Harvey Renville was convicted by a jury of two counts of sexual abuse of his eleven year old stepdaughter under 18 U.S.C. §§ 13, 1152 (1982), and S.D. Codified Laws Ann. § 22-22-1(5) (1979 & Supp.1983) (amended 1984). Renville raises three contentions on appeal: first, that the acts for which he was convicted, one act each of cunnilingus and anal intercourse with his stepdaughter, are penalized by federal law, 18 U.S.C. § 1153 (1982) (amended 1984), and therefore the Assimilated Crimes Act, 18 U.S.C. § 13, which incorporates the South Dakota rape statute prohibiting these specific acts, is inapplicable; second, that the district court erred in permitting a physician to testify to statements of the victim during an examination identifying Renville as her abuser, under Federal Rule of Evidence 803(4); and third, that the district court erred in permitting a deputy sheriff to testify to statements of the vic *432 tim during an interview identifying Ren-ville as her abuser, under Federal Rule of Evidence 803(24). We affirm the judgment of the district court. 1
Renville, an Indian, resided with his family on the Sisseton Indian Reservation in South Dakota. At the time of the offense, Renville was employed as a tribal police officer. In March, 1982, a detention hearing was held in South Dakota concerning the victim’s half-brother, Joe. At the hearing, Joe testified that the victim had admitted to him that she had been sexually abused by Renville. These allegations eventually were referred to Roberts County Deputy Sheriff Holly Butrum, who interviewed the victim to determine whether, as an emergency measure, she should be removed from her home. Deputy Sheriff Butrum testified at trial, over Renville’s objection, that during the interview the victim stated that Renville had engaged in anal intercourse with her on several occasions over the past year, and had threatened to harm her if she related the incidents to anyone.
A few weeks later, while in the care of foster parents, the victim was examined by Dr. Clark Likness, a physician specializing in family practice medicine. Dr. Likness testified at trial, again over Renville’s objection, that during the examination the victim recounted acts of anal intercourse and cunnilingus performed by Renville.
At trial, the victim recanted her earlier accusations against Renville, and denied having told anyone except Deputy Sheriff Butrum that he was the individual who had abused her. The jury found Renville guilty on both counts. He was sentenced to two concurrent fifteen year terms.
I.
Renville’s principal contention is that the district court lacked subject matter jurisdiction to convict him under the Assimilated Crimes Act (ACA), 18 U.S.C. § 13, which confers jurisdiction only when there is no applicable federal law. He argues that his conduct was punishable under 18 U.S.C. § 1153, which specifically prohibits incest.
The ACA punishes as a federal offense any act or omission which is punished under state law if committed within the state’s jurisdiction, as Jong as the act or omission is “not made punishable by any act of Congress.” 18 U.S.C. § 13. 2 The district court held that the ACA incorporated provisions in the South Dakota rape law specifically prohibiting Renville’s conduct, and carrying a maximum penalty of fifteen (15) years for each violation. 3 Renville argues that the ACA, and consequently the state rape statute, was inapplicable because his conduct was made punishable by an act of Congress, specifically the Indian Major Crimes Act (IMCA), 18 U.S.C. § 1153, which prohibits incest by an Indian in Indian territory. The IMCA, in turn, defines the crime of incest and sets the punishment for the act by reference to the statutes of the state where the offense was committed. The South Dakota incest statute provides for a maximum sentence of five (5) years for each violation. The issue, therefore, is whether Renville’s conduct is punishable under the ACA, through the adoption of the state rape law (with a corresponding fifteen-year sentence), or under *433 the IMCA, through the adoption of the state incest law (with a corresponding five-year maximum sentence).
