project ability final · for the purposes of this reference guide, project ability defines...

ProjectAbilityAReferenceGuideforInterviewingChildrenwithDisabili=es

OregonChildren’sJus1ceActTaskforceOregonDepartmentofJus1ce,ChildAbuseMul1disciplinaryInterven1on(CAMI)ProgramOregonNetworkofChildAbuseInterven1onCenters

January2017

January2017 ProjectAbilityReferenceGuide Page1

TableofContents

Acknowledgments...................................................................................................................2

Introduction............................................................................................................................3

Chapter1:DisabilityStatistics,Definitions,andVulnerabilities...............................................4

Chapter2:IdentifyingAbilityandDemystifyingDisability—ChildDevelopment,Assessment,

andDevelopmentalDisabilities...............................................................................................9

Chapter3:CommunicationDisabilities—Speaking,Understanding,andUsingLanguage.......13

Chapter4:SocialandEmotionalDisabilities—Socializing,Feeling,andBehaving...................22

Chapter5:IntellectualDisabilities—ThinkingandReasoning.................................................27

Chapter6:PhysicalDisabilities—Hearing,Vision,Movement,andHealth.............................31

Chapter7:GeneralAccommodationsforChildrenwithDisabilities.......................................33

Chapter8:Accommodations—CommunicationDifficulties....................................................42

Chapter9:Accommodations—SocialandEmotionalDisabilities............................................50

Chapter10:Accommodations—AutismSpectrumDisorder(ASD)..........................................54

Chapter11:Accommodations—IntellectualDisabilities.........................................................60

Chapter12:Accommodations—PhysicalDisabilities..............................................................64

Conclusion.............................................................................................................................67

Bibliography..........................................................................................................................68


AcknowledgmentsThis2017ProjectAbilityReferenceGuideupdatewasmadepossiblethroughthegeneroussupportofthefollowingsponsors:

• ChildAbuseResponseandEvaluationServices(CARES)Northwest• OregonChildren’sJusticeActTaskForce• OregonDepartmentofJustice,ChildAbuseMultidisciplinaryIntervention(CAMI)

Program• OregonNetworkofChildAbuseInterventionCenters

ThefollowingsubjectmatterexpertsgavetheirtimeandenergytoprovidecontentandsupportfortheupdatedProjectAbilityReferenceGuide:

• Leadauthor:o HollyBridenbaugh,LCSW,CARESNorthwest

• Additionalcontributors:o CariAllen,BA,Children’sAdvocacyCenterofJacksonCountyo KatieDeClue,MSW,LCSW,Mt.EmilySafeCentero KathrynKroeger,LCSW,CARESNorthwesto SueLewis,LCSW,Children’sCentero JenniferWheeler,LPC,CARESNorthwest

Additionalprojectsupportprovidedby:

• MadelineDailey,OregonNetworkofChildAbuseInterventionCenters• KatharineFlug,OregonNetworkofChildAbuseInterventionCenters• PattyTerzian,OregonNetworkofChildAbuseInterventionCenters

TheoriginalProjectAbilitydocumentwasdevelopedin2008withcontributionsfromthefollowingsubjectmatterexperts:

• HollyBridenbaugh,LCSW• MariekaFarrenkopf,Ed.M.,LCSW• KathrynKroeger,LCSW• KathleenShelton,PNP,PhD


IntroductionPROJECTABILITY:AREFERENCEGUIDEFORINTERVIEWINGCHILDRENWITHDISABILITIES

ProjectAbilitywasdevelopedin2008asanadvancedforensicinterviewingguideforprofessionalsthroughouttheStateofOregonwhoworkwithchildrenwithdisabilities.TheOregonChildren’sJusticeAct(CJA)TaskForcecommissionedthedevelopmentofthisworkandspecifiedafocusonstrategiesforinterviewingchildrenwithdisabilitiesaboutchildabuse.OregonInterviewingGuidelinesandtheOregonChildForensicTrainingIn2012,theOregonInterviewingGuidelines(OIG)wereupdatedtoincludeforensicallysound,research-basedbestpracticesinchildinterviewing.Theguidelinesinformforensicinterviewersonhowtoelicitreliable,detailedinformationfromachildaboutabuseinachild-sensitive,developmentallyappropriate,andlegallydefensiblemanner.TheOregonChildForensicInterviewTraining(OCFIT)wassubsequentlydevelopedin2012toprovideconsistent,standardizedtrainingontheOIGforprofessionalsacrosstheStateofOregon.OCFITprovidesawealthofinformationregardingevidence-basedpracticesupportedbycurrentresearchinforensicinterviewingtechniquestomeettheneedsofthemultidisciplinaryteam(MDT)professionalsinthestate.TheOIGandOCFITincludefundamentalinformationoninterviewingchildrenwithdisabilities.However,thistopiciscomplicated.Additionally,researchshowsthatchildrenwithdisabilitiesareatgreaterriskofchildmaltreatmentthanchildrenwithoutdisabilities.Unfortunately,mostprofessionalswhoconductchildforensicinterviewsarenot“experts”inthefieldofdisability,whichcanleadtoapprehensionaboutconductinginterviewswiththisvulnerablepopulation.Therefore,thisProjectAbilityreferenceguidehasbeenupdatedtoincludemoredetailedinformationandadvancedtechniquesderivedfromtheOIGandOCFITtohelpprofessionalsinterviewingchildrenwithdisabilitiesachievethebestoutcomes.OBJECTIVESANDCOMPETENCIES

Afterreviewingthisguide,MDTprofessionalswillbeableto:• Definetheterm“disability.”• Utilizefivestrategicquestionswhenpreparingforinterviewswithchildrenwith

disabilities.• Discussthecharacteristicsofandtheinterviewaccommodationsforachildwhohas

difficultiesordelaysinoneormoreofthefollowingareas:o Communication,intelligence,social/emotionalfunctioning,andphysical

functioning


Chapter1:DisabilityStatistics,Definitions,andVulnerabilitiesInthe2012–2013schoolyear,approximately13%ofchildrenandyouthaged3to21yearsqualifiedforspecialeducationservicesnationally(U.S.DepartmentofEducation,NationalCenterforEducationStatistics,2016).Thisstatisticdoesnotincludechildrenwithundiagnosed/unidentifieddisabilities.Undoubtedly,forensicinterviewerswillworkwithchildrenwithdisabilities.Regardlessofanycondition,difficulty,orlimitationachildmayexperienceduetodisability,interviewersmustunderstandthatthechildismoresimilartotypicallydevelopingchildrenthandifferent.Asaninterviewer,itiscrucialtobuildonthechild’sstrengthsandabilities.Thisshowsrespectforthechildand,ultimately,allowsforthebestpossibleoutcome:asuccessfulinterviewandasaferchild.DEVELOPMENTALDISABILITIESANDTHEINDIVIDUALSWITHDISABILITIESEDUCATIONACT

DevelopmentaldisabilitiesChildrengrowanddevelopintoadultsaccordingtoapredictableschedule.Theymeetdevelopmentalmilestonesastheylearnnewskillsandmovethroughtheagesandstagesofchildhood.Sometimes,childrendevelopatypically,whichcanleadtodevelopmentaldelaysand/ordisabilities.In2015,theCentersforDiseaseControlandPrevention(CDC)defineddevelopmentaldisabilitiesasagroupofconditionsthatareduetolanguage,learning,behavioral,orphysicalimpairmentsthatbecomeapparentasachildgrows.Theconditionsmayimpactdailyfunctioninginsomecapacityandusuallylastthroughoutaperson’slifetime.TheIndividualswithDisabilitiesEducationAct(IDEA)TheIndividualswithDisabilitiesEducationAct(IDEA)isafederallawthatwasenactedin1975.Itmandatesthatpublicschoolsmakeavailabletoalleligiblechildrenwithdisabilitiesappropriatepubliceducationintheleastrestrictiveenvironment,accordingtotheirneeds(U.S.DepartmentofEducation,n.d.).TheIDEAidentifies10categoriesofdisabilitiesthatqualifychildrenandyouthforspecialeducationservicesbetweentheagesof3and21.The10categoriesofdisabilitiesincludespecificlearningdisabilities,speechorlanguageimpairments,autism,emotionaldisturbances,otherhealthimpairments,andphysicaldisabilities(hearingandvisualimpairments,multipledisabilities,andtraumaticbraininjury).ProjectAbilitywillreferencethesecategoriesofdisabilities.


Figure1belowisfromtheU.S.DepartmentofEducation,NationalCenterforEducationStatistics(2016).Thegraphshowsthedistributionofdisabilitiesamongchildrenandyouthaged3to21whoqualifiedforspecialeducationservicesinthe2013–2014schoolyear.

Figure1.DisabilitytypesamongU.S.schoolchildrenwhoqualifyforspecialeducationservicesDEFINITIONOFDISABILITYFORTHISGUIDE

Professionalswhointerviewchildrenaboutpossibleabuseneedtoknowhowtointerviewchildrenwithdisabilities,butitisunrealistictoexpectthemtodevelopexpertiseineverydisability.Instead,regardlessoftheimpairment’slabelorcause,interviewersshouldunderstandhowdisabilitiescaninterferewithfourbasicareas(ordomains)offunctioning:communication,intelligence,social/emotionalbehavior,andphysicalfunctioning(sight,hearing,movement,andmaintaininghealth).Forthepurposesofthisreferenceguide,ProjectAbilitydefinesdisabilityasamedical,educational,orpsychologicalconditionthatinterfereswithachild’sabilityto:

• Speak,understand,anduselanguage• Thinkandreason• Behaveappropriately,sociallyandemotionally,inmostsettings• See,hear,move,andstayhealthy

Inthesubsequentchapters,ProjectAbilityincludesinformationaboutdisabilitiesastheyrelatetothefourbasicdomainsoffunctioning(communication,intelligence,social/emotionalbehavior,andphysicalfunctioning),aswellasappropriateaccommodationstomakeforthesedisabilities.


DISABILITIESINCREASEVULNERABILITYTOCHILDABUSE

DisabilityandmaltreatmentstatisticsResearchhasconsistentlyshownthatchildrenwithdisabilitiesareatanincreasedriskformaltreatmentandabusecomparedtochildrenwithoutdisabilities.Someconcerningstatisticsfromlargemeta-analysisstudiesinclude:

• Throughasystematicreviewandmeta-analysis,Jonesandcolleagues(Jones,etal.,2012)notedthatchildrenwithdisabilitieswereoverthreetimesmorelikelytoexperiencemanytypesofabuse,includingphysicalviolence,sexualviolence,emotionalabuse,andneglect.Inparticular,youthwithdisabilitiesexperiencedthefollowingtypesofviolence(Jones,2012,ascitedbyHamby2013):

o Approximately1in4(27%)experiencedphysicalviolence.o Approximately1in6(15%)experiencedsexualvictimization.o Childrenwithpsychologicalorintellectualdisabilitieswereatsignificantlyhigher

riskofexperiencingsexualviolencecomparedtochildrenwithphysicaldisabilities.

• AretrospectivecohortstudycompletedbyKristenandcolleagues(Kristin,etal.,2016)notedthatchildrenwithdisabilitiesascomparedtochildrenwithoutdisabilitieswereapproximately:

o 14%morelikelytobere-referredforconcernsofabuse.o 9%morelikelytoexperiencesubstantiatedmaltreatment.o 4%morelikelytobeplacedinfostercare.

• AccordingtotheChildMaltreatment2009annualreport,whichcompiledandanalyzedchildmaltreatmentdatafromtheNationalChildAbuseandNeglectDataSystem(NCANDS)from48states,11%ofchildvictimsofmaltreatmenthadareporteddisability(U.S.DepartmentofHealthandHumanServices,AdministrationforChildrenandFamilies,AdministrationonChildren,YouthandFamilies,Children’sBureau,2009,ascitedbyChildWelfareInformationGateway,2012).

FactorsthatincreaseriskofmaltreatmentforchildrenandyouthwithdisabilitiesInallcasesofabuse(physical,sexual,emotional,andneglect),themostfrequentabuseristheprimarycareprovider.Nosingleriskfactorplaceschildrenatriskofabuseorneglect;itistheinteractionofvariousfactorsthatincreasestherisk(ChildWelfareInformationGateway,2012).Commonfactorsthatincreasetheriskofmaltreatmentforanychild,regardlessofdisabilitystatus,include:

• Parent’spersonalexperienceofabuseasachild• Parent’snegativeattitudetowardthechild• Parent’slackofchilddevelopmentknowledge• Single-parenthousehold• Povertyorunemployment• Parentalsubstanceabuse,mentalhealthchallenges(e.g.,depression,anxiety),or

antisocialbehaviors


• Lackofsocialsupport;isolation• Domesticorcommunityviolence

Giventhatthesefactorscanoccurforanyfamily,itisimportanttokeepinmindthatcaregiversofchildrenwithdisabilitiesmaybeunderevenmorestress.Thisstressmaybecausedbyadditionalriskfactors,suchas:

• Lackofinformationandeducationontheirchild’sdisability,resultinginunrealisticexpectations

• Lackofrespitecareandsupportservices• Child’sincreasedneedfordailycareassistance(i.e.,bathing,toileting,eating,mobility,

dressing,andmedicalcare)• Behavioralmanagement—copingwithchallengingbehaviorssuchastempertantrums,

aggressiveness,andnoncompliance• Feelingsofguiltoverthechild’sdisability

Plus,child-relatedriskfactorscanmakechildrenwithdisabilitiesmorevulnerabletomaltreatment,including:

• Limitedcommunicationskillstotelland/orexplainabouttheabuse• Dependencyoncaregiverstohelpwithdailycareroutinesandinabilitytodifferentiate

betweenappropriatetouchandabusiveacts• Challengingbehaviorsthatcanoverwhelmthecaregiver


CASCADEOFINJUSTICES

Insummary,childrenwithdisabilitiesareathigherriskformaltreatment.ProjectAbilityisindebtedtoMarySteinberg,MD,andJudithHylton,M.Ed.(1997)fordevelopingtheCascadeofInjustices,whichcharacterizesfurtherincreasedriskfortheaftermathofabuse.


Chapter2:IdentifyingAbilityandDemystifyingDisability—ChildDevelopment,Assessment,andDevelopmentalDisabilitiesThebasisofunderstandingdisablingconditionsinchildrenisrootedintypicalchilddevelopment.Bylearning“whatwentwrong”duringtypicaldevelopment,itiseasiertoidentifywhatisgoingwell—thus,accentuatingthechild’sstrengthsandabilities.Buildingonthechild’sstrengthsandidentifyingadaptationsandaccommodationsforthedifficultiesthechildexperiencesenablesinterviewerstoconductforensicallysoundinterviews.Thischapterreviewstypicalchilddevelopment,emphasizingfourmainareas(ordomains)ofdevelopment,whichwillaidunderstandingofthemostcommontypesofdevelopmentalproblems.TYPICALCHILDDEVELOPMENT

Almosteveryonehassomeformaland/orinformalknowledgeaboutchildren.Evenanon-expertonthesubjectcandiscusschilddevelopmentinformallybecauseofpersonalexperiencesasachildgrowingup,goingtoschool,andobservingchildren’ssimilaritiesanddifferences.Asadults,raisingchildrenorwatchingothersraisechildrencanrevealthepredictabilityofchilddevelopment.Fromeachoftheseperspectives,itisapparentthatallchildrenstartsmallandgrowlarger,knowlittleatfirstandlearnmanythingsveryrapidly,andoftendevelopaheadorbehindanotherchildthesameageinonewayoranother.Sotheprocessofchilddevelopmentissequentialandpredictable.Thespeedatwhichtheprocessunfoldsvariesfromchildtochild,butthegeneralsequencethroughwhichchildrenpassissimilar.“Typicaldevelopment”referstochildrenacquiringawiderangeofskillssimilartothemajorityofchildrentheirsameagewithintheirsameculture.DomainsofchilddevelopmentChilddevelopmentisoftendescribedintermsofdomains(i.e.,physicaldevelopmentandcognitivedevelopment)andbyagesandstages(i.e.,thepredictableprocessofgrowingfrominfancytoadulthood)(CentersforDiseaseControlandPrevention(CDC),2015).ProjectAbilityreferencesfourprimarydomainsofdevelopment:physical,intellectual,speechandlanguage,andsocialandemotional.Physicaldevelopmentinvolvesincreasesinheight,weight,andheadcircumferencealongapredictabletrajectory.Physicaldevelopmentalsoincludesmotordevelopment:

• Grossmotorskillsinvolvetheuseoflargemusclegroupsforphysicalmovement(crawling,walking,running).


• Finemotorskills(dexterity)havetodowithcoordinatingsmallmusclesinmovement,oftenrelatinguseofhandsandfeetwitheyecoordination,aswellasmovementslikegraspingitemsandwriting.

Intellectualdevelopmentreferstohowthebraintakesin,processes,andusesinformation.

• Intellectualdevelopmentinvolvesbothaccumulatinginformation(learning)andprocessingtheknowledge.

• Thedevelopmentanduseofreasoningandjudgmentarepartofintellectualdevelopment.

• Intellectualdevelopmentmaybemeasuredusingintelligencetestsaswellastestsforprocessingandlearningstyles.

Speechandlanguagedevelopmentinvolvestheproductionofspeechsoundsandtheuseoflanguageforcommunicationandcomprehension.

• Speechismakingthesoundsthatbecomewords.o Speechbeginsininfancyandproperarticulationofallspeechsoundsisusually

masteredbyage8or9.• Languageistheuseofwordsandgesturestocommunicate.

o Languageincludesexpressivelanguage(messagessent)andreceptivelanguage(messagesreceived).

• Speechandlanguagedevelopmentvariessomewhatacrossspecificlanguagesandiscertainlymorecomplexforchildrengrowingupinbilingualhomesandcommunities.

Social/emotionaldevelopmentinvolvesdevelopingskillsforinteractionsandimplementingemotionaldevelopmentinasocialsetting.

• Socialdevelopmentinvolveslearninghowtoselectbehaviorsthatareappropriatetothesettingandsituation.

o Behaviorisanobservablemanifestationofcognitiveprocessesdirectingandsometimesoverridingemotionalwantsandneeds.

• Emotionaldevelopmenthastodowithpsychologicaldevelopment—establishingpersonalidentity,meetingpersonalneeds,andfindingone’splaceinrelationshipswithinfamily,school,work,andcommunity.

o Theacquisitionofself-esteemandself-regulationispartofemotionaldevelopment.

• Whilealloftheagesandstagesofchildhoodareinfluencedbyenvironment,socialdevelopmentandemotionaldevelopmentareverymuchaninteractionalprocess.

