Keywords

Introduction

Investigating and prosecuting cases of suspected child sexual abuse (CSA) against preschoolers can be notoriously difficult for law enforcement. CSA involving young children often takes place in secret by someone the child knows, and eyewitnesses rarely observe the crime (Diesen & Diesen, 2013). Children’s disclosures to adults are therefore often necessary to identify cases of suspected CSA. But studies involving cases with strong corroborative evidence substantiating the abuse allegation (such as DNA evidence or photos of the abuse) show that young children sometimes delay their disclosures or do not disclose at all (Magnusson et al., 2017), which can limit the possibility to collect forensic evidence. In cases where preschoolers do disclose substantiated abuse, their statements tend to contain fewer details compared to those of older children (Paz-Alonso et al., 2013). Suspicions of CSA against young children are also sometimes unfounded, and young children’s reports can be influenced by a wide range of factors, including misunderstandings and suggestive conversations with adults (Ceci & Bruck, 1993).

Not surprisingly, given these difficulties, international research shows that criminal investigations of CSA against preschoolers are less likely to result in prosecutions and convictions compared to cases involving older children (Cross et al., 2020). The current chapter focuses on the challenges, potential possibilities, and different tensions involved within Swedish Barnahus when investigating CSA against preschool-aged children. The analysis will primarily concentrate on aspects relevant to case prosecution and young children’s access to child-friendly judicial procedures.

Preschoolers’ Abilities to Provide Legal Testimony

A child’s statement can be crucial for investigating, prosecuting, and adjudicating a case, particularly in the absence of strong corroborative evidence (Cross et al., 2020). The ability of young children to provide reliable testimony is related to their cognitive and linguistic abilities. Studies have shown that children from around three to four years of age can provide informative, albeit brief, statements about recent past events when forensically interviewed according to research-based guidelines (Hershkowitz et al., 2012; Magnusson et al., 2021). Young preschoolers’ ability to provide legal statements, however, often shows a great deal of variability. Children’s disclosures may also be affected by different emotional and motivational factors, including fears of negative consequences, a lack of social support, or feelings of shame or self-blame (Magnusson et al., 2017). Young children can also have a limited understanding of criminal actions and legal investigations, including understanding the purpose of an investigation or what is expected of them during investigative interviews (Magnusson, 2020).

For various reasons, young children may also describe abuse that has never occurred. False allegations may be the result of intentional coaching (such as during contentious custody disputes) or unintentionally suggestive questions asked by concerned adults. Compared to older children and adults, preschoolers are especially susceptible to certain types of suggestive influences, including conversations that include leading and close-ended questions (Bruck & Ceci, 1999). Preschoolers are also vulnerable to other forms of suggestions and interviewer bias, such as positive or negative reinforcement, invitations to speculate, the introduction of stereotypes, repeated questions, and compliance with authority figures (Magnusson, 2020). Suggestive influence can lead to increased risks of inaccurate details and false reports that are not grounded in self-experienced events. Furthermore, suggestive influence can cause memory impairment, which can potentially alter the content of memories or create false memories for events that have not occurred (Loftus, 2017). Unfounded allegations can also stem from misunderstandings and possible misinterpretations of young children’s statements or behaviour (Ernberg, 2018).

Swedish Barnahus’ Investigations of CSA Against Preschoolers

In Sweden, CSA cases involving preschool-aged children are typically investigated at a Barnahus. The first Swedish Barnahus was established in 2005 (in Linköping), and today, 33 local Barnahus are spread across the country, stemming from local initiatives. Even though most Swedish municipalities are connected to a Barnahus, some areas have yet to adopt the model. In contrast to other Nordic countries, Swedish Barnahus do not have a central governance or binding national regulations. Instead, each party (e.g., child welfare services, law enforcement, and health care) follows regulations within its respective agency, and its organisation is decided through local interagency agreements.

National guidelines from the Swedish National Police Board outline the criteria for being characterised as a Swedish Barnahus (Rikspolisstyrelsen [RPS], 2009). The guidelines prescribe that the overarching goal of Barnahus is to ensure children’s victim rights, give them access to adequate services and support, and, if necessary, provide immediate crisis and treatment interventions. A central part of Swedish Barnahus is to offer consultation meetings and child investigative interviews using co-hearing (i.e., where others listen to the interviews from another room). Criminal justice and social welfare investigations should be coordinated and conducted in a timely manner, and children should be given information and the opportunity to express their views (see also article 12 of the Convention on the rights of the child [CRC]; United Nations, 1989). The national guidelines stipulate that the child’s best interests should be in focus during the entire process. Professionals who handle these cases should have competence and experience for the task at hand, and each agency should ensure that their staff is provided with sufficient education (RPS, 2009).