The IMCA specifically provides that “[IJncest shall be defined and punished in accordance .with the laws of the State in which such offense was committed as are in force at the time of such offense.” 18 U.S.C. § 1153. 4 At the time of the offense, the South Dakota incest statute prohibited an individual fifteen years or older from engaging in “sexual contact” with a person under twenty-one within a specified degree of consanguinity, S.D. Codified Laws Ann. § 22-22-19.1 (Supp.1983); 5 and sexual intercourse between unmarried individuals within a specified degree of consanguinity, S.D. Codified Laws Ann. § 22-22-19 (1979) (repealed 1984). 6 The Code defines the term “sexual contact” to include “any touching” of certain parts of the body with intent to arouse or gratify either party, but explicitly limits the scope of the statute to “touching, not amounting to rape.” S.D. Codified Laws Ann. § 22-22-7.1 (1979 & Supp.1983). 7 The state rape statute prohibits acts of “sexual penetration” committed under a variety of circumstances, including, at the time, where the victim is less than fifteen years of age. § 22-22-1(5). Renville’s actions — anal intercourse and cunnilingus — fall squarely and precisely within the Code definition of sexual penetration. 8 Since his stepdaughter was less *434 than fifteen years old at the time, Ren-ville’s actions constitute rape.
In light of this statutory scheme, we must reject the defendant’s contention that his conduct is punishable as incest under federal law. The state incest statute specifically excludes conduct “amounting to rape”: Renville’s conduct, acts of sexual penetration, is punishable under the state rape statute. Therefore, his conduct falls outside the state definition of incest adopted in the IMCA, and thus is not made punishable by federal law, 9 and the ACA applies.
To avoid the plain language of the statute, Renville relies on language in
Williams v. United States,
Renville argues that the Court held the phrase “any act or thing which is not made [punishable] by any law of Congress” should not be interpreted so narrowly as to refer only to “individual acts of parties,” but instead should be read “in a generic sense as referring to acts of a general type or kind.”
Id.
at 722,
This argument fails for a number of reasons. The Court in
Williams
began by holding that the ACA did not apply because “the
precise
acts upon which the [defendant’s] conviction depend[ed]” had been made penal by federal law (adultery),
id.
at 717,
Moreover, we believe that Renville has misconstrued the meaning of the Court’s statement that the ACA must be interpreted as referring “in a generic sense * * * to acts of a general type and kind.” The language appears in the Court’s discussion of a 1909 amendment to the ACA’s exception clause changing the phrase “[any] offense” which was not prohibited or punished by federal law, to “any act or omis
*435
sion” not penalized by federal law.
Id.
The context makes clear that the Court was not holding that the existence of a federal offense bars resort under the ACA to all state statutes which penalize conduct related in any way to the conduct penalized under the federal offense. The Court held only that the semantic change was not intended to bring within the ambit of the ACA state statutes which penalized conduct that Congress had specifically decided
should not
be punished by the federal offense. That is, Congress, in the course of defining an offense, sets the limits on the scope of liability for that offense. As the Court stated, “the new words * * * cannot * * * be regarded as changing the scope of the [ACA] so substantially as to make it amend and enlarge the definition of an existing federal offense as well as to cover the case where an ‘offense’ had not been prohibited.”
Id.
at 722-23,
Moreover, the Court noted that the legislative history of the federal criminal code revealed “an increasing purpose by Congress to cover rape and all related offenses fully with penal legislation.”
Id.
at 724,
Finally, we note that the term “generic” is not self-limiting, and as applied to a broad variety of acts punished by the federal criminal code, it is not immediately apparent where one draws lines to neatly cabin behavior into discrete classes and types. In light of
Williams,
we cannot accept Renville’s claim that sexual contact or common law sexual intercourse is the same generic conduct as the acts of sexual penetration in this case. They are simply different acts. The Court in
Williams
barred the government from resorting to state law to expand the scope of liability for a specific act by redefining the set of individuals liable for engaging in the act. The two South Dakota statutes simply do not stand in that relationship; they prohibit different conduct.
See United States v. Smith,
We are not confronted, as were the courts in Williams and Butler, with a state statute that defines more broadly or narrowly an offense covered by federal law. In such a circumstance, an inquiry into “generic” conduct is relevant. The case before us, on the other hand, is one where the IMCA adopts the state law definition and punishment of a particular offense, here incest, and our task is simply to determine the scope of that offense under the state law. We cannot adopt Renville’s argument that his conduct, specifically excluded from the incest statute, must be brought back within the statute because it involved a family member.
II.
Renville next contends, assuming the district court had jurisdiction, that it erred in permitting a physician, Dr. Likness, to testify to statements by the victim during his examination identifying Renville as her abuser. Specifically, the defendant argues that the hearsay exception found in Federal *436 Rule of Evidence 803(4) does not encompass statements of fault or identity made to medical personnel.
