Leading Stimuli, Leading Gestures, and Leading Questions
Richard A. Gardner*
ABSTRACT: Leading questions, leading stimuli, and leading gestures
can be placed on a continuum in terms of the degree to which the
question, stimulus, or gesture shrinks the universe of possible
responses by the interviewee. For each of these concepts, the
leading quality can be classified as not present (that is,
absent), minimally present, moderately present, or maximally
present. When the question, stimulus or gesture is
significantly leading, the evaluation is apt to be contaminated and the
child may be programmed to produce statements about abuse that did not
occur. Evaluators must be more sensitive to the importance of
understanding and thus avoiding these interview contaminants in
During the last few years a conflict has been raging over the value
of anatomically-correct dolls (more recently referred to as
anatomically-detailed dolls) in child sex-abuse evaluations.
Studies are coming in from both camps, each claiming that the findings
support its position. The American Psychological Association
(APA) has yet to come up with a definitive recommendation. Their
latest proposal (APA Council of Representatives, 1991) urges
"continued research" and hedges a final decision as to whether
the dolls are ethical to use, although they recommend that documentation
be provided whenever the dolls are used:
We recommend that psychologists document by videotape (whenever
possible), audiotape or in writing the procedures they use for each
administration. Psychologists should be prepared to provide
clinical and empirical rationale (i.e., published studies, clinical
experience, etc.) for procedures employed and for interpretation of
results derived from using anatomically detailed dolls.
Considering the shortcomings of the studies claiming support for the
dolls, such documentation would be very difficult to provide. In
California the dolls are not considered to satisfy the Kelly-Frye test
for admissibility, which requires that the procedure has been generally
accepted as reliable in the scientific community. This decision
was based on the weaknesses of the studies supporting their use
(Gardner, 1991; Underwager and Wakefield, 1990; Wakefield and
The American Academy of Child and Adolescent Psychiatry
(AACAP) (1988) has also issued a position statement on the use of these
dolls. The AACAP's position is similar to that of the APA's, but
is a little stronger with regard to the caveats about the dolls'
use. The AACAP makes direct reference to the fact that findings
based on the dolls are not admissible as evidence in the state of
Even those who are the strongest supporters of the use of the dolls
generally agree that leading questions should be avoided because they
can produce responses in the child that may suggest sex abuse when it
has not occurred. However, those who warn against the use of
leading questions often use them in their protocols. For example,
White, Strom, and Santilli (1985) warn, "The interviewer should
pose questions in a nonleading fashion." Yet, in the same
protocol they list 14 questions, each of which most people would
consider highly leading, e.g., "Have you been touched on any part
of your body?" "Has anyone put anything on or in any
part of your body?" "Has anyone else asked you to take
off your clothes?"
Boat and Everson (1988) exhibit the same disparity in their protocol
regarding the caveat against using leading questions. They state,
"Background information should therefore be used only for guiding
the conversation (e.g., 'Your Mommy told me you visited Uncle John last
week.') and not (except in rare circumstances to be outlined later) for
asking the child questions that may be leading or suggestive (e.g., 'Is
Uncle John the one who hurt you?')." The authors do not
appear to appreciate the fact that the statement, "Your Mommy told
me you visited Uncle John last week" is very leading. Perhaps
it is a little less leading than, "Is Uncle John the one who hurt
you?" but it is nevertheless leading in that it directs the child's
attention to the visit with Uncle John the previous week the
visit during which some sexual encounter is alleged to have taken place.
Furthermore, their protocol itself includes a series of questions,
each of which is highly leading. (In each of the examples to be
given the line (_____) represents the name the child uses for that
particular body part.) Examples are:
"Has anyone touched your _____?" "Have you ever
seen anybody else's _____?" "Has anyone asked you to
touch their _____?" "Has anyone taken pictures of you
with your clothes off?" Most people would agree that these
questions are highly leading.
Obviously, we have a problem with the exact definition of a leading
question. Providing a definition for this term is one of the
goals of this paper. However, the concepts of leading stimuli
and leading gestures are also necessary for understanding what is
actually occurring when examiners use anatomical dolls.
As discussed elsewhere (Gardner, 1987, 1991), in the early 1980s I
began seeing false sex-abuse allegations in the context of contested
child custody disputes. This allegation proved a valuable
vengeance and exclusionary maneuver. In the last few years I have
also been involved in day-care center cases in which sex abuse has been
alleged. In association with this involvement, I have reviewed
approximately 300 hours of videotapes, from all parts of the country, of
examiners using anatomical dolls in their interviews.
These tapes have been carefully scrutinized most often with a
sentence-by-sentence analysis with particular attention to the
examiner's gestures, intonations, and other details that might not be
considered by many observers. One of the unanticipated outcomes
was the discovery of a consistency and similarity in the
interviews. The examiners appear to have been influenced significantly
by the procedures promulgated by White et al. (1985), White, Strom,
Santilli, and Halpin (1986), and Boat and Everson (1988).
Not only do the examiners make frequent use of leading questions, but
they use leading gestures. Although leading questions can easily
be seen on the transcripts of these interviews, the leading gestures are
rarely described by the transcriber. These gestures play an
important role in what is actually taking place and in the
"programming" that occurs with these dolls. Leading
stimuli, which refer to dolls (especially anatomical), body charts, and
other instruments can also contaminate the interview by encouraging the
child to talk about sexual issues.
My main purpose is to discuss these three important areas in
sex-abuse evaluation interviews: (1) leading stimuli (including
anatomical dolls), (2) leading questions, and (3) leading
gestures. Defining these concepts more accurately should improve
communication among examiners, especially with regard to what is and is
not a leading question. These concepts should not be seen simply
as yes/no phenomena, whether present or absent; rather, each is best
understood as lying on a continuum from not being present at all to
being used to a significant degree.
For each of the three concepts I will demarcate four points along
this continuum: not present (that is, absent), minimally present,
moderately present, and maximally present. However, these are
merely guideposts for categorization. The general principle for
ascertaining which level is most appropriate is the degree to which the
stimulus shrinks the universe of possible responses by the
interviewee. The less the shrinkage, the greater the likelihood
the stimulus will fall at the "absent" end of the
continuum. And the greater the shrinkage or narrowing, the greater
the likelihood the stimulus will be judged "maximal" in this
Last, I will not make a distinction between leading questions and
"suggestive questions." Rather, "leading
questions" will refer to all questions that suggest an
answer. Similarly, I will not differentiate between nonleading
questions and "open-ended questions." Open-ended is
defined as any question that does not contain within it a contaminating
focus for response. My comments will refer to the various degrees
to which a question is open.
