State v. Giovanni D.: Clarifying the Child’s-Understanding Requirement for the Medical Treatment Hearsay Exception in Forensic Interviews

Note: This commentary is for informational purposes only and does not constitute legal advice.

---

I. Introduction

In State v. Giovanni D. (Supreme Court of Connecticut, December 9, 2025), the court affirmed a conviction for multiple sexual offenses against a minor, J, but in doing so it substantially refined Connecticut’s law of hearsay—specifically the medical diagnosis and treatment exception when applied to child forensic interviews.

The case arose from repeated sexual and physical abuse of J by the defendant, who was in a long-term relationship with J’s mother and functioned as a father figure. After a delayed disclosure, J underwent a forensic interview at a child advocacy center (the Klingberg Children’s Advocacy Center) and later a medical examination by a pediatrician specializing in child abuse.

On appeal, the defendant raised two principal issues:

1. Whether the trial court abused its discretion by admitting J’s statements to the forensic interviewer under the medical treatment exception to the hearsay rule (Connecticut Code of Evidence § 8-3(5)); and
2. Whether the court erred in refusing to give a special child credibility jury instruction concerning J’s testimony, or whether the Supreme Court should alter its approach to such instructions under its supervisory authority.

The court held that:

• The trial court did abuse its discretion in admitting the forensic interview statements under § 8-3(5) because the state did not show that J understood the interview to have a medical purpose, but the error was harmless.
• The trial court did not abuse its discretion in refusing a special child credibility instruction, and the court declined to modify its existing jurisprudence on such instructions.

The opinion is most significant for its doctrinal clarification: hearsay from a child forensic interview is admissible under the medical treatment exception only if (1) the child was motivated, at least in part, by a desire for medical diagnosis or treatment, and (2) the statements were reasonably pertinent to that medical purpose. Crucially, the court sharpened how trial courts must assess the child’s understanding of the purpose of a forensic interview, limiting reliance on the interviewer’s intent or statutory purposes alone.

---

II. Summary of the Opinion

A. Facts and Procedural Background

J lived with the defendant and her mother in New Britain from approximately age five to ten. During this period, the defendant sexually abused J on multiple occasions when her mother was at work, including:

• Anal intercourse;
• Fellatio;
• Having J masturbate him.

He also physically and emotionally abused her (choking, slapping, pulling her hair, and threatening to kill her).

After a domestic dispute in July 2020, the defendant was incarcerated and the relationship with J’s mother ended. In December 2020, J disclosed to her mother that the defendant used to “touch” her, but without detailed description. Believing he was not an immediate threat while incarcerated, J’s mother waited until his release in April 2021 to report the abuse to police. Detective Lisa Steeves then arranged for a forensic interview at Klingberg on May 12, 2021, conducted by forensic interviewer Nishka Ayala. A subsequent medical examination by Dr. Nina Livingston occurred on June 15, 2021; the exam was normal, and Livingston testified that the absence of physical findings neither proved nor disproved abuse.

The defendant was charged with:

• Two counts of sexual assault in the first degree, General Statutes § 53a-70(a)(2);
• Two counts of risk of injury to a child, General Statutes § 53-21(a)(2); and
• One count of aggravated sexual assault of a minor, General Statutes § 53a-70c(a)(3).

A jury found him guilty on all counts, and he received a total effective sentence of 43 years of imprisonment, followed by 16 years of special parole and lifetime sex offender registration. He appealed directly to the Supreme Court.

B. Key Holdings

1. Medical Treatment Hearsay Exception
   The court clarified that:
   • Hearsay is admissible under the medical treatment exception only if:
     1. The declarant (here, J) was motivated, at least in part, by a desire to obtain medical diagnosis or treatment; and
     2. The statements were reasonably pertinent to that diagnosis or treatment.
   • The purpose prong focuses on the child’s understanding, not the interviewer’s intent or the statutory purpose of the multidisciplinary team.
   • Because the record did not show that J understood the forensic interview to have a medical purpose, the trial court’s admission of Ayala’s testimony about J’s statements under § 8-3(5) was an abuse of discretion.
   • Nonetheless, the error was harmless because the testimony was largely cumulative, was not emphasized in closing, and similar evidence came in through Dr. Livingston and her medical report without objection.
2. Special Child Credibility Instruction
   
   • The trial court acted within its discretion in refusing a requested instruction specially cautioning the jury about the credibility of child witnesses.
   • J was twelve at trial, was conceded to be competent, and understood the concept of truthfulness; these factors did not mandate a special instruction.
   • The Supreme Court declined to exercise its supervisory authority to alter the approach adopted in State v. James, leaving intact the principle that such instructions are discretionary, not mandatory, even in child sexual abuse cases.