Rule 803(4) admits as an exception to the hearsay rule:
Statements made for purposes of 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 diagnosis or treatment.
Fed.R.Evid. 803(4). The crucial question under the rule is whether the out-of-court statement of the declarant was “reasonably pertinent” to diagnosis or treatment. In
United States v. Iron Shell,
The court in
Iron Shell
recognized, however, that a declarant’s statements relating the identity of the individual allegedly responsible for his injuries or condition “would seldom, if ever,” be reasonably pertinent to treatment or diagnosis.
The court in
Iron Shell
and the Advisory Committee used words of generality, however, not exclusion.
Iron Shell,
Statements of this kind differ from the statements of fault identified by the Rules
*437
Advisory Committee and properly excluded under our past decisions in a crucial way: they are reasonably relied on by a physician in treatment or diagnosis. First, child abuse involves more than physical injury; the physician must be attentive to treating the emotional and psychological injuries which accompany this crime.
11
See People v. Oldsen,
*438 Second, physicians have an obligation, imposed by state law, to prevent an abused child from being returned to an environment in which he or she cannot be adequately protected from recurrent abuse. 13 This obligation is most immediate where the abuser is a member of the victim’s household, as in the present case. Information that the abuser is a member of the household is therefore “reasonably pertinent” to a course of treatment which includes removing the child from the home.
The defendant contends that our decision in
Iron Shell
holds to the contrary. In
Iron Shell,
this court held that rule 803(4) did not bar the testimony of a physician reciting statements by a nine year old child abuse victim where the child’s statements were related to her physical condition and a detailed chronology of the sexual assault, but did not touch on the identity of the assaulting individual.
We therefore believe that statements of identity to a physician by a child sexually abused by a family member are of a type physicians reasonably rely on in composing a diagnosis and course of treatment. Admission of these statements, therefore, is fully consistent with the rationale underlying the second component of the Iron Shell test.
Statements of identity in this unique context also meet the first part of the Iron Shell test, which focuses on the declarant’s motivation for giving the information. Id. at 83-84. As we discussed above, this component reflects the premise underlying the rule that the patient’s selfish interest in receiving proper treatment guarantees the trustworthiness of the statements. Id. Statements of fault traditionally have failed to meet this criterion. Ordinarily, when an individual identifies the person responsible for his injuries or condition, he does so without reasonable expectation that the information will facilitate treatment.
However, this conclusion rests on the obvious assumption that the declarant is responding under the impression that he is being asked to make an accusation that is not relevant to the physician’s diagnosis or treatment. This assumption does not hold where the physician makes clear to the victim that the inquiry into the identity of the abuser is important to diagnosis and treatment, and the victim manifests such an understanding. In such circumstances, the victim’s motivation to speak truthfully is the same as that which insures reliability when he recounts the chronology of events or details symptoms of somatic distress.
We believe these circumstances are present in this case. Before questioning the child, Dr. Likness explained to her that the examination and his prospective questions were necessary to obtain information to treat her and help her overcome any physical and emotional problems which may have been caused by the recurrent
*439
abuse. Record at 94-95.
Cf. Narciso,
Therefore, we conclude that in the circumstances of this case, there were sufficient indicia of the declarant’s proper motivation to ensure the trustworthiness of her statements to the testifying physician. Since the statements are trustworthy, and the type on which physicians reasonably rely in treatment or diagnosis, they meet the criteria for admission set forth in
Iron Shell. See
III.
Reville’s final contention is that the district court erred in permitting Deputy Sheriff Butrum to testify to statements by the victim identifying him as the abuser. The victim’s statements came during the interview Deputy Sheriff Butrum held to determine if emergency removal from the home was necessary. The district court admitted the extra-judicial statements as substantive evidence under the residual, or “catch-all,” exception to the hearsay prohibition, rule 803(24). We will reverse the district court only if we find the admission to have been a clear abuse of discretion.
United States v. Poston, 121
F.2d 734, 739 (8th Cir.),
cert. denied,
Congress intended that the residual hearsay exception “be used very rarely, and only in exceptional circumstances.”