VARIATIONINCHILDDEVELOPMENT

Indailylife,informalassessmentsofchildren’sdevelopmentoftenoccur.Attheveryleast,itisnoticeablewhenchildrendonot“acttheirage”oraretaller/shorterthanotherchildrentheirage.Achartoftypicalchilddevelopmentisfrequentlyusedtoshowhowcloseachildisintheir


developmentascomparedtotheirsame-agedpeers.Incaseswherethevariationiswiderforasingledevelopmentaldomain,atypicaldevelopmentcanbeexplainedasanindividualdifference,andthechildoftencatchesup.Whentheprocessand/orspeedofachild’sdevelopmentaresignificantlydifferentfromtheirsame-agedpeers,itmaybeconsideredadevelopmentaldelay.Achildwithapossibledevelopmentaldelayshouldreceiveaformalevaluationfromahealthcareprovider,fromateamofmultidisciplinaryproviders,orthroughschool.Yettheforensicinterviewer’sroleisnottobeaformaldevelopmentalevaluator,butrathertorecognizethedelayinordertointeractwiththechildontheirdevelopmentallevelandcapacity.VARIATIONINDISABILITIES

Disabilitiesandchronicconditionscanvaryinpresentation,andtheycanaffectmultipledomainsoffunctioning.Table1belowprovidesexamplesofhowdisabilitiescanaffectvariousareasoffunctioning.DistributionofDifficultiesAcrossSeveralIDEACategoriesofDisability Speaking,

Understanding,andUsingLanguage

ThinkingandReasoning

Socializing,Feeling,andBehaving

Hearing,Vision,Movement,andHealth

Autismspectrumdisorder(ASD) X X X

Emotionaldisturbance X

Hearingimpairmentanddeafness MAYBE X

Intellectualdisabilities X X

Multipledisabilities X X X X

ADHD X X

Specificlearningdisability X

Speechorlanguageimpairment X

Table1.BreakdownbydisabilitycategoryofdifficultiesacrossdifferentdomainsoffunctioningNotwodisabilitiesaffectaperson’sfunctioningthesameway.Forthisreason,itisimportanttounderstandthatdisabilitiesvaryinseverity,complexity,andfrequency.Forexample,twochildrenwhobothhavebeendiagnosedwithautismspectrumdisorder(ASD)canhavevastly


differentfunctioningandabilities.OnechildwithASDmayhavelimitedcommunicationskills,sensorydifficulties,gastrointestinalproblems,andintellectualdelays.Theotherchildmayhavehigherfunctioningabilities,includingnormalintellectualandverbalskills,andnoproblemswithdigestion,butthatchildmayhavedifficultyrelatingsociallyandemotionallytoothers.Also,certaindisabilitiesoccurmuchmorefrequentlythanothers,suchaschildrenwithspecificlearningproblemsversuschildrenwithgeneticdisorders.Thefrequencyofgeneticdisordersamongchildrenisquitelowcomparedtothefrequencyofchildrenwithspecificlearningproblems.(SeeTable2.)

FrequencyandIntensityofDisabilities

Intensity

Frequency

High Low

High

ASD(inOregon)

VisualimpairmentHearingimpairment

ChronicillnessGeneticdisorders

Low

LearningproblemsSpeechandlanguageproblems

ConductdisordersADHD

Table2.FrequencyandintensitylevelsofcertaindisabilitiesDisabilitiesalsovaryaccordingtoco-occurringconditions.Thismeansthatthereareclustersofdisabilitiesthatmayoccurtogetherfrequentlyenoughforastatisticalcorrelationbutnotoccurringinallchildrenallthetime.Thereisalsovariationamongchildreninthenumberofdisabilitiestheyhave,assomechildrenhavebeenidentifiedand/ordiagnosedwithmultipledisabilities.Regardless,rememberthattheroleofanintervieweristounderstandthatchildrenwithdisabilitiesarealldifferentinpresentationandabilities.Understandingtheseverity,frequency,andcomplexityofthedisabilitypavesthepathtowardaccentuatingandfocusingonthatchild’sabilitiesandstrengths.Thenextchaptersdiscussthedifficultiesexperiencedbychildrenwithdisabilitiesinfourbasicareas:communication,intelligence,social/emotionalbehavior,andphysicalfunctioning.Subsequentchaptersreviewanddiscussconsiderationsandaccommodationsforinterviewerstomakewheninterviewingachildwithdisabilities.


Chapter3:CommunicationDisabilities—Speaking,Understanding,andUsingLanguageProjectAbilityidentifiesfourdomainsoffunctioningaffectedbydisabilities:communication,intelligence,social/emotionalbehavior,andphysicalfunctioning.Thischapterexploreshowdisabilitiescanimpactcommunication,includingtheabilitytospeak,use,and/orunderstandlanguage.Communicationdifficultiescanpresentinavastnumberofdifferentidentifieddisabilities/disorders,includingautismspectrumdisorder(ASD),intellectualdisabilities,learningdisabilities,andphysicaldisabilitiessuchascerebralpalsy.Also,communicationchallengesbetweentheinterviewerandchildcanoccurevenwhenthechildhasneverbeenidentifiedordiagnosedwithadisability.Regardlessofthediagnosis,disability,orlabel,theinterviewermustbeabletoadapttothechild’scommunicationabilitiesinordertoconductasuccessfulinterview.Insituationswherethereisconcernofabuse,aninterviewer’sroleistoelicitanarrativefromthechildthatincludesdetails,context,andclarificationabouttheabusiveevent.Ifthischildhasdifficultieswithcommunication,thejobofelicitinganarrativeismoredifficultandmayrequireaccommodationsbytheinterviewer.COMMUNICATIONDISABILITIES

Difficultieswithcommunicationfallintotwomaincategories—speechandlanguage(AmericanSpeech-Language-HearingAssociation,n.d.).

• Speechdifficultiesinvolveproblemswiththeproductionofunderstandablesoundsusedforwordsandcommunication.

• Languagedifficultiesinvolveproblemswithsharingthoughts,ideas,feelings,andinformation.

o Expressivelanguagereferstowhatandhowthechildspeaks.o Receptivelanguagereferstowhatthechildhearsandunderstands.

Achildcanhavedifficultywithoneorbothoftheseareasofdevelopment.Speechandlanguageproblemsrangefrommildtosevere,fromsimplemispronunciationsofcertainsoundstonotunderstandingspokenorwrittenlanguagetodamageoftheoral-motormusclesandnervesusedforspeechandfeeding.Manytimestheactualcauseofspeechandlanguageproblemsisunknown.However,hearingloss,braininjury,intellectualdelays,andbirthdefectssuchascleftlipandpalateareassociatedwithspeechandlanguageproblems(CenterforParentInformationandResources,2015).


Communicationdifficultiesarecomplexbecausetheyinvolveatleastafour-wayinteraction:• Whatthechildsays• Whatwehear• Whatthechildunderstandsaboutwhatwesay• Whatweunderstandaboutwhatthechildsays

Withorwithoutspecificinformationaboutachild’sabilitytocommunicate,theinterviewercanlistenandobserveachildtoidentifyproblemswith:

• Articulation(pronunciation)• Fluency(rate,flow,andrepetitionsinspeech,suchasstuttering)• Voicequality,pitch,loudness,andresonance• Phonology(fullrangeofspeechsoundsexpectedforage)• Comprehensionofspokenand/orwrittenlanguage• Semantics(meaningsofwords)• Syntax(grammaticalconstructionofphrasesandsentences)• Pragmatics(useofconversationalspeech)• Readingandwriting

SpeechdevelopmentSpeechincludesaseriesofdistinctandcomplexpartsthatendsinanunderstandableverbalmessage.Childrenlearnspeechandvocabularyquickly.By18months,typicallydevelopingchildrensayseveralsinglewords,at24monthstheysaytwo-wordtofour-wordsentences,andbyage3,childrencancarryonaconversationusingtwotothreesentences.Aspreschoolers,childrencontinuetoexpandtheirvocabulary,butthegreatestdevelopmentoccursinthelanguagearea—grapplingwithgrammar,syntax,andtheabstractionandutilityoflanguageforcommunicatingideas,thoughts,andfeelings(CentersforDiseaseControlandPrevention[CDC],2016).ProblemswithspeechArticulationproblemsTypically,allspeechsoundsarenotmastereduntilage8or9.Articulationproblemsarenotthesameasmispronunciationsmadewhenchildrenlearnnewwords.Therearefourmaintypesofarticulationproblems:omissions,substitutions,distortions,and/oradditions(Daymut,2009).

• Substitutionsarewhenachildreplacesonesoundforanothersound.Examplesinclude“wabbit”for“rabbit,”“thoda”for“soda,”and“wongthick”for“longstick.”

• Omissionsarewhenachildomitsasoundinaword.Examplesinclude“g_een__ees”for“greentrees”and“_ad”for“dad.”

• Distortionsarewhenachildproducesasoundinanunfamiliarmanner,suchasproducinganasalsoundforaconsonant.(Theword“pen”soundsmorelike“men”ortheword“bat”soundsmorelike“pat.”)


• Additionsarewhenachildinsertsanextrasoundwithinaword,suchassaying“runuh”for“run.”

Oftenarticulationproblemsfadeaschildrengrowandareabletomastercorrectsounds,vowels,andconsonants.Manychildrenandadultscantunetheirearstounderstandachildwhohasarticulationproblems.DiagnosesassociatedwithspeechproblemsWhenpreparingforaninterview,checkavailablerecordsforanydiagnosesrelatedtospeechproblems.Ifdiagnosesarenoted,thenit’shelpfultoresearchtheirdiagnosticcriteriaandcharacteristics.SpeechandlanguageresourceinformationcanbefoundthroughtheAmericanSpeech-Language-HearingAssociation(www.asha.org)andtheNationalInstituteonDeafnessandOtherCommunicationDisorders(www.nidcd.nih.gov).Twoexamplesofspecificspeechdisabilitiesareapraxiaanddysarthria(NationalInstituteonDeafnessandOtherCommunicationDisorders[NIDCD],2010).

• Apraxia:Sometimescalleddyspraxia,thisisamotordisorderwherechildrenhavetroubleplanningandmakingtheveryprecisemovementsofthelips,tongue,jaw,andpalatethatproduceunderstandablespeechsounds.

• Dysarthria:Dysarthriaisamoreinvolvedarticulationproblemcausedbyoralandfacialmuscleweaknessorparalysis.Childrenwithdysarthriaoftenhaveahistoryoffeedingproblemsandmayhaveothermedicalconditionsaswell.

ProblemswithlanguageDuringinterviews,children’slanguageabilitiesaffecthowtheycanrelaytheirexperiencesinawaythatisunderstandable,credible,andclear.Theinterviewer’slanguagemustbetailoredtoappropriatelycommunicatewitheachchildinadevelopmentallyappropriatemanner.Communicationbetweenchildandinterviewerischallengingwhenworkingwithtypicallydevelopingchildren.Suchcommunicationbecomesevenharderifthechildrenhavedifficultyarticulatingtheirexperiencesand/orunderstandingthequestionsposedtothemorwhatisbeingexpectedofthem.Twotypesoflanguagearenecessaryforcommunicationtooccur:expressivelanguageandreceptivelanguage.ExpressivelanguageChildrenwithexpressivelanguagedisordershavedifficultyexpressingtheirthoughtsand/orfeelings.Theymayhavelimitedaccessiblevocabularyand/orhavedifficultyarticulatingcomplexsentences(VictoriaStateGovernment,BetterHealthChannel,2016).Childrenwithanexpressivelanguagedisordermay:

• Provideshorter,lesscomplexsentenceswhenexpressingthemselvesthantheirsame-agedpeers

• Havedifficultyfindingwordsneededtoexpressthoughts


• Use“empty”words,suchas“this,”“that,”and“thing”insteadofusingdescriptivewords

• Usewordsinthewrongcontextorinconfusingways• Hesitatetoanswerquestionsorprovideminimal-wordresponsestoquestions• Talkincircleswithoutclearlymakingapoint• Repeator“echo”aspeaker’swords

Childrenwhohavedifficultywithexpressivelanguagecanexperiencelowerself-esteem,learningproblems,andsocialisolation(Kaneshiro,2014).However,itisimportanttounderstandthatchildrenwhohavedifficultywithexpressivelanguagemayhavereceptivelanguageskillsthatareageanddevelopmentallyappropriate.Theircomprehensionoflanguagemaybenormalwithoutanyimpairment.ReceptivelanguageReceptivelanguageinvolvesattendingto,processing,understanding,retaining,andintegratingintocontextaspokenmessage.Childrenwithreceptivelanguagedeficitsmayhavedifficultyunderstandingdirections,ortheymaystruggletofilteroutbackgroundsoundsandconversationsinordertoconcentrateonwhatisbeingsaidtothem.Somecharacteristicsofreceptivelanguageissuesinclude(SpecialEducationSupportService(SESS),n.d.):

• Difficultyrememberingstringsofwordssaidorfollowingcomplex/compoundquestions• Difficultycomprehendingthecontextofwhatisbeingsaidorconveyed• Difficultyunderstandingsubtleformsofcommunicationsuchasbodylanguage,facial

expressions,andtakingturnsinconversations• Difficultymaintainingattentionlongenoughtofullytakeinwhatisbeingsaid

Childrenwithreceptivelanguagedeficitssometimesareabletomasktheirlackofcomprehensionbecausetheirexpressivelanguageskillsaredevelopmentallyageappropriate.SPECIFICDIAGNOSESASSOCIATEDWITHCOMMUNICATIONDISABILITIES

Manyofthesymptomsassociatedwithexpressiveand/orreceptivelanguagearepartofthediagnosticcriteriaforvariousdisabilities,suchasautismspectrumdisorder(ASD),learningdisabilities,andattentiondeficithyperactivitydisorder(ADHD).Autismspectrumdisorder(ASD)ASDisaneurodevelopmentaldisorderthatimpairsachild’sabilitytocommunicateandinteractwithothers.In2013,theDiagnosticandStatisticalManualofMentalDisorders(5thed.;knownastheDSM-5;AmericanPsychiatricAssociation[APA],2013)incorporatedseveralpreviouslyseparatedisordersintothissingledisorder.Theseparatedisordersincludedautism,Asperger’sdisorder(alsoknownasAspergerSyndrome),childhooddisintegrativedisorder,andpervasivedevelopmentaldisordernototherwisespecified(PDD-NOS).


CriteriaforASDhavetwodomainsofimpairment:1)socialinteractionandsocialcommunicationand2)restrictedinterestsandrepetitivebehaviors,whichincludesensorydifferencesandchallenges(APA,2013).SymptomseverityandfrequencycanvarywidelybetweenindividualswhohavebeendiagnosedwithASD.SignsandsymptomsofASDtypicallyarepresentbeforeage3andincludethefollowing:

• Difficultyrelatingandinteractingwithothers• Delayedorlackofverbalcommunication• Engagementinrepetitiveactivitiesandstereotypedmovements• Resistancetoenvironmentalchangeorchangeindailyroutines• Unusualresponsestosensoryexperiences

ASDcanimpactallfourdomainsoffunctioningidentifiedinProjectAbilityasillustratedinTable3below. Speaking,

Understanding,andUsingLanguage

ThinkingandReasoning

Socializing,Feeling,andBehaving

Hearing,Vision,Movement,andHealth

ASD

• Mayormaynotspeak

• Mayhaveunusualspeechflow,intonation

• Mayrepeatothers’words,useecholalia;limitedtopics

• Mayhavein-depthknowledgeaboutcertainthings

• Mayhavedifficultywithabstractconcepts

• MayhaveloworhighIQ

• Mayhaveproblemsrelatingtopeople,especiallyunfamiliarpeople

• Playissolitary,repetitive

• Maybeinflexibleaboutchangesinroutine

• Oftenemploysrockingorotherrepetitivemotions

• Myhaveunusualresponsestosensoryinformation

Table3.EffectsofASDbydevelopmentaldomainThissectionfocusesonthecommunicationaspectsofASD.However,itisimportanttorememberthatthedistinctionbetweencommunicationproblemsandsocialandemotionaldifficultiesisarbitrarybecauseoftheinterrelationshipsofthefourdevelopmentaldomains.PleaserefertoChapter4:SocialandEmotionalDisabilities—Socializing,Feeling,andBehavingformoreinformationregardingASD’simpactonsocialandemotionalfunctioning.CommunicationdifficultiesforchildrenwithASDChildrenwithASDmayfinditdifficulttodeveloplanguage,understandwhatotherssaytothem,anduseand/orinterpretfacialexpressionsandnonverbalgestures.Suchdifficultiesmakecommunicationquitechallenging(CDC,2016).Asstatedpreviously,communicationskillsandcapacitiesvarygreatlyamongindividualswithASD.Somechildrenmayhavearichvocabularyandcandiscussingreatdepthtopicsofinterest,whileotherchildrenmayhave


minimalvocabulary.MostchildrenwithASDdonothaveproblemswithspeechandwordpronunciation,butalmostallchildrenwithASDhavesomedifficultywithexpressiveandreceptivelanguageskills(NationalInstituteonDeafnessandOtherCommunicationDisorders[NIDCD],2016).SomehallmarkcommunicationchallengesforchildrenwithASDinclude:

• Repetitivelanguage:ChildrenwithASDmayusewordswithoutanycontextormeaningwithinaconversation.Forexample,theymaylistmodelsandmakesofcarswhenaskedabouttheirday.

• Echolalia:Childrenusingecholaliatakewordsorphrasestheyhaveheardandrepeatthemoverandover;therepeatedwordsmaybeimmediatelyechoed,ortherecanbeadelaybeforethechildrepeatsthewords.ChildrenwithASDmayuseecholaliawhentheydonotunderstandwhathasbeensaidtothemand/orwhentheyareunabletomakearesponseusingmoreappropriatespeech.Anexampleofecholaliawouldbeachildrepeating,“Howareyou?”whenaskedabouttheirday.

• Unusualtoneorspeechpattern,lackofeyecontact:Childrenmayspeakinamonotone,withoutinflectionoremotionnotedintheirspeech.Theymayhavepressuredspeechandmayappeardisengagedalthoughinrealitythisisnotthecase.

• Narrowinterestsandexceptionalabilities:Somechildrenmaybeabletoconversein-depthontopicsofinterest,buttheycannotengageinatwo-wayconversationaboutthosetopics.Forexample,achildinterestedincarsprovidesdetailedinformationaboutthecarsofinterest,butwhenaskedwhichcaristhefavorite,thechildcannotrespondorcontinuetheconversation.

• Inabilitytoreadnonverbalcues,understandabstractconcepts,orunderstandsarcasm:Commonslang,dryhumor,subtlegestures,etc.canbeverydifficultforachildwithASDtounderstand.Generally,childrenwithASDareconcreteinthoughtandunderstandliteralconcepts.Forexample,achildwithASDmayinterpretthephrase“shehasachiponhershoulder”asagirlwithapotatochipplacedonhershoulder.