---

III. Analysis

A. Precedents and Framework Shaping the Decision

1. The Medical Treatment Exception and Its Rationale

The court located its analysis in the familiar hearsay framework. Hearsay—an out-of-court statement offered to prove the truth of the matter asserted—is generally inadmissible unless an exception applies (Conn. Code Evid. § 8-2(a); State v. Carrion). The medical treatment exception in § 8-3(5) covers:

statement[s] made for purposes of obtaining a medical diagnosis or treatment and describing medical history, or past or present symptoms, pain, or sensations, or the inception or general character of the cause or external source thereof, insofar as reasonably pertinent to the medical diagnosis or treatment.

Its rationale, drawn from State v. Cruz, is that a patient’s “desire to recover his health” gives a strong incentive to tell the truth to those who will diagnose or treat him or her.

The court reaffirmed the two-pronged test previously articulated in cases such as State v. Manuel T. and State v. Roy D. L.:

1. Purpose prong: The declarant must be motivated, at least in part, by a desire for medical diagnosis or treatment.
2. Pertinence prong: The statements must be reasonably pertinent to achieving that medical end.

This case is significant because the court explicitly systematizes and separates these prongs, noting that prior case law had not always clearly distinguished them, especially in the context of child forensic interviews.

2. Forensic Interviews and the Multidisciplinary Team Statute

The forensic interview in this case was conducted under the multidisciplinary team model contemplated by General Statutes § 17a-106a. As prior case law recognized (State v. Maguire, State v. Manuel T.), such teams “work collaboratively to investigate and treat cases of reported [child] sexual abuse,” and forensic interviews serve both investigative and treatment-related purposes.

Section 17a-106a(e)(5) expressly identifies one purpose of multidisciplinary teams as:

providing specialized medical evaluation and treatment, mental health services and support and advocacy services to children . . . and referral to other appropriate providers of such services.

However, the Supreme Court held that the statutory medical purpose of the team or interview process does not, by itself, satisfy the purpose prong of the hearsay exception. The focus must remain on what the child understood at the time of speaking, not on what the statute or the professionals intended.

3. Prior Connecticut Cases on Child Forensic Interviews

The opinion references a substantial line of cases where child statements in forensic or similar settings were admitted (or excluded) under the medical treatment exception:

• State v. Roy D. L.
  – The court previously upheld admission of a child’s forensic interview statements where the interviewer:
  • Introduced herself as someone who “worked for the hospital”;
  • Explained that others were observing to make sure children’s bodies were okay; and
  • Asked about the child’s physical and mental well-being.
  These circumstances supported an inference that the child understood a medical purpose.
• State v. Manuel T.
  – Emphasized that the medical treatment exception focuses on the declarant’s understanding and that admissibility can be partial (not all-or-nothing), permitting redaction of non-pertinent or unduly prejudicial portions.
• State v. Freddy T. (Appellate Court)
  – A key influence here: the Appellate Court held that the interviewer’s motivation or subsequent medical referrals do not establish the purpose prong. The test “is what the declarant understands, not what the interviewer’s motivation is.” The Giovanni D. court explicitly endorses this reasoning.
• State v. Ezequiel R. R. & State v. Abraham (Appellate Court)
  – In both, interviews at hospitals combined with explicit references to doctors and questions about bodily concerns supported findings that the child understood the medical purpose.
• State v. Telford (Appellate Court)
  – There, the appellate court treated a child’s trial testimony that she felt “upset, mad, and scared” as supporting an inference that her earlier interview had a medical purpose. In Giovanni D., the Supreme Court disagrees with Telford to that extent: a child’s trial description of feelings, without evidence those complaints were made during the interview, is insufficient to establish the medical purpose of the earlier interview.
• State v. Donald M. (Appellate Court)
  – Suggested that being told one would meet with someone at the hospital “who would help her” and determine whether therapy or treatment was needed could demonstrate that the child understood the interview as medically oriented.

