Page 172 - ประมวลสรุปความรู้เกี่ยวกับพิธีสารอิสตันบูลและพิธีสารมินนิโซตา

VI. PSYCHOLOGICAL EVIDENCE OF TORTURE AND ILL-TREATMENT ISTANBUL PROTOCOL

symptoms, such as problems with memory keep in mind that children do not often express their
and quantify actual impairment and resulting thoughts and emotions regarding trauma verbally, but
considerations for redress and rehabilitation. The rather behaviourally. The degree to which children
assessment of cognitive capacities can also be useful are able to put feelings, thoughts and memories into
in determining barriers to participate in adjudicative words depends on the child’s age, developmental level
processes. Assessment of memory difficulties may and other factors, such as family dynamics, personality
inform judges and other decision makers about characteristics, cultural norms and psychosocial
the weight to be given to discrepancies in the context. There are several guidelines regarding how
evidence. A person may lack the mental capacity 478 to best interview a child that clinicians can use to
to instruct a legal representative, to consent to an support their work (see paras. 284–293 above).
examination, to be interviewed or to give evidence.
Assessment of impairments in cognition might 568. If a child has been physically or sexually
find a person with basic decision-making capacity assaulted, it is important, if at all possible,
has a lack of insight into how their memory and for the child to be seen by an expert in child
concentration difficulties affect their ability to give abuse and by using appropriate guides. 479
evidence and be interviewed or cross-examined.
Their ability to understand the inferences others (a) Developmental considerations
may draw from the ways in which these difficulties
affect their evidence may be compromised. 569. Developmental factors affect the capacity of
children and adolescents to perform tasks that
5. Children and torture are relevant to the assessment. 480 Research on
forensic interviewing notes that children begin to
566. Torture can affect a child directly or indirectly. manifest the capacity to recall events accurately
The impact can be due to the child having been between the ages of 3 and 6, but there is high
tortured or detained, the torture of parents or close variability. 481 Nonetheless, information that is
family members, or witnessing torture and violence valuable and truthful can be obtained from children.
or learning that it occurred to meaningful others. This will require careful interviewing procedures
Torture is a significant risk factor for disrupting and an awareness of children’s capacities. 482
children’s psychological, physical, emotional
and social development and negatively affecting 570. Infants can be evaluated and observed although
children’s mental and physical health. A complete they cannot be verbally interviewed. The clinician
discussion of the psychological impact of torture can comment on the level of activity, the nature of
on children and complete guidelines for conducting interaction and relationships with others, affect and
an evaluation of a child who has been tortured is state of regulation, general mood and involvement
beyond the scope of this manual. Nevertheless, in play. The reports of parents or caregivers on
several important points can be summarized. the behaviour of their infant (eating, sleeping
and temperament) may be useful, particularly in
567. First, when evaluating a child who is suspected of relation to changes in developmental milestones or
having undergone torture, the clinician needs to be noteworthy regressions or loss of previously held
informed and adhere to the Istanbul Protocol and its capabilities. Assessments using infant development
Principles. The clinician must make sure that children scales may provide an indication of the infant’s
receive support from caring individuals and that they level of functioning in relation to age group.
feel secure during the evaluation. This may require a
parent or trusted care provider to be present during 571. Preschool children generally have high levels of
the evaluation or parts of it. Second, the clinician must suggestibility and social compliance with adults’

478 Mental capacity refers to the capacity to understand the information relevant for a decision, as well as retaining and weighing up the information and communicating the
decision effectively. In torture survivors, these capacities may be affected as mood and psychotic disorders are likely to affect the ability to weigh and balance information
and cognitive deficits may affect the ability to understand and retain relevant information.
479 Royal College of Paediatrics and Child Health, The Physical Signs of Child Sexual Abuse: An Evidence-Based Review and Guidance for Best Practice (Lavenham, United
Kingdom, Lavenham Press, 2015). See also Astrid Heger, S. Jean Means and David Muram, eds., Evaluation of the Sexually Abused Child: A Medical Textbook and
Photographic Atlas, 2nd ed. (New York, Oxford University Press, 2000).
480 Linda Sayer Gudas and Jerome M. Sattler, “Forensic interviewing of children and adolescents”, Forensic Mental Health Assessment of Children and Adolescents, Steven N.
Sparta and Gerald P. Koocher, eds. (New York, Oxford University Press, 2006), pp. 115–128.
481 Ibid.
482 Ibid.

133