These stimuli are instruments that are generally used in interviewing
by mental health professionals, especially psychologists and
psychiatrists. They are instruments that have been designed to
elicit verbal responses by the interviewee, especially responses that
reveal psychodynamic information and personality manifestations.
They all involve an external visual stimulus that serves as a focus for
the interviewee's verbal response. They differ from leading
questions in that the stimuli in the leading question category are
entirely verbal. They differ from leading gestures in that the
leading stimuli category includes standard, well-defined materials that
are easily recognized as providing visual stimuli. Leading
gestures, in contrast, although visual, are an incidental form of visual
stimulation that may not be directly attended to by the interviewer or
the interviewee but have a profound effect on the process of the
The ideal nonleading visual stimulus is no stimulus at all. The
psychoanalyst's blank screen for free associations is an example.
The blank card of The Thematic Apperception Test (TAT) (Murray, 1936) is
also a good example. Whereas all the other cards of the TAT depict
a particular scene with a specific number of individuals, the blank card
is completely blank. The universe of possible stories that the
interviewee can provide is basically infinite and the external
facilitating stimulus does not provide anything that could reasonably
contaminate the associations and thereby "shrink" the universe
of possible responses.
Minimally Leading Stimuli
The Rorschach cards (Rorschach, 1921) provide good examples of
minimally leading stimuli. These inkblots were selected because
they have only limited similarity with known objects. There are
some cards, however, that vaguely resemble known objects such as bats,
butterflies, and "two drummers drumming." These are
referred to as the "popular responses" and are not
particularly indicative of psychopathology. In fact, not to see
these popular responses may suggest the presence of such
pathology. Because most of the stimuli are not suggestive, and
because the universe of possible responses has not been significantly
reduced by these stimuli, these cards fit in the category of minimally
Another instrument in this category is The Storytelling Card Game
(STCG) (Gardner, 1988a). In this psychotherapeutic game (which can
also be used as a diagnostic instrument for eliciting psychodynamic
material), there are 24 scene cards, 4 of which are blank. The
nonblank cards depict scenes only and do not contain any figures, human
or animal. Some typical scenes are a forest, a child's bedroom, a
city street, and a farm. The child is asked to select one or more
figurines (from an array of 15, ranging in age from infancy to old age),
place them on a card, and tell a self-created story. It is almost
as if the child is creating his or her own TAT picture card. The
blank card pictures used in the STCG are somewhat more contaminating
than the blank card of the TAT because in the former there is an actual
visual stimulus (the figurines placed on the blank card), whereas in the
latter there is none. Because the children create their own
pictures, the STCG pictures are less contaminating than the standard
nonblank TAT cards (to be described in the next category).
The instruments used in this category have limited capacity to
constrain or contaminate the universe of possible responses. They
can be viewed as catalysts for projections created by the interviewee,
with little potential by the external facilitating stimulus to modify
significantly the interviewee's inner psychological processes.
Moderately Leading Stimuli
In this category the external visual stimuli are quite specific; yet
they allow for a universe of possible responses. However, because
of the specificity of the external visual eliciting stimuli, the
universe of possible responses is smaller than that provided by the
stimuli in the previous two categories. Most of the TAT cards fall
into this category. In each of the cards one can identify easily
the number of individuals depicted, the sex, and even something about
the attitudes or emotions of the individuals depicted (although these
tend to be somewhat vague). Some examples: Card No.1 depicts a boy
looking down at his violin, which is lying on the table in front of
him. Card No.2 depicts a school girl (carrying books) behind whom
is a farm scene in which an adult female, an adult male, and a horse are
clearly indicated. Card No.5 depicts an adult woman standing at a
doorway looking into a room (which could be either a foyer or a living
room). Card No. 17BM depicts a naked man climbing up a rope.
Obviously, the TAT cards shrink the universe of possible responses much
more than the stimuli in the aforementioned two categories. Yet,
there is still a universe of possible responses to each of these cards.
Maximally Leading Stimuli
The materials described in this category shrink significantly the
universe of possible responses. They provide a highly specific
stimulus that is very likely to draw the interviewee's attention
directly to it. Generally, they provide stimuli that elicit strong
emotional responses in the interviewee. Many of the cards in the Children's
Apperception Test (CAT) (Bellak and Bellak, 1949) are in this
category. Some examples: Card No.1 depicts three chickens sitting
around a table, in the center of which is a bowl of food. In the
background is the adult chicken (most likely the mother). Card
No.7 depicts a tiger leaping menacingly toward a small monkey. His
mouth is open. He is approximately ten times the size of the
monkey. Card No.10 depicts a bathroom scene in which there is a
toilet. Sitting nearby is a mother dog spanking a baby dog.
The Children's Apperception Test-Supplement (CATS) (13ellak
and Bellak, 1963) also contains cards that are in this category. Some
examples: Card No.5 depicts a kangaroo walking with crutches. Both
his left leg and tail are bandaged. Card No.10 depicts a female
cat, obviously pregnant. Because she is standing up, her abdomen
is easily recognized as protuberant.
TAT Card 8BM is also maximally leading. This card depicts a man
being operated on by two other men, one of whom is holding a knife (or
scalpel). Next to him is a gun. In front of all of this is a
young man looking out at the viewer. The presence of the gun,
knife, and surgical operation warrant this card's being placed in the
maximally leading stimulus category because it provides a much greater
shrinkage of the universe of possible responses than is provided by the
aforementioned TAT cards, which are in the moderately leading stimuli
The centerfolds of many pin-up magazines are in this category.
Whatever the nature of one's reactions, there is no question that such a
picture provides very compelling stimuli. Groth (1984) has
introduced anatomical drawings that are often used in assessing children
for suspected sex abuse. Their purported purpose is to enable the
examiner to learn exactly what terms the child uses for the various body
parts. The child is presented with cards on which are depicted
naked people. Both anterior and posterior views are presented.