National evaluations of Swedish Barnahus have found that large regional differences exist in the organisation (such as interagency agreements) and access to functions (such as services and expertise available at Barnahus) between different local Swedish Barnahus (Barnafrid, 2019; Kaldal et al., 2010; Landberg & Svedin, 2013; Åström & Rejmer, 2008); such differences may be connected to the lack of binding national regulations, coordination, and oversight. The case types that may gain access to Barnahus’ services may also vary due to differences in local interagency agreements and resource constraints (Barnafrid, 2019). Swedish Barnahus also differ in their inclusion of staff from the health care sectorFootnote 1 who may be summoned to Barnahus, such as paediatrics experts, child and adolescent mental psychiatry service staff, or specialists in forensic medicine. Swedish Barnahus also offer varying access to psychological treatment and support with local variations across the country (Barnafrid, 2019).

Because the lack of national oversight can limit the possibility to collect and compare data on Barnahus cases across Sweden, available national statistics are lacking on the number of CSA cases involving preschool-aged children and their access to different functions at Barnahus. In 2021, the Swedish police received 10,163 reports of suspected child sexual abuse against children of all ages (Swedish Prosecution Authority, 2021). Of that number, a total of 36% led to prosecution, waivers of prosecution, or impositions of a fine. We should note that these statistics include a wide range of crimes, including both online and offline offences. The Swedish National Council for Crime Prevention (Brottsförebyggande rådet [BRÅ], 2022) provides criminal statistics sorted by crime labels and age cohorts, including crimes involving children below 15 years of age. According to BRÅ (2022), the police investigated a total of 2,733 reports during 2021 involving the rape or gross rape of a child (955 [35%] led to prosecution), 939 reports of sexual assault or gross sexual assault of a child (259 [28%] led to prosecution), 160 reports of sexual exploitation of a child (24 [15%] led to prosecution), 2,792 reports of other forms of sexual molestation of a child (507 [18%] led to prosecution), and 205 reports of grooming involving children below 15 years of age (26 [13%] led to prosecution). No official statistics exist on the exact number of reports involving preschoolers, as the national database of criminal statistics does not provide detailed information about the age of the child (BRÅ, 2022).

Prosecutors play a central role in criminal investigations of CSA, since they are in charge of the criminal investigation (Swedish Code of Judicial Procedure, 1942:740, chap 23, §3). This task includes making decisions about whether an investigative interview should be conducted with the child. The interviewing task is delegated to the police, but the prosecutor should be involved when planning the interview and is advised to always observe the interview via co-hearing (Swedish Prosecution Authority, 2022). Following a child investigative interview, the prosecutor should assess the child’s statement, such as its evidential value and what further actions should be taken based on the information from the child. The prosecutor is also responsible for making further decisions about the criminal investigation (e.g., whether to request a forensic medical examination) and eventually decides whether to prosecute the case or close the criminal investigation. By law, Swedish prosecutors are required to be objective and impartial (Swedish Code of Judicial Procedure, 1942:740, chap. 23, §4). They should therefore only prosecute a case when they believe sufficient evidence exists to prove the suspect’s guilt.

The police are responsible for conducting investigative interviews and executing other investigative measures. Evidence-based child interviewing is a highly complex task that requires theoretical knowledge and ample practical skills. During interviews with young children, investigative interviewers need to skilfully be able to adapt the interview to a child’s level while being attentive to young children’s developmental abilities and limited attention spans (Magnusson et al., 2020). In Sweden, child investigative interviews should be conducted by “a person with special competence for the task” (Decree on Preliminary Investigations, 1947:948, §18), traditionally a police employee trained in child investigative interviewing. Over the past decade, Swedish police employees have been offered a specialised training programme focused on investigating crimes against children and child investigative interviewing. The training programme follows an adapted and flexible version of the internationally established National Institute of Child Health and Human Development (NICHD) protocol and its recent revisions (Cederborg et al., 2013, 2021; see also Myklebust, 2017). The revised NICHD protocol is a research-based method for conducting investigative interviews with children of different ages (see Lamb et al., 2018).

