ANSTEAD, Justice.
We have for review M.B. v. Department of Health & Rehabilitative Services, 21 Fla. L. Weekly D1817, 1996 WL 453438 (Fla. 1st DCA Aug.13, 1996). We accepted jurisdiction to answer the following questions certified to be of great public importance:
DOES THE TERM “STATEMENT” IN SECTION 90.803(23), FLORIDA STATUTES, PERMIT THE ADMISSION OF A CHILD VICTIM’S PRIOR UNSWORN STATEMENT WHICH IS INCONSISTENT WITH THE CHILD’S IN-COURT TESTIMONY, IF THE EVIDENCE SUPPORTS A DETERMINATION THAT THE EARLIER UNSWORN STATEMENT MEETS SUFFICIENT SAFEGUARDS OF RELIABILITY?
IF SECTION 90.803(23) PERMITS A CHILD VICTIM’S PRIOR INCONSISTENT STATEMENTS TO BE ADMITTED AS SUBSTANTIVE EVIDENCE, IF FOUND TO BE TRUSTWORTHY AND THE RECORD SUPPORTS SUCH A FINDING, IS THE COMBINATION OF SUCH STATEMENTS AND THE CORROBORATING MEDICAL EVIDENCE, INDICATING ONLY THE POSSIBILITY THAT ABUSE MAY HAVE OCCURRED, SUFFICIENT TO ESTABLISH THE DEPENDENCY OF THE CHILD UNDER THE PREPONDERANCE OF THE EVIDENCE OR THE GREATER WEIGHT OF THE. EVIDENCE STANDARD?
21 Fla. L. Weekly at D1818, 1996 WL 453438. We have jurisdiction. Art. V, § 3(b)(4), Fla. Const. .For the reasons expressed below, we answer both certified questions in the affirmative and quash the decision under review. We commend both the majority and the dissent in the district court for their thorough examination of the issues before us.
TRIAL COURT PROCEEDINGS
On February 16, 1993, eight-year-old D.W. told her third grade teacher that her stepfather had sexual intercourse with her during the previous month. D.W. also reported that her stepfather forced her to perform fellatio on one occasion when she was between four and six years of age. D.W. later repeated this information to a guidance counselor, a Child Protection Team (CPT) coordinator, a CPT nurse practitioner, and a clinical psychologist on referral from CPT. Medical examinations yielded physical findings consistent with the history detailed by D.W.
Detention petitions for D.W. and her four siblings were subsequently filed by the Department of Health and Rehabilitative Services (HRS)1 based on D.W.’s assertions. D.W.’s mother, G.B., acknowledged to investigating officials that her daughter had been molested, but she refused to believe her husband was the perpetrator. She also noted that several of her husband’s friends had been visiting the family’s home the night the sexual abuse occurred.
After the delinquency petition was filed, D.W. told investigators that she no longer could remember who abused her. A psychologist who examined her attributed this inconsistency to “child sexual abuse accommodation syndrome.”2 Under that theory, a child sexual abuse victim, whose story is distrusted by the non-offending parent — D.W.’s mother in this case — eventually retracts the accusation in order to restore the family system to its pre-accusation status.
At the trial on the dependency petition, D.W. testified that “someone” had sexually abused her, although she was unable to identify that person. Medical evidence, including physical findings of abuse, was also admitted. The trial court also admitted hearsay testimony of several witnesses regarding D.W.’s [1157]*1157initial statements about her sexual abuse and identifying her stepfather as the abuser. In admitting the child’s out-of-court statements, and as required by section 90.803(23), Florida Statutes (1995), providing for a child victim hearsay exception, the trial court entered a detailed order with specific findings as to the reliability of the statements.
