§ 24.16 CHILD SEXUAL ABUSE ACCOMMODATION SYNDROME

• Jurisdiction: North Carolina

§ 24.16. CHILD SEXUAL ABUSE ACCOMMODATION SYNDROME

[A] Research

The typical responses of child sexual abuse victims are counter-intuitive in many respects. Delayed disclosure, conflicting statements, and retraction suggest fabrication unless an explanation is offered for this apparently anomalous behavior. Dr. Roland Summit coined the phrase "Child Sexual Abuse Accommodation Syndrome" (CSAAS) in 1983 to describe five aspects of child sexual abuse.²⁵⁵ The first two are preconditions to child sexual abuse; the last three are "sequential contingencies" that vary in both form and degree. The factors are: (1) secrecy,²⁵⁶ (2) helplessness,²⁵⁷ (3) entrapment and accommodation,²⁵⁸ (4) delayed, conflicting, and unconvincing disclosure,²⁵⁹ and (5) retraction.²⁶⁰

Dr. Summit developed the "syndrome" to assist professionals in treating abused children. It is not a diagnostic tool,²⁶¹ and the term "syndrome" is misleading.

Sexually abused children react in a variety of ways, including anxiety, depression, nightmares, enuresis, regression, and acting out. Many of these responses, however, are also associated with other psychological problems unrelated to sexual abuse. Some reactions are strongly suggestive of abuse: "Examples of behaviors that have greater specificity for sexual abuse include age-inappropriate knowledge of sexual acts or anatomy, sexualization of play and behavior in young children, the appearance of genitalia in young children's drawings, and sexually explicit play with anatomically detailed dolls."²⁶²

[B] Admissibility

Expert testimony on child sexual abuse may be offered for several distinct purposes: (1) as substantive evidence to prove that the child has been abused; (2) to explain conduct of the child that a jury might perceive as inconsistent with a claim of abuse; or (3) to bolster or impeach the child's credibility. Moreover, the form of the testimony may vary. For example, expert testimony offered to establish abuse can take three different forms: (1) general testimony about the behavioral characteristics of abused children; (2) testimony that a particular child's behavior is consistent with that of abused children; or (3) an opinion that a particular child has been abused.²⁶³

Fact of abuse. Some courts permit expert testimony "regarding the behavioral and emotional indicia of child sexual abuse victims" as well as testimony that "an alleged victim exhibits behavior consistent with such a profile."²⁶⁴ Other courts reject the substantive use of...