Investigations of CSA should be conducted in a timely manner (within 90 days), and the initial child interview should be held within 14 days after initiating the preliminary investigation (Swedish Prosecution Authority, 2023; Decree on Preliminary Investigations, 1947:948, §2a). Children below 15 years of age generally do not provide their testimony directly in Swedish courts (Swedish Code of Judicial Procedure, 1942:740, chap 35, §14). Instead, their video-recorded police interview is presented during the trial (Swedish Prosecution Authority, 2023). During the criminal investigation, others involved in the case (e.g., prosecutor, defence attorney, children’s legal counsel, and child welfare workers) can follow the child interview via co-hearing from an adjacent room at Barnahus. Because children are not cross-examined in court, children’s video-recorded interviews should be assessed with caution, according to the Swedish Supreme Court (for more information, see Kaldal, 2023). To satisfy defendants’ rights to a fair trial, the defence should also be given the opportunity to pose questions to the child through the police interviewer (Council of Europe, 1950, art. 6), who can rephrase the questions suggested by the defence to make them developmentally appropriate and non-leading.

Initial consultation meetings should be held at a Barnahus in connection to the police report to coordinate different case actions between agencies (RPS, 2009). Importantly, the consultation meetings should involve representatives from the criminal justice system, child welfare services, and, depending on the requirements in the case, practitioners from the health care sector. The exact content and structure of the initial consultation meeting are not specified in the national Barnahus criteria (Barnafrid, 2019), and what is brought up in the meeting can depend on the specific case and the extent to which the different agencies have prior information about the child. The consultation meetings can be used to share background information about the child and the case between agencies, such as what is known about how the crime allegation surfaced, the child’s relationship to the suspect, the child’s living situation, and any special needs the child might have. The meeting is also used to plan for the child interview (such as when it should be conducted, who should participate, and what should happen after the interview) and other measures that need to be taken during the investigation, including whether a forensic medical examination should be scheduled (Swedish Prosecution Authority, 2022).

In 2014–2015, the Prosecution Development Centre in Gothenburg (2016) evaluated the quality of 60 child investigative interviews in cases that had not led to prosecution. The centre identified several problems, including that interviews were too long in relation to children’s developmental levels, the attendance of prosecutors was relatively low during child interviews, and the first interview was often not held within the stipulated time length (14 days after initiating the preliminary investigation). The evaluation also brought up a need for increased flexibility to adjust the interviewing method to individual children’s needs and the situation at hand. The problems the centre identified were particularly pronounced in cases involving preschoolers.

Following the report, the Swedish Prosecution and Police Authorities developed a handbook on child interviewing with additional guidance to address the challenges the centre had identified (Swedish Prosecution Authority, 2022). During the process, the working group went on study visits to the National Children’s Advocacy Center in Huntsville (Alabama, USA), Statens Barnehus Oslo (Norway), and Linköping Barnahus (Sweden). The working group also collected information material from different local Swedish Barnahus. The new guidelines, which were released in 2018 and updated in 2022, emphasise the need for flexibility during the child interview. Flexibility includes being attentive and making adaptations to the interviewing protocol, depending on children’s needs and maturity. The guidelines describe this factor as being especially important with younger children and children with disabilities. The guidelines also encourage close interagency collaboration when investigating crimes against children and note that child interviews should be conducted at a Barnahus when the child lives in an area that has established a local Barnahus (Swedish Prosecution Authority, 2022). In other cases, the child interview should be conducted at a police station that has special recording equipment for child interviews.

In the present chapter, we focus on challenges, potential possibilities, and institutional tensions at Swedish Barnahus when investigating CSA against preschoolers. We will first summarise and integrate the findings from our two doctoral dissertations, which focused on analysing the work of Swedish prosecutors and specialised police interviewers in CSA cases involving young children. Based on a follow-up survey with Barnahus coordinators, we then explore whether the interagency collaboration and access to specialised expertise at Barnahus could help alleviate some of the challenges that we have identified. Lastly, by situating our findings in relation to former evaluations of Swedish Barnahus (Barnafrid, 2019; Kaldal et al., 2010; Landberg & Svedin, 2013; Åström & Rejmer, 2008) and recent governmental reports (Statens offentliga utredningar [SOU], 2022a, b: 1, 70), we discuss how the use of interagency collaboration and access to specialised expertise is currently complicated by different institutional tensions.

