACs and MDTs in South Carolina are functioning at an extremely high level. With the possible exception of the speed in completing a forensic interview, child protection professionals heralded the impact CACs have had in bringing teams and communities together and in otherwise impacting the lives of children in a meaningful way. When asked about his local CAC, one law enforcement officer told us “I can’t sing their praises enough.”

When asked to rate the functioning of their MDTs on a scale of 1-5, 74% of professionals in metropolitan communities and 63% of professionals overall gave their team a 4 or a 5. Given the candor these team members had in critiquing all aspects of the system, we have no reason to believe this self-analysis is inflated. Indeed, from our experience in working with MDTs throughout the United States, we consider South Carolina’s MDTs to be among the finest in the country.

Many of the challenges South Carolina child protection professionals discussed with us—high turnover for some agencies, vicarious trauma, disagreements over the emerging ARS system, the inability to get CSA cases to court timely, properly responding to juvenile sex offenders, conducting timely forensic interviews and collecting all the evidence available—are challenges faced by most states.

What is unique about South Carolina, though, is that front line professionals—not office holders or statewide administrators or even supervisors—banded together to find private funding to hire an outside organization to ask them what they were seeing and offer concrete suggestions for making a good system the envy of the world.

Yes, indeed, the child protection professionals we encountered in South Carolina think that big and we, for one, do not believe such a flickering candle should be snuffed out. On the contrary, we believe all of South Carolina should listen to the voices of these professionals and help them set a blaze that will forever impact the lives of children in this state and that is suitable for replication for any state in which abused children dwell—and for which there burns a desire to spare no effort in helping them.

Until our dying day, all of us involved with this project will remember the faces, the voices and, in some instances, the pain of the front line child protection professionals who spoke with candor and through hearts that were often overflowing. We hope this report accurately captures what you told us and offers concrete steps that will enable you to continue this journey.



The child protection train that runs throughout South Carolina is fueled with faith, labored with love and carries the hopes and dreams of millions of children. We hope this report will aid in getting all the children on board—and getting them all home on time.

Exhibit A: Onsite Survey Instrument

Assessing the Strengths and Areas for Improvement in responding to Child Sexual Abuse Cases in South Carolina

Background on interviewee

  1. Occupation of interviewee

  2. Experience in responding to cases of child sexual abuse

    1. How many years assigned to these cases

    2. Number of cases handled in career

    3. In the past five years, is your caseload of CSA cases increasing, decreasing, or remaining the same? How about for your department?

    4. What, if any undergraduate or graduate training on responding to child sexual abuse cases did you receive? Was the training adequate? If not, what improvements would you like to see?

    5. What training have you received on child sexual abuse cases once in the field? What training has been the most helpful? What has been the least helpful? What, if any, challenges do you have in accessing training? What recommendations do you have for improving CSA training in South Carolina?

Mandated reporting

  1. What, if any, strengths do you see in the mandated reporting system in South Carolina?

  2. What, if any, weaknesses do you see?

  3. From your experience, what professions are the most likely to comply with mandated reporting laws? What professions are the least likely to comply? What factors influence whether or not a report is made?

  4. What, if any, suggestions do you have for improving the mandated reporting system in South Carolina?

  5. Please describe the training offered to mandated reporters in your community.

    1. How often is this training provided? It is required? Is it effective?

    2. What suggestions, if any, do you have for improving the training of mandated reporters in South Carolina?

Local MDT responses to CSA

  1. Does your agency respond to CSA cases as part of a team? If so, please describe how that works. Is there a written protocol for your team? Could we receive a copy? Does your agency have regular case reviews of child sexual abuse cases?

  2. In responding to CSA cases, what are the three greatest strengths of your department and local MDT? What are the three greatest challenges or areas for improvement?

  3. How quickly does your agency respond to a report of child sexual abuse? Does response time vary depending on when the report is made? Does response time vary on the basis of who makes the report? If so, how? Are anonymous reports handled differently? How quickly does the child receive a forensic interview? Who conduct the forensic interview? Where is the forensic interview conducted? If conducted at a CAC is there a 24/7 capability for doing the forensic interview? Are all forensic interviews recorded? What forensic interviewing protocol is used? Has that protocol proved helpful? Why or why not? Are forensic interviewers participating in any sort of ongoing peer review of their work? If so, describe that process?

