Attacks on credibility of abuse survivors,Flawed Theories to Explain Child Abuse

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- Attacks on the credibility of abuse survivors are not justified by research
- Courtroom Antics Cast Doubt on Child Abuse Findings
- Flawed Theories to Explain Child Physical Abuse
What Are the Medical-Legal Consequences?

"Physicians, researchers, academic medical centers, journalists, and legal scholars have a responsibility to repudiate scientifically unsupported theories that falsely purport to explain child abuse and abusive head trauma."

"In fact, scientific studies find that children are far less suggestible than we have been led to believe. Brain imaging studies have identified the neurological mechanisms involved in the process of forgetting and then recalling sexual abuse as an adult.  Delayed disclosure and amnesia are now understood as normal coping mechanisms in response to abuse."

Attacks on the credibility of abuse survivors are not justified by research
New science of trauma and memory has shown that the assertions of ‘false memory’ advocates are exaggerated

Michael Salter  Sunday 1 October 2017
For a quarter of a century, the concept of “false memories” has provided a scientific fig leaf for sceptics of child sexual abuse allegations.

The “false memory” argument is deceptively simple: children and adults are prone to invent false memories of child sexual abuse that never occurred, particularly if encouraged by a therapist or some other authority figure.

So-called “recovered memories”, in which adults recall sexual abuse in childhood after a period of amnesia, have been a particular focus of disbelief.
Abuse inquiry reforms would put more paedophiles in jail, experts say

In fact, scientific studies find that children are far less suggestible than we have been led to believe. Brain imaging studies have identified the neurological mechanisms involved in the process of forgetting and then recalling sexual abuse as an adult.

Delayed disclosure and amnesia are now understood as normal coping mechanisms in response to abuse....

However, the new science of trauma and memory has shown that the assertions of “false memory” advocates were exaggerated.

Overwhelming experiences of abuse are encoded differently in the brain than other memories, and can produce amnesia and forgetting. My research has found that many perpetrators of severe abuse deliberately traumatise children in order to take advantage of this mechanism and prevent victims from disclosing.

It is vital that abused children and adults receive therapeutic support to address the psychological changes caused by sexual abuse, and their testimony should be taken seriously by law enforcement and the criminal courts.

Nonetheless, the imperative to deny and suppress these allegations is as strong as ever. Sexual abuse is a crime of the status quo. Offenders get away with abuse because they are camouflaged within their legitimate roles (as parents, relatives, friends, clergy, teachers and so on) in the lives of children.

As a result, allegations of sexual abuse are always a challenge to authority, revealing the weaknesses and failings of treasured social institutions.

In response, many are driven to reject the allegations outright, rather than examine the uncomfortable truths they reveal. For instance, church representatives have accused journalists of pursuing clergy abuse as part of a secular attack on Christianity....

In this light, attacks on the credibility of abuse survivors and advocates, and on the findings of the royal commission, need to be placed in political context. Despite their appeals to scientific expertise, such attacks are not justified by research on sexual abuse and traumatic memory; far from it.

The royal commission has revealed the pervasiveness of sexual abuse in child-focused institutions. Recent prosecutions, and the brave testimony of survivors such as Cathy Kezelman, highlights how family dynamics are manipulated by perpetrators of incest, to the point where non-abused siblings may be entirely unaware of the plight of the victim and groomed to disbelieve them if they disclose....
https://www.theguardian.com/commentisfree/2017/oct/02/attacks-on-the-credibility-of-abuse-survivors-are-not-justified-by-research



Courtroom Antics Cast Doubt on Child Abuse Findings
Ingrid Hein  October 02, 2017
Flawed theories are being used in the courtroom to make the science that supports a diagnosis of physical child abuse look debatable, when, in fact, "there is no significant controversy about the diagnosis of physical abuse and abusive head trauma in clinical medicine," according to an opinion piece published online recently in JAMA.

"When defense witnesses have decided to cite opinions that are not real diagnoses, or when they cherry pick information by looking at half a child's findings and ignoring the other half, it's upsetting," said John Leventhal, MD, from the Yale School of Medicine in New Haven, Connecticut, who cowrote the piece with George Edwards, MD, from the University of Texas in Austin.

