The Future of Possible in Children’s Advocacy Centers, with Ted Cross

Season 4Episode 14August 25, 2022

Over the last two decades, a growing evidence base has demonstrated the effectiveness of the Children’s Advocacy Center model, but what do we still need to learn to improve our work and our practice?

We are complete nerds when it comes to research. This podcast was founded on it, and many listeners receive our weekly research-to-practice briefs. Over the last two decades, a growing evidence base has demonstrated the effectiveness of the Children’s Advocacy Center (CAC) model. And no one has contributed more to that evidence base than Ted Cross through his sustained research over 20 years. Because of research partnerships, we know more about forensic interviews than ever before. More than about evidence-based mental health treatment than ever before. More about forensic medical evaluation than ever before. And yes, more about the difference CACs make in their own local community than ever before. But there are still significant research gaps, and the CAC model is still evolving and adapting every single day.

What do we still need to learn to improve our work? How is the CAC model evolving to meet current needs, and future needs, and ever-changing needs? And most importantly, how can we partner with researchers to improve our practice? Take a listen.

Topics in this episode:

  • Origin story (1:59)
  • The flexibility of CACs for community response (9:26)
  • Different potential partners (16:58)
  • Unanswered questions (26:33)
  • Academic partners (33:15)
  • Advice and new partners for CACs (38:12)
  • Multiple forms of victimization (42:47)
  • Vacation and future episodes (44:27)

Links:

Theodore P. Cross, Ph.D., research professor at Children and Family Research Center, School of Social Work, University of Illinois at Urbana-Champaign

Debra Whitcomb, Ph.D.

The Child Victim as Witness Research Report,” Whitcomb, D.; De Vos, E.; Cross, T.P.; Peeler, N.; Runyan, D.; Hunter, W.; Everson, M.; Porter, C.; Toth, P.; Cropper, C. Office of Juvenile Justice and Delinquency Prevention (October 1994)

David Finkelhor, Ph.D., professor, Crimes Against Children Research Center, University of New Hampshire

Charles Wilson, MSSW, advisor, California Evidence-Based Clearinghouse for Child Welfare; retired senior director, Chadwick Center for Children and Families

Practice in U.S. Children’s Advocacy Centers: Results of a Survey of CAC Directors,” Cross, Theodore P.; Whitcomb, Debra; Maren, Emi. Children and Family Research Center, School of Social Work, University of Illinois at Urbana-Champaign (March 2022)

Do Children’s Advocacy Centers improve families’ experiences of child sexual abuse investigations?” Jones, L.M.; Cross, T.P.; Walsh, W.A.; Simone, M. Child Abuse & Neglect (2007)

Children’s Advocacy Center of Suffolk County, Susan Goldfarb, MSW, LICSW, executive director

Wynona’s House, the Senator Wynona Lipman Child Advocacy Center; Carol Berger, J.D., chief program officer

Victor Vieth, chief program officer, education and research, Zero Abuse Project

Faith, Trauma, and the Problem of Evil,” with Victor Vieth; One in Ten, Season 1, Episode 2 (May 13, 2019)

Elizabeth Cross, Ph.D.

Wendy A. Walsh, Ph.D., research associate professor, Crimes Against Children Research Center

Internet Crimes Against Children Task Force

New Jersey Children’s Alliance, Nydia Y. Monagas, Psy.D., director of statewide initiatives

For more about polyvictimization, listen to “Greater Than the Sum—Multiple Adversities in Children’s Lives,” with Dr. Sherry Hamby (August 6, 2020; originally broadcast February 14, 2020 as “Mending the Tears of Violence”)

For more information about National Children’s Alliance and the work of CACs, visit our website at NationalChildrensAlliance.org. And join us on Facebook at One in Ten podcast.

 

The Future of Possible in Children’s Advocacy Centers, with Ted Cross

[Intro]

Hi, I’m Teresa Huizar, your host of One in Ten. In today’s episode, “The Future of Possible in Children’s Advocacy Centers,” I speak with Ted Cross, research professor at Children’s and Family Research Center at the University of Illinois.

Now, for those of you who know me, you know I’m a complete nerd when it comes to research. I love it. That’s what this podcast was founded on, I read it all the time, many of you receive our research-to-practice briefs; so this conversation is one near and dear to my heart. Over the last two decades, a growing evidence base has demonstrated the effectiveness of the [Children’s Advocacy Center] CAC model. And no one has contributed more to that evidence base than Ted through his sustained research over 20 years. Because of research partnerships, we know more about forensic interviews than ever before. More than about evidence-based mental health treatment than ever before. More about forensic medical evaluation than ever before. And yes, more about the difference CACs make in their own local community than ever before. But there are still significant research gaps, and in exciting and important ways, the CAC model is still evolving and adapting every single day.

What do we still need to learn to improve our work? How is the CAC model evolving to meet current needs, and future needs, and ever-changing needs? And most importantly, how can we partner with researchers to improve our practice every single, solitary day? I know you’ll be as interested in this conversation as I am. Please take a listen.

[1:55] Teresa Huizar:
Hi, Ted. Welcome to One in Ten.