  4. Are medical examinations in child sexual abuse cases done in all cases, most cases, some of the cases or something else? Who does the medical examination? Who decides whether or not the medical examination is conducted? How quickly does a medical examination take place?

  5. How would you assess the strengths and weaknesses of your MDT in responding to:

    1. Allegations of CSA arising in the midst of a divorce/custody proceeding?

    2. Allegations of CSA involving a child victim who is pre or non-verbal?

    3. Allegations of CSA when the victim has a physical or mental disability?

    4. A multi-victim case?

    5. Allegations of CSA in which the perpetrator is a juvenile?

  6. What, if any, steps does your MDT take to ensure a culturally sensitive response to allegations of CSA? What have you found to be effective? What suggestions do you have for improvement?

  7. What, if any, steps does you MDT take to address the vicarious trauma of handling child abuse cases in general and CSA cases in particular? What, if anything, have you found to be effective for addressing vicarious trauma? What, if anything, have you found to be ineffective?

  8. What is the turnover rate among MDT members? Do certain agencies have a higher turnover rate? What factors contribute to turnover? With respect to the agencies that have a lower turnover rate, is there anything you can point to that keeps the turnover rate low?

Children’s Advocacy Centers

  1. Does your MDT work with a local CAC? If so, please describe:

    1. The strengths of CACs you have worked with

    2. Any areas for improvement in CACs in South Carolina

Juvenile sex offenses

  1. What are the strengths of your MDT response to cases of sexual abuse in which the offender is a juvenile?

  2. What are weaknesses of your MDT response to cases of sexual abuse in which the offender is a juvenile?

  3. What, if any, recommendations, do you have for improving the handlings of cases involving juvenile sexual offenders?

  4. Is your community seeing a change in percentage of CSA cases perpetrated by juveniles? If so, what factors are influencing this change?

  5. What, if any, treatment options or other services are available for juvenile sexual offenders?  Are these responses appropriate to the age / mental health issues of the offender?  Are these responses appropriate to the child victim and his/her families?

  6. What is the community / system response to young children (<10 years of age) who act out sexually?  Are these responses appropriate to the age / mental health issues of the offender?  Are these responses appropriate to the child victim and his/her families?

  7. Has the registration of juvenile sexual offenders in South Carolina been effective in deterring juvenile offenders from committing additional offenses? Why or why not? What, if any, suggestions to do you have for improving the registration of juvenile sexual offenders in South Carolina?

  8. How does your community respond to cases of “sexting”?  Who is perceived as the perpetrator, and who is perceived as the victim? 


The collection of physical or corroborating evidence

  1. How often are search warrants executed in child sexual abuse cases in search of physical evidence? In a typical child sexual abuse case in the past two years, would you have no physical evidence, 1-3 pieces of corroborating physical evidence, 4-6 items of physical evidence, or some other number? In what percentage of cases is there physical evidence that needs to be sent to a crime lab? When evidence is sent to the crime lab in a CSA case, how long does it take for the evidence to be processed? What, if anything, could be done to improve response time?

  2. In what percentage of CSA cases are photographs of the crime scene taken? When these photographs are taken have they proved helpful in the investigation? In the interrogation of the suspect? At trial?

  3. How often is pornography used in the grooming of CSA victims, in your experience? How often does the offender take sexually explicit photographs or other media of the victim? Are victims routinely asked whether they have been photographed?

  4. What percentage of sex offenders make incriminating statements when interviewed? What percentage of sex offenders make complete confessions? What, if anything, might help increase the confession rate?

  5. Is the prosecutor or child protection attorney involved during the investigation stage of a CSA case? If so, describe that involvement. If not, what, if any involvement would you like to see the prosecutor or child protection attorney have during the investigation stage?

  6. How long does a typical child sexual abuse investigation take? When the investigation is completed, how often is the offender arrested? How often is a child taken from the home? How often is the non-offending caretaker supportive of the child? When the mother (or other caretaker is not supportive), how does the MDT typically handle this situation?

