The precursor to today’s child sexual abuse testimony was Roland Summit’s formulation of the Child Sexual Abuse Accommodation Syndrome (CSAAS) in 1983.

The HIGHLIGHTS
The Child Sexual Abuse Accommodation Syndrome held tremendous sway in CSA trials since the early 1980s. But it was eventually thoroughly debunked as the clinical musings of a psychiatrist without any basis in scientific research. Roland Summit actually downplayed his own theories in 1993. Despite this, some CSA experts will still try to sneak in the CSAAS under different names.

If you have Dr. Wendy Dutton in your case, you’ll want to review the following from her 2011 doctoral dissertation:

The validity of the CSAAS has been challenged by both legal defense advocates and scholars (Pipe, Orbach, Lamb & Cederborg, 2007; Summit, 1992).  One of the most influential recent scholarly challenges was raised by London, Bruck, Ceci, and Shuman (2005) in a meta-analysis of 28 CSA disclosure studies conducted with adults and children published between 1990 and 2002. These authors cited methodological concerns in many of the research studies they analyzed. These concerns included the lack of definitive corroborating evidence of abuse in adult and child populations studied, and the use of suggestive or coercive interview methods by investigators to obtain abuse disclosures from children. In spite of these methodological flaws, conclusions on this meta-analysis supported the validity of Summits ‘s concerns of secrecy and delay disclosure. However, the authors challenge the rigor of scientific evidence to validate the concepts of conflicted disclosures, denial of abuse, and retractions as occurring commonly.¹  London and her colleagues argued that CSAAS did not meet the standards of reliability necessary for admission is expert evidence in legal proceedings.²  In their conclusion, the author stated,

“According to these testimonial standards, the only component of the CSAAAS that has empirical support is the delay of abuse disclosure is very common. However, the probative value of expert testimony on the latest closure, weather for evidentiary or rehabilitative reasons, is undetermined; . . . In summary, there is no convincing evidence that CSAAAS testimony on denial or recantation provides relevant or reliable assistance to the fact finder to assist allegations of CSA.” (London at all., 2005, p. 220).

This challenge to the validity of CSAAS has since stimulated new debate and additional inquiry into the nature children’s disclosures and reactions to sexual abuse (Pipe et al., 2007).

Gender differences in children’s disclosures and legal narratives of sexual abuse.
Wendy A. Dutton. A dissertation presented in partial fulfillment of the requirements for the degree doctor of philosophy.  Approved April 2011, Madelaine Adelman, Chair. Arizona State University.  Page 6.

The DEEP DIVE

Summit’s CSAAS held tremendous sway in thousands of trials for over three decades. But it was eventually debunked as unscientific, with no application to forensic matters. In 1993, Summit admitted that his formulation of the CSAAS was not based on any research, simply his clinical observations.

“It should be understood without apology that the CSAAS is a clinical opinion, not a scientific instrument.” (p.156)

“The CSAAS is meaningless in court discussion unless there has been a disputed disclosure, and in that instance the ultimate issue of truth is the sole responsibility of the trier of fact. The CSAAS acknowledges that there is no clinical method available to distinguish ‘valid’ claims from ‘those that should be treated as fantasy or deception’(p. 189), and it gives no guidelines for discrimination. The capacity to listen and the willingness to believe, which the paper invites, is not an admonition to interrogate or to assume that every disclosure is real:” (p.158)
Abuse of the Child Sexual Abuse Accommodation Syndrome. Summit, Roland C.; Journal of Child Sexual Abuse, Vol 1(4), 1992. pp. 153-163.

But CSAAS isn’t dead just yet. Child Sexual Abuse experts (CSA) have continued to promote the claims of CSAAS’s five indicators: (1) secrecy, (2) helplessness, (3) entrapment and accommodation, (4) delayed, unconvincing disclosure, and (5) retraction. They have simply dropped the name “CSAAS” from their testimony. But “a rose by any other name would smell as sweet.” Whether in whole or in part, CSA experts continue to overstate/misstate the research on the topic of child sexual abuse, which can introduce significant challenges for them on cross.

Research on Child Sexual Abuse Accommodation Syndrome (CSAAS)

The child sexual abuse accommodation syndrome.
Summit, Roland C.; Child Abuse & Neglect, Vol 7(2), 1983. pp. 177-193.