Huff v. White Motor Corp.,
We have observed that hearsay evidence must satisfy five criteria to be admissible under 803(24):
(1) The statement must have circumstantial guarantees of trustworthiness equivalent to the twenty-three specified exceptions listed in rule 803;
(2) The statement must be offered as evidence of a material fact;
(3) The statement must be more probative on the point for which it is offered than any other evidence the proponent can procure through reasonable efforts;
(4) The general purposes of the Federal Rules and the interests of justice must best be served by admission of the statement into evidence;
(5) The proponent of the evidence must give the adverse party the notice specified within the rule.
United States v. Carlson,
Renville argues on appeal only that the district court erred in finding that the evidence demonstrated circumstantial guarantees of trustworthiness. That is the only question, therefore, we need address.
United States v. Hinkson,
In assessing the degree of trustworthiness of extra-judicial statements, we must inquire into both the reliability of and necessity for the statement.
Carlson,
We believe there are significant indicia of reliability in the present case. Most important, the declarant testified at trial and was subject to cross-examination. She was given an opportunity to explain to the jury why her story had changed.
See United States v. Leslie,
It is also significant that the declarant admitted she made the out-of-court statements to Deputy Sheriff Butrum.
See Carlson,
We also believe it is significant that the victim, a child, made almost identical statements accusing Renville and describing the abuse to the numerous state and medical personnel who questioned her, and the foster parents with whom she was temporarily
*441
placed. Although these statements were not related “close on the heels of the criminal event,”
Iaconetti,
Finally, we believe that the age of the victim may be a factor guaranteeing the trustworthiness of the declarations. We have held a declarant’s young age is a factor that may substantially lessen the degree of skepticism with which we view their motives.
See Roberts v. Hollocher,
We also believe that there is a strong need for these statements. The victim was the only one who could identify her abuser. Where she later recanted her prior accusations, it was important for the government to show that she had earlier made a consistent series of accusations naming Ren-ville as her abuser.
We therefore conclude that the extra-judicial statements to Deputy Sheriff Butrum are supported by guarantees of trustworthiness equivalent to those which sanction the other enumerated exceptions to the hearsay rule. The circumstances surrounding these statements “strongly suggest that the declarant’s perception, memory, narration and sincerity concerning the matters asserted are trustworthy.”
United States v. Friedman,
We therefore affirm the decision of the district court.
Notes
. The Honorable Donald J. Porter, United States District Court Judge for the District of South Dakota.
. 18 U.S.C. § 13 provides:
Whoever within or upon any of the places now existing or hereafter reserved or acquired * * * is guilty of any act or omission which, although not made punishable by any enactment of Congress, would be punishable if committed or omitted within the jurisdiction of the state, territory, possession, or district in which such place is situated, by the laws thereof in force at the time of such act or omission, shall be guilty of a like offense and subject to a like punishment.
.The ACA is made applicable to the Indian reservation on which these acts took place by 18 U.S.C. § 1152, which provides, with certain exceptions not relevant here, that “[T]he general laws of the United States as to the punishment of offenses committed in any place within the sole and exclusive jurisdiction of the United States * * * shall extend to Indian country.”
. The relevant portions of 18 U.S.C. § 1153 provided at the time:
Any Indian who commits against the person or property of another Indian or other person any of the following offenses, namely, murder, manslaughter, kidnaping, rape, carnal knowledge of any female, not his wife, who has not attained the age of sixteen years, assault with intent to commit rape, incest, assault with intent to commit murder, assault with a dangerous weapon, assault resulting in serious bodily injury, arson, burglary, robbery, and larceny within the Indian country, shall be subject to the same law and penalties as all other persons committing any of the above offenses, within the exclusive jurisdiction of the United States.
As used in this section, the offenses of burglary and incest shall be defined and punished in accordance with the laws of the State in which such offense was committed as are in force at the time of such offense.
Congress in 1984 amended the statute by adding involuntary sodomy to the enumeration of offenses to be defined by state law. Comprehensive Crime Control Act of 1984, Pub.L. No. 98-473, Title II, § 1009, 98 Stat. 2141.
