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Forensic Mental Health
Assessment of Children
and Adolescents

EDITED BY

Steven N. Sparta
Gerald P. Koocher

1
2006
1
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Library of Congress Cataloging-in-Publication Data

Forensic mental health assessment of children and adolescents /
edited by Steven N. Sparta, Gerald P. Koocher.
p. cm.
Includes bibliographical references.
ISBN-13 978-0-19-514584-7
ISBN 0-19-514584-4
1. Behavioral assessment of children. 2. Behavioral assessment
of teenagers. 3. Forensic psychology. 4. Mental illness—Diagnosis.
I. Sparta, Steven N. II. Koocher, Gerald P.
[DNLM: 1. Forensic Psychiatry—methods—Child. 2. Forensic
Psychiatry—methods—Adolescent. 3. Personality Assessment—Child.
4. Personality Assessment—Adolescent. 5. Mental Disorders—diagnosis—Child.
6. Mental Disorders—diagnosis—Adolescent. W 740 F714245 2006]
RJ503.5.F67 2006
614'.15—dc22 2005020333

9 8 7 6 5 4 3 2 1
Printed in the United States of America
on acid-free paper
Dedicated to my favorite child, Abby Greenwald Koocher
—GPK

The editors also wish to dedicate this volume to the memory of William N. Friedrich, Ph.D., who died
just prior to its publication. Bill was a person of great character, with boundless energy, always modest
and unassuming, and his contributions to the study of child abuse were enormously significant. His as-
sessment instruments and writings will doubtless have an enduring influence in the field. In the face of
increasing debilitation from cancer and on entering hospice, he wrote to many friends and colleagues,
“Thanks for being the friends that you have been, the type of people who do things for others that make
me smile about and be pleased with the fact that we are colleagues.” He had graciously responded to
editorial requests for updated citations and other chapter information within days of his death, never
once mentioning his illness or its seriousness. Words cannot adequately convey our respect for Bill and
how his exemplary personhood and career will live on in our hearts.
This page intentionally left blank
Foreword

Long before there was a field of forensic psychol- ogy, psychiatry, or social work. No organizations
ogy, or psychiatry or social work, mental health existed for a specialty in these areas, and even fo-
professionals performed forensic mental health as- rensic evaluations of adults in criminal cases were
sessments for juvenile courts. Soon after Chicago rarely performed by clinical psychologists. Foren-
inaugurated the first juvenile court in 1899, a psy- sic mental health assessment as a professional spe-
chologist and a neurologist developed a juvenile cialty came of age in the 1960s (Bartol & Bartol,
court clinic to serve it (Napoli, 1981; Jones, 1999), 1999; Grisso, 1991). The focus of the new spe-
and the process was repeated in city after city dur- cialty was almost entirely on evaluations for adults
ing the first quarter of the 20th century. Juvenile in criminal and civil courts or in adult corrections.
court clinicians provided their judges mental health Even near the end of the 20th century, widely used
information related largely to questions of “dispo- handbooks on forensic psychology sometimes con-
sition” (how to best meet a wayward youth’s psy- tained no chapters on forensic evaluations of
chological needs), as they still do today. But across youths (e.g., Hess & Weiner, 1999). Thus juvenile
the years, these assessment services expanded to forensic mental health assessment was widely prac-
assist in adjudicating child and family welfare issues ticed for about 40 years before there was a rec-
(abuse and neglect allegations, child custody ques- ognizable field of forensic psychology with a
tions, termination of parental rights) and address- professional identity and a significant body of lit-
ing clinical and due process issues in delinquency erature. Yet after that field had crystallized, it paid
cases (risk of harm to others, transfer to criminal far less attention to forensic evaluation of youths
court for trial, and various capacities associated with than it did to evaluation of adults.
definitions of legal competency of defendants). Why this happened is a treatise for another day,
and that analysis will need to explain the newest
development as well. Forensic mental health as-
THE NEW EMERGENCE OF CHILD sessment of children and adolescents has suddenly
FORENSIC SPECIALIZATION become a primary focus of organized forensic
psychology and psychiatry. Among over 100
During the first 50 years of these developments, symposia at the 2005 meeting of the American
there was no recognizable field of forensic psychol- Psychology-Law Society, almost 25 were devoted
viii FOREWORD