"This is not how physicians work," Dr Leventhal told Medscape Medical News. "We try to understand symptoms, look at physical findings, do laboratory tests, and come up with a specific scientific diagnosis."

"The defense experts are seeing things that are not present on the x-rays. They are seeing things that aren't there," he said. "That's not good medicine."....

Dr Metz and his team use a multitiered approach to gather facts, which includes consulting with radiology, looking at lab work, examining the patient, and taking a history from family members....

Vigorous testing is the only way to rule out abuse or mimics and, in the current climate of controversy, child abuse specialists have become more cautious.

"We have doctors testing for things even when they are certain it's abuse, just because they want to be sure the testing has been done in case it gets to court," Dr Metz explained.

Improvements in radiology, genetic testing, and laboratory tests have made it easier to identify signs that a child might be suffering from a disease that causes bruising, fractures, or other physical injuries that present as abuse, said Cindy Christian, MD, professor of pediatrics at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia....

"Sometimes injuries are not easily diagnosed," she told Medscape Medical News. And "sometimes diseases look like an injury."....

"I've seen radiologists and other physicians who think something is child abuse when it's a disease, and I've seen cases where they think it's a disease and its child abuse," Dr Christian reported....

The systemic review questioning shaken baby syndrome "raises major medical concern," and "may already have disrupted efforts to protect vulnerable children," write Dawn Saunders, MD, from the Great Ormond Street Hospital NHS Trust for Children, Institute of Child Health, in London, and her colleagues (Pediatr Radiol. 2017;47:1386-1389)....

Dr Metz compared the deliberation over shaken baby syndrome with the one on climate change.

"A large majority of the scientific community has an overwhelming opinion about the science, while a very few loud people object, raising doubts in people's minds," he explained.

It is helpful to have a debate that pushes science and looks at where science falls short, "but when the science is irrefutable, or well documented, the debate does it an injustice," he said....

American Academy of Pediatrics (AAP) 2017 National Conference and Exhibition: H2115 Section on Child Abuse and Neglect Program. Presented September 17, 2017.
http://www.medscape.com/viewarticle/886422



Flawed Theories to Explain Child Physical Abuse
What Are the Medical-Legal Consequences?
John M. Leventhal, MD1; George A. Edwards, MD2
Author Affiliations Article Information
JAMA. Published online September 18, 2017. doi:10.1001/jama.2017.11703

....Proponents of these flawed theories argue that alternative diagnoses can look just like physical child abuse. They argue that if an alternative diagnosis is possible then it is not possible to conclude that abuse occurred. If it is not possible to conclude that abuse occurred, then no crime has been committed and there is no need to provide child protection. Some have even suggested that the shaken baby syndrome does not exist, despite documented admissions of shaking by perpetrators of abusive head trauma whose victims died or sustained serious neurological injuries.4

Some of these proponents of flawed theories have written articles about abuse or abusive head trauma; however, these articles have included unproven hypotheses, case reports with omitted facts and misrepresentations, descriptions of conditions that are fallacious, and commentaries or letters without supporting evidence.2,3 Such publications have then been cited or used in court to assert that there is no evidence base to support the diagnoses of abuse and abusive head trauma.

....Physicians who care for injured children must continue to use a scientific approach and careful clinical judgment in diagnosing abuse because it is critically important to get the diagnosis right. The same scientific approach and careful clinical judgment should be used by those who have advanced scientifically unsupported explanations of the findings of abuse. Denying that abusive head trauma occurs, quoting publications that describe flawed theories as if they are scientifically supported, and using fabricated diagnoses are actions that have no place in science or medicine. Furthermore, these flawed theories have no place in law or journalism. Advocacy of theories based on misrepresentation, omission, or both makes a mockery of scientific reasoning and does a disservice to children, families, and justice.

Physicians, researchers, academic medical centers, journalists, and legal scholars have a responsibility to repudiate scientifically unsupported theories that falsely purport to explain child abuse and abusive head trauma.
http://jamanetwork.com/journals/jama/fullarticle/2654400