Abstract:
Classifies the most typical reactions of children to sexual abuse into a child abuse accommodation syndrome. The syndrome is composed of 2 categories that define basic childhood vulnerability and 3 categories that are sequentially contingent on sexual assault: (1) secrecy; (2) helplessness; (3) entrapment and accommodation; (4) delayed, unconvincing disclosure; and (5) retraction. The accommodation syndrome is proposed as a simple and logical model for use by clinicians to improve understanding and acceptance of the child’s position in the complex and controversial dynamics of sexual victimization. Application of the syndrome tends to challenge entrenched myths and prejudice, providing credibility and advocacy for the child within the home and the courts and throughout the treatment process. The child’s coping strategies as analogs for subsequent behavioral and psychological problems, including implications for specific modalities of treatment, are discussed.

Abuse of the Child Sexual Abuse Accommodation Syndrome.
Summit, Roland C.; Journal of Child Sexual Abuse, Vol 1(4), 1992. pp. 153-163.
Abstract:
Discusses the origins of the concept of the Child Sexual Abuse Accommodation Syndrome ([CSAAS] R. C. Summit; see record 1984-15274-001) and the subsequent distortions that court misuse has imposed. The CSAAS is a clinical observation that has become both elevated as gospel and denounced as dangerous pseudoscience. It is hoped that such a contextual review can serve as a guide toward a more accurate understanding among clinicians, judges, and advocate attorneys.

Commentary: ‘Abuse of the Child Sexual Abuse Accommodation Syndrome.’
Elias, Harry M.; Journal of Child Sexual Abuse, Vol 1(4), 1992. pp. 169-171.
[Comment/Reply] Abstract:
Comments on R. C. Summit’s (see record 1994-02082-001) article on the Child Sexual Abuse Accommodation Syndrome (CSAAS). The original lesson to be learned from the CSAAS is that society, and many professionals who come into contact with sexually abused children, frequently have preconceived ideas about how a traumatized person will react. Such misconceptions can cause people not to listen, not to understand, and not to learn.

Commentary: Summit’s ‘abuse of the CSAAS.
MacFarlane, Kee; Journal of Child Sexual Abuse, Vol 1(4), 1992. pp. 165-167.
[Comment/Reply] Abstract:
Comments on R. C. ummit’s (see record 1994-02082-001) article on the abuse of the Child Sexual Abuse Accommodation Syndrome (CSAAS). It is argued that the fact that the CSAAS has been blamed in absentia for the reversal of cases in which it was never mentioned, speaks not only to the determination of those who have invoked it to suit their own purposes, but to the universality of its message.

The rehabilitation of the Child Sexual Abuse Accommodation Syndrome in trial courts in Kentucky.
Stewart, William F.; Young, Rose; Journal of Child Sexual Abuse, Vol 1(4), 1992. pp. 133-141.
Abstract:
Attempts to reconcile the position of Kentucky law in regard to the Child Sexual Abuse Accommodation Syndrome (CSAAS) with that of R. C. Summit’s (1992) views. Summit described this syndrome in an attempt to explain the seemingly paradoxical behavior of child victims in disclosing sexual abuse. The following conditions should be met for the CSAAS to be admissible in the prosecution of child sexual abuse: (1) The symptoms of CSAAS should be present through interviewing the child, (2) testimonial use of the CSAAS must be in general terms to avoid the hearsay objection, and (3) prosecutors should avoid specific questions about the victim. An outline of Kentucky’s legal history concerning this issue is provided.

The rehabilitation of the Child Sexual Abuse Accommodation Syndrome in trial courts in Kentucky:
Commentary. Summit, Roland C.; Journal of Child Sexual Abuse, Vol 1(4), 1992. pp. 147-151.
[Comment/Reply] Abstract:
Comments on W. F. Stewart and R. Young’s (see record 1994-02079-001) article on the rehabilitation of the Child Sexual Abuse Accommodation Syndrome (CSAAS) in trial courts in Kentucky. Rehabilitation of the CSAAS is not enough, especially if the CSAAS continues to be held as the repository for all the symptoms of child sexual abuse. The courts must initiate policies that will admit legitimate, percipient clinical information. If judges are allowed to share in court the pitfalls of abuse and the hearsay travails of those who work with abuse, they can direct their unquestioned authority in the field of law to compel the rehabilitation of the justice system for the protection of children.