to forensic issues in child welfare, delinquency, and 1996). If my sociolegal barometer is not too far off,
psychological aspects of due process in juvenile the nation is beginning to undergo a compensatory
courts. Yet as recently as 10 years ago that society’s set of legal reforms that will bring further change.
meetings offered only one or two symposia on fo- At this moment in history, forensic mental health
rensic topics pertaining to youths. Similarly, all of examiners are challenged by a short shelf life of
the child forensic evaluation handbooks that the existing laws pertaining to children and adolescents,
present one joins were published only within the requiring continuous vigilance to changes in laws
past 8 years (e.g., Grisso, 1998; Grisso, Vincent, & pertaining to their evaluations.
Seagrave, 2005; Ribner, 2002; Schetky & Benedek,
2002), with the exception of earlier editions of
Development
Schetky and Benedek’s book for child psychiatrists.
“Mental health” as a modifier when referring to
forensic mental health assessments of children and
DEFINING ASPECTS OF adolescents is a bit misleading. It promotes a mis-
THE NEW SPECIALTY taken presumption that the primary purpose of
forensic assessments of youths is to identify youths’
The assessment of children and adolescents for mental disorders or their needs associated with
courts requires some skills and knowledge that are mental disturbance. A review of this book shows
similar for both child and adult forensic mental that this is clearly not the case. If a more appro-
health assessments. But some competencies distin- priate term were sought to characterize clinicians’
guish them. There are many ways to catalogue assessments for juvenile courts, one might nomi-
these differences, but I will highlight three of them nate “forensic developmental evaluations.”
that seem to me of greatest importance: law, de- Questions of growth and development are at
velopment, and a systemic perspective. the heart of all juvenile forensic evaluations.

Youths’ developmental status is a defining dif-

Law ference between evaluations in juvenile court
compared to adult criminal and civil cases. De-
Forensic evaluations are called “forensic” because
velopmental changes during childhood and
they are performed in order to inform a court deci-
adolescence—biological, cognitive, and psycho-
sion. As such, the methods and data to be obtained social—greatly complicate all aspects of forensic
in a forensic evaluation are shaped by laws that evaluations of youths, whether we are examin-
define what it is the court must decide (often called ing the consequences of their victimization, the
legal standards for the decision), as well as laws that presumed effects of a pending parental custody
control the process for making the decision (proce- decision, the likelihood of their future harm to
dural law). Knowledge of applicable laws, therefore, others, or the relevance of their current men-
is an important part of forensic evaluation in juve- tal disorders for future disorders, needs, and
nile courts, and these laws often are quite different behaviors. Youths are “moving targets,” and
information about them at one point in time is
from those that apply in adult forensic evaluations
likely to have a short shelf life. As many chap-
(Weithorn, Chapter 1 herein).
ters in this book illustrate, the implications of
Moreover, laws are changing much more rapidly
this for assessment strategy, potential error, and
in areas of child welfare and delinquency than in limits to forensic evaluation of youths create
adult criminal and civil law. For example, the fun- demands on forensic examiners that are both
damental legal standard for competency to stand fascinating and frustrating. (Grisso, 2004)
trial in criminal court has not changed in the past
45 years. In contrast, during the 1990s, virtually
Systemic Perspective
every state experienced massive legislative reforms
in its laws pertaining to delinquency, many of them Most forensic evaluations of adults or youths re-
almost abandoning a rehabilitative objective for a quire attention to their social relations and the
retributive response to youths’ offenses (Grisso, social agencies designed to respond to their needs
 FOREWORD ix