Ted Cross:
Hi. Oh, it’s a pleasure to be here.

[1:59] Teresa Huizar:
So I cannot even remember what the original story is about how you came to research CACs and be interested in them in the first place. So tell me about that.

Ted Cross:
Oh my goodness.

Teresa Huizar:
Yeah, a walk down memory lane.

Ted Cross:
Walk down memory lane. I’m a clinical psychologist by training. And I actually worked in a mental health center before going to get my doctorate in psychology and worked with children. I was very interested in children’s issues. And in graduate school, I had the opportunity to work on an evaluation of children’s mental health services for Congress, for the congressional Office of Technology Assessment. And I did child clinical work in my clinical placement. So I was very keen to work on children’s services. When I got my Ph.D. I got a great opportunity to work with Debra Whitcomb—a giant in our field—on the first child victim as witness study, looking at the experience and outcomes for kids involved in the prosecution of child abuse. And we collected a lot of data and published some really important work. I began then—mind you, this was the early eighties, the early years of CACs.

Teresa Huizar:
Yeah, the very beginning.

Ted Cross:
Right.

You know, anytime you get serious about really serving kids who’ve been abused or involved in multiple systems, you need to learn about CACs. So, you know, we learned about that. I was connected to the Department of Social Services in Massachusetts and kind of asked to do an evaluation of their SANE program, Sexual Abuse Intervention Network, which was the precursor to their network of CACs in the state. And I, so I got involved in that situation, then I basically reached out to one of the giants in our field and research on child abuse, David Finkelhor, and I said, “Let’s work together.” And just at that time, he was getting some money to establish the Crimes Against Children Research Center and really felt it was important to do a study of Children’s Advocacy Centers, the up-and-coming thing on which there was very little research.

And the real genesis of my research on Children’s Advocacy Centers was on a cocktail napkin—

Teresa Huizar:
I love it.

Ted Cross:
—in Providence, Rhode Island.

I got together with Charles Wilson, you know, Charles, I know.

Teresa Huizar:
Oh, very well.

Ted Cross:
One of our pioneers, right?

Teresa Huizar:
Right.

Ted Cross:
—in, at a conference in Providence and we retired to the bar and found a cocktail napkin and sketched out the idea for a multisite study of Children’s Advocacy Centers.

When the funding became available—and we had a lot of flexibility about how to use that funding—we established a plan for the multisite study of Children’s Advocacy Centers, I officially signed on with David Finkelhor’s Crimes Against Children Research, and there began a more than two-decade odyssey where we’re just trying to learn more and more and more.

That was a very exciting study and the methodology was unusual in, and I think very innovative—I’ll toot my own horn a little bit—and effective. Because we funded our research staff at the University of New Hampshire, but we also provided money to the participating CACs to fund their own local research teams. And they collected data for the overall study, but then they also had data for local use as well. And we needed evidence that they had some capability to provide that research team, to collect data, to handle it responsibly. And they demonstrated that, and they did a terrific job.

And you could argue, well, you’re collecting your own data to evaluate your own programs, is there are bias there? You could wonder about that. But mainly they were collecting data—objective data—about what happened in these cases. How many times was the kid interviewed? Who was at the interviews? Who was at the multidisciplinary team? Was there a prosecution? Were there criminal charges filed? And so forth.

And it developed very rich dataset and which both shed light on the impact of CACs and also provided a lot of data for studies of things like disclosure and suspect conviction and the support of caregivers for children.

So that CAC study really, I think, provided some—

[cross-talk]

Teresa Huizar:
Oh, it’s the seminal piece—

Ted Cross:
—seminal data.

Teresa Huizar:
Yes.

Ted Cross:
On CACs, but also—

Teresa Huizar:
That’s right.

Ted Cross:
—the entire field. Yeah.

[7:00] Teresa Huizar:
Yeah, I was going to say, it’s the seminal piece of research in our field and it’s still referred to today.

Ted Cross:
Right.

Teresa Huizar:
You know, regularly it’s cited.

Ted Cross:
Right.

Teresa Huizar:
And I think, you know, one of the strengths of that original piece of research to my mind is that the sites were quite different from each other, right from the outset.

Ted Cross:
Yes. Yes, yes.

Teresa Huizar:
And that that diversity in the sort of size and structure and geographic location, that that was really important. And I think informed, in a certain way, this current piece that we’re about to talk about—

Ted Cross:
Oh, yes.

Teresa Huizar:
—your current piece of research. I think some of the questions that came out of the original piece of research about what’s standardized within a CAC and what differs—

Ted Cross:
Right.

Teresa Huizar:
—you could sort of see play out in the research that you’ve done even very recently.

Ted Cross:
Absolutely. Absolutely.

Teresa Huizar:
And I think that that’s—that’s a very interesting thing that that’s a thread that’s drawn over, you know, two decades or so. So turning—

Ted Cross:
Yes.

Teresa Huizar:
—turning to that for a moment, the more recent piece of research, which was published this year.

Ted Cross:
Right.

Teresa Huizar:
That’s based on some surveys that were done in 2015, if I’m remembering right.

[cross-talk]

Ted Cross:
Right.