At the conclusion of the dependency hearing the trial court entered an order of dependency finding that M.B. had sexually abused D.W. two different times; that G.B. failed to protect her daughter by refusing to support her emotionally after being informed of the abuse; and that G.B. neglected to provide D.W. with the necessary medical, legal, and psychological services. Based on these findings, the trial court concluded that all five children were in danger of prospective abuse and neglect. Accordingly, the trial court declared them all dependent.3
APPEAL
On appeal, the First District reversed. M.B., 21 Fla. L. Weekly at D1817, 1996 WL 453438. The district court reasoned that once D.W. failed to identify her stepfather as the abuser, her earlier unsworn statements became prior inconsistent statements and were, thus, inadmissible as substantive evidence. Id. The district court cited the common law rule that unsworn, out-of-court statements which were inconsistent with a witness’s in-court testimony were never admissible as substantive evidence and only admissible for the limited purpose of impeachment. Id. Therefore, the court concluded that “the only rational interpretation that can be given to the term ‘statement,’ as used in section 90.803(23), is that in order for it to be admitted as substantive evidence, it must be consistent with the child’s in-court testimony.” Id. Based on its conclusion that D.W.’s out-of-court statements were inadmissible, the district court determined that the medical evidence, by itself, was “insufficient to sustain the dependency adjudication,” i.e., did not meet the preponderance of the evidence standard. Id. The court cited State v. Green, 667 So.2d 756 (Fla.1995), in support of its holding. Finally, the court acknowledged a concern about its ruling and certified the above questions for this Court’s review. Id.
REQUIREMENTS OF SECTION 90.803(23)
We first hold that section 90.803(23), Florida Statutes (1995), permits the admission into evidence of certain out-of-court statements of a child crime victim without the necessity that those statements be consistent with the child’s trial testimony. Section 90.803(23) provides:
The provision of s. 90.802 to the contrary notwithstanding, the following are not inadmissible as evidence, even though the declarant is available as a witness:
[[Image here]]
(23)HEARSAY EXCEPTION; STATEMENT OF CHILD VICTIM.
(a) Unless the source of information or the method or circumstances by which the statement is reported indicates a lack of trustworthiness, an out-of-court statement made by a child victim with a physical, mental, emotional, or developmental age of 11 or less describing any act of child abuse or neglect, any act of sexual abuse against a child, the offense of child abuse, the offense of aggravated child abuse, or any offense involving an unlawful sexual act, contact, intrusion, or penetration performed in the presence of, with, by, or on the declarant child, not otherwise admissible, is admissible in evidence in any civil or criminal proceeding if:
1. The court finds in a hearing conducted outside the presence of the jury that the time, content, and circumstances of the statement provide sufficient safeguards of reliability. In making its determination, the court may consider the mental and physical age and maturity of the child, the [1158]*1158nature and duration of the abuse or offense, the relationship of the child to the offender, the reliability of the assertion, the reliability of the child victim, and any other factor deemed appropriate; and
2. The child either:
a.
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ANSTEAD, Justice.
We have for review M.B. v. Department of Health & Rehabilitative Services, 21 Fla. L. Weekly D1817, 1996 WL 453438 (Fla. 1st DCA Aug.13, 1996). We accepted jurisdiction to answer the following questions certified to be of great public importance:
DOES THE TERM “STATEMENT” IN SECTION 90.803(23), FLORIDA STATUTES, PERMIT THE ADMISSION OF A CHILD VICTIM’S PRIOR UNSWORN STATEMENT WHICH IS INCONSISTENT WITH THE CHILD’S IN-COURT TESTIMONY, IF THE EVIDENCE SUPPORTS A DETERMINATION THAT THE EARLIER UNSWORN STATEMENT MEETS SUFFICIENT SAFEGUARDS OF RELIABILITY?
IF SECTION 90.803(23) PERMITS A CHILD VICTIM’S PRIOR INCONSISTENT STATEMENTS TO BE ADMITTED AS SUBSTANTIVE EVIDENCE, IF FOUND TO BE TRUSTWORTHY AND THE RECORD SUPPORTS SUCH A FINDING, IS THE COMBINATION OF SUCH STATEMENTS AND THE CORROBORATING MEDICAL EVIDENCE, INDICATING ONLY THE POSSIBILITY THAT ABUSE MAY HAVE OCCURRED, SUFFICIENT TO ESTABLISH THE DEPENDENCY OF THE CHILD UNDER THE PREPONDERANCE OF THE EVIDENCE OR THE GREATER WEIGHT OF THE. EVIDENCE STANDARD?