By distinguishing and harmonizing these authorities, the court solidifies an approach that is both child-centered and fact-intensive.

4. Child Credibility Instructions and Supervisory Authority

On the second issue, the court’s analysis is anchored in:

• State v. James – Overruled an earlier rule (State v. Anderson) that effectively required special instructions on child credibility, holding instead that such instructions are within the trial court’s discretion and cautioning against encroaching on the jury’s role as sole arbiter of credibility.
• State v. Ceballos – Listed factors relevant to whether a special child credibility instruction might be appropriate: child’s age, corroboration, ability to recall, and understanding of truthfulness, while emphasizing lack of corroboration is not dispositive.
• State v. Angell – Reiterated James’s concerns and the skepticism towards the “conventional wisdom” that children are generally less truthful than adults.
• State v. Diaz and related cases on special instructions for categories like accomplices or jailhouse informants – The court contrasts those categories, which involve strong self-interest and incentives to lie, with child witnesses as a class, who do not share the same inherent unreliability.

The court concludes that existing doctrine—leaving child-specific credibility instructions to trial court discretion—is adequate and should not be altered via supervisory authority.

---

B. Legal Reasoning: The Medical Treatment Exception Clarified

1. The Purpose Prong: Focusing on the Child’s Understanding

The court’s most important doctrinal move is to sharpen the purpose prong of the two-pronged admissibility test.

To satisfy the purpose prong, the court holds:

• The declarant’s statement must be motivated, at least in part, by a desire for medical diagnosis or treatment.
• The focus is on the declarant’s state of mind when making the statement (Roy D. L.), not the interviewer’s intentions.
• In child forensic interview cases, the inquiry is whether “the surrounding circumstances could lead an objective observer to reasonably infer” that the child understood the interview to have a medical purpose.
• Critically, the “surrounding circumstances” must be limited to those that could be perceived by the declarant; e.g., what the child was told, the setting, the questions asked, and the child’s own complaints.

Thus, evidence about:

• The interviewer’s training or internal goals; or
• The statutory description of the multidisciplinary team’s medical role;
  

cannot by themselves satisfy the purpose prong unless they are translated into something the child actually sees, hears, or is told.

The court illustrates non-exclusive factors that may bear on the child’s understanding:

1. Communications with the child and circumstances leading up to the interview – Did someone tell the child, for example, “you are going to the hospital to see if your body is okay”?
2. Setting of the interview – Did it occur in a hospital or clinical environment, or in a non-medical advocacy center?
3. Substance of the child’s statements – Did the child complain of physical pain or emotional distress in a way that suggests she sought help?
4. Substance of the interviewer’s questions and explanations – Did the interviewer explain a medical purpose or ask about health, pain, or feelings?
5. Timing – How close in time was the interview to:
   • The alleged abuse;
   • The child’s initial disclosure; and
   • Any medical treatment before or after?

The court underscores that obtaining medical treatment need not be the primary purpose of the child’s statements. Forensic interviews often have investigative and protective goals as well; the presence of police or social workers does not disqualify statements from the exception as long as a medical purpose is among the child’s motivations.

2. The Pertinence Prong: What Counts as “Medical” and How Broad Is It?

Even where the purpose prong is satisfied, the statements must also be reasonably pertinent to diagnosis or treatment.

Key points:

• “Medical” encompasses both physical and psychological conditions (State v. Estrella J.C.).
• In sexual assault cases, statements about the identity of the assailant and the nature of the sexual acts can be pertinent to treatment (State v. Kelly), as they inform risk of pregnancy, STIs, trauma dynamics, and safety planning.
• Statements to non-physicians (e.g., social workers, forensic interviewers) can fall within the exception if they are within the “chain of medical care”—that is, if those professionals have significant interaction and cooperation with medical providers (State v. Arroyo; State v. Donald M.).