Unfortunately, these drawings provide maximal leading stimuli and
communicate to the child that sexual issues are proper and acceptable
topics to focus on. If this were indeed the only example of such
stimuli used by the examiner, the cards probably wouldn't be too high a
contaminant. However, when used along with anatomical dolls,
leading questions, and an atmosphere that tells the child sex talk is
the "name of the game in this office," they may contribute to
the creation of a false sex-abuse accusation. Their ostensible use
for learning the names the child uses can easily be seen as the
examiner's rationalization for sexualization of the interview. The
examiner could achieve the same goal by simply asking the mother,
outside of the child's presence, what names the child uses for the
various body parts. In this way, the examiner would gain the
benefits to be derived from having this information without
contaminating the interview in the sexual direction.
Anatomical dolls are also maximally leading stimuli. They
provide highly compelling and unusual stimuli that cannot but draw the
child's attention from other issues. Some of these dolls have
organs that are disproportionately large; others do not. But in
both cases the dolls are unusual and thereby attract attention.
They are not the kinds of dolls that most parents (including evaluators
who are parents) are likely to give their children as birthday or
holiday presents. If a rambunctious teenager were to surreptitiously
pencil in genitals, breasts, and pubic hair onto a set of TAT cards, the
examiner would probably consider them "ruined" and be quite
upset at the miscreant. Such alteration of the cards obviously
makes them even more contaminating and would put them in the category of
a pinup magazine centerfold. Anatomical dolls provide the same
kind of contamination as such altered TAT cards.
My conclusion from viewing videotapes is that leading questions and
leading gestures are greater contaminants than the dolls, their strong
contaminating potential notwithstanding. This is a major reason
why many studies that conclude the dolls are not contaminating are not
reproducing the actual situations in which they are used.
Specifically, these studies take place under laboratory conditions in
which leading questions are minimized. A typical study involves a
child being allowed to play along with the dolls. If an examiner
is present, he or she says nothing or makes a few catalytic
statements. Others generally observe the child through a one-way
mirror. Activities or comments that could be construed as sexual
are quantified. Therefore, these studies do not accurately
reproduce the conditions in the real world where examiners are literally
bombarding children with leading questions in association with the
In addition, the studies that claim to support the conclusion that
the dolls are not contaminating usually include a few nonabused children
who, indeed, provide responses similar to those from the abused
children. This, of course, argues against their
"safety." A common finding is that the majority (usually
80 to 95%) of nonabused children do not provide responses suggesting sex
abuse. This figure is used to justify the conclusion that the
dolls are safe. However, the same studies indicate 5 to 20% false
positives (i.e., the dolls facilitate responses that are the same as
those seen in children who were genuinely abused). From the point
of view of an accused person, this false positive rate indicates that
the dolls are very risky and even dangerous and could contribute to the
incarceration of a person who did not sexually abuse the child.
The situation is similar to the one in which a pharmaceutical company
would propose placing on the market a drug that they claim is "only
5 to 20% lethal."
Studies discussing the above issues include Gabriel (1985), White et
al. (1985), Jampole and Weber (1987), Sivan, Schor, and Koeppl (1988),
Glaser and Collins (1989), August and Forman (1989), Clarke-Stewart,
Thompson, and Lepore (1989), Mclver, Wakefield, and Underwager (1989),
and Realmuto, Jensen, and Wescoe (1990). Yates and Terr (1988a,
1988b) debate the anatomical doll issue and present the common arguments
of both those who approve of and those who object to the dolls. At
this point, the current research does not provide convincing evidence
that anatomical dolls are safe. It indicates that the dolls
even when used alone, without leading questions and leading gestures
may play a role in bringing about and/or promulgating false sex-abuse
Leading questions are questions that create a specific visual image
that is not likely to have been produced had the question not been
asked. This visual image may become a reference point for future
responses and behavior. When a leading question is asked, the
examiner cannot be sure whether the interviewee's response has been
suggested by the leading question or whether it would have been provided
anyway. Such "seed planting" interferes significantly
with data collection, the purpose of which is to ascertain whether
something really happened (such as is the case in a sex-abuse
Leading questions can contribute to the "brainwashing"
process that can take place during an evaluation. Creating as they
do fantasies of events that might not have occurred, there is the risk
that this imagery will come to be believed by the interviewee.
Even adults often have problems remembering the original source of
information or a recollection. A visual image can come to have a
life of its own, especially if repeatedly suggested and brought into
conscious awareness. And children, being more suggestible, are
more likely to forget the source of a visual image and to believe that
the events actually occurred.
Consider, for example, a 3-year-old girl who has never performed
fellatio on her father, was never asked to do so by him, and never even
entertained the notion of doing so. An examiner asks this child,
"Did your father ever put his penis in your mouth?" The
question causes the child to have the visual image of her performing
fellatio on her father. This particular thought probably never
previously entered her mind. The question, however, creates an
image of just such an event.
Her initial response may be one of denial and possibly even some
revulsion. But a few days later, when asked the same question (by
the same or another examiner), the fellatio-with-father image is then
brought into conscious awareness. However, this time she may not
be able to differentiate between a recollection derived from the
question asked a few days earlier and images related to an actual
event. At that point she may respond with, "I think so
I'm not sure."
If the examiner zealously wants the child to respond in the
affirmative (a not uncommon situation), the issue may be pursued with
statements such as, "Think hard," "You can tell me,"
"It's safe here," and, "I'll make sure he won't be able
to do it again." Add the child's desire to ingratiate herself
to the examiner, whom she recognizes wants the answer to be yes, and it
is likely that the child will consider the "recall" of the
visual image as a manifestation of her having indeed had such an
experience. It is for these reasons that leading questions can
result in a sex-abuse evaluation that is more a learning process than an
exploratory one. Leading questions, then, play a role in what is
often criticized as a brainwashing or programming process.
Leading questions are on a continuum from questions that are not
leading at all to those that are maximally leading. The focus is
on the verbal communications of the evaluator (auditory stimuli), rather
than on visual environmental stimuli (including leading stimuli and
leading gestures) that are usually operating simultaneously and also
have an effect on the child's productions.