21 Fla. L. Weekly at D1818, 1996 WL 453438. We have jurisdiction. Art. V, § 3(b)(4), Fla. Const. .For the reasons expressed below, we answer both certified questions in the affirmative and quash the decision under review. We commend both the majority and the dissent in the district court for their thorough examination of the issues before us.
TRIAL COURT PROCEEDINGS
On February 16, 1993, eight-year-old D.W. told her third grade teacher that her stepfather had sexual intercourse with her during the previous month. D.W. also reported that her stepfather forced her to perform fellatio on one occasion when she was between four and six years of age. D.W. later repeated this information to a guidance counselor, a Child Protection Team (CPT) coordinator, a CPT nurse practitioner, and a clinical psychologist on referral from CPT. Medical examinations yielded physical findings consistent with the history detailed by D.W.
Detention petitions for D.W. and her four siblings were subsequently filed by the Department of Health and Rehabilitative Services (HRS)1 based on D.W.’s assertions. D.W.’s mother, G.B., acknowledged to investigating officials that her daughter had been molested, but she refused to believe her husband was the perpetrator. She also noted that several of her husband’s friends had been visiting the family’s home the night the sexual abuse occurred.
After the delinquency petition was filed, D.W. told investigators that she no longer could remember who abused her. A psychologist who examined her attributed this inconsistency to “child sexual abuse accommodation syndrome.”2 Under that theory, a child sexual abuse victim, whose story is distrusted by the non-offending parent — D.W.’s mother in this case — eventually retracts the accusation in order to restore the family system to its pre-accusation status.
At the trial on the dependency petition, D.W. testified that “someone” had sexually abused her, although she was unable to identify that person. Medical evidence, including physical findings of abuse, was also admitted. The trial court also admitted hearsay testimony of several witnesses regarding D.W.’s [1157]*1157initial statements about her sexual abuse and identifying her stepfather as the abuser. In admitting the child’s out-of-court statements, and as required by section 90.803(23), Florida Statutes (1995), providing for a child victim hearsay exception, the trial court entered a detailed order with specific findings as to the reliability of the statements.
At the conclusion of the dependency hearing the trial court entered an order of dependency finding that M.B. had sexually abused D.W. two different times; that G.B. failed to protect her daughter by refusing to support her emotionally after being informed of the abuse; and that G.B. neglected to provide D.W. with the necessary medical, legal, and psychological services. Based on these findings, the trial court concluded that all five children were in danger of prospective abuse and neglect. Accordingly, the trial court declared them all dependent.3
APPEAL
On appeal, the First District reversed. M.B., 21 Fla. L. Weekly at D1817, 1996 WL 453438. The district court reasoned that once D.W. failed to identify her stepfather as the abuser, her earlier unsworn statements became prior inconsistent statements and were, thus, inadmissible as substantive evidence. Id. The district court cited the common law rule that unsworn, out-of-court statements which were inconsistent with a witness’s in-court testimony were never admissible as substantive evidence and only admissible for the limited purpose of impeachment. Id. Therefore, the court concluded that “the only rational interpretation that can be given to the term ‘statement,’ as used in section 90.803(23), is that in order for it to be admitted as substantive evidence, it must be consistent with the child’s in-court testimony.” Id. Based on its conclusion that D.W.’s out-of-court statements were inadmissible, the district court determined that the medical evidence, by itself, was “insufficient to sustain the dependency adjudication,” i.e., did not meet the preponderance of the evidence standard. Id. The court cited State v. Green, 667 So.2d 756 (Fla.1995), in support of its holding. Finally, the court acknowledged a concern about its ruling and certified the above questions for this Court’s review. Id.
REQUIREMENTS OF SECTION 90.803(23)
We first hold that section 90.803(23), Florida Statutes (1995), permits the admission into evidence of certain out-of-court statements of a child crime victim without the necessity that those statements be consistent with the child’s trial testimony. Section 90.803(23) provides:
The provision of s. 90.802 to the contrary notwithstanding, the following are not inadmissible as evidence, even though the declarant is available as a witness:
[[Image here]]
(23)HEARSAY EXCEPTION; STATEMENT OF CHILD VICTIM.
