## Facts

- Michael Spicola was charged with sex offenses against a young male relative involving alleged reciprocal oral-genital contact when the child was between six and eight years old.
- The indictment alleged three abuse periods spanning 1999 and 2000, during which the child frequently visited and occasionally stayed overnight at Spicola’s home.
- In 2006, after the mother observed the child react unusually during physical contact with Spicola, she questioned him about inappropriate touching.
- The child initially denied abuse but later disclosed abuse after a school presentation about sexual predators; the mother contacted police.
- The child was examined at a Child Advocacy Center by a pediatric nurse-practitioner; the exam found no physical evidence of abuse, and the child appeared embarrassed and upset.
- At trial, the prosecution offered (1) the nurse-practitioner’s testimony explaining the exam and why delayed reporting often yields no physical findings, and (2) a clinical social worker’s testimony describing Child Sexual Abuse Accommodation Syndrome (CSAAS) in general terms through hypotheticals.
- The defense denied the allegations, emphasized delayed disclosure and continued contact with Spicola, and argued the expert evidence improperly bolstered the complainant’s credibility.
- A jury convicted Spicola of six counts of first-degree sodomy (former Penal Law § 130.50[3]), three counts of first-degree sexual abuse (§ 130.65[3]), and one count of endangering the welfare of a child (§ 260.10[1]); the intermediate appellate court affirmed.

## Issues

1. Whether expert testimony concerning CSAAS was improperly admitted because it bolstered the complainant’s credibility and allegedly lacked sufficient reliability.
2. Whether the child’s detailed statements to a pediatric nurse-practitioner at a Child Advocacy Center were admissible under the hearsay exception for statements made for medical diagnosis and treatment, despite a concurrent forensic purpose and a lack of physical findings.

## Decision

- The Court of Appeals affirmed the order upholding the judgment of conviction.
- The court held that CSAAS testimony was properly admitted because it was limited to general educational testimony, given in response to hypotheticals, and did not opine that abuse occurred or that the complainant was truthful.
- The court held that the child’s statements to the nurse-practitioner were admissible as statements made for medical diagnosis and treatment because they were reasonably pertinent to medical evaluation and care, even if the examination also served investigative purposes and produced no physical evidence.
- The court rejected the claim of improper bolstering, concluding the experts did not function as “human lie detectors” and credibility remained for the jury.

## Legal Principles

- Expert testimony on CSAAS may be admitted to assist jurors in understanding delayed disclosure, continued contact with an abuser, and other behavior that might otherwise be viewed as inconsistent with abuse, so long as the testimony is general, non-diagnostic, and does not vouch for credibility.
- A child’s statements to a medical professional may fall within the diagnosis-and-treatment hearsay exception when reasonably pertinent to medical evaluation and care, even if the setting also serves forensic objectives.
- In delayed-reporting child sexual abuse cases, the absence of physical findings does not bar expert testimony explaining why physical evidence may be absent and is not dispositive of whether abuse occurred.

## Conclusion

The court affirmed the convictions, holding that properly limited CSAAS testimony may be used to explain counterintuitive child-victim behavior and that a child’s statements to a medical examiner at a Child Advocacy Center may be admitted for diagnosis and treatment purposes even when the exam has a concurrent investigative role and reveals no physical injury.


People v. Spicola, 16 N.Y.3d 441, 947 N.E.2d 620 (N.Y. 2011)