Teresa Huizar:
Is that right?

Ted Cross:
Right. Right.

Teresa Huizar:
So with that, I’m just wondering, at the time that you decided to do the original survey—and, you know, full disclosure to our listeners, NCA helped distribute the survey to our membership and beg them to participate and all of that—

Ted Cross:
Right.

Teresa Huizar:
—because we think it’s really important to partner with researchers. But I’m just wondering what sort of prompted you to want to explore the particular things you did in this study? What made you think now’s the time to visit this, or revisit it as the case may be?

Ted Cross:
Oh! Now? Always, always, always.

Teresa Huizar:
[Laughter.] Every moment. Right?

Ted Cross:
I want to get underneath the hood. What makes CACs work? What are the specifics? And I could tell you more about work that’s in process now.

Teresa Huizar:
Oh, we’ll talk about that in a second. Because I’m very curious. Yes.

Ted Cross:
Yes. Absolutely, absolutely. So, you know, CACs are doing sophisticated work with multiple disciplines, dealing with multiple issues, engaging a wide array of people, multiple functions. They’re supporting investigations and service delivery, they’re doing an enormous amount of stuff and there’s so much we need to learn about how they work.

[9:26] Teresa Huizar:
So what was your hypothesis? Just going into this research, what did you think you might find and what did you actually find?

Ted Cross:
Well, there’s one aspect of it which I think is kind of a slam dunk, but really important to show the data on. The NCA Standards specify many of the elements that CACs need to have, that they are critical. And this research shows that those pieces are in place. If you look at who needs to be, who’s specified to be required on the multidisciplinary team, you know, better than 85 and more than 90% mostly of CACs have all of these elements. That’s not a surprise, it’s a slam dunk, but it’s important to have those data.

But the other aspect of it relates to a point we made in a piece we published in 2008 and which summarized some of the results from our original study. And we made the point: You can look at CACs in terms of individual child outcomes, and that’s really important. And we now have more data on that than ever. But you can also look at them from the perspective of an entire community. That the CACs are the community expert, coordinated response to child victimization in their community. And they’re able, they have the flexibility and the teamwork and the input from multiple professions that you need to respond to child victimization in a holistic way. And they can do it. And this is no knock on other institutions, but, by and large, they have more flexibility to do it than child protective services and law enforcement and hospitals as a whole. Some of the CACs are based in hospitals and a lot of them are doing great work as well, but they’re really the community center response to child victimization. So if there’s an issue that arises in a community, CACs are often in a position to mobilize, to respond to that. And you see different issues arising in different communities and different CACs in different communities organizing response to that.

I worked with the Suffolk County Children’s Advocacy Center in Boston. Susan Goldfarb. Well, I don’t know where Susan is now.

Teresa Huizar:
She’s still there.

Ted Cross:
She’s still there?

Teresa Huizar:
She’s still in Boston.

Ted Cross:
I haven’t talked to her in a while, but I used to work with her very closely. They developed a community-based, interdisciplinary coalition to deal effectively with kids who’ve been affected by commercial sexual exploitation. So they take the lead on that.

I’ve worked closely with Wynona’s House, the CAC in Newark, New Jersey, and they’re providing ongoing support to families who they’ve been involved with. They have events and opportunities to get concrete services that span over two or three years. They stay in touch with their families over years because that’s what they need in their community. And they’ve been able to organize that response and get support for it. So their status as the community’s response to child victimization means that that they can develop services and they’re going to differ, uh, from CAC to CAC. And we wanted to get a look at that.

[12:59] Teresa Huizar:
You know, I was thinking as you were talking about the many examples where CACs now have even been used to respond to mass shootings to—

Ted Cross:
Right.

Teresa Huizar:
—community violence.

Ted Cross:
Absolutely.

Teresa Huizar:
I mean, you name it, a broad array, because often in their community, they’re the trauma experts.

Ted Cross:
Exactly. Exactly.

Teresa Huizar:
And as you say, can mobilize a lot of resources. I was thinking—when I was reading your study, I was noting the change in the types of cases coming into CACs.

Ted Cross:
Yeah.

Teresa Huizar:
Which we’ve been watching steadily over the past—

Ted Cross:
Right.

Teresa Huizar:
—well, me, at least during my tenure.

Ted Cross:
Right, right.

Teresa Huizar:
So 15 years, basically. When I first came to NCA, 85% of the cases that came to CACs that they reported statistically to us about were child sexual abuse cases.

Ted Cross:
Right.

Teresa Huizar:
As you note in your study, it’s now 60% and declining.

Ted Cross:
Right.

Teresa Huizar:
And an increasing amount of child witness to violence, physical abuse, you know, all this other array of things that we’ve been talking about.

Ted Cross:
Right. Right.

Teresa Huizar:
And I’m wondering, from other elements in your study as well, what you think that this changing array of services means for the MDT and its composition and for the service array?

Ted Cross:
I think there’s both more demand and more opportunity to expand the notion of MDTs to include an array of different organizations or agencies that may not be critical for every case, but they’re central for a certain portion of the cases.