Method

The current chapter is based on studies using various data and analytical approaches (many use a mixed-methods approach), including archival studies and survey data from practitioners. One common feature of the studies presented below is that, due to the scarcity of previous research on preschoolers in the Swedish justice system, they were conducted using an exploratory approach, with analyses being largely data-driven. We provide a brief overview of each study below.

Archival Study of Prosecuted and Discontinued Cases

An archival study was conducted to examine any differences between prosecuted and discontinued cases of alleged CSA against preschool-aged children (Ernberg et al., 2018a). An analysis of 97 court cases from a research database containing CSA verdicts from 2010 to 2014 (Ernberg et al., 2018b) was used to represent prosecuted cases. We also requested access to discontinued criminal investigation files from a Swedish police district and obtained data on 37 discontinued cases involving preschool-aged children. The dataset contained archival material on a total of 130 child complainants between 2–6 years of age at the time of the alleged abuse. A coding manual was used to quantify the material, and the data were analysed using descriptive and inferential statistics. Specifically, we used chi-square tests and binary logistic regression to examine whether different case factors would predict prosecution decisions at a statistically significant level (see Ernberg et al., 2018a).

Survey with Specialised Prosecutors

Using survey methodology, we examined Swedish prosecutors’ experiences investigating CSA against preschoolers (Ernberg et al., 2020). An online survey was distributed to all Swedish prosecutors (N = 913) with the assistance of the Swedish Prosecution Authority. A total of 94 experienced prosecutors who specialised in child cases and had experience working with CSA cases involving preschoolers participated in the survey.Footnote 2 The survey consisted of both close-ended scale items and open-ended questions; the latter for example prompted prosecutors to elaborate on perceived challenges when investigating and prosecuting cases of CSA against preschoolers. The data were analysed using qualitative (data-driven thematic analysis) and quantitative (descriptive and inferential statistics) methods.

Survey with Specialised Police Interviewers

A second online survey was distributed to Swedish police employees who specialised in interviewing children (Magnusson et al., 2020). The focus was on examining their self-reported experiences of conducting interviews with children of different ages. A total of 88 police interviewers with experience conducting child interviews responded to the survey.Footnote 3 The survey contained both close-ended scale items and open-ended questions, such as asking the participants to describe the main challenges when interviewing preschool-aged children. Their responses were analysed using quantitative and qualitative approaches, including descriptive statistics, thematic analysis, and content analysis.

Survey with Barnahus Coordinators

For the current chapter, we also collected new data during February 2023 using an online survey sent to Swedish Barnahus coordinators who had posted their email information online (N = 24 out of 33 local Barnahus). A link to the survey was also posted in a Swedish Facebook group for Barnahus employees. The survey focused on the use of initial consultation meetings and access to psychological expertise and health care involvement when investigating CSA against preschoolers. A total of 9 local Barnahus participated, and their responses were analysed using descriptive analyses. Because the sample consisted of only 27% of all local Swedish Barnahus, the results should be interpreted with caution.

Results

Differences Between Prosecuted and Discontinued Cases

Prosecuted cases of alleged CSA against preschoolers were more likely to contain a suspect confession (30%) or forensic evidence (26%), compared to discontinued cases—not a single discontinued case had any of these types of evidence available (Ernberg et al., 2018a). The most common type of forensic evidence was video or photo documentation of the abuse (16%), followed by DNA evidence (9%) and corroborative medical evidence (4%). The extent to which children had been given a forensic medical examination was roughly the same in prosecuted (19%) and discontinued cases (22%). The likelihood of prosecution also increased with the age of the child. Other factors that decreased the likelihood of prosecution included the presence of ongoing custody disputes (which was the case in 35% of the discontinued cases, compared to 7% of prosecuted cases), or if a child previously had been placed in foster care prior to the abuse allegation (22% of discontinued cases and 1% of prosecuted cases).