• Difficultyprovidingpersonalnarrativesofevents,socialsituations,andexperiences:Apersonalnarrativeistheretellingofapastexperiencethatincludesdetailsofwhathappenedandfeelings/attitudesabouttheexperience(Rollins,2014).AchildwithASDmayhavedifficultyprovidingapersonalnarrativeduetodifficultyconnectingeventsinapersonallymeaningfulwayandthenrelayingthatinformationinafamiliarandcohesivemannertoanotherperson(Brown,Morris,Nida,&Baker-Ward,2012).

DifferentlevelsoffunctioningforchildrenwithASDHigh-functioningASD(includeschildrenformerlyidentifiedwithAsperger’sdisorder)Childrenwithhigh-functioningASDmayhavenormaltoadvancedintellectandcanfunctioncloseto,ifnotat,gradelevel(AutismSpeaks,n.d.).Often,childrenwithhigh-functioningASDcanparticipatesuccessfullyininterviews.

Lower-functioningASDChildrenwithlower-functioningASDmaypresentwithlimitedverbalskillsandmayonlyspeakafewwords.Or,someofthesechildrenmayhaveage-appropriatevocabularybutareunable


toprocessthevocabularyintoconversationallanguage(APA,2013).Thesechildrenmayonlybeabletoengageminimallyininterviews,possiblyansweringfocusedanddirectquestions.Theymaynotbeabletoproviderunningnarrativesorgiveperipheral,sensory,orotherclarifyingdetailsduringaninterview.Social(pragmatic)communicationdisorder(SCD)TheDSM-5(APA,2013)identifiessocial(pragmatic)communicationdisorder(SCD)asaconditioninwhichchildrenhavedifficultywithsocialverbalandnonverbal(pragmatic)communication.Inthepast,childrenwithSCDoftenwereidentifiedwithASD,PDD-NOS,orAspergersyndrome.Thisnewdisorder’simportantdistinctionfromASDisthatchildrenwithSCDdonotpresentwithrepetitivebehaviorsorrestrictedinterestslikechildrenwithASDdo.TheDSM-5(APA,2013)indicatesthefollowingcharacteristicsassociatedwithSCD:

• Difficultyengaginginsocialconversations(e.g.,greetingothers,sharinginformationwithinasocialcontext)

• Difficultymatchingconversationalstyleamongdifferentcontextsorlisteners’needs(e.g.,notadjustingspeechfromtheplaygroundtothelibrary)

• Difficultyfollowingsocialcommunicationrulesandexpectations(e.g.,takingturnsinconversation,rephrasingifmisunderstood)

• Difficultyunderstandingabstractconceptsormakinginferences

LearningdisabilitiesLearningdisabilitiesareneurologicallybasedprocessingproblemsthatcaninterferewiththeabilitytoread,write,andunderstandmath.Learningdisabilitiescanalsointerferewithorganizationalskills,timemanagement,abstractreasoning,comprehension,attention,andmemory(LearningDisabilitiesAssociationofAmerica[LDA],2016).AccordingtotheU.S.DepartmentofEducation,NationalCenterforEducationStatistics(2016),childrenidentifiedwithspecificlearningdisabilitiesaccountforthemajorityofchildrenwhoqualifyforspecialeducationservicesinpublicschools.Learningdisabilitiesareoftenidentifiedwhenagapisnoticedbetweenachild’spotentialforachievementandtheactuallevelofperformance.Learningdisabilitiesarenotaresultoflowintelligencebutratherafunctionofhowthebrainreceives,processes,andrespondstoinformation.Peoplewithlearningdisabilitiesoftenhaveaveragetoaboveaverageintelligenceandcanmasterstrategiesforsuccess(LDA,2016).Learningdisabilitiesinclude:

• Dyslexia:Troubleunderstandingwrittenwords;readingdisability• Dysgraphia:Troubleforminglettersorwritinginadefinedspace• Dyscalculia:Troublewithmathematicconceptsandarithmetic• Auditoryandvisualprocessingdisorders:Troubleunderstandingwrittenorspoken

languagedespitenormalvisionandhearing• Nonverballearningdisabilities:Discrepancybetweenstrongerverbalskillsandweaker

grossorfinemotorskills,visual-spatialabilities,andsocialskills;oftendifficulties


interpretingnonverbalcues,suchasunderstandingfacialexpressions

Learningdisabilitiesalsocanimpactachild’smemory.Threetypesofmemoryareimportantforachild’slearning:workingmemory,short-termmemory,andlong-termmemory.Workingmemoryinvolvesretainingpiecesofinformationandprocessingthisinformationtogetheratthesametimeinbiggerchunks(Malekpour,Aghababaei,&Abedi,2013).Forinstance,whenachildreads,thechild’sworkingmemoryholdsontothewords,thenthesentence,thentheparagraphtoprocessthecontentofwhatisread.Short-termmemoryistheactiveprocessofstoringinformationobtainedandretrievingitoverabriefperiodoftime,suchasreadingachapterandrememberingdetailsofthatchapterforanupcomingtest.Long-termmemoryistheabilitytomaintainstorageandretrievaloftheinformationoveralongerperiod.Whenachildhasdifficultywithsomefacetofmemorystorageandretrieval,learningandprocessinginformationcanbenegativelyimpacted(Boudreau&Constanza-Smith,2011).Itisimportanttorememberthatlearningdisabilitiesarenotalwaysapparentorreported.Indicatorsthatachildmayhavelearningdisabilitiesandbestrugglingtoprocessinformationincludewhenthechild:

• Strugglestofollowdirections• Usesfillerwordssuchas“um,”“thing,”“stuff,”and“like”whilesearchingforcorrect

words• Hasapoorgraspofabstractconceptssuchastimeanddates• Hasdifficultyrelayingsequentialnarratives(first,second,last)• Confusestheorderofwords,numbers,orsequenceinastory• Distractstoothertopics,becomesagitated,orchangesthesubject

Attentiondeficit/hyperactivitydisorder(ADHD)AccordingtotheDSM-5(APA,2013),theessentialdiagnosticfeatureofattentiondeficit/hyperactivitydisorder(ADHD)isa“persistentpatternofinattentionand/orhyperactivity-impulsivitythatinterfereswithfunctioningordevelopment”(pg.61).Inthepast,childrenreceivedadiagnosisofADHDiftheypresentedwithhyperactivityand/orimpulsivity.Iftheyshowednosignsofhyperactivity,theyreceivedadiagnosisofADD(attentiondeficitdisorder).Now,ADHDisusedastheprimarydiagnosticlabel(JohnsHopkinsMedicine,n.d.),butithasthreetypes:

• ADHD,combinedtype:Presentationofinattention/distractibilitywithhyperactivity/impulsivity

• ADHD,impulsive/hyperactivitytype:Presentationofimpulsiveandhyperactivebehaviorswithoutdeficitsinattentionordistraction

• ADHD,inattentiveanddistractibletype:Presentationofinattentionanddistractibilitywithouthyperactivity


ThissectiondiscusseswaysADHDcanimpactachild’scommunicationabilities.However,Chapter4:SocialandEmotionalDisabilities—Socializing,Feeling,andBehavingalsocoversADHDbecausethisdisordercanaffectimpulsecontrol,socialskills,andbehavior.Deficitswithattentioncaninterferewithcommunication(Staikova,Gomes,Tartter,McCabe,&Halberin,2013).Whenachildlacksattentionalskills,thechildmayhavedifficultyfocusingonasentence,paragraph,orconversationlongenoughtoheartheentiremessage,letalonekeepthemessageinmindlongenoughtodeveloparesponse,sendameaningfulreply,andthenwaitforthenextmessage.Themultitudeofstimuliintheenvironmentalsocancompeteforthechild’sattentionduringaconversation,thuscausingthechildtobecomeeasilydistractedawayfromthetopicandhavedifficultybeingredirectedbacktotheconversationathand.AttentionalproblemsassociatedwithADHDmanifestindifferentways.Somecommoncharacteristicsinclude:

• Hyperactivityandimpulsivity:Hyperactivechildrenstrugglewithmaintainingattentionwhiletuningoutthestimulisurroundingthem.Theymaybefidgety,loud,andfastmoving.Childrenwithhyperactivetendenciesoftenhavetroublesittingstillinclassandfollowingappropriatepublicbehaviorsifmovementsaresupposedtobesuppressed.Theyalsomaybeimpulsiveinnatureandunabletoprocessconsequencesbeforeactingontheimpulse.

• Distractibility:Childrendonotneedtopresentwithhyperactivitytostrugglewithattention.Theymaybeeasilydistractedbecausetheirtrainofthoughtisinterruptedbyotherthoughtsorexternalstimuli.Thesechildrenmightseemlostinthoughtorbeconsidereddaydreamers.

• Hyperfocus:Thisattentionalprobleminvolvesfixating(i.e.,“gettingstuck”)onatopicoractivitytotheexclusionofallotherstimuli(NationalResourceCenteronADHD,n.d.).Withhyperfocus,childrenhavedifficultychangingtheirfocusfromonetopicoractivitytoanother.Theymaytalkatlengthaboutverysmallandspecificdetailsofatopicandbeunabletotransitiontodifferentaspectsofthetopic.Ifachild’shyperfocusisprematurelyinterrupted,itcanbeverydifficultforthechildtotransitiontoadifferenttopicoractivity.

• Saliency:ChildrenwithADHDalsostrugglewiththesaliency(meaningandrelevancy)ofadetail.Forexample,aninterviewermayaskanopen-endedquestiontowhichthechildprovidesnumerousresponses.However,thechildwhostruggleswithsaliencyhasdifficultyidentifyingthetopicathand(foreground)andknowingwhatislessrelevant(background).Thus,thechildmayprovideanonsequituroroff-topicresponsetotheopen-endedquestionasked.


Chapter4:SocialandEmotionalDisabilities—Socializing,Feeling,andBehavingSocialandemotionaldevelopmentbeginsatbirthanddriveshumanbehavior.Itincludeschildren’sabilitytounderstandandprocesstheirownexperiences,managetheiremotions,anddeveloppositiverelationshipswithothers.EMOTIONALDEVELOPMENT

Emotionaldevelopmentincludestheabilitytounderstandone’sownfeelingsaswellasaccuratelyperceiveandrelatetoothers’feelingsandemotions.Italsoinvolvestheabilitytoregulateone’semotionsandbehaviors,andtoexpresstheminasociallyacceptablemanner(KidsMatter,n.d.).Forexample,childrenlearnthatiftheyactoutcertainfeelings,suchaslove,thengenerallythisproducesapositiveresponseinothers.Conversely,actingoutfeelingsofselfishnessorhatemaycreateanegativeresponseinothers.Childrenlearnthatevenwhentheyfeelacertainway,theyshouldstillbehaveinasociallyacceptablemanner,thuslearningthatfeelingscanbecontrolledbythinkingbeforeacting.SOCIALDEVELOPMENT

Socialdevelopmentinvolveslearningvalues,knowledge,andskillsthathelpchildrenrelatetoothersandcontributepositivelytotheirfamily,school,andcommunity(KidsMatter,n.d.).Inotherwords,childrenareabletointegratetheirpersonalneedsanddesireswiththedesiresandneedsofthegroup.Suchbehaviorsincludehowonegreetsandtreatsothers,andhowonerespondstoauthority.Childrenlearnsocialbehaviorsthroughimitation,instruction,andtrialanderror—andoccasionallythroughtraumaticevents.Acceptablesocialbehaviorisalsosomewhatdependentonintellectualabilityandcommunicationskills.Socialbehaviorsincludebehaviorsthatdemonstrate:

• Respectforauthorityandothers• Understandingthatattimestheneedsofagrouparemoreimportantthanone’s

individualneeds• Anabilitytodelayinstantgratificationforagreatergaininthefuture• Acceptancethattherearerulestomaintainsocialordersopersonalneedscanbemet

withinasocialcontextClearly,themessagelearnedandthenatureofthesocialorderwillvarybyculture,buttheabovesocialguidelinesexistinmostcultures.


DEVELOPMENTOFSOCIALANDEMOTIONALDIFFICULTIES

Somechildrendemonstrateatypicaldevelopmentinsocialandemotionaldomains.Thiscanbeduetobiologicaland/orneurologicaldifferences,oritcanstemfromachildnotreceivingappropriatemodelingandreinforcementofthesocialnorms(Education.com,n.d.).Examplesofthelatterinclude:

• Childrenareexposedtoandimitatesociallyunacceptablebehavior.• Childrenlackinstructionaboutgettingtheirneedsmetinasociallyappropriatecontext.• Childrenexperiencelossortrauma,creatingfeelingsandneedsthatoverridetheir

abilitytomoderatetheirbehavior.• Childrenareexposedtomultiplestressorsoveralongperiodoftime,includingpoverty,

residentialinstability,abuseandneglect,oppression,andparentalstress.• Childrenexperienceadisturbanceinbrainbiochemistry.

o Negativebehaviorscausedbyimbalancesinbrainchemistrycanoftenbemitigatedwithmedication,counseling,and/orcognitivebehavioraltherapies.

Behaviorsthatsuggestsocialandemotionaldifficultiesinclude(Education.com,n.d.):

• Externalizingbehaviors(acting-outbehaviors),suchasnoncompliancewithdirectionsorwithpeopleinauthority,hittingandfighting,destroyingproperty,andstealing

• Internalizingbehaviors(oppositeofaggression),suchasdepression,moodandanxietydisorders,somaticcomplaints,andself-harm

• Inabilitytoself-regulateorcalmwhenupset• Poorsocialskills,includinginabilitytomakeandmaintainfriends,and/orimmatureand

atypicalbehaviorforage(actingmucholderoryoungerthanchronologicalage)• Difficultymakingormaintainingeyecontact• Impulsivityandhyperactivity

Ofnote,childrenwithsocialandemotionaldifficultiesareatmuchhigherriskofpooracademicachievement.Often,childrenwithemotionaldisturbancesperformbelowtheiracademicgradelevelandhavehigherratesofdroppingoutofhighschoolthantheirtypicallydevelopingpeers.Usefulresourceinformationonchildren’smentalhealthdisordersandsocialandemotionaldisabilitiescanbefoundatwww.cdc.gov,theCentersforDiseaseControlandPrevention(CDC)website(CDC,2016).COMMONDIAGNOSESANDPRESENTATIONSINSOCIALANDEMOTIONALDIFFICULTIES

AnxietydisordersChildrenwithanxietydisordersmaypresentwithanelevatedstateofworryortensionevenwhenthereislittleornothingtotriggerthisresponse.Theanxietymayalsobeaccompaniedbyphysicalmanifestations(somaticsymptoms),includingfatigue,headaches,insomnia,andirritability.


Somecommonanxietydisordersinchildreninclude(AnxietyandDepressionAssociationofAmerica[ADAA],2016):

• Generalizedanxietydisorder:Thisdisorderincludesgeneralworriesandconcernsaboutnumerousaspectsofchildren’slives,includingschool,family,andimpendingdisasters.

• Panicdisorder:Achildwithapanicdisorderexperiencesepisodesofphysicalsymptomsthataccompanyfeelingsofterror,includingsweatingorchills,tingling,numbness,dizziness,orfainting.

• Socialanxietydisorder:Thisdisorderinvolvespersistentfearofnegativeexperiencesinsocialsettingsorwithotherchildren.Itincludesworryingaboutjudgmentbyothersoraboutdoingsomethingthatcausesembarrassmentorshame.

• Obsessive-compulsivedisorder(OCD):AchildwithOCDusesrituals(compulsions)tocontrolanxiety,butovertimetheritualsendupcontrollingthechild.Examplesofritualsincludecountingobjects,insistingonaspecificorderinacertainactivity,andwashinghandsexcessively.

• Posttraumaticstressdisorder(PTSD):Achildexperiencesorwitnessestrauma,thenre-experiencesthetraumathroughimages,sounds,andfeelingsassociatedwiththetrauma.

TraumaAsnotedabove,PTSDfallsunderanxietydiagnoses(APA,2013).NotallchildrenwhoexperiencetraumawilldevelopPTSD.Traumareactionsarenothomogeneousandcandifferbetweentwochildrenwhoexperiencedthesametraumaticevent.However,achildwhopresentswithtraumasymptomscanpresentwithsocialandemotionaldifficulties.Commonsignsandsymptomsoftraumareactionsinchildreninclude(NationalChildTraumaticStressNetwork[NCTSN]):

• Difficultyregulatingemotionsandbehaviors• Excessiveangerand/oragitation• Regressioninbehaviors(revertingtoimmaturebehaviorssuchasthumbsuckingand

bedwetting)• Imitationoftheabusive/traumaticevent• Inaccuratethoughtsaboutthemselvesortheabusiveevent• Hypervigilanceandrigidity• Increasedanxiety,fearfulness,and/oravoidantbehaviors• Disassociation(disengagingand“spacingout”)

DepressionDepressionischaracterizedbyfeelingsofsadness,isolation,hopelessness,pessimism,guilt,and/orworthlessnessthatcaninterruptenjoyableactivitiesandinterests.Othersymptomsofdepressionincludechangesinappetite(overeatingorlossofappetite),fatigue,insomnia,difficultyconcentratingormaintainingattention,anddifficultymakingdecisions.Childrenwith


depressionmaydemonstratemoodswings,resistgoingtoschool,andhaveincreasedirritabilityoraggressivebehaviors(ADAA,2016).Attentiondeficithyperactivitydisorder(ADHD)ChildrenwithADHDoftenstrugglesociallyduetothebehaviorsassociatedwiththisdisorder(Holmber,2014ascitedbyADHDInstitute,n.d.).Asaresultofbehavioralchallenges,childrenareatriskofsocialisolationfrompeers,pooracademicachievement,lowself-esteem,substanceabusedisorders,behavioraldifficultieslikedelinquencyandoppositionalbehaviors,anddevelopmentofmooddisorderssuchasdepressionoranxiety(NationalResourceCenteronADHD,n.d.).Examplesofbehaviorsthatinterferewithsocialdevelopmentinclude:

• Impulsivity(difficultytakingturnsand/orfollowingdirections,interrupting)• Inattention(notlistening,actingwithdrawn)• Difficultyunderstandingsocialpragmatics(difficultyunderstandingorfollowingthe

socialnorms,suchasinvadingpersonalboundariesandspace)

Oppositionaldefiantdisorder(ODD)Thehallmarkfeatureofoppositionaldefiantdisorderisapersistentandfrequentpatternofanangry,agitated,and/orirritablemood,oftenwiththepresenceofargumentative,defiantbehaviorsandvindictiveness(APA,2013).Childrenwiththisdisorderoftenactstubborn,disobey,deliberatelyannoyothers,andshiftblamefromthemselvestoothers.Suchbehaviorscanbepresentonlyincertainsituations,suchasathomeorwithfamilymembers,butthepervasivenessofsymptomsacrossaspectsofdailylife(inpublic,atschool,etc.)isindicativeofthedisorder’sseverity.Ofnote,ODDoftenco-occurswithADHD.Autismspectrumdisorder(ASD)InChapter3,ProjectAbilityintroducedautismspectrumdisordercharacteristics.Brieflysummarizing,childrenwithASDpresentwithdifficultiesintwodomainsoffunctioning:1)socialinteractionandsocialcommunication,and2)restrictedinterestsandrepetitivebehaviors,whichincludesensorydifferencesandchallenges(APA,2013).DeficitsinsocialinteractionandcommunicationposechallengeswheninterviewingchildrenwithASD(Mattison,Dandon,&Ormerod,2015).Thedeficitsinclude:

• Difficultyprovidingandarticulatingpersonallyexperiencedevents(Brown,Morris,Nida,&Baker-Ward,2012)

• Difficultyrelayingepisodicmemoriesfromfreerecallprompts(McCrory,Henry,&Frappe,2007)

• Difficultyunderstandingsociallyrelevant,salientdetailsofevents(GoldmanS.,2008).• Inclusionofidiosyncraticlanguageinthenarrativesthatareoutofcontextand/or

confusingtoothers.(Suh,etal.,2014)• Difficultyconnectingemotionswithanexperienceoranevent(Brownetal.,2012)


ChildrenwithASDalsodisplayemotionsinavarietyofways.Whenoverwhelmed,theymaydisplayincreasesinrepetitiveand/orrestrictivebehaviors,suchasflappingtheirhandsinfrontoftheireyes.Iftheybecomeincreasinglyagitated,stressed,oruncomfortable,thentheymightbeginflappingtheirhandsmorefrequentlyandintenselyinsteadofusingtheirwordstoexpresssuchfeelings.OtherchildrenwithASDmightdisengagefromtheconversationoractivityandretreattosomethingmoredesirabletothem.Forexample,achildwhohasdifficultywithinterpersonalinteractionsbutenjoyscomputercodingmightstopinmid-conversationwhendistressedandreverttotalkingonlyaboutcomputercodes.Suchdifficultywithsocialandemotionalcommunicationandbehaviorsdoesnotmeanachildcannothaveasuccessfulinterview.AstudybyMcCrory,et.al(2007)foundthatchildrenwithASDcanprovideaccuratenarrativeaccountsofhistoricalevents,buttheyoftenrequiresupport,suchasmorefocusedanddirectquestions.PleaserefertoChapter10:Accommodations—AutismSpectrumDisorder(ASD)foraccommodationsinterviewerscanmaketosupportchildrenduringforensicinterviews.Social(pragmatic)communicationdisorder(SCD)Chapter3alsoreviewedsocial(pragmatic)communicationdisorder(SCD).SCDisaconditioninwhichchildrenpersistwithdifficultywithsocialverbalandnonverbal(pragmatic)communication(APA,2013).Inthepast,childrenwithSCDoftenwereidentifiedwithASD,PDD-NOS,orAspergersyndrome.Thisnewdisorder’simportantdistinctionfromASDisthatchildrenwithSCDdonotpresentwithrepetitivebehaviorsorrestrictedinterestslikechildrenwithASDdo.TheDSM-5(APA,2013)indicatesthefollowingdifficulties:

• Difficultyengaginginsocialconversations(greetingothers,sharinginformationwithinasocialcontext)

• Difficultymatchingconversationalstyleamongdifferentcontextsorlisteners’needs(e.g.,notadjustingspeechfromtheplaygroundtothelibrary)

• Difficultyfollowingsocialcommunicationrulesandexpectations(takingturnsinconversation,rephrasingifmisunderstood)

• Difficultyunderstandingabstractconceptsormakinginferences


Chapter5:IntellectualDisabilities—ThinkingandReasoningIntellectualdisabilities(ID)arecharacterizedbylimitationsinintellectualfunctioningandadaptivebehavior.Intellectualfunctioningreferstoone’sgeneralmentalcapacity(thinking,learningskills),IQ,andreasoningorproblem-solvingskills.Adaptivebehavioristhedevelopmentofconceptual,social,andpracticalskillsutilizedindailylife(AmericanAssociationonIntellectualandDevelopmentalDisabilities[AAIDD],2013).IDtypicallyoccurduringthedevelopmentalperiod(birthtoage18)andpersistthroughoutone’slifetime.IDareaheterogeneousconditionthatiseithercongenital(aconditionpresentatbirth)oracquired(e.g.,asevereinfectionsuchasmeningitisoratraumaticbraininjury).OthertermsthathavebeenusedpreviouslyforIDincludementalretardation,cognitivedisability,andcognitiveimpairment.OftenwhenreferringtochildrenwithID,thereismentionof“mentalage”or“developmentalage”versuschronologicalage.ForthepurposesofProjectAbility,achild’smentaland/ordevelopmentalageisassociatedwithcurrentacademicfunctioningascomparedtopeerswhoarethesamechronologicalage.Sometimes,whenachildisreferredforaforensicinterviewandanintellectualdisabilityordifficultyisnoted,thechildmightbeidentifiedasfunctioningatalower“mentalage”thanthechild’schronologicalage.Anexamplewouldbea12-year-oldwhoisworkingacademicallyatthelevelofakindergartener.ID-relatedinformationcanbequitesubjectiveandpossiblyinaccurate,dependingonitssource(anIndividualizedEducationProgramversusaquickassessmentbysomeonewhojustmetthechild).However,suchinformationcanbehelpfulinassessingandplanningtheinterviewtoaccommodatethechild’scurrentcommunicationabilitiesandconceptual(thinking/reasoning)abilities(Henry,Bettenay,&Carney,2011).ChildrenwithIDareparticularlyvulnerabletomaltreatmentduetoamyriadofdifficultieswiththeir(APA,2013):

• Socialandcommunicationskills• Abilitytoassessforrisk• Relianceonothersfordailycareneeds

DependingontheseverityoftheID,theDSM-5categorizesaperson’sintellectualandadaptivefunctioningasmild,moderate,severe,orprofound.Table4describesthesecategories.


SeverityLevel

ThinkingandReasoningAbilities

SocialFunctioning PracticalFunctioning

Mild Difficultywithacademiclearning(reading,writing,math,problemsolving)Difficultywithabstractconcepts(time,money)Poorexecutivefunctioningskills(planning,organization,prioritizing)Short-termmemoryandworkingmemorydeficits

Immatureinteractionswithotherscomparedtosame-agedtypicallydevelopingpeers,including:DifficultyunderstandingsocialcuesfrompeersSimple,concretelanguageImmatureemotionalregulationandbehaviorsGullibleandatriskofbeingmanipulatedAbletodevelopstrongfriendshipsandrelationships

Mayhaveage-appropriatepersonalcareskillsMayneedsupportwithcomplexdailylivingtaskswhenolder,suchas:GroceryshoppingTransportationNutritiousfoodpreparationBanking/moneymanagement

Moderate Throughoutdevelopment,thechild’sintellectualfunctioningisnoticeablybehindpeers.Academicprogressiondevelopsslowlyandislimitedcomparedtopeers.Asanadult,thechild’sacademicskilldevelopmentisoftenatanelementarylevel.

Socialjudgment,decision-makingskills,andsocialcommunicationaremarkedlydifferentandimmaturecomparedtopeers.Simple,non-complexlanguageskillsAbletodevelopcloserelationshipsanddevelopromanticrelationshipswhenolder

Duringchildhood,mayneedadultassistancewithdailycareroutinesandhygieneExtendedperiodofeducationandtrainingneededtobecomeself-sufficientindailycareroutinesWillneedsupportfromothersforcomplextasks

Severe Limitedabilitytounderstandwrittenlanguageornumericalconcepts(math,time,money)

Vocabularyandgrammararequitelimitedandsimple.Verbalskillsmayincludeusingsinglewordsorphrases.Useofaugmentativecommunicationmayoccurwithsimplisticrepresentationsofitemsorneeds.Relationshipswithfamilyandfriendsareverypositiveandasourceofpleasure.

Caregiversprovideextensivesupportfordailycareroutinesandadaptiveskillsthroughoutlifetime.

Profound Verylimitedcapacityforlearningandsymbolicprocessing

VerylimitedlanguageskillsandabilityforsymboliccommunicationExpressesneedsanddesiresthroughsimplenonverbalgesturesandsounds

Reliantonothersfordailycareroutinesandadaptiveskillsthroughoutlifetime

Table4.RangeofintellectualandadaptivecapabilitiesascategorizedbytheDiagnosticandStatisticalManualofMentalDisorders


Ingeneral,childrenwithmildandmoderateIDcanparticipateinforensicinterviews.ResearchindicatesthatchildrenwithIDareabletorecallforensicallyrelevant,accurateaccountswhenbestpracticesareutilized,includingtheuseofopen-ended,free-recallpromptsbutwithouttheuseofrepeated,suggestiblequestions(Brown,Lewis,&Lamb,2015).Unfortunately,biasesagainstchildrenwithID—includingconcernsaboutincreasedsuggestibilityandpresentingaspooreyewitnesses—haveledtounderreportingandlessprosecutionofabusecasesagainstchildrenwithID(Henryetal.,2011).Forinterviewingbestpracticeandaccommodations,pleaserefertoChapter11:Accommodations—IntellectualDisabilities.GENERALPRESENTATION

Ascomparedtotypicallydeveloping,same-agedpeers,commonpresentationsofchildrenwithID—dependingontheseverityofthecondition—include:

• Immatureconversationstyle(simplevocabulary,shortersentences,concreteinthought)

• Immaturesocialbehaviors(seemyoungerinpresentationthanchronologicalage)• Difficultywithabstractconcepts(time,complexhumor)• Literalinterpretationofwordsandgestures• Limitedorimmatureproblem-solvingskills• Tendenciestowardcomplianceandpleasingothers• Impulsivityindecisionmakingduetointellectualcapacity• Difficultywithshort-termmemoryandworkingmemory• Mayrequiremoretimetoprocessandmaytakelongertolearnnewconcepts(needfor

repetitiontomasterskills)• Normalsexualdevelopment,butmaylackabilitytoperceivedangerormanipulationin

relationshipsSPECIFICDIAGNOSESASSOCIATEDWITHINTELLECTUALDISABILITIES

DownsyndromeDownsyndromeisageneticconditionwithaduplicationofchromosome21.Physicalcharacteristicsincludelowmuscletone,flatnose,smallmouthandears,slantedeyes,shortarms,andalargehead.Inaddition,peoplewithDownsyndromeareatincreasedriskofheartdiseaseandleukemia(NationalInstituteofChildHealthandHumanDevelopment[NICHD],2014).Downsyndromemaycausedelaysinphysicaldevelopmentandintellectualfunctioning.However,functionalcapacitiesvarygreatlyamongindividualswithDownsyndrome.Manypeoplewiththissyndromecanliveindependently,buildhealthy,strongrelationships,andmaintainjobs.ChildrenwithDownsyndromearelikelytohaveexpressivelanguagedifficulties,includinglimitedvocabulary,shorterutterancelength,simplesentencestructure,anddifficultywitharticulation.Theymayalsohavedifficultywithshort-termmemoryandlimitedattentionspans(NICHD,2014).Incontrast,theirreceptivelanguageskills,includingnonverbalskills,areanarea


ofstrength.Thatsaid,theirreceptivelanguageskillsstillmaynotbeasstrongastheirsame-agedtypicallydevelopingpeers’skills(Henry,et.al.,2011).Autismspectrumdisorder(ASD)AutismspectrumdisorderhasbeendiscussedthroughoutProjectAbility.ASDcanimpactseveraldomainsoffunctioning,includingcommunication,social/emotionalbehaviors,andintellect.Itshouldbenotedthatapproximately50to80%ofindividualswithASDhaveanID(Shoemaker&Matson,2009).


Chapter6:PhysicalDisabilities—Hearing,Vision,Movement,andHealthThefourthcategoryofdisabilityidentifiedinProjectAbilityinvolvesphysicalfunctioning—hearing,vision,movement,andhealth.Thiscategoryofdisabilityisdiverseandencompassesnumerouschronicconditionsthatcanaffectchildren’sperformanceinschoolandtheirabilitytoparticipateinaninterview.Definitionsandclassificationsofphysicaldisabilitiesvarywidely.TheIndividualswithDisabilitiesEducationAct(IDEA)categorizesdisabilitiesthatimpactachild’smovementorbodystructureas“orthopedicimpairments,”whichtypicallyincludeorthopedicandneuromusculardisorders(Smith,2014).TheIDEAusesthephrase“otherhealthimpairments”todescribeconditionsthatcausespecialhealthcareneedsorhealthdisabilitiesforchildren(Smith,2014).Theseconditionsaffectachild’sphysicalfunctioningandalertnesstoenvironmentalstimuli,whichultimatelyinfluencethechild’seducationalperformance(CenterforParentInformationandResources,2012).Conditionsinthiscategoryincludechronicheartproblems,asthma,attentiondeficithyperactivitydisorder(ADHD),diabetes,traumaticbraininjury,epilepsy,leadpoisoning,sicklecellanemia,andTourettesyndrome.Othertypesofphysicaldisabilitiesinvolvedifficultieswithseeingandhearing.Bothvisualimpairmentandhearingimpairmentarecomplexdisorderswithvaryingdegreesofseverityandsupportneeds(e.g.,assistivetechnologysupportssuchascomputerscreenreaders,hearingaids,andcochlearimplants).SELECTEDDIAGNOSESANDPRESENTATIONSINPHYSICALDISABILITIES

VisionimpairmentandblindnessThevisionimpairmentandblindnesscategoryintheIDEAincludesdifficultywithvisionthatadverselyaffectsachild’seducationalexperienceandperformance,evenwhenvisualcorrection(i.e.,glasses)isused(CenterforParentInformationandResources,2012).Thisphraseencompasseslowvision(alsoreferredtoaspartialsightedness)andtotalblindness.

• Peoplewithlowvisionhaveaseverereductioninvisionthatcannotbecorrectedwithstandardeyeglassesorcontactlenses.

• Peoplewithtotalblindnesscannottelllightfromdarkand/orhaveatotalinabilitytosee.

Themajorityofpeopleexperiencingvisionimpairmentandblindnesshavesomeformofsightorabilitytoseelightanddark,whileapproximately15%ofthevisuallyimpairedpopulationintheUnitedStatesexperiencetotalblindness(AmericanFoundationfortheBlind,2016).DeaforhardofhearingDeaforhardofhearingincludestheimpairmentofhearing,eitherpermanentorfluctuating,thatadverselyaffectsachild’seducationalexperienceandperformance(CenterforParent


InformationandResources,2012).TheIDEAnotesthatdeafnessinvolveshearingimpairmentsoseverethatthechild’sabilitytoprocesslinguisticinformationthroughhearing,withandwithoutamplification,isimpaired(SpecialEducationGuide,n.d.)Deafnessisatermthatgenerallyreferstoone’sinabilitytohearspeechwithoutahearingaid,whilehearinglossdescribesreducedhearingacuity.Dependingontheseverityofhearingloss,deafnesscanrangefrommildtoprofound.Variationsofdeafnessincludethelevelofhearing,ageofonset,communicationmethods,andculturalidentity.TheU.S.deafandhardofhearingcommunityisdiverse,butitsmemberssharecommonhistory,values,language(AmericanSignLanguage),andmorals(Benedict&Legg,2014).Childrenwhoaredeaforhardofhearingareatgreaterriskofabuse—includingneglect,emotionalabuse,physicalabuse,andsexualabuse—thantheirtypicallydevelopingpeers(Schenkel,etal.,2014).Thereareamyriadofreasonsforthisincreasedvulnerability,including:

• Difficultyaccessingappropriateeducationalresources• Delaysincommunicationduetolackofappropriatelanguageandcommunication

education• Lackofsupportservicesandappropriatementalhealthservices

Asinterviewers,itisimportanttounderstandhowthechildwhoisdeaforhardofhearingcommunicatesandwhataccommodationsareneededtoenhancecommunicationwiththatchild.Fordetails,pleaserefertoChapter12:Accommodations—PhysicalDisabilities.CerebralpalsyCerebralpalsyisagroupofdisordersthataffectmovement,posture,andsometimesspeech.Cerebralpalsyiscausedbyabnormaldevelopmentofthebrainordamagetothedevelopingbrain.Thedegreeofbraindamageandimpairmentdoesnotchangeovertime,butcomplicationsorsecondaryconditionsmayresultindecreasedfunctionovertime(CDC,2015).Cerebralpalsy’ssymptomscanrangefrommildtosevereandmostoftenaffectthechild’smobility.Manychildrenwithcerebralpalsycanwalkunaidedandenjoymostactivitiesofchildhood.Otherchildrenwhoareaffectedmoreseriouslymayusebracesorawheelchair.Achildwithcerebralpalsymayalsopresentwith:

• Speechandarticulationdifficulties,suchasdysarthria(articulationproblemscausedbyoralorfacialmuscleweakness)

• Drooling(duetodifficultywithswallowing,notexcessivesalivaproduction)• Learningdisabilitiesorintellectualdisabilities,duetothebraininjury• Difficultywithimpulsecontrolorfocusing(associatedwithADHD)• Historyoffeedingdifficulty,resultinginpoornutrition(UnitedCerebralPalsy,2016)


Chapter7:GeneralAccommodationsforChildrenwithDisabilitiesAllforensicinterviewersshouldadheretocurrentbestpracticesinordertoconductforensicallysoundinterviewsofchildren.Accommodationsforchildrenwithdisabilitiesbuildontheinterviewguidelinesalreadyestablished.InOregon,interviewersshouldfollowtheOregonInterviewingGuidelines(2012).Thischapterreviewsimportantinterviewpreparatoryquestionsandconsiderationsaswellasuniversallyhelpfulinterviewaccommodationsforchildrenwithdisabilities.Subsequentchaptersexpandonthesegeneralaccommodationswithaccommodationsspecifictotheareaoffunctioning(communication,social/emotional,intellectual,andphysical)thatismostimpactedbythechild’sdisability.PREPARINGFORTHEINTERVIEW

ThegoalofProjectAbilityistohelpinterviewerssimplifytheirthinkingaboutdisabilityasitpertainstothefourprimarydomainsofdevelopmentandfocusonfivequestionstoaskwhenpreparingtointerviewchildrenwithdisabilities.Thesequestionspromptinterviewerstorethink“disability”byemphasizinganunderstandingofandcapitalizingoneachchild’sstrengths.Byaskingthesefivequestionspriortointerviewingachildwithadisability,theinterviewercanorganizewhatisknownaboutthechildanddeterminewhatinformationisneededbeforeproceedingtoaninterview.Thefiveinterviewpreparationquestionsare:

1. Doesthischildhaveadisabilityordifficultywith:o Speaking,understanding,and/orusinglanguage?(Communication)o Socializing,feeling,andbehaving?(Social/emotionalbehavior)o Thinkingandreasoning?(Intellectual)o Hearing,vision,movement,andhealth?(Physical)

2. Howdoesthedisabilityaffectthischild?

3. Whatstrengthsandabilitiesdoesthischildhave?4. WhatelsedoIneedtoknowaboutthedisabilityandthechild?

o Aretheremedicaloreducationalrecordsavailableforreview?o Whomightbeavailableforageneralconsultationonthisdisability?