(a) Unless the source of information or the method or circumstances by which the statement is reported indicates a lack of trustworthiness, an out-of-court statement made by a child victim with a physical, mental, emotional, or developmental age of 11 or less describing any act of child abuse or neglect, any act of sexual abuse against a child, the offense of child abuse, the offense of aggravated child abuse, or any offense involving an unlawful sexual act, contact, intrusion, or penetration performed in the presence of, with, by, or on the declarant child, not otherwise admissible, is admissible in evidence in any civil or criminal proceeding if:
1. The court finds in a hearing conducted outside the presence of the jury that the time, content, and circumstances of the statement provide sufficient safeguards of reliability. In making its determination, the court may consider the mental and physical age and maturity of the child, the [1158]*1158nature and duration of the abuse or offense, the relationship of the child to the offender, the reliability of the assertion, the reliability of the child victim, and any other factor deemed appropriate; and
2. The child either:
a. Testifies; or
b. Is unavailable as a witness, provided that there is other corroborative evidence of the abuse or offense. Unavailability shall include a finding by the court that the child’s participation in the trial or proceeding would result in a substantial likelihood of severe emotional or mental harm, in addition to findings pursuant to section 90.804(1).
(b) In a criminal action, the defendant shall be notified no later than 10 days before trial that a statement which qualifies as a hearsay exception pursuant to this subsection will be offered as evidence at trial. The notice shall include a written statement of the content of the child’s statement, the time at which the statement was made, the circumstances surrounding the statement which indicate its reliability, and such other particulars as necessary to provide full disclosure of the statement.
(c) The court shall make specific findings of fact, on the record, as to the basis for its ruling under this subsection.
Since the legislature enacted section 90.803(23) in 1985, we have decided various questions of law concerning this important hearsay exception.4
[1159]*1159In 1993, we acknowledged that the statute’s purpose as “clearly [being] the Florida Legislature’s response to the need to establish special protections for child victims in the judicial system.” State v. Jones, 625 So.2d 821, 825 (Fla.1993).5 We found that the statute’s legislative history revealed an intent to expand the medical diagnosis and treatment and excited utterance hearsay exceptions in order to include an exception for statements of child abuse victims. Id. We noted that by “providing for such safeguards as a hearing out of the jury’s presence in order to assure reliability of the statements and special notice of the intent to use the statements, the Legislature sought to strike a balance between the need to consider child hearsay statements in judicial proceedings and the rights of the accused.” Id. at 826.
In State v. Townsend, 635 So.2d 949 (Fla.1994), we emphasized the heavy responsibility of the trial court in ensuring that a high standard for reliability is met before a child victim’s hearsay statement may be admitted into evidence.6 Beyond the factors [1160]*1160for consideration specifically enunciated in the statute,7 we established the following nonexclusive list:
[A] consideration of the statement’s spontaneity; whether the statement was made at the first available opportunity following the alleged incident; whether the statement was elicited in response to questions from adults; the mental state of the child when the abuse was reported; whether the statement consisted of a child-like description of the act; whether the child used terminology unexpected of a child of similar age; the motive or lack thereof to fabricate the statement; the ability of the child to distinguish between reality and fantasy; the vagueness of the accusations; the possibility of any improper influence on the child by participants involved in a domestic dispute; and contradictions in the accusation. In sum, as noted by the United States Supreme Court in [Idaho v.] Wright, [497 U.S. 805, 110 S.Ct. 3139, 111 L.Ed.2d 638 (1990) ] a court is to use a totality of the circumstances evaluation in determining reliability.
Id. at 957-58 (citations omitted) (emphasis added).8 Our decisions in Jones and Townsend stand for the dual conclusions that strict standards of reliability must be applied before admitting child hearsay statements, and, once those standards have been met, such statements may be admitted and considered as substantive evidence by the trier of fact.