You haven’t mentioned it, but I know one area in which CACs are doing more work than they used to are cases in which the … I’ll use “a perpetrator,” because I’m not coming up with a better word, but where one child has been sexually involved with another child and there’s victimization and trauma, but you also need to consider the likelihood that both kids are victims and that both kids may have experienced trauma and both kids have needs and need a service response.

So, you know, in those cases it may be critical to have a juvenile justice professional involved in your team. Right? One area that we discussed in this most recent study is domestic violence and what’s—the more current term I think is “intimate partner violence.”

And a lot of research is, has shown substantial overlap between child abuse and intimate partner violence. It’s hard to cite an exact statistic, but studies have found 30, 40% or more of cases of child abuse also featured domestic violence. And in fact, you know, CACs are evaluating and doing interviews related to children’s exposure to domestic violence. They’re referring families for domestic violence services. They’re doing safety planning with families. Traditionally, providers responding to domestic violence, providers responding to child abuse haven’t worked well together, but this is an area where you could bring people into the multidisciplinary team to deal with the thorny issues of providing both for the safety of the mother and for the safety of the children. And maybe avoiding things like a finding that the mother was producing a finding of neglect because the mother was not able to protect the children from a violent spouse in part because of their own fear and risk at the hands of that spouse. I think you can really bring more people on a multidisciplinary team.

It produces more challenges, but I think that payoffs can be substantial. And CACs are doing that. I don’t know that we have the statistics on this in particular, but I’m willing to bet that the size and variety of disciplines in multidisciplinary teams now is greater on average than it was, you know, even 10 years ago.

[16:58] Teresa Huizar:
Oh, I feel really confident about that. I would love to see a study of it, but I feel really—

Ted Cross:
Yeah.

Teresa Huizar:
—but I feel really confident that that’s true. And we’ve seen some very interesting additions. I’m just thinking about a CAC that I’m aware of that exists in a place that has a very large Amish community. And they actually have someone from that community that sits on their MDT because they want to make sure that they’re being appropriately culturally responsive and that they have a liaison—

Ted Cross:
Right.

Teresa Huizar:
—back to that religious community.

Ted Cross:
Right.

Teresa Huizar:
So we’ve seen some very interesting, I think, additions that have made sense and often been very community-specific.

Ted Cross:
Right, right.

Teresa Huizar:
Issue-specific.

Ted Cross:
Right, right. Yeah. I mean, you probably know Victor Vieth of the Zero Abuse Project is really leading an effort to advocate for the inclusion of faith leaders on multidisciplinary teams. Because I mean abuse does not only create emotional harm and sometimes physical harm, but it also creates spiritual harm. Kids who had faith in God might lose that faith if they were abused within a pastoral context. I think it’s an important element to respond to.

[18:11] Teresa Huizar:
Well, and even if there weren’t, I mean, there is that—and Victor was on this show to talk about this when we first started the podcast—there is this problem, you know, the problem of evil.

Ted Cross:
Right.

Teresa Huizar:
How does a kid who has faith, you know—

Ted Cross:
Right.

Teresa Huizar:
—how do they struggle with the issue of why this happened to them? You know? And I think that adults struggle to deal with that—

Ted Cross:
Absolutely.

Teresa Huizar:
—much less kids struggling to deal with that.

Ted Cross:
Yeah.

[18:33] Teresa Huizar:
So you raise a really interesting point around thinking more broadly about—on any particular case—what’s the sort of specialized team that should be working on that case—

Ted Cross:
Right.

Teresa Huizar:
—in order to really make sure they have help.

I want to go back to this piece about intimate partner violence for a moment.

Ted Cross:
Sure.

Teresa Huizar:
Because I was really struck by the stats within the study, because it is a fairly routine part of many CACs work these days.

Ted Cross:
Right.

Teresa Huizar:
But it’s interesting that when I was looking at one of your handy-dandy charts, which folks who are listeners don’t have yet, but we will link to your study in the show notes.

Ted Cross:

It’s available on the internet from my research center.

Teresa Huizar:
Exactly. Exactly. So they’ll have a chance to have an access to it. The thing I was struck by is that many of the services that are provided rarely to parents within a CAC setting have to do with this sort of legal … the interface between the non-offending caregiver and the legal system—

Ted Cross:
Right.

Teresa Huizar:
—basically, as it relates to DV.

Ted Cross:
Right.

Teresa Huizar:
So things like obtaining protective orders.

Ted Cross:
Right.

Teresa Huizar:
DV risk assessment and safety planning, legal assistance. I’m wondering if you think—and you may not know from the study, but I’m just curious about your opinion about this. Do you think that is because this is just not an area that CACs have typically operated in—the whole sort of civil protection side? Or do you think that it’s because they believe that they’re relying on another partner in the community to do that work? And maybe are.

Ted Cross:
I think it’s probably some of both. I think it’s some of both. I mean, if they have a strong relationship with the prosecutor’s office or they’re even based in a prosecutor’s office and the prosecutor’s office has a strong victim advocate program, they may be getting that kind of assistance from one of the CAC’s partners.

I mean, one of the limitations of our studies, it was, it was hard to tell if they answered “no,” was it that they didn’t have the services or because they meant “we don’t have it, but our strong partner across town has it”?