Here, again, the psychoanalytic model can be useful. Although
there have been many serious criticisms of Freudian psychoanalysis, the
blank-screen principle is a valid and useful one. It is the best
setting for finding out what is on the patient's mind, uncontaminated by
comments made by the therapist. In the ideal psychoanalytic
situation, the session begins without the therapist saying a word.
Whether the therapist is behind the couch or face to face, there is
practically no direct verbal communication originating with the
therapist. The patient is expected to start talking about the
things that are coming into conscious awareness. Thus, a
completely nonleading question, in its purest form, is no question at
all. There are opening questions, however, that justify placement
in this category. Questions like, "So what's on your
mind?" and, "What would you like to talk about today?"
still provide for a universe of possible responses. Potential
contaminants provided by these questions are highly unlikely.
Young children, especially under the age of 5 or 6 (the age range in
which anatomical dolls are most frequently used), do not generally
respond well to such questions as, "What's on your mind?" and
"What would you like to talk about today?" However,
after an initial "Hello," and "Please come in"
(comments that are genuinely nonleading), the child might be observed by
the examiner to see what he or she will do. The examiner can sit
and say absolutely nothing and will sometimes be successful in getting
the child to spontaneously verbalize, especially after selecting some
object in the room to serve as a focus. However, once this object
(often a toy) is picked up, we no longer have a blank screen. (We
have, now, a category of leading stimulus.) If, however, the child
starts talking spontaneously, then we do indeed have a nonleadiing-question-type
Sometimes the child's talking can be facilitated by the child's
parent(s) coming in initially, especially at the beginning of the first
interview. The parent's presence, obviously, will make the child
more comfortable in a strange situation and increases the likelihood
that the child will verbalize. However, in order to ensure that
the child's verbal productions will not be contaminated by their
comments and/or gestures (no matter how subtle), the parents must be
strictly instructed to say nothing at all. If this is successful
(often the case, in my experience), then the child may begin to talk
spontaneously. Once the child is comfortable, the parent(s) can be
asked to leave the room. This procedure encourages spontaneous
verbalizations. The parent(s) need not be brought into the second
interview because of the child's previous familiarization with the
examiner and the procedures.
Minimally Leading Questions
These are questions that minimally narrow the universe of possible
responses. They are questions or openings that are rarely used as
foci for the interviewee's response. An example is the evaluator
providing the child with a wide assortment of materials (dolls, farm
animals, zoo animals, drawing paper, crayons, clay, doll house) and
simply saying to the child, "You can play with anything you would
like to play with here." Then, while the child is playing,
the evaluator sits silently, awaiting the child's spontaneous comments
and verbalized fantasies. There has been some minimal
contamination because the universe has been narrowed somewhat by the
child being asked to direct attention to the play material.
However, that universe has not been narrowed significantly because there
are still many possible comments the child might make.
If the child doesn't say anything, the examiner might say, "What
are you thinking about while you're playing with those
things?" Again, there is a large universe of possible
thoughts the child might have. The examiner might say, "I'd
like you to tell me a story about the things you're playing
with." Here, too, the universe is not significantly
constricted. Children under the age of 5, however, are generally
not cognitively capable of providing well-organized stories
especially with a beginning, middle, and an end. But they often
will, in response to this question, provide a string of loosely
connected associations. (They are likely to comply because of
their desire to ingratiate themselves to adult authority.)
The same principle is applicable in the introduction to the mutual
storytelling technique (Gardner, 1968, 1971, 1992). The
introductory material provided by the therapist in the
"Make-Up-a-Story Television Program" is general, nonspecific,
and does not include material that has any particular "pull"
toward a particular story theme. The examiner's responding story
(which is therapeutically designed to include the same characters in a
similar setting, but incorporates healthier modes of adaptation than
those used by the child) does provide highly specific material.
However, the response here is a therapeutic message, derived from the
child's uncontaminated fantasies, and is not presented as a
Some of the cards in The Talking, Feeling, and Doing Game
(Gardner, 1973) are in this category. This board game, which was
designed to elicit psychotherapeutically valuable information from
children in the context of a mildly competitive board game, involves
each player rolling the dice and moving a playing pawn around a curved
path from start to finish. When the player's pawn lands on a white
square, a Talking Card is taken, on a yellow square, a Feeling Card is
taken, and on a pink square, a Doing Card is taken. When a player
answers the question or responds to the instructions on the card, a
reward chip is obtained.
Obviously, the object of the game is not simply to earn chips and
acquire a prize, but to use the cards as points of departure for
psychotherapeutic interchanges between the therapist and patient.
Examples of cards that are in the minimally leading questions category
are, "Make up a dream," "Someone passes you a note. What
does it say?," and, "Make believe you're looking into a
crystal ball that can show anything that's happening anywhere in the
whole world. What do you see?" As can be seen, there is
indeed a universe of possible responses to each of these
questions. Although not as large as the blank screen universe with
completely nonleading questions, they are certainly close to this ideal.
Moderately Leading Questions
Questions in this category narrow somewhat the universe from which
the questions in the previous category draw; however, the constriction
is not so great that significant idiosyncratic material cannot be
obtained. Most of the cards in The Talking, Feeling, and Doing
Game (Gardner, 1973) are in this category, for example, "If the
walls of your house could talk, what would they say about your
family?" "Everybody in the class was laughing at a
girl. What had happened?" "A boy has something on
his mind that he's afraid to tell his father. What is it that he's
scared to talk about?" "Make up a lie."
"What's the worse thing that ever happened to you in your whole
life?" "All the girls in the class were invited to a
birthday party except one. How did she feel? Why wasn't she
invited?" and, "Suppose two people were talking about you, and
they didn't know you were listening. What do you think you would
hear them saying?"
These questions narrow somewhat the range of responses, but still
allow for a universe of possible answers. There is a universe of
possible lies that the child could possibly tell. There is a
universe of possible reasons why everybody in a class would laugh at a
girl. There is a universe of possible things a person could hear
others saying about oneself when eavesdropping. Yet, the questions
do focus somewhat on a particular area of inquiry, e.g., friendships,
lying, antisocial behavior, etc.
When doing an evaluation of children I may ask: "You know,
nobody is perfect. Everybody is a mixture of things you like and
things you don't like. Your parents are no exception. I'd
like you to tell me the things about your mother and father that you
like and the things about your mother and your father that you don't
like. Which one do you want to start with?" There is a
universe of possible responses to this question, even though it narrows
down to the assets and liabilities of the child's parents.
