Opinion ID: 2390226
Heading Depth: 1
Heading Rank: 4

Heading: The Use of CSAAS Expert Testimony in This Case

Text: Turning then to the application of the standards to the record of this trial, we find that the CSAAS evidence was not presented to the jury in accordance with its scientific theory, i.e., the evidence was not offered to explain the conflicting behavioral traits in this case either of accommodation or delayed disclosure. Rather, the evidence was presented to the jury as though it were to prove directly and substantially that sexual abuse had occurred. Dr. Milchman, the prosecution's expert witness on child sexual abuse, described CSAAS as a pattern of behavior found to occur consistently in children who are victims of incest, and she outlined Dr. Summit's five-part syndrome: secrecy, helplessness, entrapment and accommodation, delayed disclosure, and retraction. The prosecutor asked whether she had examined Connie and Norma and whether, in the course of examination, Dr. Milchman had found the children to suffer symptoms of the child sexual abuse accommodation syndrome. (Recall that Dr. Summit describes two aspects of CSAAS, secrecy and helplessness, as preconditions.) Dr. Milchman said that Norma had exhibited four of the symptoms: secrecy, helplessness, accommodation, and delayed disclosure. She said that Norma's crying, shaking, rubbing her hands in her eyes, and covering her face during the interview were manifestations of her feeling of helplessness towards the abusive situation and her fears, anxieties and anger which she had to suppress in order to accommodate the abuse. Technically, these interview observations do not seem to be the symptoms that Dr. Summit describes. Rather, they appear to us to be generic post-traumatic symptoms. Supra at 563, 617 A. 2d at 1201. Dr. Milchman pointed out that Norma had revealed the abuse only after questioning initiated by her mother. She also explained that Norma had stuck to her story, instead of recanting it, because nobody was pressuring or threatening her. Connie, on the other hand, had presented herself differently as a very brassy, very assertive, very outgoing child on the surface but [u]nderneath there was a lot of fear and anxiety. Dr. Milchman described Connie as being entrapped and accommodating to the abuse  she complied and accepted the abuse for a long time. She also believed Connie had given a delayed disclosure. Dr. Milchman believed that Connie had kept the abuse a secret for a long time because John had threatened her and her mother with physical violence, a threat she believed because she had seen her father be violent with her mother. The prosecution then made a transition into areas not covered by CSAAS. Dr. Milchman was presented with a series of questions based on a child's testimony concerning (1) the experience of feeling someone putting a finger inside the child's vagina, (2) the experience of feeling someone putting his tongue inside the child's mouth, and (3) graphic details concerning oral sexual contact. She was asked whether that testimony would be consistent with a child who had been sexually abused or would reflect a child's exposure to outside sources, such as watching others or watching an adult movie. Dr. Milchman said that such testimony was consistent with sexual abuse and added that the graphic details concerning oral sexual contact are not within a child's normal imagination. The three questions presented to Dr. Milchman obviously had no relationship to CSAAS. They pose evidentiary difficulties in the absence of a more detailed record. [7] Yet counsel did not object to them. Perhaps counsel in such cases prefer to give a wide latitude to expert testimony rather than to appear to shield the jury from such opinion evidence. Had the expert's opinion gone no further, we would not find clear error capable of bringing about an unjust result. The issues would perhaps be viewed as somewhat akin to the issue posed in State v. Zola, supra, 112 N.J. 384, 548 A. 2d 1022, in which a State forensic expert was permitted to give an opinion on a probable source of saliva found within the victim's body cavities. We ruled there that expert testimony may play a limited role in such issues as they are common sense deductions on subjects about which jurors may not have much familiarity, and such testimony does not deprive the jury of its qualitative function. Id. at 414-16, 548 A. 2d 1022. However, Dr. Milchman then proceeded to describe how one could tell whether a child is lying. For example, a child's speaking in a mechanical way, like it was by rote memory rather than by their own feelings, could raise the suspicion that the child was trying to remember what someone else had told him or her, thereby undermining the child's credibility. Or a child's perfectly consistent narration of all details of the story would be inconsistent, she said, with a child's natural tendency to forget minor detail. Certainly the prefatory basis of CSAAS has nothing to do with those areas of opinion. This type of testimony equates with the kind of expertise said to relate to eyewitness testimony. Courts are frequently requested to permit expert opinion testimony on the reliability of eyewitness