Exploring the Contours of Expert Testimony Regarding Child Sexual Abuse Accommodation Syndrome

The term “child sexual abuse accommodation syndrome” (CSAAS) was initially coined by psychiatrist Roland Summit in 1983 in an effort to understand the various ways children react to sexual abuse. From an evidentiary perspective, not all states recognize CSAAS as admissible. Indeed, CSAAS is not recognized by the American Psychiatric Association or the American Psychological Association. In California, expert testimony regarding CSAAS is admissible.  A recent case, People v. Mason, sheds light on the use of CSAAS in court. Note that Mason is an unpublished opinion.

The practice of bringing a “pure expert” to court is common. The purpose is simple: to educate the judge or jury on an important issue in the case, often including relevant research. Federal and state rules of evidence characterize an expert as someone with specialized acumen or knowledge—having one degree or many degrees is not necessarily how an individual is recognized as an expert by a judge. The judge acts as a gatekeeper. As such, the judge must be convinced that a mental health professional proffered as an expert can validate their opinions and recommendations. Expert witnesses traditionally must present “a reliable basis in the knowledge and experience of the discipline.” What type of information helps substantiate expertise? “Sufficient data, reliable principles and methods, reliable application of those principles and methods to the case facts.” (“How to Examine Mental Health Experts,” Zervopoulos, 52).

The presentation of expert mental health information to the court is essential, but such evidence does not need to be characterized as a “syndrome” and it is likely to draw objections based on the fact, as mentioned above, that neither APA recognizes such a distinction. But a person’s behaviors based on observations, evaluations and appropriate records may indicate a pattern of behaviors that have been described and identified in relevant, empirically-sound and peer-reviewed research as indicative of someone having experienced certain sorts of trauma. This may provide the expert confidence to report to the court that a person under the circumstances as are present in the case is likely to have experienced the trauma. An expert might even question the necessity of using the term “syndrome” to describe a pattern of behaviors. 

In the Mason case, the defendant, Anthony Maurice Mason, was convicted of two counts of continuous sexual abuse of his two daughters. Mason appealed the conviction, contending that the trial court abused its discretion in allowing certain expert testimony on CSAAS, as well as due to the trial court allegedly giving improper instructions to the jury regarding that issue. What is unique is that the expert, Dr. Carmichael, acknowledged in his testimony that “… he did not know anything about the facts of the case, had not read reports or interviews related to the case, and knew nothing about the specific victim in the case or the relationship of ‘the victim’ to the defendant.”

What did Carmichael know and testify about? Carmichael opined on the five aspects of CSAAS, and the correlation of how those five items impact disclosure of sexual abuse. Precedent in California stands for the proposition that trial courts may allow CSAAS testimony in order “’to explain the emotional antecedents of abused children’s seemingly self-impeaching behavior,’ such as delayed exposure of the abuse.” The five stages of CSAAS have been identified as: 

  1. Secrecy
  2. Helplessness.
  3. Entrapment (accommodation).
  4. Delayed and unconvincing disclosure.
  5. Retraction of the complaint due to adult disbelief and blaming the victim.


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