Who is the next Larry Nassar?
Pennsylvania professionals must refer child-abuse cases to the experts and have more trust in what children tell them, urges. RACHEL P. BERGER, chief of child advocacy for Children’s Hospital
Like many other Americans, I read with horror about how Larry Nassar, as a doctor for USA Gymnastics and Michigan State University, abused the child athletes under his supervision for years. This happened despite a long history of disturbing rumors, whispered complaints and questions about the appropriateness of his behavior with his patients.
Unlike most Americans, I am not surprised. As a child-abuse pediatrician at the Child Advocacy Center at Children’s Hospital of Pittsburgh of UPMC for more than 15 years, I have seen up close a system that permits pedophiles like Larry Nassar — and former Pennsylvania State University football coach Jerry Sandusky before him — to abuse children, sometimes for decades. The Nassar and Sandusky cases followed a similar pattern: multiple victims, multiple missed opportunities to intervene, and a perpetrator revered by all in his community.
How can we prevent this from happening yet again?
First and foremost: We need to listen to our children and believe what they tell us. When a child makes a concerning statement, we, the adults, must contact the police or child protective services.
Too many children have told me they said nothing because they knew no one would believe them, especially when the person who abused them was in a position of authority or prestige in the community. Sometimes children know other children who are also victims and have witnessed them tell and not be believed, or even punished for lying.
Sexual predators take advantage of this; they almost always tell children no one will believe them. They are master manipulators of their victims, their victims’ parents, their own families — and even the police and child protective services. Sexual predators have so much control over children precisely because adults so often refuse to believe children.
We have learned a lot in the field of child protection over the past 30 years and we have developed a field of experts — forensic interviewers — who are specially trained in speaking with children who are possible victims of abuse. They do so in child-friendly environments.
There are approximately 800 Child Advocacy Centers around the country, including two in Pittsburgh. Child Advocacy Centers were established, in part, because of cases with multiple victims in which professionals responsible for investigating alleged abuse and ensuring children’s safety were not working collaboratively. Once our children speak up, it is incumbent upon the professionals who respond to seek out trained experts and give children the opportunity to speak with them; it is no different than giving children with cancer the opportunity to be treated by an expert in pediatric oncology.
Second is the issue of the burden of proof needed to label a child as a victim of abuse and an adult as a perpetrator of abuse. To be considered a perpetrator of abuse under the child protective services law, an adult needs to be a parent, guardian or someone in a caretaking role. Larry Nassar was none of these. As a result, he was a perpetrator only under criminal laws, which is why the police and FBI rather than child protective services investigated the reports of his abuse of children. In Pennsylvania, we call these cases “LEO” — Law Enforcement Only.
Under criminal law, the accused is innocent until proven guilty beyond a reasonable doubt. The accuser — the child in cases of
child abuse — is essentially considered to be lying unless there is proof that he or she is not. This contrasts with the much lower burden of proof for civil courts — where the child protective services system functions.
In many states, the burden of proof in civil childabuse cases is a “preponderance of evidence;” in Pennsylvania it is “substantial evidence.” Pennsylvania’s standard is higher than most states, but still lower than the criminal standard. And this is appropriate; the punishment in criminal court is incarceration of the perpetrator whereas the punishment in civil court is lack of continued access to children.
Most child-abuse cases, whether physical abuse, neglect or sexual abuse, are not prosecuted as criminal cases because the burden of proof is so high and the criminal justice process is so intimidating and traumatizing that children and their parents often want to avoid it at all costs. Because the complaints against Nassar were investigated only as crimes, the “beyond a reasonable doubt” statute was used; this bar was so high that it wasn’t reached until it was far too late.
Even if there was not enough proof two or three years ago to prosecute Nassar in criminal court, child protective services laws would have almost certainly been able to make a finding of abuse and prevented him from having contact with children. The current burden of proof is too onerous for abuse cases which are investigated only by law enforcement. We need to find novel solutions for these LEOcases.
Finally, we must have a sense of urgency for every child-abuse investigation. Child protective services agencies have strict regulations about the need to talk with alleged victims within a certain time frame — often within 24 hours — and to complete their investigations within 30 to 60 days. Law enforcement needs to have the same urgency, both to start and to complete an investigation. Sexual predators will continue to abuse even once they know they are being investigated.
In the end, Larry Nassar and Jerry Sandusky were to blame for what they did. But professionals’ and agencies’ desire to believe whatever they said enabled them to continue abusing children over many years.
I served on the Pennsylvania Task Force for Child Protection, which was established in Pennsylvania after the Jerry Sandusky prosecution, and many of the task force recommendations resulted in changes to our own state’s child protection laws. But these laws alone are not enough to protect children.
A law can require a multidisciplinary approach to evaluating abuse or an interview by a forensic interviewer, but no law can force professionals or any mandated reporter to believe what children say or to question the veracity of what adults say. Ultimately, it is believing what children say and ensuring that children know they will be believed that protects them.
Every professional involved in the Nassar case may ultimately resign, as did many involved in the Sandusky-scandal. But unless we fundamentally change the way we respond when children disclose abuse, lower the burden of proof and investigate every case expeditiously, we are unlikely to protect children in Pennsylvania from abuse.