identification. Although People v. McDonald, 37 Cal. 3d 351, 208 Cal. Rptr. 236, 690 P. 2d 709 (1984), allowed expert testimony from a psychologist concerning the ability of eyewitnesses to perceive, remember, and relate accurately and the distorting effects of fear and excitement, courts have sometimes hesitated to allow such testimony because it may interfere in the truthfinding function or create an unwarranted aura of expertise. Thus, if the child-sexual-abuse expert testifies that the child is believable or truthful, the courts will most likely exclude the evidence. Linda E. Carter, Admissibility of Expert Testimony in Child Sexual Abuse Cases in California: Retire Kelly-Frye and Return to a Traditional Analysis, 22 Loyola L.Rev. 1103, 1118 (1989). Yet, in this case Dr. Milchman was asked, How can you tell when a child or a victim is telling the truth about the fact that they have been sexually abused? Although the court cautioned the jurors that it was up to them ultimately to determine that, the expert proffered a theory  again unrelated to CSAAS: Okay. I look for  I look for many different things. I look for whether the child appears to be sincere. I look for whether or not the feeling that they have at the time goes with what they are saying or whether it contradicts what they are saying. I go for whether there are a lot of different behaviors that all point to the same conclusion. For example, is what the child saying, does that match the demonstrations that they give when they try to explain it with their hands or with dolls, does it match the pictures that they draw for me? Does it match what they told the mother; does it match what they told the DYFS worker; does it match what they told the Prosecutor or investigator; or does it match what they told me? I look for consistency across a lot of different kinds of behaviors.    I look for    realistic, concrete, specific, kinds of details that are not the kinds of things that you would tend to see on a television so that any kid could pick up or any cable T.V. or movie that any kid could just pick up   . The final question to the witness was: Doctor, based on your examinations of the girls can you give this jury your expert opinion as to whether or not both [Connie] and [Norma] were sexually abused? Answer: I believe that they were sexually abused. At this point, whether Dr. Milchman had reached that opinion on the basis of her credibility assessments or on the basis of her understanding of CSAAS evidence is not clear to us and could not have been clear to the jury. If it were the former, it would be improper opinion evidence because it would introduce an unwarranted aura of scientific reliability to the analysis of credibility issues. If it were the latter, it would be improper opinion evidence because CSAAS is not relied on in the scientific community to detect abuse. There has not been a showing in the record in this case, nor seemingly in other scientific literature or decisional law, of a general acceptance that would allow the use of CSAAS testimony to establish guilt or innocence. See David McCord, Expert Psychological Testimony About Child Complainants in Sexual Abuse Prosecutions: A Foray into the Admissibility of Novel Psychological Evidence, 77 J.Crim.L. & Criminology 1, 24, 38 (1986). Such use of CSAAS evidence would present the analog to State v. Cavallo, supra, 88 N.J. 508, 443 A. 2d 1020, and would require a study of the reliability of psychiatric or psychological testimony on the likelihood that the traits found in the victim will establish that another had engaged in the conduct that had caused the symptoms. It strikes us that the premise would be strained, at least on the basis of the Summit studies. As Myers noted: Summit did not intend the accommodation syndrome as a diagnostic device. The syndrome does not detect sexual abuse. Rather, it assumes the presence of abuse, and explains the child's reactions to it. Thus, child sexual abuse accommodation syndrome is not the sexual abuse analogue of battered child syndrome, which is diagnostic of physical abuse. With battered child syndrome, one reasons from type of injury to cause of injury. Thus, battered child syndrome is probative of physical abuse. With child sexual abuse accommodation syndrome, by contrast, one reasons from presence of sexual abuse to reactions to sexual abuse. Thus, the accommodation syndrome is not probative of abuse. Unfortunately, a number of mental health professionals, lawyers, and commentators drew unwarranted comparisons between battered child syndrome and child sexual abuse accommodation syndrome. This error led to considerable confusion. First, some professionals misinterpreted Summit's article, believing Summit had discovered a syndrome that could diagnose sexual abuse. This mistake is understandable, if not forgivable. Mental health and legal professionals working in the child abuse area had long been accustomed to thinking in terms of syndrome evidence to prove physical abuse. Battered child syndrome was an accepted diagnosis by the time Summit's accommodation syndrome came along in 1983. It was natural for professionals to transfer their understanding of battered child syndrome to this new syndrome, and to conclude that the accommodation syndrome, like battered child syndrome, could be used to detect abuse.            [T]he accommodation syndrome was being asked to perform a task it could not accomplish. The accommodation syndrome has a place in the courtroom. The syndrome helps explain why many sexually abused children delay reporting their abuse, and why many children recant allegations of abuse and deny that anything occurred. If use of the syndrome is confined to these rehabilitative functions, the confusion clears, and the accommodation syndrome serves a useful forensic function. [Myers, supra, 68 Neb.L.Rev. at 67-68 (footnotes omitted).] This we believe is the most concise summary of the proper use of CSAAS and will serve as a useful road map in the trial of such cases. Another commentator agrees. Much of the legal controversy about CSAAS is a product of legal misuse and misunderstanding which is a direct result of the fact that CSAAS is a misnomer. The term syndrome may refer to two different things. In laymen's terms it is defined as either a group of signs and symptoms that occur together and characterize a particular abnormality or a set of concurrent things (as emotions or actions) that usu[ally] form an identifiable pattern. Medically, however, the term refers to the aggregation of symptoms associated with a morbid process which forms a disease. CSAAS, as it is currently defined, is neither a disease nor a pattern of abnormality.            [T]he syndrome seeks to define a coping process and not behavior that will identify the existence of sexual abuse.    Since this syndrome is only a piece of the child sexual abuse machinery, testimony concerning CSAAS may only be offered for the purpose for which it was defined  to explain the child's irrational behavior. [Holmes, supra, 25 Tulsa L.J. at 157-59 (footnotes omitted).] The California Court of Appeals has thus refused to admit testimony about the general characteristics of molested children for the purpose of allowing the jury to conclude that a particular child is a victim of abuse. People v. Bowker, supra, 203 Cal. App. 3d 385, 249 Cal. Rptr. 886. Instead, because CSAAS has a limited, therapeutic purpose and not a predictive one, the evidence must be tailored to the purpose for which it is being received. Id. at 891, 203 Cal. App. 3d 385. [A]t a minimum the evidence must be targeted to a specific `myth' or `misconception' suggested by the evidence and limited to explaining why the victim's reactions as demonstrated by the evidence are not inconsistent with having been molested. Id. at 891-92, 203 Cal. App. 3d 385. The court must also explain to the jury that the expert's testimony is not intended to address the ultimate question of whether the victim's molestation claims are true and must admonish the jury not to use the testimony for that purpose. Id. at 892, 203 Cal. App. 3d 385. That use of CSAAS testimony is consistent with the use to which we put the battered-woman-syndrome evidence in Kelly, supra, 97 N.J. 178, 478 A. 2d 364. Other jurisdictions follow that approach. See State v. Reser, 244 Kan. 306, 767 P. 2d 1277, 1283 (1989) (qualifying clinical specialist with training in child sexual abuse to testify to common patterns of behavior resulting from abuse and that this victim had symptoms consistent with those patterns); People v. Beckley, 434 Mich. 691, 456 N.W. 2d 391, 407 (1990) (finding appropriate expert testimony limited to providing jury with background information, relevant to specific aspect of child's conduct at issue, which it could not otherwise bring to its evaluation of child's credibility); State v. Middleton, 294 Or. 427, 657 P. 2d 1215, 1220 (1983) (explaining superficially bizarre behavior of victims of abuse helps jury to assess credibility). But see State v. Bachman, 446 N.W. 2d 271, 276 (S.D. 1989) (allowing opinion testimony that victim's allegations were truthful). Such use accords with the use now generally afforded to rape trauma syndrome (RTS) evidence most often in the context of adult rape. RTS describes symptoms frequently experienced by rape victims, e.g., phobic reactions and sexual fears. Because RTS was developed as a therapeutic tool, not as a test to determine the existence of a past event, the California Supreme Court in People v. Bledsoe, 36 Cal. 3d 236, 203 Cal. Rptr. 450, 681 P. 2d 291 (1984), questioned the reliability of RTS in determining whether a rape has occurred. Thus, the court held that, given the history, purpose and nature of RTS, testimony on the concept was inadmissible to prove that a rape occurred, but recognized that RTS testimony has been admitted in cases in which the alleged rapist suggests that the victim's conduct after the incident was inconsistent with her claim of rape. Id. 203 Cal. Rptr. at 457-460, 681 P. 2d at 298-301. In the latter context, expert testimony of RTS may play a particularly useful role by disabusing the jury of widely-held myths and misconceptions about rape and rape victims. Id. at 457, 681 P. 2d at 298; see also People v. Taylor, 75 N.Y. 2d 277, 552 N.Y.S. 2d 883, 552 N.E. 2d 131 (1990); State v. Saldana, 324 N.W. 2d 227 (Minn. 1982) (both holding that RTS is not reliable as substantive proof of rape).