Challenges Related to Prosecutors’ Decision-Making

Swedish prosecutors (N = 94) described several challenges when investigating and prosecuting cases of alleged CSA against preschoolers (Ernberg et al., 2020). Prosecutors emphasised that young children cannot be expected to remember and retell their experiences like adults do, since preschoolers’ developing cognitive and linguistic abilities will affect their narratives. Prosecutors also emphasised that preschoolers are more vulnerable to suggestions and that their statements could be influenced by prior conversations with adults, such as worried parents or social welfare interviewers. Some noted that abused children may have difficulty disclosing their experiences due to feelings of guilt, shame, or loyalty to the perpetrator. Prosecutors might encounter additional difficulties in cases of ongoing custody disputes or other conflicts present in connection to the CSA investigation. They also brought up various legal requirements in criminal cases and described CSA against preschoolers as being particularly challenging to prosecute, as such cases often lack corroborative evidence. Some prosecutors discussed Swedish court standards for evaluating testimony, which can be difficult to fulfil in cases involving preschoolers; for example, a testimony should be clear, long, and detailed (Nytt Juridiskt Arkiv [NJA], 2017, p. 316).

The prosecutors also emphasised that the quality of the child investigative interview was crucial to the investigation, such as being able to adapt the interview to each child in a developmentally sensitive and non-suggestive manner. But interview quality could depend on the competence of the investigative interviewer and the available resources within the police. According to some prosecutors, interviewing skills are related to personal qualities (such as social aptitude) as well as experience. Organisational limitations, including the scarcity of qualified child interviewers, may lead to substantial delays in child interviews, which could limit the possibility to collect corroborative evidence and might impair young children’s memory recall. Some prosecutors brought up other organisational limitations, such as stretched resources and high employee turnover rates within the police.

Challenges for Child Investigative Interviewers

Swedish police interviewers (N = 88) reported several challenges when conducting investigative interviews with preschoolers (Magnusson et al., 2020), including that young children’s limited communication skills, memory abilities, and short attention spans made interviews with them particularly difficult. They often perceived preschoolers’ testimony as being brief and incoherent. Some interviewers noted that preschoolers generally have difficulties providing certain details of forensic value, such as time and frequency estimates. Another challenge the interviewers brought up concerned their questioning strategies. Preschoolers could have difficulty responding to broad open-ended questions and approaching the topic under investigation. Some mentioned the challenge of trying to ask more direct questions, necessary for investigative purposes, without being too suggestive. Interviewers described that they felt time pressure during these interviews, since preschoolers quickly become tired and inattentive.

The police interviewers reported having to modify their procedures when interviewing young children, including reducing the length of the introductory phase of the interview to prevent fatigue. Other common adjustments involved adapting their language, for example by talking more slowly and using simple words and short sentences (Magnusson et al., 2020). We could not find any systematic pattern in their reported adaptations. Nearly all police interviewers stated that they mainly conducted their child interviews at Barnahus (95%); furthermore, approximately 72% had completed the child interviewing training programme available to Swedish police at the time of data collection.

Current Practices, According to Barnahus Coordinators

According to Barnahus coordinators (N = 9 local Barnahus), initial consultation meetings were commonly used in CSA cases involving preschoolers (see Table 8.1). Some coordinators reported that they sometimes made exceptions to this practice in urgent cases. Others reported that consultation meetings were primarily used in CSA cases that included preschoolers who had been victimised by family members and/or other cases that involved the child welfare services, hence potentially excluding CSA cases with suspects outside the child’s immediate family.

Table 8.1 Barnahus coordinators’ responses regarding access to different functions at their local Barnahus when investigating CSA against preschoolers (N = 9)
Full size table

Similarly to past evaluations of the state of Swedish Barnahus (Barnafrid, 2019; Kaldal et al., 2010; Landberg & Svedin, 2013), we found that access to staff with expertise in developmental psychology and medicine varied between different local Barnahus.Footnote 4 As Table 8.1 shows, staff with expertise in these areas rarely participated during the child investigative interview. Seven Barnahus coordinators chose to elaborate in response to an open-ended question asking if they had experienced a need for more specialised knowledge about investigative interviews with preschoolers in CSA cases. The most common responses mentioned a need for more knowledge and continued competence development for different practitioners involved with these cases, the benefits of receiving support from psychologists with expertise in child development, and the need to have realistic expectations of preschoolers’ capabilities (such as their difficulty providing time estimates).