. Section 22-22-19.1 provides:
Any person, fifteen years of age or older, who knowingly engages in sexual contact with another person, other than his spouse,, if that other person is under the age of twenty-one and is within the degree of consanguinity or affinity within which marriages are by the laws of this state declared void is guilty of a Class 5 felony.
. Section 22-22-19 provided:
Persons who are not legally married and who are within the degrees of consanguinity within which marriages are by the laws of this state declared void, and who have sexual intercourse with each other are guilty of incest.
The state criminal code does not define the term "sexual intercourse." It appears to be consistent with the common law definition of the term, which, both parties admit, does not cover Renville’s acts.
. Section 22-22-7.1 provides:
As used in this chapter, the term, "sexual contact,” means any touching, not amounting to rape, of the breasts of a female or the genitalia or anus of any person with the intent to arouse or gratify the sexual desire of either party.
. Section 22-22-2 • defines "sexual penetration” as used in the rape statute, with exceptions not relevant here, as:
[A]n act, however slight, of sexual intercourse, cunnilingus, fellatio, anal intercourse, or any intrusion, however slight, of any part of the body or of any object into the genital or anal openings of another person’s body.
S.D. Codified Laws Ann. § 22-22-2 (1979 & Supp.1983).
As authoritatively construed by the South Dakota Supreme Court, rape and sexual contact are mutually exclusive conduct. In
State v. Brammer,
. The defendant does not contend that his conduct is made punishable by any other federal law. See infra note 10.
. The defendant does not argue, nor could he, that these offenses precisely or generically cover the conduct for which he was convicted, oral and anal intercourse.
. Dr. Likness testified to the importance of diagnosing and treating the psychological injuries that accompany child abuse:
[T]here is an ongoing emotional trauma, and an emotional trauma that is sometimes extremely hard to define, but it shows up and affects all of those people that have been abused in some way or form. * * * Those are things that don’t necessarily show up in a physical exam, but are definitely important in the well being of this child how I then will be able to take care of her in the future, what type of sexual care does she need medically, psychiatrically, and how is it going to affect her life.
Record at 101, United States v. Renville, No. 84-10016-01 (D.S.D. Nov. 14, 1984).
. This point was specifically addressed by Dr. Likness in response to a question by the Assistant United States Attorney:
Q What about the identity of the person that did this to [the victim], does that have any significance important for the purpose of your diagnosis and treatment of her?
A I think it is extremely important.
Q Why is that?
A If the perpetrator or the person who is alleged to be the abuser either physically or sexually is someone who is close to her, someone who she lives with, someone who she spends time with and if she can tell me that there have been several incidents of this ongoing, the chances of that to continue [sic] and to continue to be a problem is very, very high and the probability that will occur again is definitely there. * * * Again, these children that are abused, 80 percent of the abusers today grew up from being abused. They were abused themselves as children either sexually or physically.
Record at 102.
This point was again made by Dr. Likness in response to a related question inquiring whether the victim’s state of mind toward Renville had any significance in determining a diagnosis or course of treatment. Dr. Likness testified:
[A fear of the defendant] would relate in that it would indicate to me significant problem with her emotional and physical well being, not only at the present time but into the future * * *. [I]f we can get to these children early, if we can help them work though their problems, if we can help them learn to understand what has happened and why and that it is not their fault, they can then hopefully go on to live a fairly healthy life. But, as I said, if we don’t get these children and we can't help them, most of them will grow up to be abusers themselves and/or end up with adolescent problems from truancy to breaking the law to sexual deviation on down the line and so it is extremely important for me from a medical point of view to gather as much of that knowledge that I can so that I can then hopefully direct her care down the line for treatment
Record at 118-119.
. Most states have statutes requiring a physician to report suspected child abuse to the appropriate authorities. E.g., Ark.Stat.Ann. § 42-808 (1977); Iowa Code § 232.69(l)(a) (1985); Mo.Rev.Stat. § 210.115(1) (1983); Minn.Stat. § 626.556(3) (Supp.1985); Neb.Rev.Stat. § 28-711(1) (1979 & Supp.1984); N.D.Cent.Code § 50-25.1-03(1) (1982); S.D.Codified Laws Ann. § 26-10-10 (1984).
. The same reasons serve to distinguish the Ninth Circuit’s decision in
United States v. Nick,