From investigation to trial

  1. What percentage of cases of CSA result in a plea agreement or other guilty plea? When there is a plea agreement, how long does that typically take? In your experience, are the plea agreements too tough, too lenient, or just about right? If the plea agreements are too lenient or too tough, what recommendations do you have for a more just outcome?

  2. What, if any tactics, have you seen defense attorneys, defense investigators or other agents of the defense team use to intimidate or otherwise negatively influence children in the interim between investigation of the case and the actual trial? What, if any tactics have you seen that serve to intimidate or negatively influence the victim’s family? Do you have recommendations on what, if anything, could be done to address this?

  3. What percentage of CSA victims receive mental health services? How soon are these services received? From your perspective, are the mental health services provided adequate or inadequate? Why do you say this? What, if any recommendations do you have for improving the delivery of mental health services to victims of CSA?

  4. What, if any, community support do CSA victims receive? What, if any, community pressures are placed on children?

  5. How often do CSA victims in your community recant an allegation of abuse? When this happens, what are the factors you most commonly see that lead to a recantation? Have you found some interventions to be more effective than others in preventing a recantation? If so, what are those interventions? Is there anything else that could be done to reduce the chance a child will recant a CSA allegation?

Preparation for court

  1. Who is responsible for preparing children for court? How is this done?

  2. To your knowledge how often are these pre-trial motions filed:

    1. Child friendly oath

    2. Silent objections

    3. Request the court to order attorneys to ask only developmentally and linguistically appropriate questions

    4. To grant the child a support person when testifying

    5. A comfort item (blanket, teddy bear, etc)

    6. Closed circuit or alternative means for taking the child’s testimony

    7. Other courtroom modifications (i.e. allowing the child to sit on the floor, or on a pillow, etc)

Victim assistance services

  1. Does your agency have a Victim Advocate on staff?

□ Yes □ No

  1. If yes, what services does your Victim Advocate provide (check all that apply)

□Referrals


□Case

Management



□Crisis

Counseling



□On Scene

Response



□Community Outreach


□Court

Preparation



□Court Accompaniment

□Crime Victim

Fund Assistance



□Criminal Justice System Education

□Home

Visits


□Safety

Planning


□Other_________



  1. If no, which (if any) of the following provide Victim Assistance Services to victims of child maltreatment in your community?

□Sheriff’s Office □Prosecutor’s Office

□Police □Private Agency



□Other_________

  1. Do any of the above agencies have a Victim Advocate to respond on scene in cases of child maltreatment?

□ Yes □ No

  1. If two or more agencies provide Victim Assistance to victims of child maltreatment in your community, who takes the lead? What kinds of policies are in place?

  2. What services would your ideal Victim Advocate provide in cases of child abuse?

  3. Is there a Victim Advocate on your Multi-Disciplinary Team?

□ Yes □ No

  1. Does the Victim Assistance agency that you work with most frequently provide materials in English, Spanish, and other languages as appropriate for your community?

□ Yes □ No

  1. Do you feel these materials are helpful to those who use them?

  2. How could the materials be improved?

  3. Using a scale of 1 to 10 with (1 being poor and 10 being outstanding) please rate the service provided by the Victim Assistance Agency that you access most often for your cases of child maltreatment.

Child Sexual Abuse Trials—criminal court

  1. After a case is charged, how long does a CSA case take to get to trial? What causes the delay? What, if any, recommendations do you have for expediting CSA trials?

  2. What, if any, precautions do judges take to protect child witnesses?

  3. What are the most common defenses to CSA crimes? What defenses are the least effective? What defenses are the most effective? What, if any, additional training or resources might assist the prosecution team in overcoming the most successful defenses?

  4. What percentage of cases that goes to trial result in a conviction? What, if any, training, resources or policy changes could increase the conviction rate?

  5. How often are expert witnesses used in a CSA case by the prosecution?

    1. How often are medical experts used?

    2. How often are mental health experts used?

    3. DNA or crime lab experts used?

    4. Forensic interviewers as expert witnesses?

    5. When used, and on a scale of 1-10, how helpful (in your opinion) are these experts in convincing a jury of the defendant’s guilt?