CONSISTENCY
Today, in reaffirming those conclusions, we hold that the admission and subsequent consideration of the statements as substantive evidence by the trier of fact does not require that the child’s testimony at trial be consistent with the out-of-court statements. We believe a reasonable analysis of the legislature’s intent as discussed above and a plain reading of the statute itself support this conclusion.9 The statute explicitly provides for admission of a statement once the trial court finds (1) it is reliable, and (2) the child testifies. § 90.803(23)(a) 1., 2. On the other hand, the statute contains no “consistency” requirement. In contrast, and to demonstrate that the legislature knew how to impose a “consistency” requirement if desired, the legislature specifically addressed the issue of consistency between out-of-court statements and in-eourt testimony in' section 90.801, Florida [1161]*1161Statutes (1995), in defining non-hearsay.10
We have stated that “[t]he legislature is presumed to know the meaning of words and the rules of grammar, and the only way the court is advised of what the legislature intends is by giving the [statutory language its] generally accepted construction.” Florida State Racing Comm’n v. Bourquardez, 42 So.2d 87, 88 (Fla.1949). Therefore, if the legislature intended to use the modifier “consistently” with the word “testifies,” it could have said so. Since it did not, we have concluded in similar situations that “there is no occasion for resorting to the rules of statutory interpretation and construction.” Holly v. Auld, 450 So.2d 217, 219 (Fla.1984). Further, we find that a literal interpretation of the statute without a requirement of “consistency” does not lead to an “unreasonable or ridiculous conclusion.” Id. To the contrary, if we judicially imply an in-court testimony consistency requirement, we would be ignoring the major purpose of the act and would render at least part of section 90.803(23) meaningless. Surely, at least one purpose of the act was to allay the problems inherent in a child victim’s live appearance and testimony at trial, and to permit an additional means of providing a child’s evidence for the trier of fact.
One respected commentator has noted some confusion on the case law on this issue:
There is some authority that, if the victim’s trial testimony does not indicate that abuse occurred, the victim’s out-of-court statements that the abuse occurred are not sufficient, by themselves, to support a conviction. The rationale for these decisions is not clear. If the rationale is that the out-of-court statement is lacking the necessary reliability as a result of the circumstances in which it was made, the analysis is appropriate. Section 90.803(23) and the defendant’s confrontation rights require this analysis. If the basis is that, because the out-of-court statement which is admissible under a recognized hearsay exception, is inadmissible simply because it is inconsistent with the in-court testimony of the witness, the reasoning should not be followed. Although a prior statement which is admitted pursuant to section 90.801(2) is not sufficient by itself to support a conviction, the rationale should not be extended to statements admitted under a section 90.803 hearsay exception. These exceptions are surrounded by circumstantial guarantees of reliability which are not necessarily present when a statement is offered under section 90.801(2).
Charles W. Ehrhardt, Florida Evidence § 803.23, at 702 (1996 ed.) (footnote omitted) (emphasis added). We agree with this commentary.
Employing similar reasoning in an analogous situation, for example, we have observed that “an identification made shortly after the crime is inherently more reliable than a later identification in court.” State v. Freber, 366 So.2d 426, 428 (Fla.1978). Realizing that physical appearances can change and memories dim, we concluded that the use of prior identifications as substantive evidence of identity was imperative or “conviction would in some instances be impossible.” Id. Under section 90.801(2)(c), the codification of the Freber holding, this out-of-court statement of identification is considered non-hearsay and, thus, “is admissible in court to prove the truth of the matter asserted, e.g., to prove that the person identified was the person who committed the act.” Charles W. Ehrhardt, Florida Evidence § 801.9, at 592 (1996). More importantly, no in-court consistency requirement attaches as the “failure of the witness to repeat the identification in [1162]*1162court does not affect the admissibility of evidence of the prior identification.” Id. at 582. The same may be said of the provisions of section 90.803(23).
Against this backdrop, we cannot accept the district court majority’s holding that the child’s trial testimony must be consistent with the out-of-court statements as a condition of admissibility, nor its conclusion that it is not “pertinent to our decision whether the child’s earlier, unsworn statements were properly determined to be reliable, because, as we have said, the statements were simply inadmissible hearsay,” M.B., 21 Fla. L. Weekly at D1818, 1996 WL 453438. Based on the above analysis, we hold that hearsay statements such as those in this ease, even if “inconsistent” with a child’s in-court testimony, are admissible as substantive evidence in a dependency hearing once they have satisfied the stringent reliability safeguards established in section 90.803(23) and refined in our prior case law. Accordingly, we answer the first certified question in the affirmative.