5. HowcanIstructurethesettingandthequestionsforasuccessfulinterview?


Question1:“Doesthischildhaveadisabilityordifficultywith…”relatestothefourdomainsoffunctioningdiscussedthroughoutProjectAbility.Considerwhatareasaremostimpactedforthechild.Question2:“Howdoesthisdisabilityaffectthischild?”exploresinmoredetailthechild’scurrentleveloffunctioning,presentation,andeffectsofthedisability.Suchinformationcanbefoundinvariouscollateralreports,suchas:

• Schoolrecords—suchasanIndividualizedEducationProgram(IEP)—thatdocumentleveloffunctioning,currentstrengths,weaknesses,andacademic/behavioralaccommodationsatschool

• Medicalrecords,includingspecificdiagnoses,medications,andtherapiesreceived• Othercollateralreports,suchaspolicereportsortheOregonDepartmentofHuman

Services(DHS)reports• Historiesprovidedbycaregiversandadultswhoworkandinteractwiththechild

PleasenotethatIEPsoftenarelong,complicateddocuments,brokenintodifferentsectionsrelatedtotesting(thechild’scurrentacademicfunctioning),academicandbehavioralchallenges,goals,andaccommodations.IEPscanprovideinformationaboutthechild’sacademicfunctioning,socialandemotionalchallenges,andcurrentaccommodationsinplaceintheschoolsetting.ImportantinformationtogleanfromtheIEPincludesthechild’s:

• Currentproblem/disability• Currentacademicfunctioning(i.e.,“mentalage”ascomparedtochronologicalage)• Currentstrengths(whetherthechildisengaged,abletositthroughclass,etc.)• Currentaccommodationsusedinclassorwithpeers

Caregiverinputshouldneverbeoverlooked.Caregiverstypicallyhavethebestunderstandingofhowthechildcommunicatesandfunctionsaswellasthecurrentaccommodationsalreadyestablishedforthechild.Suchinputcanalsocomefromotheradultswhoknowthechild,suchasextendedrelatives,teachers,andtherapists.Question3:“Whatstrengthsandabilitiesdoesthischildhave?”Alwaysrememberthatchildrenwithdisabilitiesrelyontheirstrengthsandabilitiestoovercomechallenges,adversity,andprejudiceeveryday.Itistheinterviewer’sjobtoask,seek,andacknowledgethechild’sstrengths.Examplesofstrengthscouldbegeneric(e.g.,thechildisgenerallyhappyandeasilyengageswithothers)ormorespecific(e.g.,thechildutilizesgestureseffectivelytogetneedsmet).


Question4:“WhatelsedoIneedtoknowaboutthedisabilityandthechild?”mayinvolvegatheringmoreperson-specificinformation.Examplesinclude:

• Doesthechildtakeanymedications?Howdotheyaffectthechilddependingonthetimeofday?(Knowingwhenthemedicationsareatpeakperformancemayinfluencetheinterviewtime.)Isthechildexperiencinganysideeffects?Hasthechildbeenwithoutmedicationsforsometimeandexperiencinganyadverseeffects?

• Doesthechildhaveaspecialstuffedanimalthathelpscalmthechildwhenupset?Canthechildbringthisstuffedanimalintotheinterview?

Certainsituationscallfortheinterviewertoexplorebroaderquestionsaboutthechild’sfunctioning.Forexample,ifthechildhasararegeneticdisorder,inquireaboutcommoncharacteristicsofpeoplewhohavethatsamedisorder.

Question5:“HowcanIstructurethesettingandthequestionsforasuccessfulinterview?”relatestoaccommodationsthatcanbemadepriortomeetingthechildandduringtheinterview.CONSIDERATIONSFORTHEINTERVIEWSETTING

Importantconsiderationsthatcanbehelpfulinmostcircumstancesforchildrenwithdisabilities:

• Thewaitingroomshouldadequatelyaccommodatethechildandfamily,includinghavingage-anddevelopmentallyappropriateactivitiesavailableifpossible.

• Minimizedistractionsintheinterviewroom,suchaslimitingthenumberoftoys,objects,andobstaclesintheroom.

• Ideally,incandescentlightingandlampsarebestininterviewroomsbecauseflorescentlightingcanbeharshandoftenhaveadistracting“humming”sound.

• Haveaccesstowritingtools(paper,crayons,markers)incasethechildchoosestodraw,write,ormapduringtheinterview.

• Sometimes,Play-Dohorothernontoxicmoldingmaterialscanprovideopportunitiesforchildrentostaybusyandengagedduringtheinterview.However,ifthechildbecomesagitatedortoodistractedbythis,thentheinterviewershouldplanforhowtoremovethisitem.

INTERVIEWGUIDELINES

Allforensicinterviewersshouldadheretocurrentbestpracticesinordertoconductforensicallysoundinterviewsofchildren.Accommodationsforchildrenwithdisabilitiesshouldbuildontheinterviewguidelinesalreadyestablished.Thosebestpracticesandguidelinesshouldremainthefoundationofanyinterviewforachild;however,accommodationscanbemadeatanytimeandasneededwhenthestandardfortheinterviewisnotmeetingthechild’sneeds.


InOregon,interviewersshouldfollowtheOregonInterviewingGuidelines(OIG,2012),whichinclude:

• Begintheinterview.o Roleintroductions/roomexplanationo Establishingrapporto Instructionsandansweroptionso Narrativepractice—encouragingthechildtotellaboutasalienteventfrom

beginningtoend• Transitiontothetopicofconcerninthemostopen-endedandnon-suggestivewayby

usingopen-endedquestionsandprompts.o Interviewertransitionsfromneutraltopictotopicofconcern.o Duringthisphase,followthequestioncontinuum:

− Open-endedquestions/prompts:Useinvitationalpromptsthatallowthemostspontaneousresponsesandprovidethemostaccuratedetails.(“Tellmeeverything…beginningtoend.”)

− Focusedquestions:Thesequestionsdirectthechildtoaparticulartopic,place,orpersonbutrefrainfromprovidinginformationaboutthesubject.

§ Focusedquestionsareusedtoelicitclarificationandmorespecificdetailregardingstatementsthechildprovidedduringthenarrative.

§ Focusedquestionsalsoprovidesensorimotorandotherdetailsabouttheincident(e.g.,“Whatdidthehandfeellike?”).

− Directquestions:Questionsthatspecifyactorandact.Directquestionscanconfirmorclarifyinformationachildhasalreadyprovidedduringtheinterview(e.g.,“YousaidDadhityou.WhatdidDadhityouwith?”).

§ Theinterviewershouldalwaysreturntoopen-endedquestionsafterdirectandfocusedquestionsifpossible.

− Multiplechoiceandclose-endedquestions:–§ Multiplechoicequestionsshouldalwaysincludeanopen-

endedoption,suchas“orsomethingelse”.(e.g.,“Wasthedooropen,closed,orsomethingelse?”).

§ Close-endedquestionsallowforone-wordresponses;theyincludeyesornoquestions.

§ Interviewersshouldfollowmultiplechoiceorclose-endedquestionswithanopen-endedquestion(e.g.,“Tellmeaboutthedoorbeingclosed.”).

• Concludetheinterview.o Endtheinterviewaftersufficientinformationhasbeenobtained.


o Endtheinterviewifthechildisunabletocontinuetoparticipate.o Endtheinterviewifthechildrequeststoendtheinterview.

GENERALACCOMMODATIONSFORCHILDRENWITHDISABILITIES

Priortotheinterview,meetthechildinthewaitingroom.• Taketimetoexplainrolesandtheevaluationprocess.Forexample:

o “Wetakelotsofturnshere.Firstwearegoingtomeetwithyourmom,thenyouhaveacheckupandtalkingtime,thenyourmomhasaturnagain.”

• Beflexible!Considerofferingthechildatourofthecenterandthevariousroomsthatwillbeused.

Duringtheinterview:• Reviewroles,introductions,androomexplanationsagain,evenifthesewerereviewed

whenmeetingthechildinthewaitingroom.• Usethechild’snamefrequentlythroughouttheinterviewtomaintainattentionand

groundthem.• Spendtimeestablishingrapport.

o Usethistimetoevaluatethechild’sspeechandlanguageaswellasthechild’sabilitytorespondtoopen-ended,moreabstractquestions.

o Noticeifthechildhasdifficultyprovidingalotofdetailsand/orlong-runningnarrativesregardingneutraltopicsorinterests.

o Buildingrapportalsoallowsthechildtorelaxandfeelsafe.• Reviewinstructions/answeroptionsoneatatime.

o Givethechildtimetoprocesseachinstruction/answeroptionbeforemovingtothenextinstruction/answeroption.

o Practicewiththechildifdevelopmentallyappropriate.Forexample:− Interviewer:“Mia,ifIhearsomethingyousayandIhearitwrong,

pleasetellmeI’mwrong.”− Mia:“Okay.”− Interviewer:“Let’spractice.WhatifIsaidyournamewasMindy?”

Pause.− Mia:“MynameisMia.”

o Reinforceaccurateanswers.− Interviewer:“That’sright,youdothat.TellmeI’mwrongandtellme

therightanswer.”• Thenarrativepracticeisaveryimportantcomponentoftheinterview.

o Ifthechildprovidesfewresponsesand/orisunabletoprovideanarrativeinresponsetoanopen-endedprompt(e.g.,“Tellmeeverything”),youcanscaffoldquestions,possiblyusingmorefocusedanddirectquestions,toelicitmoreinformation.Whenscaffoldingquestions,usethechild’swordsascues.Forexample:


− Interviewer:“Sam,tellmeeverythingyoudidduringyourbirthdayparty.”

− Sam:“Atecakeandopenedpresents.”− Interviewer:“Okay,sotellmethefirstthingthathappenedatyour

birthdayparty.”− Sam:“Myfriendscameover.”− Interviewer:“Yourfriendscameover,thenwhathappenednext.”− Sam:“Weplayed.”− Interviewer:“Youplayed,thenwhatdidyoudo?”− Sam:“Momgotthecake.”− Interviewer:“Afterthecake,thenwhathappened?”

• Ifscaffoldingquestionshelpedduringthenarrativepractice,thisstructuremostlikelywillbeneededwhenexploringthetopicofconcern.

o Utilizeopen-endedprompts/questionsasmuchaspossible.Forexample:− Interviewer:“Jake,howcomeyourmombroughtyoutotheclinic

today?”− Jake:“Joeytouched.”Jakepointstogenitals.− Interviewer:“Whatdoyoucallthatpartwhereyouarepointing?”− Jake:“Myprivate.”− Interviewer:“Jake,tellmeallaboutJoeytouchingyourprivate.”− Jake:“Hetoucheditwithhishands.”− Interviewer:“WherewereyouwhenJaketouchedyourprivate?”− Jake:“Iwasinmybedroom.”− Interviewer:“TellmeallaboutJoeytouchingyourprivate,fromstart

tofinish.”− Jake:“Hecamein,pushedmedown,andtouchedit.”

• Itmaybenecessarytointroducethetopicofconcerndirectlyifthechilddoesnottransitiontothetopicofconcern.

o Forinstance,theinterviewermayneedtoaskaboutaparticularactionwithoutintroducingtheactor,orintroducethenameoftheperson(actor)withoutstatingtheaction.Forexample:

− Interviewer:“Sue,howcomeyoucametotheclinictoday?”− Sue:“Idon’tknow.”− Interviewer:“Sometimeskidscomehereifsomeoneisworriedabout

them.Isanyoneworriedaboutyou?”− Sue:“No.”− Interviewer:“Sometimeskidscomeifsomeoneisworriedthatakid

hasbeenhitorhurtontheirbody.Isanyoneworriedaboutthathappeningtoyou?”

− Sue:“No.”


− Interviewer:“Okay,soyouknowItalkedwithyourmomtoday.Shesaidshewasworriedaboutabruiseonyourarm.”

− Sue:“Ohyeah,thisone.”Sueshowsupperarmbruise.− Interviewer:“Tellmeaboutthebruise.”

• Usingtoolsduringtheinterviewcanhelpelicitmoredetailsabouttheconcerns.Toolsincludemaps,drawings,anatomicallydetaileddollsorbodydrawings,andaskingthechildtousegesturesorshowbodypositioning.

o Mapshelporganizelocationandcangroundachild.Askthechildtodrawamap,thenrefertothemapanduseittohelpstructurequestions,includingwherethechildand/orallegedperpetratorwere,whoelsewasthere,andperipheraldetailsofthesurroundings(sounds,smells).

− Reassurethechildthatthemaps(ordrawings)canbesimpleanddonotneedtobeperfect.

− Askingthechildtoarticulatewhattheyaredrawingcanelicitadditionaldetails.

o Drawingpicturesoftheabuseincidentafterthechildhasdisclosedinformationcanhelpprovideadditionalclarificationanddetails.Periodically,askthechildaboutthepicturebeingdrawn(e.g.,“Whatisthis?”“Bed.”)Orhavethechildtellyouwhattheyaredrawing,ifable.Askopen-endedquestionsregardingthedrawing.Forexample:

− Interviewer:“John,youdrewthebed.Tellmeaboutthebed.”− John:“Ionit.”JohnthendrawsanXonthebedandabiggerXbythe

bed.− Interviewer:“John,tellmeaboutthisbigX.”− John:“Thatuncle.”− Interviewer:“Tellmeaboutuncle.”

o Anatomicallydetaileddollsand/orbodydrawingscanbehelpfulforachildtoshowwhathappened,suchasbodypositioning,clothingpositioning,force,bodymovement,etc.(Hlavka,Olinger,&Lashley,2010).Dollsshouldbeusedonlyafteradisclosurehasbeenmade.Notethatdifferentjurisdictionsandmultidisciplinaryteams(MDTs)maynotsupporttheuseofdollsorbodydrawings.Ifdolls/bodydrawingsaretobeutilized:

− Theinterviewershouldbetrainedonappropriateprotocolswithinthejurisdictionontheuseofanatomicallydetaileddollsandbodydrawingsbeforeutilizingthesetools.

o Gesturesincludehavingthechildshowhowsomethingoccurred(e.g.,thechildholdsupafisttoshowhowtheywerehit),pointingtoabodypart(e.g.,pointingtothegenitalswhenreferencingwheretouchingoccurred),andshowingbodypositioning(e.g.,thechildliesfacedownonthefloortoshowbodypositioning).

• Introducingevidenceisanotherconsiderationforcueingachild’smemoryandtransitioningtothetopicofconcern.However,interviewersshouldreviewappropriate


protocolsanddiscusstheplanwithMDTpartnersbeforeintroducingevidence.Trainingsareavailableontheintroductionofevidence,suchastheHomelandSecurityPrepareandPredictMethod(Levi,Siegel,Allen,&Gregory,n.d.).Examplesofevidenceinclude:policereports,textmessages,journals,andphotographs.

o Ifevidenceisintroduced,thechildstillmaynotdiscusstheconcerns.(Ifthisisthecase,respectwherethechildisinthedisclosureprocess.)

• Bepatientandpauseoften!o Givethechildtimetospeak,processquestions,andexpresseverythingthechild

wantstosharebeforeposingthenextquestion.o Resistfillingintheblanksforachildifthechildisnotspeakinginfullsentences.o Pauseafterachild’snarrative;thenusepartofthechild’sstatementwithout

addingmorewords.Forexample:− Child:“Stevehadthebelt,anditwasblack.”− Interviewer:“Stevehadthebelt…”Pause.− Child:“Yeah,andthenhestartedwhippingitaround.”

• Whenposingquestions,remember:o Useshortsentenceswithonlyoneideapersentence.o Startwithopen-endedquestionsandprompts.Ifthesearedifficultforthechild,

thenmovetowardfocusedanddirectquestions.Movebacktoopen-endedpromptswheneverpossible.

o Useyes/no(closed-endedquestions)asalastresort.Alwaysfollowupwithanopen-endedquestion/prompt.

o Avoidusingdoublenegatives.o Avoidasking“why”or“if”questions.o Usethechild’swordswheneverapplicableandclarifytermsthechilduses.For

example:“YousaidDaddywasmean.TellmeaboutDaddybeingmean.”o Allowthechildtoexpressfeelingsornoemotionsatall.o Allowforlongsilences.o Avoidinfantilizingthechild(e.g.,“babytalk”).

• Asbestpracticesdictate,avoidaskingthenumberoftimesanincidentoccurred.Focusonaspecificevent,whichcananchorthechildandhelpthechildprovideadditionaldetailsofthatevent.

o Ifachildusesdescriptivewordsindicativeofmultipleevents(e.g.,“always,”“everytime,”etc.),askaboutatimewhensomethingdifferenthappened.

o Insteadofaskingaboutdatesandtimes,askaboutlocations(e.g.,whathouse,whatrooms,anyotherhome).

• Payattentiontothechild’sresponsestoquestions.Aretheypatterned?(Forexample,thechildalwaysrespondswith,“Idon’tknow”oralwayschoosesthelastoptionifmultiplechoice/forced-choicequestionsareposed.)Patternedresponsescouldindicatethatthechildisfatiguingoravoidingthetopic.Considercheckinginwiththechildbyaskingiftheydonotknowananswerorifitishardtotalkabout.


• Ifachildisshowingsignsoffatigueorwaningattention,considerhavingthechildreturnforafollow-upinterview.

ADDITIONALINTERVIEWS

Additionalchildabuseforensicinterviewsarepotentiallybeneficialforsomechildrenwhohavebeenabused,includingforchildrenwhoexperiencedmultipletypesofmaltreatment,childrenwhoarereluctanttodisclose,andchildrenwithdisabilities(Williams,Nelson-Gardell,CoulbornFaller,Cordisco-Steele,&Tishelman,2013).Andadditionalinterviewsaboutanabusiveeventcanelicitmoredetailsforamorecompleteaccountoftheevent(Brown,Lewis,&Lamb,2015)(LaRooy,Katz,Malloy,&Lamb,2010).Additionalinterviewsshouldfollowbestpracticeguidelines(open-endedquestions,narrativeprompts,etc.)andavoidleadingandsuggestiveinterviewingtechniques(LaRooyetal.,2010)(CoulbornFaller,Cordisco-Steele,&Nelson-Gardell,D.,2010).Additionalinterviewscanbeespeciallybeneficialforchildrenwithanxiety,limitedattention,intellectualdisabilities,andcommunicationdifficulties.Somebenefitsofadditionalinterviewsforchildrenwithdisabilitiesinclude:

• Theinterviewercanspendmoretimebuildingtrustandrapportwiththechild.• Thechildspendslesstimeinanysingleinterview,thusaccommodatingforattentional

issuesandpotentialfatigue.• Additionalinterviews,whenconductedwithopen-endedandfree-recallprompts,tend

toelicitmorerecallofnewinformationaboutabuse.Reasonsafollow-upinterviewmightbecontraindicatedinclude:

• Thechildistoostressedorexperiencestraumareactionswhenhavingtotalkabouttheincident.