    6. If experts are not used, why not?

  6. How often are defense experts used in a CSA case?

    1. How often are medical experts used?

    2. How often are mental health experts used?

    3. DNA or forensic experts used?

    4. Forensic interviewers as expert witnesses?

    5. When used, and on a scale of 1-10, how helpful are these experts in obtaining an acquittal? On a scale of 1-10, how successful is the prosecutor in undermining the testimony of these defense experts on cross-examination?

    6. If defense experts are not used, why not?

  7. How often do defendants take the witness stand in their own defense? Is this generally helpful or unhelpful to the prosecution? When defendant’s take the witness stand, how effective is the prosecution in undermining their credibility during cross examination—on a scale of 1-10?

  8. How often is the forensic interview played for the jurors? On a scale of 1-10, how helpful in convincing the jury of the defendant’s guilt have you found the admission of the forensic interview to be? Can you explain your answer? How, if at all, has Crawford v. Washington impacted the usage of recorded forensic interviews in criminal courts of law? When the victim is unavailable, have you had success in admitting a forensic interview pursuant to the doctrine of forfeiture by wrongdoing?

  9. On a scale of 1-10, how effective have you found defense attorneys in representing their CSA defendants? How effective are they in creating reasonable doubt in the minds of jurors?

Child Sexual Abuse Trials—civil child protection court

  1. Do familial CSA cases typically result in a civil child protection petition, termination of parental rights petition or something else? What factors influence this decision?

  2. After a civil child protection petition is filed, how long does a CSA case take to get to trial? What causes any delay? What, if any, recommendations do you have for expediting CSA trials? Does the petition have to wait until the criminal case is done?

  3. What level of coordination/involvement does the child protection attorney have with the criminal prosecutor and vice versa? Is there communication about how cases proceed (whether the civil or criminal trial proceeds first)? What is your experience with testimony/evidence generated in one court proceeding (civil or criminal) being used in the other court proceeding? How is this coordinated?

  4. Does the victim typically testify in a civil child protection case? If so, what, if any, precautions do judges take to protect child witnesses?

  5. What are the most common defenses to CSA petitions? What defenses are the least effective? What defenses are the most effective? What, if any, additional training or resources might assist the civil child protection attorney in overcoming the most successful defenses?

  6. What percentage of cases that goes to trial result in a finding of need for protection or services? What, if any, training, resources or policy changes could increase the government’s success rate?

  7. How often are expert witnesses used in a CSA case by the government’s attorney?

    1. How often are medical experts used?

    2. How often are mental health experts used?

    3. DNA or crime lab experts used?

    4. Forensic interviewers as expert witnesses?

    5. When used, and on a scale of 1-10, how helpful are these experts to the government?

    6. If experts are not used, why not?

  8. How often are defense experts used in a CSA civil child protection case?

    1. How often are medical experts used?

    2. How often are mental health experts used?

    3. DNA or forensic experts used?

    4. Forensic interviewers as expert witnesses?

    5. When used, and on a scale of 1-10, how helpful are these experts in obtaining a dismissal or all or part of a child protection petition? On a scale of 1-10, how successful is the government’s attorney in undermining the testimony of these defense experts on cross-examination?

    6. If defense experts are not used, why not?

  9. How often do accused CSA perpetrators take the witness stand in a civil child protection trial? Are they typically called by the government or the defense attorney? Is this generally helpful or unhelpful to the government? When CSA suspects take the witness stand, how effective is the government’s attorney in undermining their credibility during cross examination—on a scale of 1-10?

  10. How often is the forensic interview played for the court in a child protection proceeding? On a scale of 1-10, how helpful in convincing the judge of the suspect’s offense have you found the admission of the forensic interview to be? Can you explain your answer?

  11. On a scale of 1-10, how effective have you found defense attorneys in representing their CSA clients in civil child protection cases? How effective are they in getting a petition dismissed?

Post-trial

  1. Are CSA sentences in South Carolina too lenient, too strict, or just about right? Explain your answer.

  2. Please provide your assessment of South Carolina’s sex offender registration laws. Are they effective in deterring offenders from re-offending? Why or why not? What, if any recommendations would you make for:

    1. Improving these laws with respect to juveniles

    2. Improving these laws with respect to adults

    3. Improving the enforcement of these laws

  3. What adult sex offender treatment programs are available in South Carolina? Have you found these programs to be effective? Why or why not? What recommendations, if any, do you have for improving sex offender treatment programs in South Carolina?

