Finding the Right Words

Bridging Best Practice Interviewing and Healthcare Communication in Cases of Child Abuse

Sammendrag

The ability to express one’s thoughts and be understood is fundamental to meaningful human interaction. In cases of child abuse or neglect, providing children with the opportunity to share their experiences and ensuring they are understood is not only a right but also crucial for identifying and addressing maltreatment. Healthcare professionals may encounter children who are victims of suspected abuse or neglect in both primary healthcare and forensic healthcare settings. Although effective communication between healthcare professionals and children is vital, poor communication can result in missed signs of maltreatment or even compromise the reliability of a child’s testimony regarding alleged abuse. While paediatricians have traditionally played a key role in responding to cases of child abuse, there is increasing recognition of the role that dental professionals can play in identifying and addressing such cases. This thesis was part of a multidisciplinary research initiative aimed at exploring best practice interviewing techniques within the context of child healthcare, with a particular emphasis on forensic dental and medical examinations. Adopting a post-positivist approach, the research examined the current body of knowledge in this field while seeking to contribute new insights. The first objective was to review existing literature on healthcare professionals’ ability to conduct conversations in accordance with best practice interview guidelines. The second objective was to assess the feasibility of an interview training program using a digital child avatar for healthcare professionals. Finally, the third objective was to investigate current communication practices during forensic examinations conducted as part of child abuse investigations. Study I was a scoping review that identified a significant gap in research on this topic, particularly highlighting the lack of literature involving dental professionals. Study II piloted an interview training program for healthcare professionals with experience working with children, featuring a child avatar chatbot driven by artificial intelligence. While no overall improvement in questioning strategies was observed, the study laid the groundwork for a promising training program adapted towards healthcare professionals. Study III examined current communication practices with children during forensic dental and medical examinations. The findings revealed that healthcare professionals primarily relied on close-ended questioning strategies, with only a minimal use of open-ended invitations. This thesis highlights the existing gap in both research and practice concerning best practice interviewing strategies in healthcare settings. It represents the first known study to assess the quality of conversations during forensic health examinations. The findings underscore the need for healthcare professionals working with children to be actively involved in discussions and training initiatives focused on best practice interviewing techniques.