• Ifmultiplesuggestive,leadingquestionswereaskedduringthefirstinterviewandagaininthefollow-upinterview(LaRooy,Katz,Malloy,&Lamb,2010),thenthiscanleadtothechildbeingmoresuggestibleandatriskofchanginganswers.

Forsuccessfulmultiplesessioninterviews,theinterviewershouldassurethattheinterviewcenterandMDTsupportthisplan.Aswell,itisimportanttodiscusswiththecommunityprovidersandthecaregiveranycontaminationissuesthatmayhaveoccurred.(Forexample,continuedcontactwiththeallegedoffenderorfamilymemberscontinuingtointerviewthechildathome.)Thefollowingaccommodationchaptersdiscussadditionalconsiderationsforadditionalinterviewsofchildrenwithdisabilities.


Chapter8:Accommodations—CommunicationDifficultiesTheaccommodationsdiscussedbelowarebasedoncurrentbestpracticesforforensicinterviews.InOregon,interviewersshouldfollowtheOregonInterviewingGuidelines(2012).TheinformationcontainedinthischapteralsobuildsontheaccommodationsdiscussedinChapter7:GeneralAccommodationsforChildrenwithDisabilities.Theinterviewapproachforchildrenwithcommunicationdisorderswilldependonthetypeandextentofthedisorder.UsethefiveinterviewpreparationquestionsfromChapter7tohelpidentifywhatdifficultiesthechildexperiencesandwhatadditionalinformationmaybehelpfulwheninterviewingthechild.PREPARATIONCONSIDERATIONSSPECIFICFORCOMMUNICATIONDISABILITIES

Particularlywithcommunicationdifficultiesand/ordisabilities,itisimportanttoconsiderwhattypeofcommunicationisimpacted(speechversuslanguage).Interviewpreparationquestionsinclude:

• Doesthechildhavespeechorarticulationproblems?o Ifso,askforclarificationonthespeechorarticulationdifficulty,whatitsounds

like,andifthechildcompensatesforthedifficulty.Ifso,how?o Askhowthechildtypicallyrespondswhenmisunderstood.Willthischildbecome

frustratedandtrytocorrecttheadultornot?• Doesthischildhavereceptiveorexpressivelanguagedifficulties?Howwillthe

interviewerknowifsomethingsaidisnotunderstood(eitherbytheinterviewerorthechild)?

• Doesthischildcommunicateinotherways(gestures,writing)and/orneedextratimetoprocess?

o Explorethisquestionforinsightaboutthechild’spersonaladaptationstotheirchallengesandtheirstrengths.

• Doesthischildusecommunicationtoolsoraids,knownasaugmentativeandalternativecommunication(AAC)devices?Ifso,trytofamiliarizeyourselfwiththedevicethechilduses.

o AACdevices:Thesecanrangefromsimplesystems(pictures)tohighlycomplexcomputerprogramsthatgeneratespeechfromtypedwordsorimages(ASHA,n.d.)(CooperativeEducationalServiceAgency7[CESA7],n.d.).Examplesinclude:

− Picturepointcommunicationsystems:Thesesystemsusepictures,photos,orothervisualaids—onboardsorcomputerapplications—thatthechildcanreferandpointto.Theyhelpchildrenexpressthemselves.


− PictureExchangeCommunicationSystems(PECS):Withthesesystems,childrenusevisualrepresentations(picturesorphotos)toindicatesomethingtheywant.Forinstance,ifachildhasseveralimagesoffoodand/ordrinksavailable,thechildcangesturetooneorpickitupandhandittosomeoneinordertoaskforspecificitem.

− Breakcards:Breakcardshelpchildrenindicatewhentheyneedabreakfromanactivityorsomequiettime.Thechildusesthiscardtocommunicatethismessageratherthanbecomingincreasinglyanxiousorfrustrated.

o Facilitatedcommunication:Inthisassistedcommunicationscenario,anindividualwithaseverecommunicationproblemhasafacilitatorwhophysicallyassistsbyguidingthatperson’shandtoeithertypeorwritesothattheindividualcanprovideresponsestoquestionsandrelaydesires/needs.Facilitatedcommunicationiscontroversial,andithasbeendiscreditedasareliableformofcommunicationbynumerousexpertsandinmuchliterature.Therefore,donotconductaforensicinterviewusingfacilitatedcommunication.


INTERVIEWACCOMMODATIONSFORCOMMUNICATIONDIFFICULTIES

Interviewsinvolvingchildrenwithdisabilitiesshouldbeginandprogressinasimilarmannerasinterviewswithtypicallydevelopingchildren.Theaccommodationsdiscussedinthischaptershouldoccurasneededandwhentheinterviewernoticesthatthestandardprotocolfortheinterviewisnotmeetingthechild’sneeds.Evenwiththeaccommodationsrecommended,interviewersshouldattempttouseopen-endedpromptsasmuchaspossible,becausetheseallowthechildtorelayastoryinthemostaccurateandfruitfulmanner.However,focusedand/ordirectquestionsmayprovidesomechildrenwiththeorganizationandstructureneededtohelpthemtelltheirexperienceinacohesiveandconciseway(McCroryetal.,2007;Goldman&DeNigris,2015).Accommodationsforspeechandarticulationdifficulties

• Lookatthechildwhentheyspeak.Noticeifthechildseemstousehandgestureswithwordswhenspeaking.

• Atthebeginningoftheinterview,explainthatyoumightrepeatthechild’swordstoensurethatyouunderstoodwhatwassaid.Also,explainthatyourjobisnottoguessaboutwhatthechildsays.

o Forexample,tellthechild,“Susie,it’smyjobtomakesureIdon’tguessaboutyourwords.ImayrepeatwordsyousaytomakesureIheardyoucorrectly.”

• Providepositivereinforcementifthechildcorrectsyouwhenmisunderstood.• Offerthechildtheoptiontowriteordrawapictureinresponsetoaquestion.• Allowthechildtostutter,stammer,andpause.• Resistthetemptationtofillinthewordthatthechildistryingtosay.• Ifthechild’sarticulationisdifficulttounderstand,offerthechildtheoptiontowritea

wordornarrative,ifdevelopmentallyappropriate.

AccommodationsforreceptiveandexpressivelanguagedifficultiesReceptivedifficulties

• Afteranyquestionposed,pause!Pausinggivesachildwithprocessingdifficultiestimetounderstandthequestionandformulatearesponse.

• Usethechild’sname.Thishelpsgroundthechildinthemoment.• Askonequestionatatime.Givethechildachancetoanswerthequestionbefore

movingtoanotherquestion.• Whenreviewinginstructions/answeroptions,stresstheimportanceofthechildstating

iftheydonotknowananswer.Practicebyaskingaquestionthechildmightnotknow.Forexample:

o Setupthepracticebyclearlystating,“It’sokaytotellmeifyoudonotknowananswer.Let’spracticethat.WhatifIasked,‘What’smycat’sname?’”Pausetogivethechildachancetoanswer.

o Ifthechildguessesaname,itisfinetoclarifythatthechildactuallydoesnotknowthecat’sname.Thenconsiderpracticingagain.Askthesamequestion.If


thechildsays,“Idon’tknow,”thenpositivelyreinforcethisanswer.(Forexample,“That’sright,thankyoufortellingmeyoudon’tknow.MycatisCleo.”)

o Ifthechildguessesagain,remindthemofthecat’snameandreinforcethatitisokaytosay,“Idon’tknow.”Thenmoveontothenexttopic.

• Payattentiontothechild’seyecontact,bodylanguage(squirming,grimacing),andothercues,suchaschangingthesubjectorrespondingwithanonsequitur,whichmightindicatethechilddoesnotunderstandthequestion.

• Periodicallycheckinwiththechildtomakesurethequestionwasunderstood.Forexample:

o “Sam,wasthatahardquestiontounderstand?”Ifhesaysyes,thenoffertoaskthequestioninadifferentway.Oryoucansay,“Thatwasahardquestion.Letmeaskitinadifferentway.”

o Considerhavingthechildrepeatyourquestionintheirownwords,butavoidsoundingpunitive.Ifthechildcannotdothis,thentheymightnothaveprocessedthequestion.Regardless,thankthechildfortryingandrephrasethequestion.

Expressivedifficulties

• Afteranyquestionposed,pause!Thechildmayrequireextratimetoformulatethoughtsandresponsestoquestionsbeforebeingabletostatethem.

• Ifthechildhasdifficultyexpressingthoughts,askifwritingordrawingwouldbeeasierthanspeaking.Offerthechilddifferentcommunicationmethods,suchaswritingaresponse,drawingapicture,drawingamap,usinganatomicallydetaileddollsorbodydrawings,orusinggesturestoshowwhathappened.

o Fordetailsregardingthesemethods,pleaserefertoChapter7:GeneralAccommodationsforChildrenwithDisabilities.

• Repeatthechild’sstatementsperiodicallytomakesureyouunderstood,andusepositivereinforcementifthechildcorrectsyou.

• Clarifypronounsanduseidentifiersand/orpropernounswheneverpossible.o Ifthechildcontinuallysays“he”whentalkingaboutanincident,askwho“he”is,

thenusethenameofthatpersonduringfollow-upquestions.(“YousaidUncleJohnhit.ThenwhatdidUncleJohndo?”)

• Notallchildrenwillspeakinfullsentences.Resistthetemptationtofillintheblanks.Ifthechilddidnotfinishthesentence,itisokaytorepeatwhatwassaidandthenpause.Forexample:

o Child:“ThenAuntBeckydid…”Pause.o Interviewer:“ThenAuntBeckydid…”Waitfortheresponse.Ifnoresponse,try

saying,“AuntBeckydidwhat?”• Ifachildanswersmultiplequestionswithautomaticresponsessuchas“Idon’tknow,”

thencheckinwiththechild.Askifthequestionwasahardone.Offertostatethequestiondifferently.Forexample:


o Interviewer:“YousaidFredhityou.TellmeallaboutFredhittingyou.”o Child:“Idon’tknow.”o Interviewer:“Isthatahardquestion?”o Child:“Yes.”o Interviewer:“Okay,letmeaskitdifferently.WheredidFredhityou?”Child

pointstoarm.“ShowmehowFredhityou.”Childpunchesarm.o Interviewer:“WhatdidFredhityourarmwith?”Childshowsafist.

• Anotheroptionforaddressingachildwhofrequentlyrespondstoquestionswith,“Idon’tknow”istosay,“Tellmewhatyoudoknow.”

• Payattentiontosignsoffatigue,agitation,orfrustration.Ifthechildisshowingsignsoffatigue,considerbringingthechildbackforafollow-upinterview.

• Beforeconcludingtheinterview,checkinprivatelywithcommunitypartners/teammates.Thepartnersmighthearinformationsaidbythechilddifferentlythanyoudid,whichisimportanttoknow.Theyalsomayhavehelpfulsuggestionsonrewordingdifficultquestionsorothercommunicationaccommodationsthatwouldbehelpfulforthechild.

LearningdisabilitiesInterviewersshouldbecognizantofanylearningdisabilityidentifiedforthechild.Dependingonthelearningdifficulty,interviewscanbetailoredtoavoidpitfallssuchasaskingachildwithdysgraphia(difficultywithwritingordrawing)todrawamap.

Accommodationsforchildrenwithlearningdisabilities

• Offerdifferentmodesofcommunicationforrelayingnarratives(verbalizingthenarrativeaswellasshowingwhathappenedbygestures,positioning,pointing).

• Allowforsilence.Thechildmayneedadditionaltimetoprocess.• Askonequestionatatime.• Avoidaskingthenumberoftimesanyincidentoccurred.Focusonspecificevents,

becausethatcanhelpthechildprovideidiosyncraticdetailsofeachevent.• Ifthechildusesnondescriptwordsduringnarratives(e.g.,“that,”“there,”“those,”

“thingy,”etc.),askforclarificationoneachnondescriptword.Forexample:o Alex:“Hehitmewiththatandthenthosethingshappened.”o Interviewer:“Whohityou?”o Alex:“Joe.”o Interviewer:“Joehityouwithwhat?”o Alex:“Hehitmewiththebelt.”o Interviewer:“Joehityouwiththebelt,thenwhathappened?”o Alex:“Thosethingshappened.”o Interviewer:“Tellmewhatthethingswerethathappened?”o Alex:“Youknow,thosethings.”o Interviewer:“Alex,it’smyjobnottoguess.Iwasn’tthere,sohelpme

understandwhatyoumeanwhenyousay,‘thosethings.’”


o Alex:“Liketyingmeupandyellingatme.”o Interviewer:“Okay,Isee.Tellmeallaboutbeingtiedup.”

Attentiondeficithyperactivitydisorder(ADHD)Asstatedpreviously,childrenwhohaveattentionalissuesdonotnecessarilypresentwithhyperactivetraits.Therefore,itisimportantfortheinterviewertoexploredetailsaboutthechild’sattentionalchallenges.Thefollowingaccommodationstrategiesrelatetohowtheattentionalchallengesaffectcommunication.Often,childrenwithADHDexperiencebehavioralchallengesrelatedtoimpulsivityandself-regulation.RefertoChapter9:Accommodations—SocialandEmotionalDisabilitiesforadditionalinterviewingstrategiesandaccommodationswhensuchbehavioraldifficultiesarepresent.Accommodationsforchildrenwithhyperactivity

• Limitdistractionsintheinterviewroom.• Ifthechildspeaksloudlyandataquickpace,bepatient.Thechildmightnotpossessthe

self-awarenessnecessarytoregulatevoiceorpaceinthemoment.Ifthechild’spaceorloudnessisnotdisruptingthenarrative,thensitpatientlyandlisten.

o Ifthechildspeakssoquicklythatthenarrativeisdifficulttotrack,checkinwiththechildtomakesureyouunderstandwhat’sbeingsaid.

− Takenotesofsalientdetailsinthenarrative.Whenthechildpausesorfinishesanarrative,relayanypiecesofsalientdetailandaskthechildtoclarify.

− Youcanalsoparaphrasethechild’snarrativeafterward.Alwaysremindthechildtocorrectyouifyougetsomethingwrong.Usethelanguagefromthechild’snarrativewhenparaphrasing.Paraphrasingcanhelporganizeanddirectthechildtocontinuewithamorecohesivenarrative.Forexample:

§ Hazel:“Iwentintotheroom.Itwasdarkandspooky.ThingsseemedtobeeverywhereandIwastotallyfreakedout.Iamrunningaround,bumpingintothings,andIkepthearingthem.Theywerecrazyloud.Ididn’tknowwhattodoandbumpedintothebed,thenfellonsomeshoes.Iwascryingandmyleghurt.TherewascrashingandIkepttryingtofindmyphone.Icouldn’tbecauseitwasdark.Igetfreakedinthedark.ItstillwasloudandIwasscared.”

§ Interviewer:“Okay,Hazel,letmemakesureIunderstoodyou.Yousaidyouwentintoadarkroomandheardthem.Whodidyouhear?”

§ Hazel:“MomandDad.”


§ Interviewer:“SoyouheardMomandDadandtheywereloud.Yousaidyouweretryingtofindyourphoneinthedark,thenyouheardcrashing.Isthatcorrect?”

§ Hazel:“Yes.”§ Interviewer:“Tellmeallaboutthecrashing.”

• Allowopportunitiesforthechildtomoveandsquirmintheseatormoveabouttheroomaslongasthechildissafe.Itisokaytoremindthechildnottojumpoffthingsormoveinawaythatcompromisestheirsafety.Childrenwithhyperactivetendenciesoftenstrugglewiththeinternalneedformovement(kinestheticenergy)versushavingtoexpendmentalenergytofocusonaconversation.Whenchildrenhaveopportunitiestoreleasethekinestheticenergyinsidethem,theyareactuallyabletoattendbettertoconversations.

o OfferPlay-Doh,sothechildcanplaywithitwhiletalking.o Considergivingthechildapilloworsomethingelsetositonthatallowsfor

movementintheseat.o Havethechilddraworcolorapictureduringtheinterview.

• Ifyousensethatachildistoodistracted,saythechild’snameandaskthechildtolookatyou.Repeatyourquestionwhenthechildlooksatyou.

o Interviewer:“Jimmy.”Thechildcontinuestorunaroundtheroomanddoesnotrespond.

o Interviewer:“Jimmy,pleaselookatme.”Interviewerpausesandwaitsforhimtolook.Jimmycontinuestomove,buthelooksattheinterviewer.

o Interviewer:“Jimmy,howdidXmakeyoufeel?”• Pickyourbattles.Havingachildmovingaroundtheroommaybedistractingtoyouas

aninterviewer,buthavingthechildsitstill—especiallywhentalkingaboutsomethingdistressing—couldnegativelyaffecttheproductivityoftheinterview.

Accommodationsforchildrenwithattentionissueswithouthyperactivity

• Provideclearinterviewinstructions.• Checkinwiththechildtomakesuretheyarefollowingyouandunderstandthe

interviewexpectations.Thisallowsachancetoassesshowwellthechildisattending.• Payattentiontohowmuchyouspeakversusthechildspeaks.Ifyouarespeakingmore

thanthechild,thechildmayloseinterestorbecomedistracted.• Usethechild’snametogroundthemandretaintheirattention.• Askthechildtorepeataquestionifthereareconcernsaboutinattention.Forexample:

o Interviewer:“Dylan,Iwanttomakesureyouunderstoodmyquestion.TellmeinyourwordswhatIjustasked.”

• Donotusecompoundquestions.Trytokeepquestionstoonethoughtatatime.• Listenforpatternedresponsesfromthechild,whichmayindicatethechildistunedout

oftheinterviewand/ordisengagedfromtheprocess.Ifyousensepatternedresponses,


pauseandaskthechildhowtheyaredoing.Reinforcethattheycanstateiftheydonotknowanansweroraskforclarificationifneeded.

• Considerconcludingtheinterviewifyoufeelthechildhasdisengaged.Askifthechildwantstocomebackonadifferentdaytotalkmoreabouttheconcerns.


Chapter9:Accommodations—SocialandEmotionalDisabilitiesTheaccommodationsdiscussedbelowarebasedoncurrentbestpracticesforforensicinterviews.InOregon,interviewersshouldfollowtheOregonInterviewingGuidelines(2012).TheinformationcontainedinthischapteralsobuildsontheaccommodationsdiscussedinChapter7:GeneralAccommodationsforChildrenwithDisabilities.Theinterviewapproachforchildrenwithsocialandemotionaldisabilitieswilldependonthetypeandextentofthedisability.UsethefiveinterviewpreparationquestionsfromChapter7tohelpidentifywhatdifficultiesthechildexperiencesandwhatadditionalinformationmaybehelpfulwheninterviewingthechild.PREPARATIONCONSIDERATIONSFORSOCIALANDEMOTIONALDISABILITIESHelpfulquestionstoconsiderifthechildhasbehavioralchallengesinclude:

• Whatarethechild’sbaselinebehaviorsathomeorwheninneutralsettings?• Doesthechildpresentwithspecificdifficultiesand/orbehaviors?Forexample:

o Verbalperseverationso Compulsivebehaviorso Self-harmingbehaviorso Assaultivebehaviors(toselforothers)o Sexualizedbehaviorso Hyperactivebehaviorso Oppositionalbehaviorso Withdrawalo Sensitivitytoenvironmentalstimuli(noises,mirrors,crowdedrooms,etc.)