  4. What juvenile sex offender treatment programs are available in South Carolina? Have you found these programs to be effective? Why or why not? What recommendations, if any, do you have for improving sex offender treatment programs in South Carolina?

Civil Child Protection Response to Cases of CSA

  1. How are children and families involved in case planning? With what frequency are case plans reviewed? Are recommended services generally available? If so, are they effective? What makes the services effective or ineffective?

  2. When children are in foster care, how long do they stay? What strengths or weaknesses do you see in your local foster care system?

  3. What, if any, challenges are you facing in making “reasonable efforts” to reunite parents with children? Under what circumstances are reasonable efforts waived? How often do child protection workers and attorneys pursue this option and proceed directly to termination of parental rights? Should termination of parental be pursued more frequently, less frequently, or is the frequency of TPR about right?

Prevention

  1. What, if any, child sexual abuse prevention programs are offered in your community? Personal safety classes for children? Classes for parents? Public information campaigns? Darkness to Light? Other programs? Have you found these programs to be effective? Why or why not?

  2. What, if any, policies are in place to prevent CSA at youth groups, schools, day cares, religious institutions and other settings where children gather? Do these policies address only sexual abuse? Do the policies take into account the cross-occurrence of sexual abuse with other forms of maltreatment including physical abuse, child neglect and emotional abuse?

  3. Would you, or your agency, be interested in training or better educating the community on CSA prevention? What, if any, additional resources would you need to provide this service?

  4. On a scale of 1-10, how important is it to engage the faith community in CSA prevention efforts?

Working with immigrant children

  1. With respect to immigrant children who may have been abused or in need of protection or services:

    1. Is there a system in place for identifying immigrant children?

    2. Are there services in place for non-English speaking children including

      1. Interpreters for forensic interviews, therapy or other services

      2. Providing benefits to immigrant children

  2.  Are immigrant children encouraged to seek out available services?

  3. What, if any recommendations do you have for improving the child protection system’s handling of cases involving immigrant children?

Training needs

  1. On a scale of 1-10, how important is it to provide additional or improved training in the following areas:

    1. Assessing sexual abuse among pre and non-verbal children

    2. Assessing sexual abuse among children with physical or developmental disabilities

    3. Advanced forensic interview training

    4. Interrogation of CSA suspects

    5. Investigating/prosecuting CSA cases arising in the context of a divorce or custody case

    6. CSA crime scene investigation

    7. Trial skills:

      1. Jury selection/voir dire

      2. Opening statements/closing arguments

      3. Cross examination of defendants and defense witnesses

      4. Cross examination of expert witnesses

    8. What, if any, additional training needs do you think are critical?

Differential response

  1. South Carolina is implementing an alternative or differential response system for handling cases of child abuse deemed less severe. Have you had experience with this system? If so, how would you describe your experience? What strengths do you see with this model? What weaknesses? What suggestions would you have for improvement? How, if at all, do you see this model impacting South Carolina’s response to cases of CSA?

Cross-concurrence of CSA with other forms of maltreatment

  1. On a scale of 1-10, how likely have you found CSA to exist with these additional forms of maltreatment:

    1. Child physical abuse

    2. Neglect

    3. Emotional abuse

    4. Spiritual abuse (using religious or spiritual themes in the abuse of a child)

    5. Animal abuse

    6. Domestic or interpersonal violence

  2. On a scale of 1-10, how effective have you found your MDT in cross-screening for multiple forms of maltreatment? Would additional training in cross-screening be helpful?

Public policy

  1. What, if any, statutory or court reforms would you like to see in South Carolina?

Trafficking/sexual exploitation

  1. What, if any, involvement does your agency have in the trafficking or sexual exploitation of children (child pornography, etc)? If you have a role in addressing these cases, how would you assess the strengths and weaknesses of your agency’s response to these cases?

  2. Does your community have one or more strip clubs, adult bookstores or other sexually exploitive establishments? What if, any, efforts are made to make sure children are not being exploited or trafficked through these establishments? Have you found these efforts to be effective? Why or why not?

