Anatomically-Detailed Dolls

Anatomically-detailed dolls are routinely used in interviewing children suspected of being abused. The dolls are made of plastic or cotton and come dressed with easily-removable clothing. There are several commercial manufacturers who sell the dolls but they are also sometimes hand made. The mature female dolls have representations of breasts that protrude and the boy and mature male dolls have penises. There are holes in the dolls representing the mouth, anus, and vagina. The penis is able to fit into these openings. Often, the dolls have fingers that also fit into the openings. The mature male and female dolls have pubic hair. Although some early versions of the dolls appeared to have genitals that were disproportionately large, a survey of 17 sets of anatomical dolls (Bays, 1991) indicated that the genitals were not exaggerated in size. The design of the dolls is not standardized (see Figure 1).

Anatomical dolls are used by many different types of professionals (Boat & Everson, 1988, 1996; Conte et al., 1991; Kendall-Tackett & Watson, 1992), many of whom may have little or no training in their use. Despite their widespread use, these dolls are extremely controversial and there is disagreement in the professional community as to whether they should be used (e.g., Koocher et al., 1995; Yates & Terr, 1988). However, all agree that they have no demonstrated validity and reliability.

The dolls are sometimes used in ways that can induce serious error into the interview. In one videotape we reviewed, the mother, who was part of the interview, took the dolls, put them in the intercourse position, and then asked the child to do this. In another, the interviewer pointed to and touched the genitals of a doll that had been labeled "daddy" and told the child, "Show me where daddy touched you." Boat and Everson (1996) describe an example of a young child putting the doll's penis in her mouth but not responding when asked about it. Later, the interviewer asked, "You put [the doll's] wienie in your mouth. Whose wienie have you had in your mouth?" Boat and Everson (1996) also note that in 28% of the interviews with 2- to 5-year-olds and 9% of the interviews with 6- to 12-year-olds, the terms "play" or "pretend" were used as part of the doll interview. To invite a young child to play or pretend as a part of an interview about real events can be very confusing. This is compounded if the adult then assumes the pretend behavior reflects actual events.

We believe the dolls should not be used. There are no accepted standards for their or normative data on them (APA Council of Representatives, 1991; Koocher et al., 1995; Levy, Markovic, Kalinowski, Ahart, & Torres, 1995). The dolls, in the way they are often used, may become learning experiences for a child (Wakefield & Underwager, 1988; Underwager & Wakefield, 1990). Interviewers may model handling the dolls, undress them, or name them for the child. They may ask the child to show with the dolls what the accused person did. They may place the dolls in sexually explicit positions. Although some researchers claim the dolls are not necessarily suggestive (e.g., Everson & Boat, 1994), some nonabused children engage the dolls in representations of sexual play (Dawson & Geddie, 1991; Dawson, Vaughan, & Wagner, 1992; Everson & Boat, 1990; Gabriel, 1985; Glaser & Collins, 1989; McIver, Wakefield, Underwager, 1989).

Studies that claim to show differences between the doll play of sexually abused and nonabused children have major methodological shortcomings which limit any conclusions that can be drawn from them (Ceci & Bruck, 1993; Skinner & Berry 1993; Underwager & Wakefield, 1990, Wakefield & Underwager, 1988, 1989, 1994; Wolfner, Faust, & Dawes, 1993). DeLoache (1995b) notes that the basic reason for using anatomical dolls is the belief that the dolls will elicit information from children who are unable or unwilling to verbally describe the abuse. She observes, however, that not only is there no good evidence that dolls help in interviews with young children, but the presence of the dolls might result in the youngest children providing less information. Younger children cannot understand the basic self-doll relation assumed by interviewers. They cannot use dolls as symbols or representations for themselves and therefore cannot use the dolls to enact their own experiences. DeLoache concludes that the presence of an anatomical doll might even interfere with the memory reports of younger children.

Wolfner et al. (1993) point out that the necessary research to determine whether the dolls provide any incremental validity in establishing abuse would involve a group of children who were all suspected of being abused who, based on subsequent evidence, could be definitely divided into those who have and have not been abused. The doll interviews would have to take place prior to the children undergoing the standard procedures for investigating sexual abuse, since the process of being questioned about abuse could affect their reactions to the dolls. Such research has not been done-the studies that are claimed to support the use of the dolls only compare children suspected of abuse to those who are not suspected.

In summary, anatomical dolls are controversial, with some professionals claiming they are useful and others contending that they are too suggestive. Their use is especially problematical if the child's interaction with the dolls forms the basis for a conclusion about sexual abuse. Some professionals maintain that the dolls can be used if great care is taken not to be suggestive, if the child's interaction with the dolls is not the basis for an opinion about sexual abuse, and if they are not be used with very young children (e.g., Boat & Everson, 1996; Koocher, et al., 1995; Simkins & Renier, 1996).