Accordingly, this is a moderately leading question.
A verbal projective instrument designed by Kritzberg (1966) also is
in this category. The child is asked the question, "If you
had to be turned into an animal, and could choose any animal in the
whole world, what animal would you choose?" After responding,
the child is asked the reason for that choice. Following this, the
child is asked for the second and third choices and the reasons
why. Then the child is asked what three animals he or she would
not want to be, and the reasons why. A similar series of questions
could be asked about objects into which the child could be transformed
and, for older children, the specific persons they would choose and not
choose to be changed into if they were free to select from the whole
array of humanity, living and dead, famous and not famous, real and
Although there is a finite number of animals, objects, and persons
from which to choose, the number is still quite large (and the older the
child, the larger the number). Although the word
"universe" is not applicable here, we still do not have the
kind of constriction and seed planting found in the
maximally-leading-question category. Furthermore, once the animal,
object, or person has been selected, the reasons for that selection
allow for many possible responses. The second part of the question
(the "why" part) provides, therefore, the more valuable
information because it allows for the tapping of a larger universe of
It is in this category that we begin to see some of the contaminating
leading questions used by many sex-abuse evaluators. For example,
the examiner might ask, "Tell me about the school you used to go
to." On the surface, this seems like an innocuous enough
question and would be the kind that many evaluators might ask in the
course of their evaluations. However, in this particular case the
examiner knows that the school the child used to attend was closed down
because the directors allegedly sexually molested the children
there. Taking this into consideration, and taking into
consideration the fact that this was the first substantive question
asked in the interview, we see how the word "universe" has no
A response that includes nonsexual events is usually of little
concern to such an evaluator. This is an important point. To
the degree that the evaluator is thinking about a particular answer, to
that degree the question is likely to be leading. Of course, the
inclusion of this criterion makes it more difficult to assess the
question on its face value, but it is not usually difficult to speculate
about what's going on in the evaluator's mind when all questions are
directed toward the alleged sex-abuse event, no matter how unrelated to
sex they may initially appear.
This point cannot be overemphasized. The competent examiner is
truly going to be open to any response the child provides and use
that as a point of departure for further inquiry and elaboration,
whether for evaluative or therapeutic purposes. This is the
opposite of the approach used by many sex-abuse examiners who assume
that the sexual abuse has happened and their job is merely to fill in
the details. Noncorroborative data are ignored, denials are
rationalized away, and ostensibly minimally leading questions such as,
"Tell me about the school you used to go to" are actually
Another example: "Tell me about your Uncle Bill."
This may not appear to be highly leading, although it is intrinsically
leading under the best of circumstances because the focus is on one
person of the 5.3 billion people on earth. However, there is still
a universe of possible statements one could make about Uncle Bill.
But in this case Uncle Bill is the alleged perpetrator and he has been
selected from the wide assortment of the child's friends and relatives
who the examiner could have chosen to focus on. We know, then,
that the examiner is primarily interested in discussing the alleged
sexual encounters between the child and Uncle Bill, even though the
examiner may be professing a completely neutral position regarding
whether sex abuse took place the usual position of many
evaluators (especially "validators"), claims of neutrality
notwithstanding. Accordingly, it has a "seedplanting"
effect in that the child gets the message that the examiner is
interested in talking about issues related to sex abuse, a subject
selected from the universe of issues that could be focused upon in the
Maximally Leading Questions
A maximally leading question is one about which there is no doubt
what the examiner is interested in discussing and/or hearing. It
is one star pulled out from a million galaxies. Many are totally
innocuous, e.g., "How old are you?" "What grade are you
in?" and, "What's your teacher's name?" These are
highly selected questions, point out exactly what the examiner is
looking for, and lead the child down a very specific path. Such
questions may even have the fringe benefit of relaxing a child during
the first interview with a strange therapist.
The question "What's the name of your school?" might very
well be in the same category. However, if the school is the place
where the alleged sex abuse took place, and if the school question is
one of the first the examiner asks, then the same question now falls
into the moderately leading question category (for reasons described
above). If, however, the examiner asks, "Tell me exactly what
your teacher, Mr. Jones, did to you after he pulled down your
pants," we have a maximally leading statement. It evokes a
specific image of Mr. Jones pulling down the child's pants. Mr.
Jones may or may not have actually pulled down this child's pants.
But once the question is asked, the likelihood of our knowing whether
this actually happened (at least with the child as a source of
information) is reduced significantly. (And this problem is
compounded by examiners who see only the child and then come to a
conclusion regarding whether Mr. Jones perpetrated an act of sex abuse.)
Many of the questions in the White et al. (1985) and Boat and Everson
(1988) protocols are in this category. For example, the question,
"Did anyone ever touch you in the wrong place?" elicits the
specific fantasy of the child's being touched sexually, whether or not
the child ever was.
The question "Has anyone ever taken your picture?" seems
innocuous enough and, one could argue, certainly does not warrant
placement in the maximally-leading-question category. However, we
know that the examiner who asks this question is not thinking of
pictures taken at the zoo, on picnics, or at amusement centers.
Rather, the examiner is thinking about child pornography, and the visual
image in the examiner's mind is of an adult with a camera taking
pictures of one or more naked children, possibly engaged in a wide
variety of sexual activities. This is confirmed by the fact that
the question is one of a series, all of which relate to sex abuse.
if the child were to respond, "Oh, yes. My daddy took a
lot of pictures of me when we visited Disney World," that would not
be considered a satisfactory or acceptable answer. In all
probability the examiner would then ask about pictures taken in other
settings in the hope that a sex-abuse scenario would be described.
Or, the examiner might get more specific and ask leading questions about
whether the child were naked in the pictures, questions about a
particular person (especially the alleged perpetrator) taking pictures,
etc. Another example: "Have you ever been without your
clothes?" If the child were to say, "Of course, when my
mommy gives me a bath, I don't have clothes on," the examiner is
not likely to accept this and will next ask questions about other
people, especially the alleged perpetrator.
Many yes/no questions fall into this category. For example,
"Did anyone ever touch your private places?" serves as an
entree into a specific discussion about sex abuse. Whether the
child says yes or no does not usually provide useful information.
