APPENDIX B: A Sample Continuum of Medical History Questions and Confidence in the Responses :: Child Abuse Evaluation & Treatment for Medical Providers :: Child Abuse MD :: SUNY Upstate Medical University

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APPENDIX B: Text Description		A Sample Continuum of Medical History Questions and Confidence in the Responses

	Question Type	Example	Child Response

OPEN-ENDED	General	Why are you are here today?	Because Uncle John was mean to me.	MORE CONFIDENCE

	Focused	What happened with Uncle John?	He hit me.
		Where (on your body) did he hit you?	He hit my legs.
		What did he hit you with?	A stick.

	Multiple Choice	Did he hit you with a stick, a cane, a whip or something else?	He used a stick.
		Did this happen in the daytime or nighttime?	In the day and night.

	Yes/No Questions	Did he tell you not to tell?	Yes, he said not to tell my mother.
		Did you have your clothes off?	No, but my pants were down.

	Leading Questions	He pulled your pants down, didn't he?	Yes.
CLOSED-ENDED		Didn't he pull your pants down before he hit you?	Yes.	LESS CONFIDENCE

SOURCE: Adapted from Faller KC. A continuum of types of questions used in interviewing children alleged to have been sexually abused and confidence in responses. The Advisor 1990; 3(2).

Text Description for Appendix B

This table illustrates five types of questions and that confidence in the response decreases as questions become closed-ended.

Open-ended, general questions like "Why are you here today?" and a child's response of "Because Uncle John was mean to me." provide the most confidence in the response.
Open-ended, focused questions such as "What happened with Uncle John?" and a response of "He hit me." or "Where (on your body) did he hit you?" and a response of "He hit my legs." or "What did he hit you with?" and a response of "A stick." provide just slightly less confidence.
Multiple-choice questions like "Did he hit you with a stick, a cane, a whip, or something else?" and a response of "He used a stick." or "Did this happen in the daytime or nighttime?" and a response of "In the day and night." provide less confidence in the answer because the questions are no longer open-ended.
Answers to yes/no questions like "Did he tell you not to tell?" and a response of "Yes, he said not to tell my mother." or "Did you have your clothes off?" and a response of "No, but my pants were down." provide less confidence because the question is closed-ended.
Questions like "He pulled your pants down, didn't he?" and a response of "Yes." or "Didn't he pull your pants down before he hit you?" and a response of "Yes." provide the least confidence in the response because they are

Appendices Appendix B: A Sample Continuum of Medical History Questions and Confidence in the Responses Appendix C: Body Diagrams Appendix D: Burn Assessment - Rule of Nines Appendix F: Common Types of Diaphyseal Fractures Seen in Childhood Appendix G: Findings That May Be Confused with Abuse Appendix H: Differential Diagnosis Table Appendix I: List of Community Services Appendix J: Supplemental Resources Appendix K: Emergency Contraceptive Pills

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