For and AgainstThe Use of Anatomically Correct Dolls
For and Against The Use of Anatomically Correct Dolls The use of anatomically correct dolls has become a frequently used practice in the assessment of sexual victimization in young children. The basic rationale for using anatomically correct dolls is that they may elicit information from children who are unable or unwilling to provide a verbal report (Boat & Everson, 1986). Dolls are particularly advocated for interviewing very young children: “It is primarily the 2, 3, and 4 year old children for whom sexually anatomically correct doll interviews are geared” (Yates & Terr, 1988, p.256), and “the dolls are especially useful with children who are younger than age 3…” (Yates & Terr, 1988, p. ... According to recent estimates, anatomically correct dolls are used by the majority of professionals involved in sexual child abuse investigations, including therapists, psychologists, police, child protection workers, and attorneys. ... However, a substantial proportion of the individuals using the dolls have received little or no training in their use and great variation exists in how the dolls are actually employed (Boat & Everson, 1988). In a 1985 study conducted by Boat & Everson (1988) the usage of the dolls ranged from 40% among law enforcement agencies, to 67% among mental health professionals, to 94% among child protection service agencies. Among a sample of over 200 professionals identified nationwide, Conte, Sorenson, Fogarty, and Rosa (1991), reported anatomical dolls were the most commonly used tool in child sexual abuse evaluations, with 92% of the respondents using the dolls. In a recent survey of 201 Boston-area professionals, 80% of mental health workers and 62% of law enforcement professionals reported using anatomical dolls (Kendall – Tackett & Watson, 1992). ... Communication with young children is enhanced by the use of nonverbal techniques and a range of clinical tools, including dolls, toys, and drawings. ... Second, in the proper hands, anatomical dolls are a highly effective and efficient tool for helping young children disclose and describe their sexual experiences. ... The children were interviewed first without them, then with, anatomical dolls. In interviews utilizing the dolls, the children were three times more likely to provide a detailed description of sexual abuse and twice as likely to name a suspected perpetrator than they were in interviews without the dolls. The use of anatomical dolls has not been universal. The dolls have been the focus of intense legal debates (Boat & Everson, 1994). While legitimate concerns about the use of the dolls exist, the extreme reactions of some critics of the dolls have been surprising. For example, in some cases the dolls have been described as “dirty, ugly, bizarre, an affront to common decency, and a form of child abuse. ... Professionals who have used the dolls have also been labeled as “incompetent” and accused of being guilty of malpractice and unethical conduct (Gardner, 1992). Some of the negative outbursts may be caused due to the dolls sexual genitalia, especially on objects viewed as children’s toys. ... Negative Criticisms towards Anatomical Dolls The following four criticisms have warranted reasoned consideration about the use of the dolls in sexual abuse evaluations. 1) There is no commonly accepted, standard protocol for the use of anatomical dolls. ... 2) Available norms on how sexually abused and nonabused children respond to and interact with anatomical dolls are inadequate. ... 3) Anatomical dolls are by their nature, suggestive and sexually over-stimulating. ... 4) The use of anatomical dolls promotes interviewer error and misuse. Specifically, their use encourages, leading or suggestive lines of questioning, over interpretation of the child’s play, shortcuts in the evaluation process, and over reliance on a single tool. In a review of the research literature, Everson and Boat (1994) concluded that the first three criticisms of the dolls, including the most common criticism that the dolls are overly suggestive to young, sexually naďve children, either are not supported by available research or are relevant concerns only if the dolls are being used inspecific ways during the interview. For example, if an interviewer were using the dolls as a diagnostic test – a use that is not considered acceptable (American Professional Society on the Abuse of Children, 1995) then all four criticisms would be relevant. ... However, the study determined that the most troubling major criticism is that use of anatomical dolls may encourage interviewer errors. Examples of these errors would include posing the dolls to model specific sexual acts, naming a doll before the child does, failing to clarify the child’s names for the persons the dolls are representing, assuming that what the child is demonstrating with the dolls has actually happened to the child, failing to ask clarifying questions about sexualized behaviors with the dolls, and rewarding a child verbally, or in more subtle body language, for playing with the dolls in sexual ways. Everson & Boat (1994) reviewed 20 written guidelines on interviewing young children that included directions for using anatomical dolls and subsequently identified five functional uses of the anatomical dolls in sexual abuse investigations. ... Comforter (2 guidelines): The dolls function as “play” objects. ... Icebreaker (5 guidelines): The dolls aid in focusing in a child’s attention on sexual issues and body parts. ... Anatomical Model (16 guidelines): The parts of the dolls are used to assess a child’s labels for each part. ... Demonstration Aid (18 guidelines): The dolls are used as props for helping children that have limited vocabulary skills, and have the child demonstrate with the dolls what happened. ... Diagnostic Screen (11 guidelines): An interviewer can observe how the child plays with the dolls and listen to their remarks. Considerations of Specific Criticisms Everson & Boat (1994) researched the previously stated criticisms and came up with the following findings: Criticism 1: There is no commonly accepted, standard protocol for the use of anatomical dolls. ... In fact, a uniform protocol for the Anatomical Model Use of the dolls may be within reach. A review of guidelines that endorse the function of the dolls reveals substantial consensus on such issues as presenting the dolls clothed, asking the child to name body parts beginning with the more neutral parts and having the child undress or participate in undressing the dolls, accepting and using the child’s terminology (Boat & Everson, 1986).