If the child says yes, there is no way to determine whether the child is
trying to ingratiate himself or herself to the evaluator or whether the
child really had such an experience. If the child says no, there
is no way to know if the no answer relates to reality or if the child
had such an experience and is too ashamed, guilt-ridden, or fearful to
answer in the affirmative.
But less important than the significant drawbacks of the yes/no
question (and lawyers have yet to learn this) is the fact that the
question plants a seed because it creates a fantasy of a child's being
touched in "private places," whether or not the child has had
such an experience. And this is one of the ways that legal
interrogations (with their frequent use of yes/no questions) program
children into believing they have had such experiences, when they did
Leading gestures have not been given proper attention by those
involved in sex-abuse evaluations. Written transcripts of
videotapes rarely mention the gestures of the evaluator only the
verbalizations are recorded, unless something very unusual and dramatic
has taken place. Audiotapes tell us practically nothing about
gestures and other body movements. Yet, throughout much of the
interview, the child is looking at the evaluator and obviously is being
affected by what is seen.
Children model themselves after adults, especially their parents and
other authorities. This teaches them how to function in the adult
world. Children imitate significant adults because they need to
learn the behaviors that enable them to fit in with and be accepted by
Another operative factor is that of sanction. If the child
observes the evaluator to be performing an act that might generally be
considered unacceptable (for example, placing a finger in a doll's
vagina or stroking a doll's penis), the child is more likely to repeat
that act, even if aware of its unacceptability. The child often
operates on the principle: "If it's okay for him to do it, it's
okay for me to do it also."
Once again, we start with our old friends, the classical
psychoanalysts, many of whom (but certainly not all) are experts at
doing nothing. One of the reasons given for sitting behind the
couch is to lessen the likelihood that the patient will be affected by
the psychoanalyst's facial expressions and gestures. Although much
is lost by conducting therapy from this position, especially the human
relationship (Gardner, 1988b, 1992), these people do have a point.
Although the psychoanalyst sitting behind the couch provides one of
the best examples of nonleading gestures, most children who are being
evaluated for sex abuse are not coming to be analyzed and most children
who are in analysis do not have analysts who work from behind the
couch. Although I do not recommend that sex-abuse evaluators buy
couches, the evaluator can avoid leading gesture gestures that
provide communications that will contaminate the blank-screen
interview. To ask a nonleading question without any contaminating
facial expressions or gestures is easily accomplished. One can say
to a child, "What would you like to do here today?" without
any kind of directive movement or glances. Also, after asking
nonleading introductory questions in the name-rank-and-serial-number
category, the examiner just might sit, somewhat expressionless, watch
the child, and wait until the child begins to speak.
Minimally Leading Gestures
These gestures are usually associated with verbalizations that may or
may not be in the same category regarding the contamination of the blank
screen. If the examiner wishes to direct the child's attention to
the toys, because they are likely to catalyze the expression of the
child's naturally occurring fantasies, he or she might, with a sweep of
the hand across the toy shelves, say, "You can play with any of the
toys in the room." This gesture is selective in that it
strongly suggests that the child play with the toys and not other
objects in the room. It restricts somewhat the universe of
possible activities and statements, but it is minimally
contaminating. The child still has the option to select any of the
toys and if they are intrinsically of low-contamination potential, then
the gesture will have served its purpose. (Obviously, the toys
referred to here do not include anatomical dolls.)
The examiner might take a pad of drawing paper and crayons, put them
in front of the child, and say, "I'd like you to make a
drawing. Any drawing at all. Draw anything in the whole wide
world that comes to mind. Then, when you finish, I'd like you to
tell me about what you've drawn." This can be said while
pointing to the crayons and blank sheet of paper. These gestures
reinforce the verbal request and increase the likelihood that the child
will provide a reasonably pure projection. The same principles
hold when instructing a child to draw a figure for the Draw-a-Person
Test, the Draw-a-Family Test, or requesting the child to play
with dolls, clay, fingerpaints, sand, or other traditional play therapy
materials. (My assumption here is that the examiner recognizes the
contaminating effects of such games as chess, Monopoly, Candy
Land, etc. Unfortunately, there are many therapists who do not
appreciate this obvious fact.)
Winnicott (1968) uses a game that he refers to as
"squiggles." The therapist or the child begins by
drawing with pencil on blank paper a nonrecognizable scribble
("squiggle"). The other party then pencils in additional
lines and curves. Back and forth they go until the child reaches
the point where some identifiable figure is recognized. Then the
figure serves as a point of departure for either storytelling or other
therapeutic communications. The gestures here are of limited
contaminating potential. They contribute to the drawing of a
figure of varying similarities to actual objects. However, the
child is a contributor and the identification of the figure so drawn is
based on what the child sees in it, i.e., the child's
projections, rather than what the examiner considers the squiggle to
look like. Because there is still a large universe of possible
associations and stories to the squiggle, the game warrants
categorization in the minimally-leading-gesture category.
Moderately Leading Gestures
Evaluators who use anatomical dolls will commonly say to children,
"Show me how he did it with the dolls." The ostensible
purpose here is to facilitate the child's providing an accurate
description in order to compensate for the child's immature verbal and
cognitive communicative capacity. Another argument is that they
help inhibited children talk about sex abuse. Although there may
be some minimal justification for these arguments, the encouragement of
the physical enactment entrenches the child's belief in the events so
portrayed, whether or not they actually occurred. When this
direction is given, the evaluator often picks up the dolls and hands
them to the child, again strengthening the power of the verbal request.
An example of a moderately leading gesture is an examiner who picks
up a family of puppets and says, "Let's play with these hand
puppets. I'll take the mother and father (places them on his
hands) and you take the boy and the girl and put them on your
hands. Now what happens?" Under these circumstances the
child is likely to start moving his or her hands and verbalize some kind
of activity while engaging the therapist's puppets in a similar
activity. If it were the therapist who suggested the game, then
the universe of possible associations has been significantly
contaminated. But even if the child suggests the game, the game in
itself has limitations imposed upon it by the physical structure of the
puppets and the hands of the humans who are playing with them.
