Wednesday, February 05, 1986

No One Invented McMartin `Secret' Techniques Were Right Ones to Get at Facts, Help Victims

No One Invented McMartin `Secret' Techniques Were Right Ones to Get at Facts, Help Victims
By Roland Summit
Los Angeles Times - February 5, 1986

The latest pronouncement in the McMartin Preschool saga takes us further into Wonderland. Like some hapless Alice plunging into a rabbit hole, the case has been trapped in paradox for two years, growing and shrinking on cue, both too large to fit in and too small to climb out. And somewhere in the uneasy alliance of adversary attorneys is a cardboard monarchy dispensing justice. The edict is clear: "Off with their heads." The question of whose head must roll shifts as capriciously as the apparent size of the case.
With the announcement by Dist. Atty. Ira Reiner that all charges would be dropped against five of the seven defendants, the case is small again. Now those five have gone from supposed villains to certified victims.
"There simply isn't any evidence" to justify their extended ordeal throughout the monstrous preliminary hearing, Reiner's office says. And hundreds of parents and their children are cast as fools.
Everyone caught up in this case has reason for agony and fury. Someone must be stupid or evil or both. But who? Now the legal adversaries are in concert: The blame lies on the head of the messenger. The social workers who claimed to speak for the children gave us an unacceptable message.
What about these messengers? Were their controversial techniques so unusual or inappropriate? Did they reward children for the wrong stories? If we don't trust the sometimes fabulous stories told by children, should we trust those who claim to translate such fancies into fact?
Whatever the eventual judgments in the McMartin case, it should be clear that there was both reason and precedent for the methods used in the initial interviews with children. And, despite all the wondrous processing of those interviews through the tunnels of the adversary process, it is not too late to recover the light of reason that those recorded images can provide.
Child psychiatrists have recognized for most of this century that children don't freely voice their complaints. Psychiatric diagnosis depends on inferences drawn from the way a child relates through toys in a structured playroom. Words and conflicts too difficult to verbalize may be expressed through puppets and dolls, trucks and tanks, crayons and clay.
But it was not until 23 years ago that pediatricians discovered the concept of child abuse, the "battered-child syndrome," through patterns disclosed in X-rays. In turn they learned that victimized children were seldom able to speak about what had been done to them; they were too fearful of adults in positions of authority. Something more incisive than therapeutic play was needed in order to unlock those secrets.
With this dreadful knowledge of the battered-child syndrome came the obligation to recognize signs of abuse and to provide protective intervention. Emerging specialists developed interviewing techniques that combined interpretation of play with direct questions and gentle reassurance to coax children into sharing their fearful secrets.
Sexual abuse was eventually found to be the most sinister of those secrets. It took 15 years of child-abuse awareness before child-protection workers, emergency-room nurses, rape counselors, sociologists and others discovered that sexual assaults against children were a substantial and almost totally neglected problem.
By 1978 professional and popular information about the sexual abuse of children had proliferated. Specialists in police departments pioneered the use of anatomically specific dolls to help children find words and gestures to express the unspeakable. Federally supported sexual-abuse treatment centers attracted thousands of previously silent victims. For the first time in history, police, treatment specialists and prosecutors developed teamwork to hold child molesters accountable.
The one person in the country who shepherded this growth and who was most known and respected throughout the field was a young social worker, Kee MacFarlane, the coordinator for sexual-abuse programs at the National Center on Child Abuse and Neglect in Washington.
When MacFarlane came to Los Angeles in 1982 to become director of the Child Sexual Abuse Diagnostic Center at the Children's Institute International, she brought with her the state of the art in clinical evaluation of suspected sexual abuse. That art-highly evolved, intensely specific and largely unknown outside the fledgling specialty of child-abuse diagnosis-is an amalgam of several roles. It combines the knowledge of a child-development specialist to understand and translate toddler language, a therapist to guide and interpret interactive play, a police interrogator to develop evidentiary information and a child-abuse specialist to recognize the distinctive and pathetic patterns of sexual victimization.
Most of that specialist understanding is both unexpected and counterintuitive. Sexual assault is not a rarity for children. Only molestation by strangers is rare; 90% of the risk is from people whom we know and trust. Molestation leaves only subtle traces, usually not evident to parents or doctors. Even when bleeding or discharge is present, parents and doctors will usually find some harmless reassurance to explain the injuries. Children who have been molested are typically ashamed, fearful and specifically forbidden to tell. Mothers are usually the last to know. Children are especially afraid of telling them for fear of causing distress or losing their love. Even if children can be encouraged to admit to abuse, they may withhold the worst problems at first and may take back various disclosures if the accounts are seen to be upsetting or unbelievable to their listeners. A forthcoming, clear, consistent, durable accounting is not only rare but also suspicious. It is simply not normal for a child to tell, or for a parent to believe, that a solid citizen could be sexually dangerous.
