By Dr. Suruchi Sood

What really happens to children who testify about sexual abuse?

and what the research says we must do differently

Imagine being a child who has survived something unspeakable. Trusted adults tell you that going to court is important, that it will help, that your voice matters, and that telling the truth will set things right. And so, you go.

You sit in a room that feels completely different from anywhere you’ve ever been. You’re asked to describe in detail what was done to you. And across the room, sometimes just feet away, sits the person who did it.

For many children, this is not the start of healing; it’s a second wound.

This is not a minority opinion or a fringe concern. It is the conclusion of decades of thorough, peer-reviewed research across psychology, law, medicine, and child development (Goodman et al., 1992; Nathanson, 2003; Quas et al., 2005; Elmi et al., 2018; Pantell, 2017). It is the position of the American Academy of Pediatrics. It is included in the United Nations guidelines on child justice. And it is reported, in their own words, by survivors who have experienced it, including a 2024 UK study of sexual violence victim-survivors navigating the court process (Victim Support, 2024).

This piece examines that evidence in three parts: what retraumatization in the courtroom looks like and what it costs; why it happens, from the neuroscience of traumatic memory to the structural features of adversarial legal proceedings; and what we already know how to do differently because the research that documents the problem also clearly points toward solutions.

The evidence is clear, but the real question is whether we are willing to act on it.

Part One: What Retraumatization Looks Like

The Courtroom Was Never Designed for Children

Courts are meant to discover the truth and administer justice. They were designed predominantly for adults—people with fully developed cognitive skills, life experience with formal institutions, and at least a basic understanding of why the process works as it does. For adults who have experienced sexual violence, the process can still be challenging. For children, especially those still dealing with the effects of abuse they are asked to recount, it can become something fundamentally different: not just a journey through harm, but a continuation of it.

What researchers mean by “retraumatization” in this context is specific. It’s not just that the court is stressful or that reliving painful events is uncomfortable. It’s that the conditions under which children testify — including the physical environment, social interactions, cognitive challenges, and the presence of the perpetrator — come together to recreate, in measurable ways, the fear, helplessness, and physiological arousal that define traumatic experiences. When that occurs, the child isn’t simply upset; they are, in a clinically meaningful way, experiencing trauma again.

What the research found — and who it found it in

One of the most influential studies on this topic did not take place in a laboratory. It tracked 218 real children involved in actual criminal cases of sexual assault in the United States (Goodman et al., 1992). This was a prospective study, meaning the researchers observed the children before, during, and after their legal proceedings, evaluating their emotional state, behavioral outcomes, and testimony quality at different times. The result was a detailed, ground-level view of what the legal process really does to children.

What the children reported about their own experience was clear. When researchers asked them to identify their biggest fear about going to court, the most common answer was not the formality of the setting, not the lawyers, not the judge. It was seeing the person who had abused them (Goodman et al., 1992). And this fear was not just an uncomfortable feeling. It had direct, measurable effects on what the children could do in court. Those who reported higher levels of dread about facing the defendant gave less complete testimony, responded to questions less effectively, and showed significantly greater emotional distress during their time on the stand. Fear, in other words, was not a psychological side effect of testifying. It was an active obstacle to the legal process itself.

The study also tracked children through one of the most damaging parts of their involvement in legal proceedings: the requirement to testify multiple times. Delays, retrials, appeals, and procedural delays mean that some children face the courtroom not just once but several times, sometimes over many years. Goodman and colleagues discovered that children who testified multiple times showed significantly more behavioral problems in the months after the proceedings than those who testified only once or not at all, especially when family or caregiver support was limited (Goodman et al., 1992). This issue is important because behavioral problems in this age group are not just theoretical outcomes. They lead to real disruptions in school performance, relationships, emotional regulation, and development.

The long shadow: what happened years later

Perhaps the most convincing evidence about the costs of child testimony doesn’t come from the process itself but from what researchers found when they revisited the same children years, and in some cases more than a decade, later. Quas and colleagues (2005) conducted a long-term follow-up study that tracked many children from Goodman’s original group into adolescence and early adulthood, challenging the idea that the effects of testifying are short-term or self-resolving.

Young adults who were required to testify multiple times as children experienced significantly worse psychological outcomes than those who testified only once or not at all. They reported higher levels of depression and anxiety, along with greater difficulty managing daily activities (Quas et al., 2005). The broader research literature also shows that, especially for older children, serving as a witness in court often has a lasting negative impact on their view of the legal system (Pantell, 2017), meaning they were not only more psychologically distressed but also developed a diminished trust in the very institutions meant to protect them. These effects have serious implications for their future help-seeking behaviors, including whether they report abuse, cooperate with investigations, or seek legal redress as adults.