The role of police chaplains

  1. Do you see benefit in expanding the involvement of police or other chaplains in South Carolina’s response to CSA cases? If so, where would you like to see this expansion occur? In providing victim services? Family support? Emotional support at trial? In assisting investigators and prosecutors with handling the vicarious trauma of working CSA cases? Something else?

Adult survivors

  1. What, if any, services are available in your community for adult survivors of child maltreatment, including child sexual abuse? How effective do you believe these services are? Please explain your response. What barriers do adult survivors have in accessing any existing services? What improvements need to be made? What else should be done to meet the needs of adult survivors?









Silent Tears Survey Analysis




March, 2013



©METROPOLITAN STUDIES INSTITUTE AT USC UPSTATE

Authors: Kathleen Brady, PhD Jennifer Parker, PhD

Research Support: Sarah Wilson


Silent Tears Survey Analysis
A survey of providers of services to victims of Child Sexual Abuse (CSA), and of other adults who routinely come into contact with victims in South Carolina, was undertaken in February and March of 2013. The purpose was to determine the extent of providers’ academic and on-the-job preparation, their experience, how well they work together, legal processes, treatment options, geographic differences, and the quality of systems in place to address CSA. The following is an analysis of the 404 total surveys submitted from respondents around the state of South Carolina.

In an effort to avoid redundancy and to maximize robustness of this analysis, aggregations and disaggregations are only reported where remarkable or for comparison purposes.

Overall Respondent Demographics
Most respondents were female (86%), had worked with victims of Child Sexual Abuse (CSA) for many years (41% for more than 10 years, and 23% for 6-10 years), and were well educated (at least 51% of respondents had graduate or professional degrees). At least 45% of respondents were mental health counselors, social workers, clinicians, caseworkers, or law enforcement personnel, although 36% of these had no training in CSA before entering the field. Almost all respondents had obtained some form of training in CSA since entering the field. Most respondents (53%) reported that there are some CSA prevention programs available in their counties, such as Project BEST, Darkness to Light, Talk About Touching and Healthy Relationships. Thirty-one percent reported that there are one or more excellent programs in their communities, and 22% were unsure. A significant portion (20%) of respondents came from Greenville County, and a number of the smaller, poorer counties were not represented. Some general demographics follow.
1. In which South Carolina county do you work? (n=378)


  1. Greenville – 75 responses (20%)

  2. Charleston – 30 responses (8%)

  3. Anderson – 25 responses (7%)

  • Counties with zero responses: 11 (Bamberg, Barnwell, Calhoun, Edgefield, Fairfield, Hampton, Laurens, Marion, McCormick, Saluda, Williamsburg)


2. What is your job category? (n=385)

  1. Clinician/therapist/mental health professional – 67 responses (17%)

  2. DSS caseworker – 53 responses (14%)

  3. Law enforcement – 52 responses (14%)

  • Zero responses: 2 (defense attorney, principal)



3. How long have you worked with victims of child sexual abuse (CSA)? (n=380)

  1. Less than one year – 29 (4%)

  2. 1-5 years – 107 (28%)

  3. 6-10 years – 88 (23%)

  4. More than 10 years – 156 (41%)


4. What is your gender? (n=380)

  1. Male – 53 (14%)

  2. Female – 327 (86%)


5. What is your highest level of education? (n=384)

  1. Graduate degree – 166 (43%)

  2. Bachelor’s degree – 132 (34%)

  3. Law degree – 30 (8%)

6. What is the field of study in which you obtained your degree/training? (n=373)



  1. Social work/counselor – 116 (31%)

  2. Psychology – 84 (23%)

  3. Other – 64 (17%)

  • Other responses: public relations, journalism, business, child life, criminal justice & mental health, education, English, finance, liberal arts, sociology, pastoral counseling, public administration, sciences and business administration


7. How much training did you have in CSA prior to entering the field? (n=382)

  1. Some undergraduate academic courses - 61 (16%)

  2. Some graduate academic courses – 65 (17%)

  3. Some on the job – 109 (29%)

  4. None – 138 (36%)

  5. Unsure – 9 (2%)


8. How much formal training in CSA have you had on the job? (n=378)

  1. 1-3 seminars/training programs - 84 (22%)

  2. More than 3 seminars/training programs – 240 (69%)

  3. 1 or more academic courses – 26 (7%)

  4. Other – 28 (7%)






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