The court also reiterates the possibility of partial admissibility, stressing that trial courts can:

• Redact portions of forensic interview statements that are not pertinent to treatment or are unduly prejudicial; and
• Admit those parts that meet both prongs of the test (Manuel T., Roy D. L.).

This flexibility is particularly important in forensic interviews, which can cover a broad range of topics beyond immediate medical needs.

3. Application to J’s Forensic Interview

Applying this framework, the court found that the purpose prong was not satisfied for J’s statements to Ayala.

a. The setting

• J was interviewed at the Klingberg Children’s Advocacy Center, not at a hospital or clearly medical facility.
• There was no evidence that the environment would signal to a child that she was in a medical setting (e.g., medical staff, equipment, signage).
• There was no evidence that anyone explained to J that Klingberg was involved in medical referral or treatment.

b. What J was told and what Ayala asked

• The record was silent on:
  • How Ayala introduced herself or her role;
  • Whether Ayala told J that part of the interview’s purpose was to help doctors treat her or make sure she was healthy; or
  • Whether Ayala asked about J’s physical pain, injuries, or emotional state.
• Ayala testified that forensic interviewers “typically” ask about body concerns, but the court refused to assume that this occurred in J’s case, because the inquiry must be grounded in what this child actually experienced, not in typical protocol.

c. J’s complaints (or lack thereof) during the interview

• The record did not show that J raised physical or mental health complaints in the interview.
• Although at trial J testified that the abuse “hurt” and made her feel “scared,” there was no evidence she made these complaints during the forensic interview itself—thus they could not prove that the interview statements were made for medical reasons.
• In explicitly disagreeing with Telford to the extent it relied on trial testimony to infer an earlier medical purpose, the court tightened the evidentiary standard.

d. Timing

• The last abuse occurred at least ten months before the forensic interview.
• J disclosed the abuse to her mother about five months before the interview.
• Her mother reported to police roughly four months after that disclosure, triggering the interview.
• The court found that this extended lapse made it less likely that J would understand she was seeking immediate medical help, especially given that the mother reported to police out of concern for safety rather than for medical care.

e. Use of anatomical drawings

• Ayala used an anatomical drawing of a male body to clarify the acts J described.
• She could not recall whether she used a drawing of a female body to explore J’s own physical condition.
• While anatomical aids sometimes suggest a medical context, the court held that use of such drawings for descriptive clarity alone is insufficient to establish that the child appreciated a medical purpose.

Given all these circumstances, the court concluded that an objective observer could not reasonably infer that J understood the forensic interview to be for medical diagnosis or treatment. Accordingly, admitting her interview statements under the medical treatment exception was an abuse of discretion.

4. Pertinence and Chain of Medical Care in This Case

Although the purpose prong failed, the court found that the pertinence prong would have been met for at least some statements:

• Ayala was within the chain of medical care:
  • She worked as part of the multidisciplinary team.
  • Her interview informed medical and psychological referrals.
• Dr. Livingston relied on Ayala’s forensic interview report to obtain J’s medical history and to plan and interpret the medical examination.
• J’s statements about the types and frequency of sexual acts were reasonably pertinent to medical evaluation, even though the physical exam was normal.

This reinforces that the failure in this case was not that the content was irrelevant to treatment, but that the child’s understanding of purpose was not established.

5. Harmless Error Analysis

Because the error was evidentiary and nonconstitutional, the court applied the standard for harmless error articulated in cases like State v. Myers:

whether the jury’s verdict was substantially swayed by the error . . . [and whether] the appellate court has a fair assurance that the error did not substantially affect the verdict.

Key considerations:

• Centrality of credibility – The case turned overwhelmingly on J’s credibility; there were no eyewitnesses and no corroborating physical findings.
• Cumulative nature of Ayala’s testimony:
  • Before Ayala testified, J had already told the jury:
    • That the defendant had her masturbate his penis;
    • That he engaged in penile-anal and penile-oral penetration;
    • That the abuse occurred many times;
    • That he physically abused and threatened her.
  • Ayala’s challenged testimony essentially repeated these core allegations in less detail.
  • She did not add new material details about specific acts of abuse.
• Alternative, unchallenged sources of the same content:
  • Dr. Livingston, without objection, testified that J reported:
    • Penile-oral penetration;
    • Penile-anal penetration;
    • Being made to stroke the defendant’s penis until ejaculation.
  • Livingston’s medical report, admitted in redacted form without objection, contained the same “history” from the forensic interview.
• Use in closing argument:
  • The prosecutor did not emphasize Ayala’s recounting of J’s allegations in closing.
  • Instead, Ayala was referenced primarily to explain the process of disclosure in child sexual abuse cases and to give the jury a framework for understanding delayed or gradual disclosures.
  • This limited use diminished the likelihood that her hearsay testimony “substantially swayed” the verdict.
• Jury’s playback request:
  • The jury requested a replay concerning the responsibilities and composition of multidisciplinary teams, not the substance of J’s allegations.
  • This suggested interest in context and process, not dependence on Ayala’s hearsay account.

Although the court acknowledged that the issue was a close call given the centrality of credibility, it ultimately had “fair assurance” that the error did not substantially affect the verdict and thus was harmless.

---

C. Legal Reasoning: Special Child Credibility Instruction

1. General Rule Against Singling Out Witnesses

The defendant requested a lengthy instruction directing jurors to treat children’s testimony with caution, emphasizing, among other things, their susceptibility to suggestion, imagination, and desire to please adults. The requested language is reminiscent of pre-James instructions.

The court restated the general rule (e.g., State v. Jones, State v. Hayes):

• A defendant is not entitled as of right to a jury instruction that singles out any particular witness (including a child) and comments on his or her possible motive to testify falsely.
• Such cautionary instructions are within the trial court’s discretion.

In considering whether to give a special child credibility instruction, courts may look to:

• Child’s age;
• Corroboration (though its absence is not dispositive);
• Child’s ability to recall and discuss past events; and
• Child’s understanding of truth and falsehood (Ceballos).

2. Application to J’s Testimony

Applying this framework, the Supreme Court found no abuse of discretion:

• J was twelve years old at trial.
  • Prior cases have held that even younger children (e.g., eight years old in Ceballos) did not necessarily require a special instruction.
  • In James itself, the court upheld the denial of a special instruction for a twelve-year-old child.
• The defendant conceded that:
  • J was a competent witness; and
  • She understood the concept of truthfulness.
• The court found no case-specific factors—beyond those that are broadly common in child abuse cases (e.g., lack of physical corroboration, memory gaps)—that would require singling out J’s testimony for heightened skepticism.
• Any credibility concerns could be, and were, addressed through:
  • General credibility instructions; and
  • Cross-examination and argument by defense counsel.

3. Refusal to Alter the Law Under Supervisory Authority

The defendant urged the court to use its supervisory power to require a special child credibility instruction whenever:

1. There is a continuing course of conduct charge;
2. Disclosure is delayed; and
3. There is particularized evidence suggesting suggestibility.

The court declined. It emphasized:

• Supervisory authority is reserved for issues of “utmost seriousness” affecting the integrity and perceived fairness of the justice system as a whole (State v. Medrano).
• James already gives trial courts discretion to craft special instructions in appropriate cases; there is no systemic problem warranting a new mandatory rule.
• Conceptually, children as a class are not analogous to:
  • Jailhouse informants,
  • Accomplices, or
  • “Complaining witnesses” in some contexts,

Those categories involve strong self-interest and incentives to fabricate (Diaz). Children, by contrast, do not have a comparable, generalized incentive structure. The research and commentary referenced in James and Angell cast doubt on broad assumptions that children are inherently less reliable than adults.

The court reiterated its confidence that in child sexual abuse cases:

cross-examination and argument by counsel are . . . likely to be adequate tools for exposing the truth . . . .

Accordingly, the court declined to impose a new rule and left intact the existing, discretion-based regime for child-specific credibility instructions.