Children commonly will bang the heads of the puppets, one against the
other. The examiner who interprets this to mean that the child is
angry may be greatly stretching the point. The dolls almost ask to
be banged together or to be engaged in various kinds of hostile
play. Accordingly, the therapist's leading gestures bring the
child down a somewhat narrow path, the path of hostile play.
Levy (1939, 1940) describes a type of child psychotherapy that he
refers to as "release therapy." This method was designed
to help children verbalize their thoughts and release their feelings
about traumatic situations. In order to facilitate this process he
structured the doll play in such a way that the child is likely to talk
about a particular situation, especially a traumatic one. For
example, if a child were dealing with the trauma of being in a hospital,
he might walk a boy doll into a make-believe hospital room, lay the
child down in a hospital bed, and ask the child to talk about what's
happening to the little boy. The child who is reacting to the
birth of a new sibling might be confronted with a structured doll-play
situation in which the mother is breast feeding the baby doll. The
little boy doll is walked into the room, looks at the mother and baby,
and the patient is asked to describe what the little boy is thinking and
This game clearly involves the therapist in moderately leading
gestures. Its risk is that it will pressure children into talking
about issues they may be too anxious to discuss. It also has the
drawback of "muckraking" and bringing up past traumas that
have already been put to rest in a way that is not pathological.
The principle here is that the more intrusive the therapist is, the
greater the likelihood of brainwashing and programming, and the greater
the likelihood that the therapy will produce psychological trauma.
This is what happens with children who have never been abused and who
have been "treated" for abuse that never took place.
They are made to believe that they were abused. The effects of such
programming have yet to be studied because these children represent what
is now a new form of psychopathology (Gardner, 1991).
Many evaluators are advised to ascertain, early in the first
interview, the terms the child uses for the various body parts,
especially the sexual ones. The ostensible purpose is to enable
the examiner to communicate better with the child and to understand
exactly what organs are being referred to when the child mentions these
in the course of the evaluation. This is traditionally
accomplished by the examiners pointing to sexual parts on pictures of
naked people or special dolls. Commonly, anatomical dolls are used
for this purpose, although body charts are also used. Typically,
the examiner first points to the various body parts on the clothed doll
and asks, "What's this called?" After a few body parts
are identified, the clothes come off. Usually the examiner
undresses the doll or will ask the child to assist. Once naked,
the examiner routinely proceeds to point to the various body parts
(breasts, bellybutton, penis, vulva, buttocks, anus) and asks the child
specifically to name the part pointed to.
The message given is that it is perfectly acceptable, proper, and
even desirable to point to and even touch these organs. This is a
unique situation for the child. If teachers were to do this, the
Board of Education might unanimously vote to discharge them. If
parents, relatives, or neighbors were to do this, they would be suspect
as child abusers.
Not only is a verbal question being asked when the examiner touches
the doll's penis and says, "What's this called?" A
physical activity is being performed which sanctions such pointing and
touching. Some examiners, when asking this question, will take the
penis between their thumb and forefinger and talk while manipulating
it. This communicates that this kind of activity is acceptable and
if the child would like to act similarly with the doll's penis, he or
she is free to do so. This same principle operates even more
strongly when examiners put their fingers in the doll's vagina or anus
and ask, "What's this called?" These same examiners will
then consider the child's physical activities with the anatomical dolls
to be a reenactment of their own sexual encounters.
Maximally Leading Gestures
In this, the most contaminating category, the examiner uses the dolls
to demonstrate a sexual encounter that has not been enacted or even
described by the child. The examiner might insert a finger into
the doll's vagina and say, "Did your grandpa put his finger in
here?" The child, therefore, is likely to engage in this same
behavior with the doll, either in that session or in a subsequent
session (either with the same examiner or another evaluator).
This is an activity that may never have entered the child's mind
previously. Talking about it provides one level of implantation of
a visual image. Combining the question with the doll demonstration
provides specific visual details that become incorporated into the
child's mental image. This enhances the likelihood of a visual
image forming, an image that will be referred to in future
sessions. If the examiner believes that what the child does with
the dolls is a true reenactment of actual experiences, a false sex-abuse
accusation is likely to be created.
In one videotaped evaluation, the examiner was convinced that the
alleged perpetrator had taken photographs of the alleged victims in a
nursery school. The examiner placed the naked anatomical doll on
its back, pulled up the legs, and then asked the child, "Did he
take a picture of you while your legs were up like this?"
When the child initially did not respond affirmatively, he placed the
doll in the knee-chest position and asked the question again. This
was repeated with other positions, many bizarre, to all of which the
child eventually responded positively.
In another case, the examiner presented the child with a picture of a
naked woman, pointed to the vagina, and asked the child, "Did he
touch you right here?" But the transcript did not indicate
that the examiner was pointing to the vaginal area of the picture.
Not surprisingly, the child not only answered in the affirmative, but
the examiner used this response as evidence that the child had been
Often, transcripts simply indicate that the examiner is saying,
"Show me on the girl doll where he put his penis." Not
reported on the transcript is the examiner's pointing to and even
placing his or her finger on the vulva or even inside the doll's
vagina. The child, then, takes her finger and puts it in the same
orifice. It's almost like playing the game, "First you put
your finger in, then I'll put my finger in." Children are the
world's greatest imitators. They adhere slavishly to the dictum,
"if you're going to do it, I'm going to do it too." In
this insidious way, yet another sex-abuse accusation becomes
"validated," with no evidence in the transcript of what has
actually gone on.
Readers of transcripts are not generally aware of the significant
amount of activity that is taking place with the dolls while the
evaluator and child are talking. This is especially the case with
regard to the dressing and undressing of the dolls. I have seen
many tapes m which the child, after a snort period of "sex
play" with the dolls, wants to dress the dolls. Typically,
the examiner will find a variety of excuses for discouraging the child
from doing so, even to the point of physically preventing the child from
putting on the doll's clothing. Obviously, the evaluator wants to
prolong the period of exposure of the child to the naked dolls.
And even when the child is engaged in activities with no sexual import,
the naked dolls are prominently present within the child's visual field
and serve as a reminder that they can once again be played with.
Generally, it is only at the end of the session, just before it is time
to leave, that the dolls are dressed. But even during the dressing
phase, in which both the examiner and the child are engaged, there is
visualization and touching of the sexual parts.