When asked to estimate the number of child interviews with preschoolers in CSA cases that were conducted during 2022, the estimates varied significantly between the different local Barnahus. Three Barnahus staff members reported zero cases (two Barnahus staff members handled cases involving preschoolers but did not conduct interviews due to children being too young or other unspecified reasons), others reported between 1–11 cases, and one Barnahus member estimated between 100–200 cases. Importantly, several Barnahus coordinators emphasised that they did not have access to the exact statistics of cases handled by the police, for example because the police can sometimes conduct separate child interviews at Barnahus without using the Barnahus’s other functions. These estimates should therefore be interpreted with caution.

Discussion

In the following sections, we describe areas where we believe the interagency collaboration and specialised expertise at Barnahus could help alleviate some of the challenges identified above when investigating CSA against preschoolers. Specifically, we will discuss access to corroborative evidence through interagency collaboration, the importance of providing high-quality and timely child investigative interviews, and the potential use of developmental expertise when planning, conducting, and evaluating interviews with preschoolers. Drawing on our findings and previous evaluations of Swedish Barnahus (Barnafrid, 2019; Kaldal et al., 2010; Landberg & Svedin, 2013; Åström & Rejmer, 2008), as well as governmental reports (SOU, 2022a, b: 1, 70), we also identify different tensions that complicate the realisation of these objectives within the Swedish Barnahus context.

Searching for Corroborative Evidence

Having an increased ability to identify and access corroborating evidence could be one way to strengthen criminal investigations of CSA cases against preschoolers. Clearly, the type of evidence available in a case will influence prosecutorial decision-making (Ernberg, 2018). Access to corroborative evidence of strong evidential value (e.g., DNA evidence or photos of the abuse) and suspect confessions were the strongest predictors for prosecution, according to our studies. We should note, however, that this type of evidence only occurs in a small number of investigations and that its absence does not indicate that a crime has not taken place (Diesen & Diesen, 2013). As demonstrated in our archival study of CSA cases involving preschoolers, both prosecuted and discontinued cases often lacked evidence of strong corroborative value (see also Cross et al., 2020). Furthermore, 55% of prosecutors who responded to our survey reported that the main challenge in these cases was the lack of corroborative evidence.

The use of initial consultation meetings at Barnahus could help provide ideas for other potential evidence, including gathering information about possible witnesses and other case-relevant history, such as children’s early disclosures to other agencies. And since young children cannot be expected to provide details that exceed their developmental level, such as time and frequency estimates, law enforcement may benefit from having information from other agencies about the child’s background and living situation when trying to ascertain the time and location of a suspected crime. According to our survey with Barnahus coordinators, consultation meetings were regularly held in CSA cases involving preschoolers, with potential exceptions in urgent situations and in cases that did not involve child protective services. But while representatives from the police, prosecution, and social welfare services are typically present at these meetings (Barnafrid, 2019), local Swedish Barnahus differ in their inclusion of staff with medical expertise and staff with expertise in developmental psychology. The varying access to representatives from the health care sector is concerning, since it indicates local differences in children’s access to relevant competence at the initial consultation meeting (see also Barnafrid, 2019).

Exchange between agencies has also proven to be a challenging obstacle for information-sharing during consultation meetings at Swedish Barnahus. Currently (as of 2023), the legal conditions for sharing case-specific information during these meetings are unclear, which has led to regional differences in the interpretation of the current legalisation (Barnafrid, 2019; SOU, 2022b: 70). This legal dilemma thus limits the possibility to exchange information about the child during consultation meetings. Among others, Landberg and Svedin (2013) have brought up the need for new legislation to facilitate interagency collaboration at Swedish Barnahus.

In our review of CSA cases from 2010–2014, only a small percentage contained evidence related to forensic medical examinations. Medical examinations conducted at Barnahus could offer one potential way to identify corroborating medical evidence,Footnote 5 which in turn could affect prosecutorial decisions (Ernberg et al., 2018a). While the possibility exists to conduct forensic medical examinations at many local Swedish Barnahus, either in their own facilities or at nearby hospitals, not all children suspected of being victims of CSA are examined (Barnafrid, 2019). The inclusion of medical staff during consultation meetings and the co-hearing of children’s interviews could potentially help increase access to medical examinations. However, while a representative with medical expertise can often participate during consultation meetings, albeit with local variations across different local Barnahus, the use of forensic medical examinations is still limited in Swedish settings (Barnafrid, 2019; see also Stefansen et al., Chapter 4, for an overview of medical examinations in a Norwegian context). The medical expertise at Barnahus could also be valuable to help law enforcement and the social welfare services interpret children’s medical journals, although current regulations on information exchange have created substantial difficulties for Barnahus to utilise medical expertise for these tasks. For a more in-depth discussion of current challenges related to medical examinations and information exchange, see Barnafrid (2019); for a Nordic perspective, see Stefansen et al. (2017).

