The history taken from the child is often the most
important part of the overall evaluation. The child’s history
should always be carefully documented using actual quotes from the
child when possible. If a skilled social worker has already obtained
a detailed history from the child, the physician’s interview
can be abbreviated. Further questioning of a child can be deleterious.
The child may find repetitive questioning unpleasant or threatening,
may infer that he or she is not believed, or may modify his or her
history in response to repetitive questioning. Ideally, the interviewer
should use opened-ended nonleading questions. “W” words
(who, what, where, when, and how) are recommended. However, “Why” questions
should be avoided because they may imply blame to the child. If
possible, it is recommended that children with a developmental age
of 3 or older should be interviewed alone. Having the family leave
the room for the interview will often allow the child to open up
more without the fear of upsetting the family or getting into trouble.