[20:32] Teresa Huizar:
Yeah. You know, it’s so funny. And always with research, I find that as I’m marking my little pen marks all over the piece of paper, there are lots of questions and I’m like, “Oh gosh, I wish they had also asked this,” or, “Oh, I wish this had put they had included this.” I’m sure you feel exactly the same way. You know?

Ted Cross:
[Laughter.] Well, I’ll tell you. I think somebody said this, but it’s certainly true of me: Your next piece of research is to try to correct for the shortfalls of your previous piece of research.

Teresa Huizar:
[Laughter.] I love it.

So are you planning to redo this one anytime soon, just so you know?

Ted Cross:
No, but can I tell you what I am planning to do?

Teresa Huizar:
Yes, please.

Ted Cross:
I think you’ll this.

Teresa Huizar:
I can’t wait to hear.

Ted Cross:
My wife, Liz Cross, is also a Ph.D. researcher, and we’ve done some work with NCA. We also got a small grant to work with Wynona’s House, the CAC in Newark, and, you know, we work very closely with the staff there. We have a fantastic relationship with Carol Berger, who’s their MDT coordinator there. And through the small grant we got to be observers of their case review meetings. They have wonderful case review teams. They have several different ones that meet monthly to deal with different types of cases, involve different players.

Teresa Huizar:
Interesting.

Ted Cross:
They’ll get 15, 20, 25 people attending and participating. And this was really eye-opening for me. And this is an area that, you know, we really want to write about and do research on. MDTs are central to CACs. They’re indispensable. But there’s not a lot of research on them. And even after I had been in this area of research for so many years, I didn’t really understand. I mean, I’m still learning, but I didn’t understand them as well as I do now.

And you might even think—well, if you are a little cynical, you might think—it’s a bunch of people getting together, holding hands and, you know, singing “Kumbaya.” But it’s much more than that. What I saw in those case review meetings is how complicated these cases are. And how many moving pieces they are. And how nobody can do them effectively alone. They need help from each other. And it’s very specific, concrete help.

So, you know, there were cases—it’s the Jones family and, you know, we’re worried about Susie Jones. And these are the risks and how we’re going to deal with the risk. And then, the other person pipes in and says, “Well, did you know that Uncle George just moved back into the neighborhood? The fellow who’s the registered sex offender.” “No, I didn’t know that, that’s really important.”

We had one instance and what I observed, and I want to try to write about and hope to do research on, is that the benefits were so tangible and so self-evident that it made it very clear why these multidisciplinary teams were important. So for example, in one of the MDTs I observed, the medical professional on the team—I think it was a pediatrician—gave a two-minute presentation to the child protective services workers instructing them how to get the child’s medical records one to two months earlier than they had been previously, so that they had that data, they knew what the child’s medical needs were sooner. I mean, that’s self-evidently good. That’s self-evidently important for that child. Right? So if we can document the specific assistance and specific support that team members give to each other, I think you increase even more the empirical base for CACs, which I think is already considerable.

[24:25] Teresa Huizar:
I mean I think that case review for some CACs, even though there’s guidance in the Standards and there’s technical assistance documents that the Regionals [Regional Children’s Advocacy Centers] put together, I think if you’ve not experienced a good one, it’s a little bit of a black box to you.

Ted Cross:
Yes. Yes.

Teresa Huizar:
And I think that if we can document good case review—

Ted Cross:
Right.

Teresa Huizar:
—CACs can learn from that. And they can say, “If I add this, if I change that, I’m going to get a better result” in a very practical way in the way that their team is working together. And so I think what you’re exploring, you know, I’m very interested in, and I look forward to reading about it when you get it published, because I think it’s critical, you know?

[Laughter.]

Ted Cross:
Yeah. There’s a bit of a queue of things that are unpublished.

Teresa Huizar:
Yeah.

Ted Cross:
Right. Um, Yeah, no, it’s great. I mean, a corollary to that is the idea of having a measurement tool where you would code the kind of assistance that’s provided at a CAC. So you’d have this grid and you’d say, OK, who’s providing the assistance? Is it the medical professional? The assistant district attorney? Law enforcement? And so forth. And who’s receiving the assistance? And you could actually have observers code the data on what happens in the CACs and who’s participating, who’s contributing, and who’s receiving help.

So in these case review team meetings that we observed, they would handle, let’s say 15 cases during a meeting. And in each case there were three to four concrete examples of assistance such as, “Oh, here’s how to get your medical records a month earlier, two months earlier.” You could code data on that. It would provide evidence for what really is happening in MDTs and you could even use as a diagnostic tool. “Oh, we looked at our charts for the last six months and we saw that, you know, law enforcement hasn’t been coming that often. And when they come, they’re not getting the assistance that they need.”

So one of my goals is to develop that further.

[26:33] Teresa Huizar:
I mean from your lips to God’s ears, I hope that’s developed. I would love to see it.

Ted Cross:
Right.

Teresa Huizar:
I think that that would be, I think that would be a huge to help to the field.