---

IV. Impact and Implications

A. For Prosecutors and Multidisciplinary Child Protection Teams

The decision significantly raises the bar for admitting forensic interview statements under the medical treatment exception in Connecticut. Prosecutors and child protection professionals should now:

• Anticipate foundational challenges to forensic interview hearsay and be prepared to establish:
  • What the child was told about the purpose of the interview;
  • How the interviewer presented their role (e.g., as part of a hospital or medical team);
  • Any questions asked about the child’s physical or emotional state; and
  • Any complaints of pain, injury, or distress made by the child during the interview.
• Document and, where appropriate, record on video the introduction to the interview, including any explanation of:
  • The medical or therapeutic aspect of the process; and
  • The involvement of doctors or therapists.
• Consider location choices:
  • Interviews at or in conjunction with a hospital or medical clinic will more readily support an inference of medical purpose.
  • When conducted at a child advocacy center, care must be taken to convey and document the link to medical care in terms the child can understand.
• Coordinate with medical providers:
  • Ensure that the medical provider testifies how the forensic interview report informed diagnosis or treatment.
  • Establish the “chain of medical care” clearly.
• Use redaction strategically:
  • Offer to redact portions of interviews or reports that are not clearly pertinent to medical care, to increase the likelihood that the remainder will be admitted.

B. For Defense Counsel

Defense counsel now have a clearer roadmap to challenge forensic interview hearsay:

• Attack the purpose prong by eliciting:
  • Testimony about the interview’s setting and lack of medical trappings;
  • Admissions that the child was never told the interview was for medical help;
  • Evidence that the interview occurred long after the alleged abuse and after any acute medical concerns would have passed; and
  • Silence in the record regarding questions about pain, injury, or emotional distress.
• Emphasize timing:
  • Significant delays between abuse, disclosure, and interview may weaken any inference that the child was seeking medical help.
• Challenge cumulative bolstering:
  • Where the child testifies in detail, argue that repeating the allegations through professionals (especially multiple professionals) unfairly bolsters credibility.
• Be alert to multiple hearsay paths:
  • In Giovanni D., similar statements came in through Dr. Livingston and her report. Defense counsel should object not only to the interviewer’s testimony but also to any medical records or physician testimony that might incorporate the same hearsay, unless a proper foundation is established.

C. For Forensic Interviewers and Child Advocacy Centers

Forensic interviewers at advocacy centers bear much of the practical burden of this decision. Without changing the fundamental non-leading, child-centered** nature of forensic interviews, they may need to adjust practice to:

• Explicitly, but appropriately, explain the medical aspect of the process to the child (e.g., “The doctor wants to know what happened so they can see if your body is okay or if you need help”).
• Ask open, non-suggestive questions about physical and emotional well-being (e.g., “Do you have any worries or concerns about your body?” “How does your body feel now?” “Do you feel safe?”).
• Ensure that those explanations and questions are visible in the record:
  • By video recording;
  • By documenting them clearly in the written forensic interview report.

If interview protocols do not meaningfully convey a medical purpose to the child, it will be harder for the state to rely on the medical treatment exception—especially when interviews are conducted outside formal medical settings.

D. For Trial Courts and Appellate Practice

Trial courts now have a more structured analytical framework:

• They should make explicit findings on:
  • The child’s perceived understanding of the interview’s purpose (purpose prong); and
  • Which specific statements are pertinent to diagnosis or treatment (pertinence prong).
• They should consider partial admission and redaction, particularly in jury trials, to manage prejudice.
• They should recognize that evidence of medical referrals or statutory purposes is relevant but not dispositive and must be tied back to the child’s perspective.

Appellate courts, in turn, gained a clearer doctrinal structure for reviewing such rulings and for distinguishing between admissibility errors and questions of harmlessness.

E. On Child Witness Credibility Instructions

The reaffirmation of James and Ceballos has several implications:

• No categorical entitlement – Defendants in child sexual assault cases cannot claim a right to child-specific credibility instructions simply because the witness is a child or because evidence is uncorroborated.
• Fact-specific arguments remain available – Defense counsel can, and should, argue for tailored instructions where a particular child’s circumstances (e.g., very young age, documented suggestibility, severe memory problems) warrant it, but such requests remain discretionary.
• Reliance on cross-examination and expert testimony – Where suggestibility, coaching, or memory issues are real concerns, the primary remedy remains:
  • Effective cross-examination;
  • Expert testimony on child development or memory, where appropriate; and
  • Argument, rather than special jury instructions that may appear to endorse broad generalizations about child unreliability.