GREEN
We must also address the district court majority’s concern with our ruling in State v. Green, 667 So.2d 756 (Fla.1995), wherein we determined that a prior statement of the child victim, directly conflicting with the victim’s trial testimony, standing alone, was insufficient to sustain a criminal conviction.11 We held that convicting the defendant “based solely on the prior inconsistent statements of the victim would indeed create too great a risk of ‘convicting an innocent accused,’ especially when we consider the immense potential for manipulation of a retarded child.” Green, 667 So.2d at 761.
However, consistent with our emphasis on the importance of the reliability determination of the child’s hearsay statements, we have refused to establish “a blanket rule that no conviction can stand based solely on hearsay testimony.” Anderson v. State, 655 So.2d 1118, 1120 (Fla.1995). In Green, we explicitly noted that our prior decisions barring criminal convictions “based solely on the prior inconsistent statements of the victim ... [do] not mean that inconsistent statements admitted under section 90.803(23) can never be used as substantive evidence when other proper corroborating evidence is admitted.” Green, 667 So.2d at 761.
In Green, unlike the instant case, the alleged victim, a mentally retarded child of the mental age of seven, explicitly “recanted” her earlier statements implicating Green as her abuser. The child victim had an IQ of 50, and before accusing Green, she had accused another man. She not only testified at trial that Green had never abused her, but she also denied ever telling anyone that he had and, indeed, at trial she identified a different alleged abuser. We found that the child’s out-of-court testimony was insufficient as a matter of law to sustain the criminal conviction. In essence, we determined that the reliability of the child’s statement identifying Green had been so diminished by the child’s other testimony that we could not have sufficient confidence in the criminal conviction to allow it to stand. See also State v. Moore, 485 So.2d 1279 (Fla.1986); Santiago v. State, 652 So.2d 485 (Fla. 5th DCA 1995).
Our rulings in Green and Moore were primarily concerned with the minimum standard of evidence required to sustain a criminal conviction and the potential miscarriage of justice that could occur if that standard was not maintained. We were also concerned, of course, about the constitutional rights of the accused in a criminal proceeding. See Green, 667 So.2d at 760. Those concerns are not present in these dependency proceedings, where it is undisputed that the child victim was the subject of sexual abuse, and the issue is the child’s welfare and not the alleged abuser’s criminal culpability. We conclude that Green, because of its unique circumstances and the substantial distinctions from this case as noted above, does not control the outcome here.
Furthermore, whether D.W.’s testimony at trial amounted to a “recantation” of her earlier statements, as the district court majority [1163]*1163opinion characterizes her trial testimony, is open to question. To recant is “[t]o withdraw or repudiate formally and publicly.” Black’s Law Dictionary at 1267 (6th ed.1990) (citing Pradlik v. State, 131 Conn. 682, 41 A.2d 906, 907 (1945)). Significantly, D.W. did not testify that her stepfather did not abuse her, only that “someone” had sexually assaulted her. She did not deny her previous statements. Therefore, her trial testimony certainly did not exonerate her stepfather and was not the equivalent of the conflicting and contradictory testimony involved in Green.
EVIDENTIARY STANDARD TO ESTABLISH DEPENDENCY
Finally, we find that an affirmative answer to the second certified question is dictated by our affirmative answer to the first question permitting admission and consideration of the child’s out-of-court statements.12 When combined with the objective and unchallenged corroborating medical evidence that was presented in this case, that some form of sexual penetration had occurred, we find the evidence sufficient to meet the preponderance of the evidence standard. We note that the majority opinion below also acknowledged that the medical evidence of D.W.’s sexual abuse “could conceivably be viewed as corroborating [her] report of abuse.” M.B., 21 Fla. L. Weekly at D1818, 1996 WL 453438. Again, we must remember that the alleged abuser’s culpability is not the focus of a civil dependency proceeding.13 Dependency proceedings are to be initiated for “the protection of the child and not the punishment of the person creating the condition of dependency.” § 39.404(2), Fla. Stat. (1995). Accordingly, we answer the second certified question in the affirmative.
In summary, we answer both certified questions in the affirmative, quash the decision under review, and remand the case to the First District with directions for further proceedings consistent with this opinion, including the resolution of any issues not previously decided.
It is so ordered.
KOGAN, C.J., and OVERTON, SHAW, GRIMES, HARDING and WELLS, JJ., concur.