Providing High-Quality Child Interviews in a Timely Manner

According to our current studies, and in line with international research, the quality of child investigative interviews can be critical for the criminal investigation (Cross et al., 2020). Swedish prosecutors emphasised that the competence of the interviewer is paramount when interviewing preschoolers. Police interviewers described these interviews as particularly challenging and reported making various deviations from the NICHD protocol. Beyond adapting their language and question strategies, interviewers described that they shortened, modified, or removed different parts of the introductory phase of the interview (e.g., explaining and practising different conversational rules) to accommodate preschoolers. While we could not find any systematic pattern in these self-reported adaptations, the substantial variation between interviewers is concerning and indicates a need for clearer guidelines on adaptations when interviewing young children.

Due to the added complexities when conducting interviews with preschoolers, other countries, such as Finland and Norway, have implemented systems for using specialised staff when interviewing preschoolers and children with cognitive disabilities or neuropsychiatric disorders. Specifically, Norway uses police investigators who have attended specialised training focused on interviewing preschoolers (see Langballe & Davik, 2017), and Finland uses experts in forensic psychology who specialise in handling challenging cases involving young children (see Korkman et al., 2017). As of today (2023), Sweden does not require in-depth specialisation in these cases. Instead, interviews with children of all ages are conducted by police employees with “special competence for the task” (Decree on Preliminary Investigations, 1947:948. §18). No regulated criteria currently exist for what this competence should entail, but in practice, the interviewer should preferably have completed the available training programme (Swedish Prosecution Authority, 2023). However, according to a recent government report that surveyed members of Sweden’s seven police regions, child investigative interviews are sometimes conducted by staff with limited training (SOU, 202a2: 1). Requiring in-depth specialisation in interviewing young children could provide one way forward to facilitate investigations of CSA against preschoolers.

In line with the concerns reported by prosecutors, members of the Swedish police regions also described issues with employee turnover among child investigative interviewers (SOU, 2022a: 1). The limited number of properly educated child interviewers could lead to increased time delays between the case being reported to the police and the child interview, as well as a need to prioritise between cases. Currently, because no national evaluations have examined the actual quality of child interviews from a large and representative sample (SOU, 2022b: 70), we do not know the extent to which child investigative interviews with preschoolers follow research-based recommendations, nor do we know the number of child interviews that are conducted by police employees who lack education in the complexities of interviewing young children.

The Swedish child interviewing programme was recently reformed, from a three-step tier system (around 82 days) to a short hybrid course (30 days), to quickly increase the number of child interviewers (SOU, 2022a: 1). While the beneficial effects of the previous child interview courses have been scientifically studied (Cederborg et al., 2013, 2021), the potential consequences of this reduction have not been systematically investigated to date. According to the national Barnahus criteria (RPS, 2009), each agency should ensure the competence of its staff, and investigations should be conducted in a timely manner. As seen in the example above, however, organisational and professional limitations pose various restrictions on law enforcement agencies’ ability to fulfil these criteria. Time delays before conducting a child interview and limited access to specialised staff with the necessary competence required to interview young children could adversely affect the criminal justice investigation and children’s access to child-friendly justice.

Potential Use of Psychological Expertise When Planning, Conducting, and Evaluating the Child Investigative Interview

According to the prosecutors and police interviewers we surveyed, identifying young children’s cognitive and communicative abilities can be valuable when planning, conducting, and evaluating a child investigative interview. The practitioners described that this task can be difficult, however. Although research shows that children can begin to be interviewed about recent events starting from approximately three to four years of age, their reports tend to be brief and unstructured (Magnusson et al., 2021). Recommending a cut-off point based on chronological age is also difficult, as young children’s interviewing abilities depend on a wide range of developmental abilities and situational factors (see Brubacher et al., 2019). Prosecutors and police interviewers alike acknowledged that preschoolers’ abilities to provide testimony varied between children. Cases involving young preschoolers may be particularly difficult to investigate, as demonstrated in our archival study on prosecuted and discontinued cases (see also Bunting, 2008), where young preschoolers were sometimes not interviewed due to their limited verbal abilities. Police interviewers described the difficulty in collecting information about young preschoolers’ verbal abilities prior to the interview, especially since an investigative interview is such an unfamiliar setting compared to preschoolers’ everyday conversations with familiar adults.