A separate longitudinal study on children’s recovery after testifying in sexual abuse cases confirmed these results (Elmi et al., 2018). Children involved in legal proceedings showed increased emotional distress two years after the process ended. Importantly, the study highlighted testifying frequency as a key factor: children who testified more often experienced worse long-term outcomes. It also identified caregiver support as a significant moderating element — children with strong, consistent adult support fared better, which has direct implications for how families and professionals can help lessen the harm caused by the legal process, even if they cannot eliminate it (Elmi et al., 2018).

The paradox of courtroom stress

There is a paradox at the core of child testimony, and it must be clearly stated. Experimental research has demonstrated that children questioned in courtroom-like settings—formal, authority-heavy environments with strangers in official roles—experience significantly higher anxiety and physiological stress than children questioned in familiar, warm, and supportive surroundings (Nathanson, 2003; Saywitz & Nathanson, 1993). Under these high-stress conditions, children perform worse on the exact cognitive tasks needed for legal testimony: they recall less accurately, organize their accounts less coherently, and are more likely to be confused and inconsistent.

This puts the legal system in a position of its own making. Courts require children to give clear, detailed, and consistent testimony. However, the conditions courts create, formal settings, adversarial questioning, and the presence of the accused actively undermine children’s ability to do this. Legal scholars have observed that behavioral signs of stress in child witnesses, hesitation, vagueness, apparent inconsistency, and reluctance to elaborate, are often seen as signs of unreliability, when in fact they are predictable responses to extreme psychological pressure (Thoman, 2014). The child is not failing the legal system. The legal system is failing the child.

Professional and international recognition

The documented harms in research literature are not debated among relevant professional bodies. The American Academy of Pediatrics, in a policy statement specifically addressing child witnesses in criminal cases, explicitly recognizes that children involved in court proceedings face a risk of secondary traumatization—trauma caused not by the initial abuse but by the process designed to address it (Pantell, 2017). The AAP urges medical professionals, legal practitioners, and courts to collaborate to reduce this risk, highlighting that many jurisdictions’ current procedures are inadequate to protect children’s well-being.

On the international level, the guidelines from the United Nations Economic and Social Council on justice for child victims and witnesses identify children in legal proceedings as a particularly vulnerable group that needs specific, active protections (United Nations, 2005). These guidelines acknowledge that children’s participation in justice systems can, if poorly managed, result in hardship and extra trauma. They establish a framework of four key principles: dignity, non-discrimination, the best interests of the child (which explicitly includes the right to protection from hardship and abuse), and the right to participate. These are not just aspirational statements; they are a minimum standard that many current systems still do not meet.

The question is no longer whether the courtroom can retraumatize child victims. That question has been answered. The evidence is consistent, longitudinal, and drawn from real children followed over real time. What still needs to be answered is why it happens, and what can be done practically.

References

Campbell, R., Wasco, S. M., Ahrens, C. E., Sefl, T., & Barnes, H. E. (2001). Preventing the “second rape”: Rape survivors’ experiences with community service providers. Journal of Interpersonal Violence, 16(12), 1239–1259.

Elmi, M. H., Daignault, I. V., & Hébert, M. (2018). Child sexual abuse victims as witnesses: The influence of testifying on their recovery. Child Abuse & Neglect, 86, 22–32. https://doi.org/10.1016/j.chiabu.2018.09.001

Goodman, G. S., Taub, E. P., Jones, D. P. H., et al. (1992). Testifying in criminal court: Emotional effects on child sexual assault victims. Monographs of the Society for Research in Child Development, 57(5). https://doi.org/10.2307/1166127

Nathanson, R. (2003). The effects of the courtroom context on children’s memory and anxiety. Journal of Psychiatry & Law, 31, 67–96.

Pantell, R. H. (2017). The child witness in the courtroom. Pediatrics, 139(3), e20164008. https://doi.org/10.1542/peds.2016-4008

Quas, J. A., Goodman, G. S., Ghetti, S., et al. (2005). Childhood sexual assault victims: Long-term outcomes after testifying in criminal court. Monographs of the Society for Research in Child Development, 70(2). https://doi.org/10.1111/j.1540-5834.2005.00324.x

Saywitz, K. J., & Nathanson, R. (1993). Children’s testimony and their perceptions of stress in and out of the courtroom. Child Abuse & Neglect, 17, 613–622. https://doi.org/10.1016/0145-2134(93)90030-3

Thoman, D. H. (2014). Testifying minors: Pre-trial strategies to reduce anxiety in child witnesses. Nevada Law Journal, 14, 236–267.

United Nations Economic and Social Council. (2005). Guidelines on justice in matters involving child victims and witnesses of crime (Resolution 2005/20, adopted 22 July 2005). https://www.refworld.org/legal/resolution/ecosoc/2005/en/22129

Victim Support. (2024). Suffering for justice: Sexual violence victim-survivors’ experiences of going to court and cross-examination.