One of my questions to you, and you’ve partially answered it just by running through the research you’re working on right now, but I’m just wondering, what do you think are still outstanding questions? As you say, after 40 years of research, there’s quite a bit about CACs, but there’s still unanswered questions.

What are the unanswered questions that you think are most pressing or most interesting to you?

Ted Cross:
Oh, yeah.

Teresa Huizar:
That you think are most ripe? Whatever part of that you want to address.

Ted Cross:
Well, there’s one at the top of the list and that, gosh, darn, the National Institute of Justice has been good to me on many occasions, but they did not see it in their wisdom to fund this study.

Wendy Walsh—you know Wendy—

Teresa Huizar:
Yes, very well.

Ted Cross:
—Wendy Walsh and I submitted proposal through Violence Against Women funding initiative to study CACs’ response to adolescent sexual assault victims.

Teresa Huizar:
Mm. Interesting.

Ted Cross:
And this is an area of, I think tremendous ambiguity in need. You know, in a lot of ways, 13-year-old sexual assault victims are treated as adults, right?

You know, for example, the Massachusetts has a pediatric forensic evidence kit. But it’s for those 12 and, and younger and their pediatric sexual assault nurse examiners—I think this is right—see kids 12 and under. Rape crisis centers see a lot of adolescents as well as adults and, you know, God love them. They’re doing God’s work. They’re doing good stuff, and they can really contribute. But they are not necessarily going to have the expertise to respond to the family the way they CACs do.

They’re not necessarily going to be able to deal with the developmental issues that you need to deal with, you know? Yes, a 13-year-old, I mean, they may be independent in some ways they may be postpubescent, but a 13-year-old’s still a child.

Teresa Huizar:
Yes.

Ted Cross:
And I don’t think we have developed effective methods everywhere to respond to that population. And I would really like to see CACs and rape crisis centers working closely on this and to learn more about that. So that’s an area that I think really needs development. And, you know, when there’s certain CACs—listen, I know that I don’t have to pretend to you that all CACs are perfect. This is—

Teresa Huizar:
No.

Ted Cross:
—it’s always an area in development.

Teresa Huizar:
Of course, and learning.

Ted Cross:
Right. And, you knthere are a lot of communities in which the CACs don’t see kids older than age 12. And the Red Cross centers are doing amazing work, but I don’t think they have the range to deal with all the issues and all the needs that you have when there’s a 13-year-old victim.

[29:35] Teresa Huizar:
I think that’s right. And I think when you even talk to CACs that are not seeing, um, teenagers or older teens, I think almost always they’ll tell you they’re triaging cases because they’re overwhelmed. Not because they don’t think that kids could benefit from their services.

Ted Cross:
Oh, yeah. Right.

Teresa Huizar:
And so I think, you know, that’s not only a research area—

Ted Cross:
Right.

Teresa Huizar:
—worth exploring, but it’s a funding area, you know, worth exploring too on that as well. What else is in the queue?

Ted Cross:
My wife and best colleague, Liz Cross, and I have a grant from the Oak Foundation to study online child sexual abuse material. Images, pornographic images of children that are traded online. And it’s really hard work. It’s stomach turning, but we’re actually analyzing—we’re not viewing the images, but we’re looking at the material that’s used to market these: “Come look at this,” you know, “stepmom, get it on with her 6-year-old,” right?

It’s stomach-turning, but it’s, it’s very revealing. And what we’re finding is the substantial proportion of these files involve incest. So they’re family issues. And one really important area is to look at the linkage between in-person sexual abuse and online sexual abuse, and the extent to which perpetrators are doing both, and whether a coordination of the investigation could actually enhance both the online investigator and the in-person investigators’ collection of evidence and identification of abusers.

And one—you know, we keep adding people to the multidisciplinary team, we’re going to have 500-member multidisciplinary teams. [Laughter.] But another role to consider [for the multidisciplinary] team is the professional in the local Internet Crimes Against Children Task Force, which exist around the country. Because if you could develop that coordination between what you’re finding out online and what you’re finding out through a disclosure from a child, you could really enhance evidence collection.

What has been reported—and this relates to some work by Camille Cooper in Virginia—is that investigators are not always seizing the perpetrator’s computer and looking for images on the computer when that might be a really important source of evidence and also might have the effect of preventing abuse of other victims as well.

[32:22] Teresa Huizar:
You know, as you were saying that, Ted, I was thinking how perplexing that is, you know, that that wouldn’t be recovered along with the person’s phone because, you know, one of the just shifts in our field because of the shift in technology is the just widespread availability of abusive images. And that so many cases that come through CACs—

Ted Cross:
Right.

Teresa Huizar:
—as touch incidents, where a child is physically sexually abused, there are also abusive images floating out there that, even if they haven’t been commercially traded, you know, the perpetrator has them on their phone or something of that nature. So I think you’re right, bringing these—because they’re often specialized units that deal with technology facilitated crimes because of the technology piece—making sure that they’re under the same umbrella and working together, I think is really important instead of doing the siloed work.

[33:15] You know, I wanted to also just talk a little bit about something you addressed in the paper about the fact that CACs, you know, by and large often don’t have academic partners.

Ted Cross:
Yes.