Police and prosecutors may benefit from having specialised knowledge from fields such as developmental and forensic psychology when investigating and prosecuting CSA against young children (see Korkman et al. [2017] for an overview of the use of forensic experts when investigating crimes against young children in Finland). Experts may be involved during the preliminary investigation to provide guidance and/or during court proceedings to deliver expert testimony. Unlike other countries, following substantial controversy in the past, the use of psychological experts in CSA cases is uncommon during Swedish investigations and court proceedings (Gumpert et al., 1999). For example, in our review of prosecuted cases involving preschoolers between 2010 and 2014, only 5% contained an expert statement about the child’s testimony that was presented during trial (Ernberg et al., 2018b). The need for specialised expertise is addressed in the guidelines for Swedish prosecutors, however, which specify that prosecutors and police interviews may need to acquire expert knowledge of child development during the preliminary investigation (Swedish Prosecution Authority, 2023; see also the Decree on Preliminary Investigations, §19). The interagency collaboration at Barnahus could present an opportunity to include developmental expertise to a larger extent when planning and conducting the child interview (see also Langballe & Davik, 2017). According to our survey with Barnahus coordinators, most had access to expertise in developmental psychology during the initial consultation meetings. Many coordinators also reported that they could include practitioners with developmental expertise during the co-hearing of the child interview, although this was not a regular practice. This expertise typically consisted of clinical psychologists or other staff from the child and adolescent psychiatry service (BUP).

The inclusion of developmental expertise to facilitate the child interview provides both promise and a dilemma. While clinical child psychiatric staff may be able to help assess children’s cognitive and linguistic abilities and provide suggestions on how to adjust the interview to children’s developmental levels, such staff in Sweden are typically not trained in the intricacies of evidence-based child investigative interviewing, which differ significantly from therapeutic conversation methods. Child psychiatric staff can also have varying knowledge of contemporary research on young children’s testimony in CSA cases (Bjørdal Kostopoulus et al., 2019). The potential assistance of developmental expertise also cannot replace the need for a skilled child interviewer who has practical expertise in questioning young children. Whether the emphasis on, and access to, specialised developmental expertise will affect current interviewing practices in Sweden remains to be seen. Future research is urgently needed to systematically examine the knowledge and potential advice provided by child psychiatric staff in CSA cases. If these practices adhere to available research on children’s testimony and evidence-based child interviewing, then the psychological expertise at Swedish Barnahus could provide a promising resource to help facilitate communication during investigative interviews with preschoolers. If any limitations come to light, then educational initiatives or specialisation courses may be helpful to bridge the gap between clinical and forensic psychology.

Conclusions

The interagency collaboration and access to specialised expertise at Swedish Barnahus could provide promising solutions for overcoming some of the present challenges when investigating child sexual abuse (CSA) against preschoolers within the criminal justice system. Different organisational and professional tensions complicate these investigations, however, including uncertainty about information exchange during consultation meetings, the limited use of forensic medical examinations, resource constraints within the police, and access to specialised staff who have in-depth expertise of evidence-based investigative interviewing techniques involving young children in CSA cases. As evident by current studies and previous evaluations of Swedish Barnahus (Barnafrid, 2019; Kaldal et al., 2010; Landberg & Svedin, 2013; Åström & Rejmer, 2008), preschoolers may have varying access to child-friendly justice, depending on local agreements and practices.

During the writing of this chapter, a comprehensive governmental report was released by the Commission of Inquiry comprising a proposed national strategy for preventing and combating violence against children (SOU, 2022b: 70). The report emphasises the importance of providing children equal access to child-friendly justice across Sweden, including the need for national coordination and oversight of Swedish Barnahus. The report also discusses the importance of interagency collaboration and information exchange between agencies when children are subjected to violence. Furthermore, the commission’s report addresses the value of timely child interviews that are conducted by qualified child interviewers with specialised competence in interviewing young children. Taken together, these proposals are in line with the challenges we have presented in this chapter. The report is currently (as of 2023) under consideration at 159 different referral bodies. We have yet to see what effects the proposed national strategy will have on the criminal justice system and preschoolers’ access to child-friendly judicial procedures.