“Confounding variables” gets a bit technical but it is important for your cross.  There are internal, external, cultural, and gender factors that impact how children react to claimed sexual assault.

1. Subject (internal) Variables
   “Subject variables” asks the question “What is going on inside a child that impacts their reactions?”  Problematic behaviors cannot be assumed to be exclusively caused by a sexual assault. Symptoms can be due to a wide assortment of personal factors.  But experts testifying about CSA typically have failed to conduct a clinical assessment of the complaining witness and to account for other psychopathology that may better explain symptoms (e.g., anxiety, depression). CSA theory often does not distinguish between child, adolescent and adult victims. It is not clear how reactions generalize across ages or developmental stages.

• Research shows that intentional false accusations can reflect a variety of motives. A study of 576 child sexual abuse allegations made to the Denver Department of Social Services found that 3% were unreliable accounts and 8% were purely fictitious. Clinical features relevant to the fictitious accounts included: lack of emotion and an absence of coercion and threat in the recount. [Jones & McGraw, Reliable and fictitious accounts of sexual abuse to children. Journal of Interpersonal violence, Vol 2(1), Mar 1987, pp. 27-45]

• Mikkelson, et al. identify specific subtypes of false allegations (1) arising out of custody disputes, (2) stemming from accusers’ psychological disturbances, (3) resulting from conscious manipulation, (4) being caused by iatrogenic elements. [False sexual-abuse allegations by children and adolescents: Contextual factors and clinical subtypes. Mikkelsen, Edwin J., et al., American Journal of Psychotherapy, Vol 46(4), Oct, 1992. Boundaries, behavior, and sexual misconduct: Current issues and the medicolegal interface. pp. 556-570.]

All of these internal conditions may have existed long before the purported sexual assault in your case.  How has the CSA expert accounted for the presence or absence of these psychological conditions in the complaining witness?  Could these psychological conditions be a better explanation for odd behaviors or even a false report?

2. Possible External Mediators
How have external events impacted a person displaying problematic behaviors?

• During child-custody disputes, false allegation rates as high as 36-55% have been reported. [False sexual-abuse allegations by children and adolescents: Contextual factors and clinical subtypes. Mikkelsen, Edwin J., et al., American Journal of Psychotherapy, Vol 46(4), Oct, 1992. Boundaries, behavior, and sexual misconduct: Current issues and the medicolegal interface. pp. 556-570.

• Are symptoms better or worse if a complaining witness reports their sexual assault right away as compared to delaying for several months?
• Does getting therapy change the report or behaviors?
• What about talking with friends?

What research can the expert point to that accounts for important mediating factors?

• Was there information regarding whether research participants did or did not receive any type of treatment between the initial assault and subsequent research interview?
• How did counseling (if any) influence the relationship between sexual assault and symptom severity?
• Research has shown that social support and coping styles impact CSA symptom development and severity (Ullman, Relyea, Peter-Hagene, & Vasquez, 2013; Wright, Kelsall, Sim, Clarke, & Creamer, 2013). How has the expert accounted for these influences in this particular victim?
• In published research there is typically no information about how recently the claimed sexual assaults had occurred.
• There are various levels of sexual assault. The Sexual Experiences Survey (SES; Koss & Gidycz, 1985), is a measure frequently used in sexual trauma research (Marx & Soler-Baillo, 2005; Wilson, Calhoun, & Bernat, 1999; Yeater & O’Donohue, 2002). The SES distinguishes between sexual contact, attempted penetration and completed penetration, as well as the types of penetration.  CSA experts typically describe reactions in victims of sexual assault but make no distinctions between various levels of sexual assault (i.e., digital penetration of the vagina versus anal intercourse) and how these might be related to CSA.
• How does research distinguish between various degrees of sexual assault, time since the assault, number of sexual assaults, getting therapy versus no therapy, disclosing to friends, etc.
• How has the expert accounted for these in the present case?

3. CSA Testimony Is Not Culturally or Gender Sensitive
Victim behavior may vary considerably from person to person. In addition, responses may also be varied when compared across different racial and ethnic minority groups.

• There is little in the research literature on the cultural sensitivity of CSA behaviors, meaning advocates have failed to describe how symptoms differed across ethnicities. This is problematic because members of different cultures report different symptoms of the same disorder (e.g., somatic versus cognitive symptoms of depression; Kirmayer, 2001).
• There is little description for how boys and girls differ in their response to sexual assault.

Bottom Line:

• What has research discovered about how internal, external and/or cultural-gender factors impact CSA behaviors?
• How has the CERT expert accounted for these in the complaining witness?
• How has the research distinguished between true and unproven claims of sexual assault?
• How does a complaining witness who is lying impact the behaviors they display?