Teresa Huizar:
And so lots of CACs listen to this podcast. So I want to give you the opportunity to talk to them about why that would be important.

Ted Cross:
One of the crowning achievements of CACs is that you have really insisted on being evidence-based. Right?

Teresa Huizar:
That’s true.

Ted Cross:
One of the really, really important achievements of CACs is that you facilitate mental health services for victimized kids, for traumatized kids. And you do it in such a way that cost is not a barrier. And there is ample research that shows that trauma-informed mental health methods really do assist kids’ recovery. OK? And that the outcomes for kids getting those services are much better for kids getting therapy as usual. And you’ve insisted on having that kind of evidence base. And because you’ve connected those services to the centers, and you’ve made sure kids are getting them, then you have better outcomes for kids.

So that’s, I’m kind of being a little roundabout here, but you have a commitment to research and you can use that both to contribute to the evidence base generally and develop research that really can help demonstrate the effect of CACs and the value of CACs. I want to—I mean, this relates to a presentation I did a while ago and yet another thing I have to write up.

Teresa Huizar:
You’re going to be busy, Ted.

Ted Cross:
Right. Yeah. There’s been research about CACs, and that’s been important. There’s also been research in CACs.

Teresa Huizar:
That’s right.

Ted Cross:
CACs have been a great place to learn about all of the processes that you need to understand what kids are going through and what kind of response you need to give the kids. So there’s been basic research on disclosure, on forensic interviewing, on suspect confession, on involvement of intimate partners violence services, and on and on and on and on that have been conducted in CACs. And again, the flexibility of CACs means that CACs really can get involved in university researchers and do great work.

Teresa Huizar:
You know, I—

Ted Cross:
I think—well, well, go, go ahead.

[36:13] Teresa Huizar:
I was just going to say, I think it’s just so critical also because in contributing to the research, you can also make sure that questions that you care about within the field actually get answered, you know?

Ted Cross:
Right. Right.

Teresa Huizar:
And I think that that’s just a concrete benefit, if you’re like, “I’ve always been wondering about X.” Well, guess what? If you find an academic partner that’s interested, you can get an answer to that question probably.

Ted Cross:
Right, right. And I think there’s a method to do that. One is to really make a link with young researchers.

Maybe they’ve worked in your CAC, work with your CAC. Now they’re going to get their Ph.D. Support them, help them, you know, encourage them, give them opportunities to do their master’s thesis in the CAC. And then you’re on their master’s thesis committee, maybe the CAC director, but you’re also connecting with their faculty advisors who are on that project as well. You know, collaborate with the researchers who are writing grants, and the CACs have been great about doing that. I wish we had a better track record with getting—I mean, Wendy and I and other researchers have written a bunch of grant proposals.

The tricky thing is you’re competing against everybody. You know, you’re competing—

Teresa Huizar:
That’s true.

Ted Cross:
—against the neighborhood violence people in a wide range. But, you know, collaborate with university researchers on writing grant proposals to do research. And maybe you’ll only get one out of four, but that could, that one out of four could be a groundbreaking study.

[37:43] Teresa Huizar:
Well, I think one of the things that you were really pointing out too is that, especially if you catch someone earlier in their career, they can wind up with a lifelong interest in it and keep coming back to do the next study—

Ted Cross:
Exactly.

Teresa Huizar:
—and the next study, just like you did, you know, which I think is just an amazing thing—

Ted Cross:
Right. Yeah.

Teresa Huizar:
—to have this long track record of research interest, in that way.

I’m just thinking about the implications of this particular study for CACs.

Ted Cross:
Mm-hmm.

[38:12] Teresa Huizar:
If you were to, you know, give CACs a couple of pieces of advice based on your findings here, what would it be?

Ted Cross:
I’d say, reach out to those other organizations that you’re not used to working with but are serving the same kids or serving kids that you want to serve: rape crisis centers, the intimate partner violence services. At least develop a relationship. And I think CACs have a real opportunity to do that because they have hands in each world. They have connections to each world, but they’re not embedded within the world. So some of the difficulties that law enforcement or child protective services might have with these other services, CACs are not going to have.

Liz and I just did a study with the New Jersey Children’s Alliance. You know, I’m sure you know Nydia.

Teresa Huizar:
I do.

Ted Cross:
Right. We did a profile of all the data on child abuse in New Jersey, and we were given a charge to connect with seven key stakeholders. But we also discovered there’s a network of rape crisis centers in New Jersey. They’re serving adolescents.

The public schools keep data on—you know, you can hardly believe this. This is on the internet. They have data on sexual assault within schools. So they’re already organizing within the schools about interpersonal violence that takes place within the schools. The state police are implementing a new data system that for the first time will allow them to separate out crimes with child victims from other crimes.

Teresa Huizar:
Oh, that’s interesting.

Ted Cross:
It’s a national rollout.

Teresa Huizar:
Yeah, that’s great.

Ted Cross:
A new data system. And local law enforcement agencies will be reporting these data to the FBI. And for the first time, they’ll all be able to pull out data on child victims. Previously—

Teresa Huizar:
Uniform crime statistics. Is that what you’re talking about?