• Whatbehaviorsand/orreactionsdoesthechildhavewhenstressedoranxious?o Doesthechildarticulatefeelingstressedoranxious?o Doesthechildactaggressivewhenupset,ordoesthechildregressorshut

down?• Whatcopingmechanismsdoesthechildusewhenupset?Canthesetechniquesbeused

duringtheinterview?o Doesthechildhaveacalmingobject,likeastuffedanimal,thattheycanbringto

theinterview?o Doesthechildusegesturestosignalwhengettingfatiguedorreadytostop?

• Doesthechildtakemedicationsforthisdisability?Ifso,whenarethemedicationsadministeredandwhendotheytendtowearoff?

o Considerschedulingtheinterviewwhenthemedicationsareatpeakperformance.


• Canthechildtoleratesittingstillfortheinterview,orwillthechilddobestifgiventheopportunitytomoveabouttheroom?

ACCOMMODATIONSDURINGTHEINTERVIEW

Beginningtheinterview:• Aftercompletingintroductionsinthewaitingareaandexplainingtheinterviewprocess,

allowthechildtoaskquestionsaboutwhattoexpectandprovidedetailsabouttheinterviewroom.

o Beforestartingtheinterview,considergivingthechildatouroftheinterviewroomandtheroomswhereMDTpartnerswillmonitortheinterview.Thiscanalleviateanxiety.

• Oncetheinterviewstarts,clearlyreviewroles,instructions,andansweroptions.o Slowlyreviewtheinstructions/answeroptions,oneatatime.o Practicetheinstructions/answeroptionsifdevelopmentallyappropriate.

Positivelyreinforcethechildforanswering,“Idon’tknow”andcorrectingyou.− Ifthechildcorrectsyouduringtheinterview,thankthechildfor

makingthecorrection.• Spendtimebuildingrapport.• Conductthepracticenarrative.

Duringtheinterview,considerthefollowing:

• Ifthechildprovidesramblingnarratives,remainpatient.Listenforsalientdetailsduringthenarrativethatyoucanaddressinafollow-upquestion.Usethechild’swordswhenpossible.

• Allowforsilencesbetweenquestionsorafterthechildprovidesanarrative.Silencecanevokeadditionaldetailsfromthechild.

• Bepatientandflexiblewiththechild.Followthechild’sleadandstructurequestionsaccordingly.

• Allowthechildtomove,crawl,wiggle,orfidgetbecausekineticactivitymaybethechild’sattempttocalmdown.

o Ifthemovementorbehaviorbecomesdisruptiveforyouorthechild,setlimitswiththechildinagentlebutfirmmannerandredirectthechildifnecessary.Forexample,ifthechildattemptstojumpoffthechairduringtheinterview:

− Interviewer:“Sage,pleasedon’tjumpoffthechair.Idon’twantyoutohurtyourself.It’sokaytomovearoundtheroomifyouwant.”

• Powerstruggleswithchildrenwhohavebehavioralchallengestendtoshutdownanyproductiveinteraction.

o Pickyourbattles;setclearandreasonableboundaries.• Ifthechildisteary,seemsdistressed,orisveryquiet,consideracknowledgingthe

difficultybyasking,“Howdoesitfeeltotalkaboutthis?”Considertakingabreakfrom


thesubjecttotalkaboutsomethinglessdifficult,thenreturntothesubjectwhenthechildseemscomposed.

• Ifthechildseemsagitated,offerothercommunicationmethods,suchasmappingaroom,drawingapictureoftheevent,orgesturing.

• Ifavailable,considerusingafacilityortherapydog.Thisdogshouldbecertifiedandtheinterviewershouldbetrainedonproperuseofthedog.Thefacility/therapydogcanhelpachildwithbehavioraloremotionaldifficultiesregulateandfocus.

• Ifthechildistoodistracted,tooanxiousorupset,orisfatiguing,considerofferingthechildanopportunitytocomebackforasecondinterview.PleaserefertoChapter7:GeneralAccommodationsforChildrenwithDisabilitiesformoreinformationaboutadditionalinterviews.

CONSIDERATIONSFORSPECIFICDISABILITIES

AnxietydisordersandtraumareactionsIfthechildhasahistoryofanxiety,gatherasmuchinformationaspossibleaboutthechild’spresentationwhenanxiousandwhattechniqueshelpthechildcalmdownifanxietyescalates.Traumareactionscanoccurwithorwithoutadiagnosisofposttraumaticstressdisorder(PTSD).Interviewersshouldhaveabasicunderstandingofcommontraumareactionsinchildren.Evenifachilddoesnothaveadiagnosedanxietydisorder,thatchildcouldbecomeanxious.Ifthechildexhibitsvisualorverbalsignsofanxiety,thenconsiderthefollowing:

• Encouragethechildtotakeseveraldeepbreathsbeforecontinuing.• Saythechild’snameandaskforeyecontact.Thiscanhelpgroundthechildiftheyare

disassociatingorexperiencingemotionalnumbing.• Askthechildhowtheyaredoing.Also,askifitisokaytocontinuetalkingaboutwhat

happened.o Ifthechildcancontinue,considermovingawayfromtheabusiveortraumatic

eventandinsteadaskingmoreneutralquestions,suchasperipheralquestionsabouttheroomorotherlocationwheretheincidentoccurred.Returntoabuse-relatedquestionsifthechildseemscalm.

o Ifthechildexpressesfeelingtoodistressedtotalkabouttheincident,oritisapparentthatthechildisexperiencingdifficulty,considerchangingthesubjecttoanunrelatedtopic.Forexample,ifthechildtalksaboutsexualabusebythefatherbutbecomesoverwhelmed,seemsfloodedbyemotionormemory,etc.,askwhatthechildlikedaboutthefather.Orchangethesubjecttotallytoaneutraltopic.Returntotheabuseconcernifthechildcalmsand/orarticulatesthatitisokaytotalkmoreaboutthetopic.

• Considerbringingthechildbackonadifferentdaytocontinuetheinterview.Askthechildifthisissomethingtheycoulddo.PleaserefertoChapter7:GeneralAccommodationsforChildrenwithDisabilitiesformoreinformationaboutadditionalinterviews.


Oppositionaldefiantdisorder(ODD)Ifachildhasoppositionalbehaviors,avoidpowerstrugglesduringtheinterview.Followinterviewingbestpractices(reviewingrolesandtheinterviewprocess,buildingrapport,reviewingansweroptions,etc.)toprovidethechildwithclearinformationandexpectations.Additionalconsiderationsinclude:

• Allowthechildtomovearoundtheroomaslongasthechildremainssafe.• Donotemotionallyreacttooppositionalbehaviors.Pickyourbattles;setclearand

reasonableboundaries.o Forexample,ifthechildisthrowingPlay-Dohhardagainstthemirrorbutisnot

damagingthemirror,considerallowingthistocontinueaslongasitisnottoodistracting.IfthechildthrowsPlay-Dohatyou,askthemnottodothisasitcouldcauseaninjury.Redirectthechildtocoloring.

o Ifthechildcontinuestobedisruptiveand/orisunsafe,considerendingtheinterviewandreschedulingforadifferentday.

Autismspectrumdisorder(ASD)andSocial(Pragmatic)CommunicationDisorder(SCD)SocialandemotionalaccommodationsaswellascommunicationaccommodationsforchildrenwithASDandSCDarediscussedinChapter10:Accommodations—AutismSpectrumDisorder(ASD),becausedifficultieswithbothcommunicationandsocial/emotionalfunctioningarehallmarksforthesedisorders.


Chapter10:Accommodations—AutismSpectrumDisorder(ASD)Theaccommodationsdiscussedbelowarebasedoncurrentbestpracticesforforensicinterviews.InOregon,interviewersshouldfollowtheOregonInterviewingGuidelines(2012).TheinformationcontainedinthischapteralsobuildsontheaccommodationsdiscussedinChapter7:GeneralAccommodationsforChildrenwithDisabilities.ChildrenwithASDcanhaveawiderangeofabilities,challenges,andpresentations.Regardless,childrenwhohavebeendiagnosedwithASDpresentwithdifficultiesintwodomainsoffunctioning:communicationandsocial/emotional.Thus,theinterviewaccommodationsforchildrenwithASDdiscussedinthischapterarerelatedtobothcommunicationdifficultiesaswellassocialandemotionaldifficulties.PREPARATIONCONSIDERATIONSSPECIFICFORASD

Priortointerviewing,usethefiveinterviewpreparationquestionsfromChapter7tolearnaboutthechild’scommunicationabilitiesandsocialandemotionalfunctioningabilitiesaswellasanyadditionalinformationthatmaybehelpfulwheninterviewingthechild.Ifcommunicationisnotedtobedifficultforthechild,explorehowcommunicationisdifficult.Forexample:

• Doesthechildengageinconversations,ordoesthechildspeakinshortsentencesand/orutterances?

• Doesthechildpresentwithecholalia?Ifso,howdoestheecholaliaoccur?o Doesthechildrepeatquestionsseveraltimesbutprovidearesponseifgiven

time?Ordoesthechildutterrepeatedstatementsthatareunrelatedtothetopicdiscussedandfailtoprovideanyadditionalinformationduringconversations?

• Doesthechilduseaugmentativeandalternativecommunication(AAC)devicesandservicesforcommunication?Ifso,pleaserefertoChapter8:Accommodations—CommunicationDifficultiesformoreinformationontheuseofAAC.

• Whatisthefunctioningcapacityofthechild(e.g.,higher-functioningversuslower-functioningASD)?Ifthechildisatahigher-functioningcapacity,thenasuccessfulinterviewislikely.Interviewingachildwithalower-functioningcapacitymaybemoredifficultandrequiresignificantaccommodations,and/oritmaynotbepossibleduetotheseverityofthedisorder.


Ifsocializing,expressingemotions,andregulatingbehaviorsaredifficultforthechild,explorehowthesedifficultiespresentforthechild.Forexample:

• Doesthechildhavedifficultyexpressingemotions?Cantheyexpresssimpleemotionssuchasmad,sad,orhappy?Oristhechildabletousenarrativestoprovidemoredetailedaccountsoftheirfeelings?

• Doesthechildbecomeagitatedbydifferentsensoryinputfromtheenvironment(e.g.,florescentlightingthatmakesa“humming”soundortickingclocks)?

• Doesthechildhavedifficultywithcrowdedroomsorloudchildren,whichthechildcouldexperienceinthewaitingroom?

• Ifthechildbecomesagitatedorfatigued,howdoesthispresent(e.g.,thechildrocksbackandforth,increasesecholalia,verbalizesfeelingstressed)?

Gatherhistoryandcurrentinformationaboutthechild’sstrengthsandabilities.Thesemayinclude:

• Thechildattendsamainstreamclassroomwithlittleadultsupport.• Thechildperformsattheirgradelevel.• Thechildusescommunicationaidsforself-expression.• Thechilddoesbestinone-on-oneinteractions,soaquietinterviewroommaybe

suitablefortheinterview.• Thechildhasanobject(suchasa“petrock”)thattheycanholdtohelpthemfeelcalm.• Thechildhasaspecialinterestorexpertiseonacertainsubject.Thismightbeanice

neutraltopictodiscussfirstintheinterviewwhenbuildingrapport.• Thechildneedsextratimetounderstandprocessesandroutines.Oncethechild

understandsthese,thenstressdecreases.Preparetheinterviewroomtominimizepotentialdistractionsasmuchaspossible.Forexample:

• Usearoomthatissimplydecoratedwithaslittlevisualstimuliaspossible.• Uselampsforlightinginsteadofoverheadflorescentlighting.• Avoidhavingloudclocksintheroom.

Ideally,introduceyourselftothechildandexplainyourrolebrieflybeforetransitioningtotheinterviewroom.Considerofferingatouroftheinterviewroomandobservationroombeforebeginningtheinterview,whichcouldhelpalleviateanxietiesordifficultywithtransitionsorunknownsituations.


THEINTERVIEW

Followforensicinterviewingbestpractices,suchreviewingroles,aspectsoftheroom,andinterviewexpectations.Inparticular,considerbeingveryconcreteandspecificabouttheinterviewprocess.Allowthechildtoasklotsofquestionsabouttheroomoraboutyourrole.Thendothefollowingwiththechild:

• Clearlyreviewinstructions/answeroptions.o Considerhavingthechildpracticeansweringquestionsifdevelopmentally

appropriate.• Buildrapportandattempttodiscussaneutraltopic.

o Ifthechildisabletodothis,thencapitalizeontheopportunitytoaskopen-endedquestionsandprompts.Askclarifyingquestionstodeterminethecommunicationstyle,ability,andanydifficultiesthechildmayhave.

• Conductapracticenarrativefocusingonadiscreteevent.o Startwithanopen-endedprompt(e.g.,“Tellmeeverythingthathappenedon

yourbirthday,fromstarttofinish.”)KeepinmindthatchildrenwithASDmaynotprovidelengthynarrativeresponsestoopen-endedpromptsorquestions—theymayrequiremoregeneralandfocusedquestionstoelicitmoredetails(McCroryetal.,2007)(Henryetal.,2011).

o Ifthechilddoesnotprovidenarrativesthatincludeabeginning,middle,andend,thenhelpguidethechildthroughnarrativesbyusingmorefocused,non-suggestivequestioning.Forexample:

− Interviewer:“Joey,tellmeeverythingyoudidtodayfromthemomentyouopenedyoureyesuntilyougottothisdoctor’soffice.”

− Joey:“Igotupandthencamehere.”− Interviewer:“Tellmethefirstthingyoudidwhenyougotup.”− Joey:“Igotupandpeed.”− Interviewer:“Afteryougotupandpeed,thenwhatdidyoudo?”− Joey:“Igotdressed.”− Interviewer:“Yougotdressed,thenwhatdidyoudo?”− Joey:“Iatebreakfastthendidcomputercodes.”− Interviewer:“Youdidcomputercodes,thenwhat?”− Joey:“Wedrovehere.”

• Avoiduseofmetaphors,sarcasm,andslang.ChildrenwithASDandSCDareliteralandoftenlackskillsassociatedwithunderstandinglanguagenuances.Forinstance:

o Thesaying“It’srainingcatsanddogsoutside”mightbeliterallyinterpretedbythechild,whowouldquestionhowcatsanddogscouldbefallingfromthesky.

Transitioningtoatopicofconcern:

• Alwaysinvitethechildtoprovidenarrativesinwhatevercapacitythechildisablebyaskingopen-endedquestions/prompts.Thechildmightincludeirrelevantdetailswithinthenarrativeabouttheabuse.Ifthishappens:


o Refrainfrominterruptingthenarrative.o Listenforthesalientdetailsaboutthetopicofconcern.o Ifthechildseemsunabletomovebeyondspecialinteresttopics(suchastalking

abouteverydecorationonthedeskinthechild’sbedroominsteadofdiscussingthetouchingthathappenedinthebedroom),allowthechildtocompletethatthoughtanddescriptionbeforemovingon.Thismaytakealotofpatience.

o Oncethechildcompletesthenarrative,bringthechildbacktothetopicathandusingdirectorfocusedquestionsthatcanhelpcuethechildtosalientdetails.

− Forexample,Susie,a10-year-oldgirlwithhigh-functioningASD,wasreferredduetosexualabusebyherfatherthatoccurredtwodaysprior.WhentheintervieweraskedSusiewhyhermombroughthertotheclinic,shereplied,“Mydaddylickedmyprivate.”Susieidentifiedherprivateasthepartshepeesfrom.Uponbeingaskedfocusedquestionsaboutwherethetouchinghappened(shesaidithappenedinherbedroomonthebed),andwhowasthere(shesaidonlyherdad),theintervieweraskedthefollowingquestions:

§ Interviewer:“Susie,tellmeeverythingthathappenedwhenDaddylickedyourprivate.”

§ Susie:“Helickedit,thenheleft.”§ Interviewer:“Okay,soyoutoldmethatthelickinghappened

onyourbed.TellmewhatyouweredoingbeforeDaddylickedyourprivate.”

§ Susie:“IwasasleepandthenDaddycameinandwokeme.Hemademecold.Idon’tlikecold.”

§ Interviewer:“TellmeaboutDaddywakingyou.”§ Susie:“Igetcoldatnight.Igetcoldinthemorning.Ineedmy

blanket.Idon’tlikecold.”§ Interviewer:“Youdon’tlikebeingcold.”§ Susie:“No,Ihatecold.ItiscoldinAntarctica.Icouldnotlive

inAntarctica.”§ SusiecontinuestorelayhowcolditgetsinAntarcticaand

variousdetailsofitsweather.Thistakesseveralminutes,whiletheinterviewerlistenspatiently.SusiepausesafterherlastdetailaboutAntarctica,asdoestheinterviewer.

§ Interviewer:“Okay,Susie,youdonotlikefeelingcold.YousaidDaddymadeyoucoldwhenhewokeyou.TellmehowDaddymadeyoucold.”

§ Susie:“Daddysatonmybedandtookoffmycovers.Iwascold.Idon’tlikeitcold.Coldbothersme.Coldmakesmesick.”

§ Interviewer:“Daddytookoffyourcoversandyouwerecold.Thenwhathappened?”


§ Susie:“Daddypulledoffmypants.Thatmademecoldtoo.Idon’tlikethat.”

§ Interviewer:“ThenwhathappenedafterDaddypulledoffyourpants?”

§ Susie:“DaddylickedmyprivateandIwascold.”

AdditionalconsiderationsHigh-functioningASD(includeschildrenformerlydiagnosedwithAspergersyndrome)Childrenwithhigh-functioningASDtypicallycanhavesuccessfulinterviews,butchallengesmayinclude:

• Althoughtheymayhavestrongvocabularyskillsandfactualknowledge,theymayhavedifficultyprovidingautobiographicalnarrativesthatconnectrelevanteventsinmeaningfulways,strugglingtoarticulatesalientdetailsoftheeventthataninterviewermightfindimportant.

o Thisdoesnotmeanthatthesechildrencannotprovidesalientdetails.Instead,theymaybenefitfromguided,generalquestionstoelicitthosedetailsinacohesivemanner.