and behaviors. But evaluation of youths in legal A BIFURCATED SPECIALTY

contexts raises this to a different level.
For example, occasionally there have been All of the core perspectives that I have described
professional debates concerning whether mental pervade the chapters that follow. Yet there is one
health experts can form an opinion about crimi- contour of the specialty of forensic mental health
nal adult defendants without interviewing them. assessments of youths that this book does not make
In child forensic practice, the parallel question is clear. It does not reveal to students or to nonchild
whether one can form an opinion if one has only forensic professionals that the specialty includes
interviewed the youth. Youths’ dependent status two groups who do not always identify with each
(and their continuous movement toward more other and who often find the other’s interests only
autonomous adulthood) makes evaluations of their marginally relevant to their own.
behavior and their life potential literally incom- The bifurcation is roughly defined by what a
plete if they are not evaluated in the context of colleague of mine (Geri Fuhrmann) has called “kids
their interactions with parents, peers, and social who are done to and kids who do unto others.”
institutions. Forensic examiners who evaluate chil- Forensic examiners who perform evaluations for
dren consider it an essential part of their role to child abuse and neglect cases, termination of pa-
be evaluating others in the context of their evalu- rental rights, and divorce custody litigation op-
ation of the individual—a youth’s parents, peers, erate in a very different context than forensic
teachers, therapists, and even attorneys—in an examiners who perform evaluations of juveniles’
effort to understand past and future development potential for future violence or sexual offending,
and behavior of the child. competence to stand trial, or eligibility for trial as
A systemic perspective is also essential in trans- adults. In one sense, both groups evaluate the same
lating evaluation data into recommendations and youths, but often at different times in the youths’
actions in the youth’s and society’s interests. Fo- lives. They work with youths who are typically of
rensic examiners of children must have extraor- very different ages and are before the court for
dinarily thorough knowledge of social services, different reasons (broadly speaking, either protec-
mental health services, educational and employ- tive or accusatory). As a consequence, somewhat
ment options, and rehabilitation services within different interviewing skills are needed, associated
the child welfare and mental health system in their with the characteristics of their examinees, quite
communities. Unlike most child mental health different assessment methods, and attention to
professionals, the primary objective of forensic very different bodies of law and judicial objectives.
child mental health professionals is referral, not In fact, it is a rare child forensic assessment pro-
treatment. Their role typically is not as a therapist, fessional who can practice competently across the
but as a social engineer who designs therapeutic full domain of cases that these two subspecialties
plans and offers potential solutions in the interests represent.
of children, the courts, and society. I believe the editors of this volume will not take
In this sense, most forensic mental health as- offense if I note that a handbook devoted to the
sessments of children are “local.” I can go to any different needs of these two subspecialties requires
state in the nation and competently perform an compromises. For example, those who are aware
adult evaluation for competence to stand trial or of my career-long interest in legal competencies
criminal responsibility. But I can competently per- (e.g., capacity to waive Miranda rights, compe-
form a disposition evaluation in a delinquency case tence to stand trial), especially their evaluation in
only in the jurisdiction in which I reside. A dispo- juvenile cases (Grisso, 1998, 2005), would find it
sition evaluation aims substantially to recommend strange if I did not note that the present volume
appropriate interventions with the youth, and I offers no guidance regarding the assessment of
cannot sustain an intimate knowledge of the avail- legal competencies in children and adolescents. On
able (and continuously changing) intervention ser- balance, there is a bit more in this book for those
vices outside my own community and the justice who evaluate “kids who are done to” than for ex-
system that serves it. aminers of “kids who do unto others.” Given that
x FOREWORD

compromises had to be made, I believe this was a Grisso, T. (1991). A developmental history of the
wise choice by the editors, because past literature American Psychology-Law Society. Law and
on the child welfare side of the specialty has been Human Behavior, 15, 213–231.
far less available than information for examiners Grisso, T. (1996). Society’s retributive response to
juvenile violence: A developmental perspec-
dealing with due process issues in delinquency
tive. Law and Human Behavior, 20, 229–247.
cases.
Grisso, T. (1998). Forensic evaluation of juveniles.
This volume is historically significant. For al-
Sarasota, FL: Professional Resource Press.
most 100 years, mental health professionals have Grisso, T. (2004). Double jeopardy: Adolescent of-
offered assessments to serve children, families, and fenders with mental disorders. Chicago: Univer-
legal professionals in juvenile courts. Yet only re- sity of Chicago Press.
cently have we begun the process of developing Grisso, T. (2005). Evaluating juveniles’ adjudicative
textbooks that identify forensic mental health as- competence: A guide for clinical practice. Sarasota,
sessment of youths as a specialty, establishing its FL: Professional Resource Press.
standards, and exploring its strengths and limits. Grisso, T., Vincent, G., & Seagrave, D. (Eds.). (2005).
This volume is not the last word on the topic, be- Mental health screening and assessment in juve-
nile justice. New York: Guilford.
cause we all recognize that we have far to go. But it
Hess, A., & Weiner, I. (Eds.). (1999). The handbook
is among the first, its guidance is sound, and it will
of forensic psychology. New York: John Wiley.
have a defining impact on the growth of the field.
Jones, K. (1999). Taming the troublesome child:
American families, child guidance, and the lim-
—Thomas Grisso, University of its of psychiatric authority. Cambridge, MA:
Massachusetts Medical School Harvard University Press.
Napoli, D. (1981). Architects of adjustment. Port
Washington, NY: Kennikat.
References
Ribner, N. (Ed.). (2002). Handbook of juvenile fo-
Bartol, C., & Bartol, A. (1999). History of forensic rensic psychology. San Francisco: Jossey-Bass.
psychology. In A. Hess & I Weiner (Eds.), The Schetky, D., & Benedek, L. (Eds.). (2002). Principles
handbook of forensic psychology (2nd ed.). New and practice of child and adolescent forensic psychia-
York: John Wiley. try. Washington, DC: American Psychiatric Press.
Acknowledgments