How do children tell? The disclosure process in child sexual abuse.
Bradley, April R.; Wood, James M.; Child Abuse & Neglect, Vol 20(9), Sep 1996. pp. 881-891.
Abstract:
Examined children’s disclosures of sexual abuse in 234 sexual abuse cases validated by Protective Services in Texas. Denial of abuse occurred in 6% of cases, and recantation in 4% of cases in which a child had already disclosed abuse. Four of the 8 victims who recanted appeared to do so in response to pressure from a caretaker. 72% had disclosed abuse to someone else prior to contact with Protective Services or the police. 96% made a partial or full disclosure of abuse during at least 1 interview with Protective Services or police. The child sexual abuse accommodation syndrome described by R. C. Summit (1983) seems to be infrequent among the types of cases seen by child protection agencies. Findings do not support the view that disclosure is a quasi-developmental process that follows sequential stages.

Expert witnesses in child abuse cases: What can and should be said in court.
Ceci, Stephen J. (Ed);Hembrooke, Helene (Ed); pp. 159-184. Washington, DC, US: American Psychological Association, 1998. viii, 299
(from the chapter)
Contributes to the ongoing efforts of mental health and legal practitioners to meet forensic and ethical demands for valid sexual abuse assessment by providing an overview and critique of instruments and techniques currently applied to the validation of child sexual abuse. Topics discussed include defining child sexual abuse; theoretical models applied to the validation of child sexual abuse; the Child Sexual Abuse Syndrome and the Child Sexual Abuse Accommodation Syndrome; traumatic sexualization; and interviewing children about sexual abuse.

Disclosure of Child Sexual Abuse: What Does the Research Tell Us About the Ways That Children Tell?
London, Kamala; Bruck, Maggie; Ceci, Stephen J.; Psychology, Public Policy, and Law, Vol 11(1), Mar 2005. pp. 194-226.
Abstract:
The empirical basis for the child sexual abuse accommodation syndrome (CSAAS), a theoretical model that posits that sexually abused children frequently display secrecy, tentative disclosures, and retractions of abuse statements was reviewed. Two data sources were evaluated: retrospective studies of adults’ reports of having been abused as children and concurrent or chart-review studies of children undergoing evaluation or treatment for sexual abuse. The evidence indicates that the majority of abused children do not reveal abuse during childhood. However, the evidence fails to support the notion that denials, tentative disclosures, and recantations characterize the disclosure patterns of children with validated histories of sexual abuse. These results are discussed in terms of their implications governing the admissibility of expert testimony on CSAAS.

From London, 2005:
“Summit’s (1983) original model was based on disclosure patterns of children who were victims of familial abuse. Thus, one would expect that such children would be less likely to disclose than children who were abused by nonfamilial perpetrators. The results of two studies (Hanson, Resnick, Saunders, Kilpatrick, & Best, 1999; Smith et al., 2000) are consistent with these claims; CSA disclosure was more likely when the perpetrator was a stranger rather than a family member. Consistent with these findings, Ussher and Dewberry (1995) reported longer delays to disclosure among intra- versus nonfamilial abuse. In contrast to these three supporting studies, five studies failed to find an association between relationship to perpetrator and CSA disclosure (Arata, 1998; Kellogg & Hoffman, 1995; Kellogg & Huston, 1995; Lamb & Edgar-Smith, 1994; Roesler, 1994). These are surprising findings given the fact that Summit (1983) originally constructed his model to account for nondisclosure in the context of intrafamilial abuse.”

From London, 2005:
“The results of the retrospective studies make two important contributions to our knowledge about the patterns of children’s disclosure of abuse. First, these data, when taken at face value, reveal that approximately 60%–70% of adults do not recall ever disclosing their abuse as children, and only a small minority of participants (10%–18%) recalled that their cases were reported to the authorities (see Table 1, Column 7). Furthermore, to underscore the results of nondisclosure, many of the adults reported that their first disclosure was during the study survey. Thus, the retrospective studies provide evidence to support the assumption that many incidents of CSA go unreported and that the stage of silence in the CSAAS model has a strong empirical foundation. Second, analyses of predictor variables in these retrospective studies provide few insights into the factors associated with disclosure. They do suggest, however, that commonly held assumptions, such as fewer disclosures among more severe cases of CSA, or in cases of intrafamilial abuse, lack empirical support.”