---

V. Complex Concepts Simplified

1. Hearsay

Hearsay is any statement made outside the courtroom that is offered in court to prove that what it says is true (for example, “She told me he hit her,” offered to prove that he did hit her). Hearsay is usually not allowed unless it fits a recognized exception.

2. Medical Treatment Exception (Conn. Code Evid. § 8-3(5))

This exception allows hearsay statements if:

• They were made for the purpose of getting medical diagnosis or treatment; and
• They describe symptoms, pain, or how an injury happened, in a way that is reasonably important to the doctor or therapist.

The logic is simple: people who want to get better have a strong reason to tell the truth to medical professionals.

3. Forensic Interview

A forensic interview is a structured conversation with a child, typically by a specially trained interviewer, designed to:

• Gather information about possible abuse in a neutral, non-leading way; and
• Reduce the number of times the child has to retell painful events to different adults.

The interview is often observed or recorded so it can be used by:

• Police and prosecutors (for investigation and prosecution); and
• Medical and mental health professionals (for diagnosis and treatment).

4. Multidisciplinary Team

Under Connecticut law (General Statutes § 17a-106a), a multidisciplinary team brings together professionals such as:

• Police;
• Social workers (e.g., from the Department of Children and Families);
• Prosecutors; and
• Medical and mental health providers,

to coordinate how they respond to child abuse allegations. One goal is to make sure the child gets needed medical and psychological care while also supporting the investigation.

5. Chain of Medical Care

A non-medical professional (like a social worker or forensic interviewer) is within the “chain of medical care” if they:

• Work closely with medical providers; and
• Gather information that doctors or therapists will use to diagnose or treat the child.

If the child is speaking to such a person with at least some medical purpose, the child’s statements can sometimes be admitted under the medical treatment exception.

6. Supervisory Authority

The Supreme Court’s supervisory authority is its power to set rules and procedures for lower courts, even when those rules are not required by the state or federal constitution. The court uses this power sparingly, usually to address serious, systemic issues affecting fairness or public confidence in the justice system.

7. Harmless Error (Nonconstitutional)

A harmless error is a mistake the trial court made that did not change the outcome of the trial. For nonconstitutional errors, the reviewing court asks whether it has a fair assurance that the error did not substantially influence the jury’s decision. If not, the conviction stands despite the error.

8. Special Child Credibility Instruction

A special child credibility instruction is a jury instruction that tells jurors to treat a child’s testimony with particular caution, sometimes mentioning children’s suggestibility or limited understanding. Under current Connecticut law, judges may give such instructions in appropriate cases, but defendants are not automatically entitled to them.

---

VI. Conclusion

State v. Giovanni D. stands as a leading decision in Connecticut on the intersection of hearsay law, child forensic practice, and jury instructions in child sexual abuse prosecutions.

On the evidentiary front, the decision:

• Clarifies and tightens the two-pronged test for the medical treatment exception;
• Places the child’s understanding, not the professional’s or statute’s intent, at the center of the “purpose prong” analysis;
• Recognizes that forensic interview statements can be within the chain of medical care but will be admitted only when both prongs are met; and
• Signals that courts must be careful about cumulative bolstering through multiple professional witnesses, even though in this case the error was ultimately harmless.

On the jury instruction issue, the court:

• Reaffirms the discretionary nature of special child credibility instructions under State v. James;
• Rejects an attempt to create a new mandatory rule via supervisory authority; and
• Declines to treat children as inherently comparable to classes of witnesses (like accomplices or jailhouse informants) who warrant automatic cautionary instructions.

Practically, the opinion will influence:

• How multidisciplinary teams plan and document forensic interviews;
• How prosecutors and defense counsel litigate the admissibility of child hearsay;
• How trial judges structure evidentiary rulings and jury instructions in child sexual abuse cases.

Ultimately, Giovanni D. represents an effort by the Connecticut Supreme Court to balance three competing imperatives:

1. Protecting the reliability of hearsay evidence admitted under exceptions;
2. Ensuring fair trials for defendants in cases that often turn solely on credibility; and
3. Recognizing the practical realities of investigating and treating child sexual abuse within a multidisciplinary framework.

In doing so, the court both refines evidence doctrine and provides concrete guidance for the day-to-day practice of child protection and criminal adjudication in Connecticut.