Forensic services are provided to children who may have experienced abuse or who have witnessed a crime or other violent act. The primary aim of forensic services is to aid in ensuring the safety of the individual child as well as other children in the community. Forensic services are provided in a safe and child-friendly environment.

What should my child know about the interview?
Children seem to be put at ease by knowing what to expect. It is helpful to inform your child that someone wishes to talk with him or her about what was reported. It is important to reassure your child and give him or her permission to talk freely; however it is equally important not to rehearse with your child or tell your child what to say.

What can I expect immediately following the interview?
At the end of the interview, the DHR investigator and law enforcement will inform you about what will happen next. Unless told otherwise, you and your child are free to leave after talking with the investigators. The team will meet and develop a plan. An advocate or the DHR investigator may contact you at a later date with more detailed information.
will tell your child everything that she will be doing prior to the exam. If a medical is not requested by the MDT, you may request a medical exam by contacting the family advocate.

Forensic Interview
A forensic interview is a single session, recorded interview designed to elicit a child’s unique information when there are concerns of possible abuse or when the child has witnessed violence against another person. The forensic interview is conducted in a supportive and non-leading manner by a professional trained in the NCAC Forensic Interview model. Interviews are remotely observed by representatives of the agencies involved in the investigation (such as law enforcement and child protective services).

Extended Forensic Interview
An extended forensic interview is a multi-session interview conducted by professionals trained in the NCAC Extended Forensic Interview model. Extended forensic interviews are conducted with children currently involved in a criminal or child protection investigation who may experience difficulty relaying their information during a single interview session.

A medical exam is offered to any child who has allegations or concerns of abuse. Cramer CAC has a pediatric nurse practitioner on staff and is available to perform specialized medical evaluations on site in a child friendly, non-threatening environment.

Purpose of Exam
The purpose of the exam is to collect evidence and document trauma if present (especially in acute cases). The exam is also used to assess for and treat sexually transmitted infections, injuries, and pregnancy. Most importantly, it is performed to reassure the child and family that his/her body is okay.

What to Expect
The medical exam will take place at the Cramer Children’s Center in a child friendly room. The exam will include a medical history from the caregiver as well as from the child. The child will receive a thorough head to toe exam similar to a normal check-up at a Pediatrician’s office. This exam will also include an external inspection of the genitalia and anal area to make sure they appear normal. It is highly unusual for a preadolescent child to require an internal vaginal or rectal examination. It is important to understand that the child’s medical exam is different and less invasive than an adult pelvic examination.
For most children, the check-up is not painful. Nevertheless, children may feel worried, embarrassed or uncomfortable about their exam. It is normal for children to feel anxious about their examination. The nurse practitioner will take as much time as necessary to help children throughout the medical evaluation by explaining each step of the check-up and finding ways to put the child at ease.

Family Advocacy services are provided to the parents and guardians of children who participate in forensic interviews, although other caregivers may be referred to the program as well. These services are designed to give support and education to caregivers in a one-on-one setting or through support groups.

Mission of Family Advocacy Services
To support caregivers of children who have allegedly been sexually abused so that they may support their children.

Victim Advocate Interview
Crisis interviews are conducted by the family advocate with the caregivers while their child is being forensically interviewed. A crisis interview explores the abuse-related needs of the caregivers, provides education on the investigation process, and provides general reassurance and support. After the crisis interview, the family advocate follows up with the caregivers for up to several months to assist with any additional services and referrals the family may need.

Children between the age of 2 and 18 who have experienced a trauma may be referred for therapy. In addition, siblings of those children are eligible for services. Several types of therapy are offered, including Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Parent-Child Interaction Therapy (PCIT), and play therapy.

What to Expect
Therapy is a unique opportunity for a child to meet with a trained professional who is willing and able to work to establish goals for treatment and to develop a pathway toward achieving those goals. For children who are coming to therapy with a history of physical or sexual abuse, this process also uses research-based treatment that has been proven to be effective in coping with trauma. Occasionally, a child may leave a session feeling temporarily worse before realizing the full healing effect. Therapy relies on the child’s willingness to be open and to participate in the process, and the family should feel welcome to voice any concerns, discomfort, and scheduling issues with the therapist.
Parents and guardians maybe asked to participate in the majority of a child’s sessions in order to add to the child’s sense of support in the healing process. Participation and support are a vital aspect of therapy at the CAC. This may involve participation in sessions with or without the child, availability in lobby during sessions for consultation as needed, and initiation by parent of meetings with the therapist.

Children younger than 14:
Parents and guardians may feel free to telephone or ask the therapist in person about any questions or concerns regarding the child’s treatment.

Children 14 and older:
Participation, questions, and concerns on the part of the parents or guardians are subject to the confidentiality rights of the child. By law, a child aged 14 or older may choose to share or limit access to personal treatment information.

Evidence-Based Treatment Models
Several types of therapy are offered, including Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). TF-CBT is a treatment focused on helping children recognize how some of their thoughts, feelings, and behaviors have been shaped by their trauma. TF-CBT helps children to cope with and change those thoughts, feelings, and behaviors. The therapists using these therapies have been specially trained in these techniques.

History and Rationale
The Multidisciplinary Team concept was a core aspect of the original Child Advocacy Center model developed by Bud Cramer during the early 1980’s. Previously, the United States’ response to child sexual abuse was poorly coordinated between the various entities with a responsibility for conducting the initial investigation and response to child sexual abuse. With a committed group of community volunteers, Mr. Cramer refined and implemented the first Child Advocacy Center in Huntsville, AL in 1985. This innovative model recognized that in order for the United States to effectively respond to this issue that a unique public-private partnership was essential, and that the various agencies and departments responsible for the protection of children must be united in a collaborative effort to respond with the recognition that no one agency by itself could assure the protection of children. Only by working as a multidisciplinary team could we effectively respond to child abuse.

What is the investigative process?
The MDT consists of social workers, police officers, assistant district attorneys, advocates, nurses, and a child interview specialist. All of these professionals are sensitive to the difficult and confusing time that you and your child may be experiencing. The social worker must assess the safety and protection of your child. The interview specialist will ask your child questions and be part of the team discussion following the interview. A nurse will address any medical concerns, and a medical exam is available to every child. The police officer is from the location where the alleged incident occurred, and along with the assistant district attorney will determine if a crime has been committed and what other investigative steps must be taken. The victim advocate will be your link to the court system, if and when criminal action is taken. The MDT’s overall goal is to complete the investigation in a child friendly, timely and professional manner.

This bold effort to reformulate the nation’s response to child abuse was met with a mixture of skepticism and excitement. The various institutions of law enforcement, child protective services, mental health, medical health, and victim advocacy were unaccustomed to working in a collaborative fashion, but they quickly realized the value and impact of this multidisciplinary model. Currently, this approach has been widely adopted as a best practice in responding to child sexual abuse in the United States. Throughout the United States, there are now more than 950 Children’s Advocacy Centers which served more than 270,000 children, and this model has now been implemented in more than 25 countries throughout the world.