• Theymayprovidefewerresponsestoopen-endedquestions.• Theirresponsestoquestionsmayincludedetailsthatarenotsociallysalienttothetopic

discussed.o Forexample,whendiscussingarecenttriptoWaltDisneyWorld,achildwith

high-functioningASDmayprovidefewdetailsaboutwhattheylikedaboutthetripandinsteadfocusontheminutemechanicsofaparticularrollercoaster.

Lower-functioningASDChildrenwithlower-functioningASDmaypresentwithlimitedverbalskillsandmayonlyspeakafewwords.Thesechildrenmayonlybeabletoengageminimallyininterviews,possiblyansweringfocusedanddirectquestions,butnotnecessarilyabletoproviderunningnarrativesorperipheral,sensory,orotherclarifyingdetails.Considerstructuringaninterviewofachildwithlower-functioningASDinaverytargetedway.Somesuggestionsinclude:

• Havepicturesoffamilymembersandrelevantindividualsinthechild’slife,includingpicturesoftheallegedoffender.Thechildcouldpointtopeopletoexplainwhoisintheirfamily.Ifthechildmakesastatementofabuse,consideraskingthemtoalsopointtothepictureofthatperson.

• Askthechildtoshowwhathappened,includingbypointingtobodyparts.• Allowthechildtospeakinshortutterances.

o Includethechild’sphrasesorutterancesinfollow-upquestionstohelpguidequestioningoraskforclarification.


− Forexample,ifthechildsays,“Bobbyhurt,”theinterviewercouldask“HowdidBobbyhurt?”or“ShowhowBobbyhurt.”

• Assessifthechildseemstocomprehendquestions.• Stopifthechilddoesnotseemtounderstandtheprocessorquestions.


Chapter11:Accommodations—IntellectualDisabilitiesTheaccommodationsdiscussedbelowarebasedoncurrentbestpracticesforforensicinterviews.InOregon,interviewersshouldfollowtheOregonInterviewingGuidelines(2012).TheinformationcontainedinthischapteralsobuildsontheaccommodationsdiscussedinChapter7:GeneralAccommodationsforChildrenwithDisabilities.Theinterviewapproachforchildrenwithintellectualdisabilities(ID)willdependonthetypeandextentofthedisability.UsethefiveinterviewpreparationquestionsfromChapter7tohelpidentifywhatdifficultiesthechildexperiencesandwhatadditionalinformationmaybehelpfulwheninterviewingthechild.PREPARATIONCONSIDERATIONSSPECIFICFORINTELLECTUALDISABILITIES

ParticularlyforchildrenwithID,itisveryimportanttogatherinformationaboutthechild’smentalage,whichrelatestothechild’scurrentacademicfunctioningascomparedtopeerswhoarethesamechronologicalage(Brown,Lewis,&Lamb,2015)(Henry,Bettenay,&Carney,2011).Henryetal.(2011)summarizedbodiesofresearchandnotedthatchildrenwithmildtomoderateintellectualdisabilitiescanrecallforensicallyaccurateandusefulinformation,andthechild’smentalageisahelpfulindicatorforthechild’sperformance.Thus,thementalagecanbeagoodindicatorfortheinterviewer’sapproachandquestioningofthechild.Keepinmindthatthechild’spresentationduringtheinterviewcandiffer,sometimesdrastically,fromwhatmightbeexpecteduponreadingpastreportsordevelopmentaltesting.Asstatedinpreviouschapters,children’sdevelopmentcanvaryacrossdevelopmentaldomains.

• Forexample,theinterviewerreceivesrecordsindicatingthata10-year-oldgirlfunctionslikea5-year-old.Duringtheinterview,thechild’slanguageskillsaremuchbetterthanthoseofatypicallydeveloping5-year-old,butthischildcannotread.Therefore,theinterviewermaynotneedtomakeasmanyaccommodationswheninterviewingthechildasfirstanticipated.

Informationaboutthechild’smentalageand/orcurrentacademicperformancecanbegatheredinseveralways,suchas:

• IfthechildhasanIEP,thefirstfewpagesofthatdocumentshouldincludesummariesofthechild’scurrentacademicskillsforreading,writing,andmath.

• Askthecaregiverand/orschoolstaff:o Whatarethechild’sinterests?o Howdoesthechildplay?o Isthatplayageappropriateoryounger?o Whatcomparableagegroupplaysinthesamemanner?


Otherimportantinformationtoascertainpriortotheinterviewincludes:• Whatarethechild’sexpressivelanguageabilities?

o Doesthechildspeakinfullsentences?o Isthechildabletobeunderstood?o Doesthechilduseanaugmentativecommunicationdevice?Ifso,canthisdevice

beusedduringtheinterview?• Doesthechildhaveanyco-occurringdisabilities?Ifso,howdotheseimpactthechild’s

functioning?o Forexample,childrenwhohaveDownsyndromecanalsopresentwithsome

hearingloss.Hearinglosscanaffectthechild’sreceptivelanguageskills,soadditionalaccommodationsmaybenecessary.

GENERALACCOMMODATIONSFORINTELLECTUALDISABILITIES

InterviewsofchildrenwithIDshouldbeginandprogressinasimilarmannerasinterviewswithtypicallydevelopingchildren.Theaccommodationsdiscussedinthischaptershouldoccurwhentheinterviewernoticesthatthestandardprotocolfortheinterviewisnotmeetingthechild’sneeds.Alwaysattempttouseopen-endedprompts/questionsduringinterviews,butscaffoldquestionsusingfocusedand/ordirectquestionsasneededtoaccommodatethechild.THEINTERVIEW

• Spendtimeprovidingthechildwithclearintroductionsandafullexplanationoftheinterviewprocess.

o Speakataslowpace.o Explainthatitisokayforthechildtotakeabreakatanytime.

• Donotuse“babytalk”withachildevenifthechildhasamuchlowermentalagethanchronologicalage.Talkingdowntochildrenisdisrespectful.Useplainlanguage.

• Assessthechild’slanguageskillsthroughouttheinterview.Thiswillhelpguidehowinterviewquestionsareposed.

o ChildrenwithIDhavebeenfoundtoprovideless-detailed,shorternarrativesinresponsetoopen-endedpromptssuchas“Tellmeallaboutthetouching.”Buttheinformationtendstobeaccurateascomparedtochildrenwiththesamementalage(Henryetal.,2011)(Brown,Lewis,&Lamb,2015).

o Askinggeneralquestionsthataremorefocusedordirect(“WhathappenedafterJohnnytouched?”)canelicitmoredetailsaboutanevent.

o Usingopen-endedquestionsandpromptsthatincludethechild’swordscanhelpstructurethechild’snarrativeandstillallowforfreerecall.Forexample:

− Interviewer:“Quinn,tellmeaboutNanna.”− Quinn:“Nannahitme.Ithurt.Icried.”− Interviewer:“TellmeallaboutNannahittingyou.”− Quinn:“Nannagotthespankingstickandhitmehereandhere.”

Points.


o Ifthechildhastroubleprovidingnarratives,thenusestatementssuchas“Andthenwhathappened?”or“TellmemoreaboutX.”Or“WhatdidXdo?”Forexample:

− Interviewer:“Tellmemoreaboutthespankingstick.”− Quinn:“It’sbrownandhardandhaswritingonit.”

• Limittheuseofclosed-ended(yes/no)andmultiplechoicequestions.o Thesequestionscanhelpprovideclarifyinginformation,buttheinterviewer

shouldalwaysfollowupwithanopen-endedprompt/question.Forexample:− Interviewer:“WhenNannahit,wasNannahappy,sad,orsomething

else?”Alwaysmakethelastansweroptionopen-endedinamultiplechoicequestion.

− Quinn:“Shewasmad.”− Interviewer:“TellmeaboutNannabeingmad.”

o ChildrenwithIDhavebeenfoundtobemoresuggestiblewhenspecificorsuggestivequestionsarerepeatedseveraltimes(Cederborg,Danielsson,LaRooy,&Lamb,2009).

• Askonequestionatatime.• Pauseafteraskingquestions.Donotrushchildreniftheytakealongtimetorespond.

Givechildrentimeforprocessingandfindingthewordsneededtorelaytheirexperiences.

• Checkinwiththechildperiodicallyandaskifthechildunderstoodthequestion.ChildrenwithIDmaynotreadilytellyouwhentheydonotcomprehendaquestion.

• Avoidasking“why”questions.o Thechildlikelywillnotknowtheanswerandmayfeelbadaboutnotbeingable

toansweryou.• Offerbreaksduringtheinterview.Abreakcanincludechangingthesubjecttoaneutral

topicorsteppingouttousetherestroom.o Breaksarebeneficialifthechildisshowingsignsofstress,fatigue,ordiscomfort.o Thechildmaynotarticulatetheneedforabreak,sowatchforpossiblesignsof

stressorfatigueandofferabreakifappropriate.Signsofstressorfatigueinclude:

− Withdrawaland/ornotansweringquestions− Distraction(lookingaround,changingtopics)− Fidgeting,handwringing,rockinginthechair− Humming/groaning− Coveringface,hiding

• Considerendingtheinterviewandhavingthechildreturnforafollow-upinterviewonadifferentday.Brown,Lewis,andLamb(2015)foundthatchildrenwithmildandmoderateIDcanbenefitfromfollow-upinterviews.TheresearchersfoundthatchildrenwithmildIDprovidedmoreinformativeandaccurateinformationinafollow-upinterview,andthechildrenwerelesssuggestible.ChildrenwithmoderateIDrecalled


fewerdetails,butthosedetailswerestillaccurate(Brown,Lewis,&Lamb,2015).Benefitsforhavingthechildreturnforanotherinterviewinclude:

o Thefirstinterviewestablishedtheinterviewprocessandexpectations(open-endedpromptstoelicitfreerecall).Thechildisnowfamiliarandcomfortablewiththisprocessforthefollow-upinterview.

o Thechildhasbuiltrapportwithyouandmayfeelmorecomfortabletrustingyou.Feelingmoreateasewiththeprocessmayhelpthechildaccessmemorieswithoutextensiveprompting.

• Reasonsafollow-upinterviewmightbecontraindicatedinclude:o Thechildistoostressedorexperiencestraumareactionswhenhavingtotalk

abouttheincident.o Ifmultiplesuggestive,leadingquestionswereaskedduringthefirstinterview

andagaininthefollow-upinterview(LaRooy,Katz,Malloy,&Lamb,2010),thenthiscanleadtothechildbeingmoresuggestibleandatriskofchanginganswers.

• Ifthechildcomesbackforafollow-upinterview,itisimportanttodiscusswiththecommunityprovidersandthecaregiveranycontaminationissuesthatmayhaveoccurred.PleaserefertoChapter7:GeneralAccommodationsforChildrenwithDisabilitiesformoreinformationaboutadditionalinterviews.


Chapter12:Accommodations—PhysicalDisabilitiesTheaccommodationsdiscussedbelowarebasedoncurrentbestpracticesforforensicinterviews.InOregon,interviewersshouldfollowtheOregonInterviewingGuidelines(2012).TheinformationcontainedinthischapteralsobuildsontheaccommodationsdiscussedinChapter7:GeneralAccommodationsforChildrenwithDisabilities.Theinterviewapproachforchildrenwithphysicaldisabilitieswilldependonthetypeandextentofthedisability.UsethefiveinterviewpreparationquestionsfromChapter7tohelpidentifywhatdifficultiesthechildexperiencesandwhatadditionalinformationmaybehelpfulwheninterviewingthechild.PREPARATIONCONSIDERATIONSSPECIFICFORPHYSICALDISABILITIES

Insomecases,interviewingchildrenwithphysicaldisabilitiesmaybequitechallenging,suchaswhenseverecerebralpalsyaffectsachild’sspeech.Inothercases,difficultywithcommunicationisnotanissueandthephysicaladaptationistheonlynecessaryaccommodation.Barringco-occurringdisorders,childrenwithphysicaldisabilitiesunderstandandprocessinformationsimilarlytochildrenwithoutphysicalimpairments.PriortotheinterviewToadequatelyaccommodateachildwithaphysicaldisability,informationabouthowthechildisaffectedbythedisabilityandwhatphysicalaccommodationsarenecessaryshouldbegatheredbeforehand.Attentionmustbepaidto:

• Arrangingappropriatetransportationandparking• Physicalaccesstothebuildingandinterviewroom• Waitingareaandbathroomaccessibility• Timingoftheappointment(morningversusafternoon)

INTERVIEWSTRATEGIESFORSPECIFICDIAGNOSES

DeafandhardofhearingGatherinformationaboutthechild’smeansofcommunication:

• Whendidthechildacquirethehearingloss(e.g.,atbirth,afteraninfectionintherecentpast,etc.)?

• Arethechild’sparentsdeaforhardofhearing,oraretheparentswithouthearingimpairment?

o Nineoutoftenchildrenwhoarebornwithhearingimpairmentareborntoparentswhohear,solanguagedelayduetolackoflanguage(e.g.,useofAmericanSignLanguage[ASL])exposurecanoccur.

o ChildrenwhoaredeaforhardofhearingborntoparentswhoaredeaforhardofhearingandwhoalreadyuseASLinthehomewillacquireASLasquicklyas


hearingchildrenacquirespokenlanguage(NationalInstituteonDeafnessandotherCommunicationDisorders,2015).

• Whatcommunicationdoesthechilduseathomeand/oratschool?o ASLmaybethepreferredchoice,orthechildmayprefertoverbalizeorwrite

wordsinsteadofusingASL.• Doesthechildhavehearingaidsorcochlearimplants?Withthesedevices,isthechild

fluentwithspokenlanguage,ordoesthechildusesignlanguageaswell?• Ifthechildislearningsignlanguage(ASLorother),howfluentarethey?• Doesthechildand/orthefamilyuseidiosyncraticorspecialsigns(nameorhomesigns)

thatarenotincludedinASL?ChildrenwhouseASLtocommunicateideallyshouldbeinterviewedbyaforensicinterviewerwhoisfluentinASL.Unfortunately,thoseinterviewersarenottypicallyavailableinmostsituations.Ifthechild’sprimarylanguageisASL,thenacertifiedASLinterpretershouldbeused.Children’sfamilymembersorfriendsshouldnotbeusedasinterpreterseveniftheyknowsignlanguage.AnothertypeofinterpreterisaCertifiedDeafInterpreter(CDI).CDIsareinterpreterswhoaredeaforhardofhearingandhaveknowledgeandunderstandingofdeafness,deafcommunication,anddeafculture.Theycanbringinsightandexpertisetothespecialconsiderationsrequiredwhenworkingwiththispopulation.CDIsshouldhavegeneralinterpretertraining,andtheyalsowillhavespecializedtrainingintheuseofgestures,mime,props,drawings,andothercommunicationtools.Often,anASLinterpreterworksintandemwithaCDI.CircumstancesinwhichtoconsiderusingaCDIinclude(Cassady,Kellogg,MacDonald,Mounty,&Northrop,2005):

• ThechildisnotfluentinASLandusesnonstandardsigns/gesturestocommunicate.• Thechildusesaforeignsignlanguage,andacertifiedinterpreterforthatparticularsign

languageisnotavailable.• TheASLinterpreterisunfamiliarwithdeafculture,whichthechildandfamilyhave

embraced.• Thechildisexperiencingtraumareactionsandishavingdifficultycommunicatingvia

ASL.Additionalstrategiesinclude:

• Facethechildsothatthechildandyouseeeachother.• Ifaninterpreterisbeingused,ensurethatthechildisabletoseeboththeinterpreter

andyou.• Speakinanormalvoice;yellingmaydistortwordsorinterferewithlipreading.• Ifthechilddrawsananswer,pauseandwaittorespondoraskquestionsuntilthechild

finishes.


• Touchingthechild’sarmorshouldertogetthechild’sattentionisculturallyappropriateandacceptable.

• Checkinwiththechildtoensurethattheyunderstandthequestionsposed.

VisionimpairmentandblindnessDonotassumethatthechildhasnousablevision;manypeoplewhoexperiencevisualimpairmentcanseeshapes,colors,andlight(AmericanFoundationfortheBlind,2016).Toaccommodatechildrenwithvisualimpairments:

• Askwherethechildwouldliketositintheroom.• Usenaturalorlamplightingifpossible.Fluorescentlightscanbedistressingand/or

distracting.• Announceyourselfwhenyouenterorleavetheroom.• Alwaysaskbeforepettingaserviceanimal,asthisanimalisnotapet;itisworking.• Donottakethechild’sarmwithoutpermissiontoguidethechild.Instead,verballyoffer

thechildyourarmforguidancetoadestination.Statewhereyouaregoingandwhatisinfrontofyouasyoumove.

• Ifpossible,havewrittenmaterialsinotherformats,suchaslargeprint,pictures,audiorecordings,andBraille.

• OfferPlay-Dohormoldingclayforthechildtouseinsteadofdrawingorcoloringduringtheinterview.

CerebralpalsyCerebralpalsyaffectsmovement,posture,andsometimesspeech,butitdoesnotnecessarilyaffectintellectualfunctioning.Donotassumethatachildwithcerebralpalsyhasintellectualdelaysbasedonthechild’sinvoluntarymovementsorspeech.Appropriateaccommodationsduringtheinterviewinclude:

• Allowformovementintheinterviewroomoratanytimeduringtheinterview.• Ifthechildusesawheelchair,donottouchthewheelchairormaneuveritwithoutthe

child’spermission.• Payattentiontothechild’scomfortandrespiratoryefficiency;thechildmayneed

repositioningduringtheinterview.• Ifthechildisdrooling,seeifthereissomethingthechildusestowipeawaysaliva.Ifnot,

haveappropriatetowelsavailable.Ifspeechandarticulationaredifficultforthechild,consideraskingthechildhowtheyprefertocommunicate.Thechildmightusepicture/wordboardsoraugmentativecommunicationdevices,butthesedevicescanbetimeconsumingandexhausting.Thechildmayprefertotalk.Ifso,thentheinterviewershouldrespectthatpreferenceandbepatient.AccommodationsandstrategiesforspeechandarticulationdifficultiesaredescribedinChapter8:Accommodations—CommunicationDifficulties.


ConclusionThisProjectAbilityreferenceguideaimstodemystifydisabilitiesforprofessionalswhointerviewchildrenwithdisabilitiesaboutabuse.Ahugeamountofinformationhasbeendistilledintofourareaswhereproblemscanresultfromalmostalldisablingconditions:difficultieswithcommunication,intelligence,social/emotionalbehavior,andphysicalfunctioning.Thisreferenceguideisa“dropinthebucket”ofinformationaboutdisabilities.Resourcesthatprovideadditionaldetailsandinsightsaboutdisabilitiesincludethechild’scaregivers,educationalandmedicalrecords,andreputablewebsites.Thebestadviceforanyintervieweristorememberthatthechildwithadisabilityisfirstandforemostachild.Aswithallchildren,thatchildhasstrengthsandlimitations.Buildonthechild’sstrengthsandmakeaccommodationsforthethingsthataredifficultorchallenging.Thechildandfamilywillbegrateful.


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