To my wife, Mary, I thank her for her love, dedi- I also wish to acknowledge the support and expert
cation, and support. Completing a volume of this legal comments from Marc R. Stein, Esquire, for
nature was particularly long and arduous, and reviewing selected chapters.
with all things significant in my life for the past In unity there is strength and thus we were for-
39 years, my wife has been my greatest friend. To tunate to have so many professional leaders in their
my children, Jason and Christopher, thank you respective fields contribute to this volume. I thank
for enriching my life. my old friends and look forward to working again
I owe a huge debt of gratitude to my co-editor, with new friends and colleagues. We are thankful
Gerald P. Koocher, for his exceptional generosity, for their efforts and contributions to law and men-
skill, and wisdom. While the experience was de- tal health.
manding for a substantial period of time, it was also To our editor Joan Bossert at Oxford Univer-
professionally rewarding in great part due to the sity Press and staff, thank you for your great pa-
personal and professional strengths of Dr. Koocher. tience and continued support.

—Steven N. Sparta, Ph.D.

This page intentionally left blank
Contents

Foreword by Thomas Grisso vii 3. Ethical Issues in Forensic Assessment of

Children and Adolescents 46
Contributors xvii Gerald P. Koocher
Introduction to Forensic Assessment
of Children 3 4. Ten Rules: How to Get Along Better
With Lawyers and the Legal
System 64
Part I Forensic Assessment Issues:
William E. Foote
Ethics, Lawyers, Courts,
Cultural Considerations,
and Professional Liability 5. Avoiding Malpractice in Child Forensic
Assessment 74
1. The Legal Contexts of Forensic O. Brandt Caudill, Jr.
Assessment of Children and
Families 11
Lois A. Weithorn 6. Working With Courts, Judges,
and Lawyers: What Forensic
2. Integrating Assessment, Treatment, and Mental Health Professionals
Justice: Pipe Dream or Possibility? 30 Should Know About Being Expert
Gary B. Melton and Witnesses 88
Robin J. Kimbrough-Melton Steven R. Smith
xiv CONTENTS

7. Interpreting Forensic Interview 14. Assessing Eligibility for and

and Test Data of Latino Appropriateness of Special Education
Children: Recommendations for Services 230
Culturally Competent Stephen T. DeMers and
Evaluations 97 Leah Nellis
Roberto J. Velásquez,
Jeanett Castellanos, 15. Examining Children in Personal
Maria Garrido, Paula Maness, Injury Claims 245
and Ulla Anderson Michael A. Goldberg

16. Neuropsychological Considerations in

Forensic Child Assessment 260
Part II Forensic Mental Health Karen E. Wills and Jerry J. Sweet
Applications
17. A Pediatric Lead Litigation Primer:
Foundations for Mental Health
8. Forensic Interviewing of Children and
Assessment 285
Adolescents 115
Steven B. Bisbing
Linda Sayler Gudas and
Jerome M. Sattler
18. Bullying and Stalking in Children and
Adolescents: Assessing Obsessional
9. Assessing Child Sexual Abuse Harassment 301
Allegations in a Legal Context 129 Joseph T. McCann
Kathryn Kuehnle and
Steven N. Sparta 19. Forensic Assessment of Amenability
to Rehabilitation in Juvenile
Delinquency 311
10. Evaluating the Effects of Domestic
Robert Kinscherff
Violence on Children 149
Lois Oberlander Condie
20. Forensic Assessment of Parenting in
Child Abuse and Neglect Cases 330
11. Child Physical Abuse and Neglect: Catherine Ayoub and
Medical and Other Considerations Robert Kinscherff
in Forensic Psychological
Assessment 175 21. Forensic Evaluation of Juvenile Sexual
Amy C. Tishelman, Offenders 342
Alice W. Newton, David Medoff and
Jennifer E. Denton, and Robert Kinscherff
Andrea M. Vandeven
22. Assessing Childhood Trauma and
Developmental Factors as Mitigation
12. Assessing Risk for Violence Among
in Capital Cases 365
Juvenile Offenders 190
Alan M. Goldstein,
Randy Borum
Naomi E. Goldstein, and
Rachel Kalbeitzer
13. Psychological Evaluation for Child
Custody 203 23. Assessing Firesetting Behavior in
Steven N. Sparta and Children and Adolescents 381
Philip M. Stahl David K. Wilcox
 CONTENTS xv

Part III Selected Measurement Issues 26. Measuring Adolescent Personality

and Psychopathology With the Millon
24. The MMPI-A in Forensic Adolescent Clinical Inventory
Assessment 401 (MACI) 424
James N. Butcher and Joseph T. McCann
Kenneth S. Pope
Index 441
25. Measures for Evaluating Child Sexual
Abuse 412
William N. Friedrich