Ted Cross:
Crime statistics, right. Right. So there are more, many more opportunities—now, God knows CAC directors are probably the busiest people in the world. So, you know, I’m loathe to load more responsibilities on them, but there are real opportunities to reach more kids and understand more about them and serve them by broadening your thinking about who your partners are.

[40:52] Teresa Huizar:
It’s so true. And, you know, just thinking about this rollout with the update to the uniform crime statistics, I mean, that’s something we’ve all been hoping for a long, long time.

And so taking advantage of that, knowing that it’s happening, taking advantage to encourage your law enforcement partners, to be really diligent about. Making that—you know, because it’s hard to change habits. If you’ve been used to checking one box—

Ted Cross:
Right.

Teresa Huizar:
—that encompass both adult and child victims, it’s hard to change that habit, but encouraging them to really do that so that you can get the stats you need back as a CAC to know. You know, one of the questions that CACs often have is: Am I really serving all the kids I should be? You know, am I seeing the total pool of victims I should be?

Ted Cross:
Yes. Right.

Teresa Huizar:
Well, very soon you’ll be able to know the answer to that—

Ted Cross:
Right.

Teresa Huizar:
—on the law enforcement side, which I think will be very, very interesting. So …

Ted Cross:
But, you know, that depends on your relationship with the crime data people in your state.

Teresa Huizar:
Yes, of course.

Ted Cross:
You have to cultivate that because it will take a little bit of an extra effort to pull out those data—

Teresa Huizar:
That’s right

Ted Cross:
—for you. It’s interesting. I had a—beginning of the year, I published a study on the new FBI crime data, because we had done a little research in Massachusetts on it. I heard from crime data people across the country, because I basically was arguing for more support and for them.

Teresa Huizar:
Yes.

Ted Cross:
Because they have a huge challenge.

Teresa Huizar:
Yeah.

Ted Cross:
And I, I connected with this fellow in Oklahoma, and I said, “You know, what if I asked you for this?” Well, 10 minutes later, he’d run the numbers.

Teresa Huizar:
Wow.

Ted Cross:
And he had it for me.

Teresa Huizar:
How great is that?

Ted Cross:
Right? But—

Teresa Huizar:
So good.

Ted Cross:
You know, that involved, making that relationship, making that connection.

[42:32] Teresa Huizar:
I feel like the common thread in all that we’ve been talking about has been about that, right? Making that connection, making those relationships on the MDT.

Ted Cross:
Right.

Teresa Huizar:
And expanding the MDT.

Ted Cross:
Right.

Teresa Huizar:
And looking at partnering with researchers.

Ted Cross:
Right. Right.

Teresa Huizar:
All of those kinds of things.

Ted Cross:
Right.

[42:47] Teresa Huizar:
Let me ask you, is there any other question I should have asked you and didn’t or anything else you’d like to make sure our listeners know about?

Ted Cross:
Well, I think, I think most of your listeners know this, but it’s really important to underline: A lot of kids who’ve experienced one form of victimization have experienced another.

Teresa Huizar:
Mm mm.

Ted Cross:
There’s a term for it: polyvictimization. So it’s important to assess for multiple forms of victimization. And it’s important that your MDT is prepared to deal with multiple forms of that victimization. And it’s really, really important. Because, not surprisingly, the research shows that those kids who’ve experienced multiple forms of victimization, polyvictimization, have substantially worse outcomes than kids who’ve only experienced one form victimization, right? So the communication, the linkages are even more important because of that.

[43:47] Teresa Huizar:
Well said, completely agree. And I can’t—you know, you’ve talked about, I feel like half a dozen either studies that are in the works currently or future studies. So I can’t wait to have you back on this show after some of those are published, and we dig them out. And, you know, send them our way because we’d love to talk about them.

I just really appreciate not only you coming onto the podcast, Ted, but your many years of looking at our practices.

Ted Cross:
Right.

Teresa Huizar:
Because it’s helped us build our practice. So, thank you.

Ted Cross:
Right. It’s my pleasure. And, you know, this stuff rattles around my—I sit at my desk in front of my computer, and this stuff rattles around in my brain. So it’s a relief and a pleasure to get to talk about it.

[44:27] [Outro]

Hi, One in Ten listeners. Our podcast is taking a break for the month of September for vacation and R&R. But, never fear, we’re going to re-release two of my most favorite episodes during that period of time. One, “Faith, Trauma, and the Problem of Evil,” with Victor Vieth—really a fascinating exploration of the issues around how we cope, really, with abuse and how that may affect our own faith, religious beliefs, and finding of meaning in what has happened to us.

And secondly, “Are We Solving the Wrong Problem in Child Welfare?” with Jerry Milner. As you may know, he probes deep into the work that’s being done in neglect and how we work with families. I don’t want to tell you more than that if you haven’t listened to it yet because it is a fascinating conversation. And I know you’ll enjoy them both whether you’re listening to them for the first time or whether you’re reminding yourself about their wonderful content.

Don’t worry, though. We’ll be back in October with all new episodes. And in the meantime, if you’d like more information about any episode on our podcast, please visit our podcast website at OneInTenPodcast.org. See you in October.