The term leading question can be subcategorized for the purposes of
understanding better the various levels of leading questions and to
improving communication among those who are using this term. There
are also various degrees of leading stimuli (i.e., body charts,
anatomical dolls, projective cards) and leading gestures, which refers
to a maneuver that frequently operates simultaneously with leading
stimuli and leading questions. Evaluators must be more sensitive
to the importance of these, especially the leading gestures, in
American Academy of Child and Adolescent Psychiatry (1988).
Guidelines for the clinical evaluation of child and adolescent sexual
abuse: Position statement of the American Academy of Child and
Adolescent Psychiatry. Journal of the American Academy of Child and Adolescent Psychiatry,
APA Council of Representatives
(1991. February 8). Statement on the use of anatomically detailed dolls
in forensic evaluations.
August, R. L. & Forman, B. D. (1989). A comparison of sexually
abused and nonsexually abused children's behavioral responses to
anatomically correct dolls. Child Psychiatry and Human
Development, 20(1), 39-46.
Bellak, L., & Bellak, S. S. (1949). Children's Apperception
Larchmont, New York: C.P.S. Co.
Bellak, L., & Bellak, S. S. (1963). The Supplement to the
Children's Apperception Test (CAT-S). Larchmont, New York: C.P.S. Co.
Boat, B. W.. & Everson, M.D. (1988). Interviewing young children
with anatomical dolls. Child Welfare, 67, 337-351.
Clarke-Stewart, A., Thomson, W. C., & Lepore, 5. (1989).
Manipulating children's interpretations through interrogation. In G. S.
Goodman (Chair), Can children provide accurate eyewitness reports?
Symposium conducted at the biennial meeting of the Society for Research in Child Development,
Kansas City, Missouri.
Gabriel, R. M. (1955). Anatomically correct dolls in the diagnosis of
sexual abuse of children. Journal of the Melanie Klein Society, 3(2),
Gardner, R. A. (1968). The mutual storytelling technique: Use in
alleviating childhood oedipal problems. Contemporary
Gardner, R. A. (1971). Therapeutic Communication With Children: The
Mutual Storytelling Technique (). Riverdale, NJ:
Jason Aronson, Inc.
Gardner, R. A. (1973). The Talking, Feeling, and Doing Game. Cresskill, New Jersey:
Gardner, R. A. (1987). The Parental Alienation Syndrome and the Differentiation
Between Fabricated and Genuine Child Sexual Abuse ().
Cresskill, New Jersey: Creative
Gardner, R. A. (l988a). The Storytelling Card Game. Cresskill, New
Gardner, R. A. (1988b). Psychotherapy with Adolescents (). Cresskill,
New Jersey: Creative
Gardner, R. A. (1991). Sex Abuse Hysteria: Salem Witch Trials
Revisited (). Cresskill, New Jersey:
Gardner, R. k (1992). The Psychotherapeutic Techniques of Richard A.
Gardner: Revised Edition (). Cresskill, New Jersey:
Glaser, D., & Collins, C. (1989). The response of young,
nonsexually abused children to anatomically correct dolls.
Journal of Child Psychology
& Psychiatry, 30, 547-560.
Groth, A. N. (1984). Anatomical Drawings: For Use in the
Investigation and Intervention of Child Sex Abuse (). Newton Centre,
Massachusetts: Forensic Mental Health Associates.
Jampole, L., & Weber, M. K. (1987). An assessment of the behavior
of sexually abused and nonsexually abused children with anatomically
Child Abuse & Neglect, 11, 187-192.
Kritzberg, N. I. (1966). A new verbal projective test for the
expansion of the projective aspects of the clinical interview. Acta
Paedopsychiatrica, 33(2), 48-62.
Levy, D. M. (1939). Release therapy. The
American Journal of Orthopsychiatry, 9, 713-736.
Levy, D. M. (1940). Psychotherapy and childhood. The
American Journal of Orthopsychiatry, 10, 905-910.
Mclver, W. F., Wakefield, H., & Underwager, R. (1989), Behavior
of abused and nonabused children in interviews with anatomically correct
dolls. Issues in Child Abuse Accusations, 1(1),
Murray, H. (1936). The Thematic Apperception Test ()(). New York:
Realmuto, G. M., Jensen, J. B., & Wescoe, S. (1990). Specificity
and sensitivity of sexually anatomically correct dolls in substantiating
abuse: a pilot study. Journal of the American Academy of Child and Adolescent Psychiatry,
Rorschach, H. (1921). The Rorschach Test. New York: The
Sivan, A. B., Schor, D. P., Koeppl, G. K., & Noble, L. D. (1988).
Interaction of normal children with anatomical dolls.
Child Abuse & Neglect, 12, 295-304.
Underwager, R. C., & Wakefield, H. (1990). The Real World of
(). Springfield, Illinois:
Wakefield, H., & Underwager, R. (1988). Accusations of Child
Sexual Abuse ()(). Springfield, Illinois:
White, S., Strom, G. A., & Santilli, G. (1985). A protocol for
interviewing preschoolers with the sexually anatomically correct dolls.
Unpublished manuscript. Case Western Reserve University
School of Medicine, Cleveland, Ohio.
White, S., Strom, G. A., Santilli, G., & Halpin, B. M. (1986).
Interviewing young sexual abuse victims with anatomically correct dolls.
Child Abuse & Neglect, 10, 519-529.
Winnicott, D. W. (1968). The value of the therapeutic consultation.
In E. Miller (Ed.). Foundations of Child Psychiatry (pp. 593-608). London:
Yates, A., & Terr, L. (1988a). Debate forum: Anatomically correct
dolls: Should they be used as the basis for expert testimony? Journal of the American Academy of Child and Adolescent Psychiatry,
Yates, A., & Terr, L. (1988b). Debate forum Issue
continued: Anatomically correct dolls: Should they be used as the basis
for expert testimony? Journal of the American Academy of Child and Adolescent Psychiatry,
A. Gardner is a psychiatrist, author, publisher, and lecturer at
155 County Road, P.O. Box 522, Cresskill, NJ, 07626-0317.
This selection is adapted from his forthcoming book, True and
False Accusations of Chill Sex Abuse: A Guide for Legal and
Mental Health Professionals, Cresskill, NJ: Creative