At the clinical level the goal of most child-abuse diagnostic specialists is to discover and help victims. If a child suspected of being abused is unable to volunteer information, it must be elicited with warm reassurance and specific, potentially leading questions. A child who can only answer "yes" to specific questions, and who is obviously terrified at the mention of a suspect's name, is of no value as a witness for the prosecution. But that provisional confirmation can lead to therapy and healing for the child and family.
To apply a criminal-justice standard to clinical diagnosis is an absurdity confined to this unformed, multiturf world of child sexual abuse. It's like saying that we should discard any culture for strep throat if it merely diagnoses the illness without proving who is to blame for infecting the patient. By further analogy to the theories of the courtroom, if the doctor can't prove where the infection came from, then we'll blame the doctor for implanting the germs.
Fortunately, we do not have to depend on courtroom oratory or reductionist strategies to search for the lessons in the McMartin ordeal. The entire diagnostic process at Children's Institute International is recorded on videotape. Videotaping was intended to reduce the number of interviews in the investigative process. It also helped families in the crisis of fear and denial. Parents could believe from a tape what they might never personally hear from their children. The tapes built an unexpected support between parents and children and a bridge to follow-up communication and recovery. Unfortunately, the tapes also provided shortcuts from standard witness-screening practices. This left prosecutors poorly acquainted with their witnesses and unprepared for their testimony.
The preliminary hearing process of the McMartin case has shown us a few moments out of thousands of hours of videotape records. Furthermore, these are fragments selected by defense attorneys to make the diagnostic procedures look corrupt. Professional skeptics have used a microscope to pick out a few bacteria that don't fit the streptococcal pattern. Accurate diagnosis requires an overview of the whole growth.
Since the case in court continues to shrink, there will be no access there for understanding the plight of hundreds of children who were diagnosed as abused but discarded by the criminal-justice system. Any child who can't prove a charge beyond reasonable doubt doesn't count.
The residual dust of the case must be viewed as the most meticulous pickings from the millstones of justice. This processed flour offers no track to the bundles of grain that went into the mill. Most of the wheat has been discarded along with the chaff. We would do well to develop some process of secondary recovery to examine the lawyers' dumpheap before it is lost to the broader interests of society.
We need to know what happened-not only what happened to the children but what happened to the investigation. No citizen should be branded and criminalized for two years (or even two days) without evidence. A public should not be polarized into fearful, warring camps over false issues. And professionals attempting to help children and families should not be sources of confusion or potential abuse.
But if there is a danger out there-if children aren't always safe with people whom we trust, if some apparently safe places must be unmasked as fronts for perversion and exploitation-then we must look to sources apart from the criminal-justice system to show us the danger.
I watched the McMartin investigation develop. I heard MacFarlane's dismay as she recorded unexpected accounts from increasing numbers of children. I talked to parents searching for answers. And I have seen all of us-parents, professionals, police, prosecution, press and public-paralyzed and befuddled by the immensity of the implications and the shrinking away of the proofs. I know that the process of investigation was an honest one, just as I know that everyone involved was handicapped with imperfect knowledge, inadequate resources and intolerable urgency.
MacFarlane and the Children's Institute were asked to do a job that seemed at first to be perfectly matched to their resources. For all the burgeoning and punishing demands on that one agency, there emerged hundreds of children who could share with their parents and therapists a secret so dangerous that no one had shared it before.
Now some would say that MacFarlane invented the secret. Let it be a hysteria rather than a horror-merely a reinforcement of fantasy between children and "the puppet lady." But this is missing the point. Her diagnostic techniques were meant to find victims of abuse, not prosecute the perpetrators. Rather than discredit MacFarlane, the criminal-justice system needs to better understand the problem of child sexual abuse and make accommodations to new sources of evidence.
The court record will not reflect the representative experience of the children. And charges, convictions or acquittals will not guide our trust and judgment toward the many institutions still clouded with uncharged suspicions and incredible accusations. The record that we need to see and the testimony that must be analyzed remain under wraps-never transcribed or indexed, never even reviewed by any single observer-encrypted on miles of magnetic tape.
If the process was honest, if the stories of all the children interviewed combine into an integrity that could not have been suggested by the contributions of the interviewers, then we deserve to know that, especially if the stories define a public health hazard that cannot be proved in courts of law. If those stories do match with physical injuries as indicated in the preliminary hearing, what can we expect of medicine to define the hazard? We must remember that the battered-child syndrome came out of a medical publication, not a court decree. There was no attempt to prove who broke the bones pictured in those X-rays.
There is still another rational, clinical record deserving of attention. There are children examined in other clinics, some in other states, who gave indication of abuse in the McMartin school.
We are not trapped in Wonderland unless we choose to be. The way out was charted on the way in. Rather than decapitate the messenger, we might better take a second look at the message.