Child Protection Program - Child Abuse Fellowship
The Child Abuse Pediatrics Fellowship at Indiana University and Riley Hospital for Children in Indianapolis, Indiana is a 3 year ACGME accredited program. Our fellowship program offers extensive clinical subspecialty training in child abuse pediatrics at Indiana’s only Level I Pediatric Trauma Center. Our 4 full-time and 1 part-time faculty physicians are all board certified child abuse pediatricians. Our Section also includes nurse practitioners (NPs), social workers, registered nurses, and an education coordinator-research/data specialist. Fellows will also have opportunities to work closely with a wide variety of other medical subspecialists and community partners.
The IU Child Protection Program (CPP) was founded in 1985 and provides consultation services to children, families and professionals involved with child maltreatment. The CPP mission is to improve care, evaluation and coordination of services to children who are suspected victims of child abuse or neglect. Collaboration with professionals from other disciplines that work in this field and work with multidisciplinary teams is an important component of the CPP work.
Comprehensive medical evaluation for children about whom abuse or neglect is suspected,
Crisis counseling services for families,
Professional consultation for health care providers, child protective services (CPS), law enforcement officers or other professionals,
Expert testimony in legal settings,
Prevention efforts, and
Leadership in identifying and solving community issues dealing with child abuse.
The Child Abuse Consultation Service provides comprehensive medical evaluations for children alleged to have been physically abused or neglected. For the year ending June 30, 2016, our program received a total of 5,924 consultations. Included in these were a total of 596 patient examinations (343 sexual abuse, 253 for physical abuse/other) performed by our physicians at Riley Hospital for Children. In addition, CPP physicians, social workers and nurses regularly receive telephone calls and requests for consultation from CPS, law enforcement, attorneys and other professionals seeking guidance on cases they are handling. This includes the PEDS Program described below.
The Pediatric Center of Hope (child sexual abuse clinic) provides comprehensive medical evaluation for children alleged to have been sexually abused. Services are provided by pediatricians with expertise in child abuse, pediatric sexual abuse nurse examiners and pediatric social workers. Children are referred primarily by CPS, law enforcement, and health care providers. Both scheduled and acute examinations (many of the latter involving forensic evidence collection) are performed by physicians.
PEDS Program (Pediatric Evaluation and Diagnostic Services): The goal of the PEDS program is to provide expert knowledge from child abuse pediatricians in order to assist case managers in differentiating abusive injuries, accidental injuries and medical conditions. Since 2008 in collaboration with the Indiana Department of Child Services (which houses CPS), CPP physicians have provided formal consultation for case managers for specific types of cases reported to the agency. Currently these cases involve suspected head trauma in a child less than 6 years of age and fractures and burns in children less than 3 years of age. However, CPS case managers are welcome to consult the CPP with medical related questions they have about any case.
Crisis Counseling Services are an extension of the Pediatric Center of Hope and bridge the gap from the time a child is referred through the typical several weeks until formal ongoing counseling is available. This program serves children and families in person and by telephone. Follow up is provided for children examined in the Pediatric Center of Hope. Consultation is also provided for children and families not actually seen in our programs at the medical center, as well as to community professionals. This program has served a tremendous need in providing support to families in the early stages of an allegation and investigation when there is much turmoil and families are not sure where to turn. Over 1,500 families receive these services annually.
The Liaison Child Abuse Forum is a community coordination effort founded and directed by the Child Protection Program. This forum brings together Marion County CPS, law enforcement, prosecutor, and public school system representatives on a monthly basis to solve community problems in the identification, evaluation and handling of child abuse cases. This group has been responsible for developing community protocols on handling child abuse cases in schools, developing hospital guidelines for handling cases of suspected child abuse/neglect, initiating a battered women’s domestic violence training protocol, and developing a protocol to address the problem of educational neglect in the community.
The Marion County Child Fatality Review Team was developed in 1994 under the leadership of the CPP. This team meets monthly and reviews child fatalities in Marion County to assess (1) the epidemiology of child deaths not due to natural causes, and (2) the potential to better understand child deaths and possibly their prevention. In addition to CPP physicians, social workers and other professionals, the team includes representatives from the county coroner’s office, CPS, juvenile court, law enforcement, prosecutor’s office, county health department, emergency medical services, mental health and the city’s public school system.
Educational Efforts: Our team has regular multi-disciplinary case review and educational sessions. One is a weekly review of hospital based consultations (primarily physical abuse and neglect cases). CPP physicians and NPs participate in a monthly radiology and neuroradiology child abuse case review conference. Another is a monthly review of acute sexual assault examinations. Team members participate in a monthly multi-disciplinary case review at the county children’s advocacy center. There is ongoing education with team members and trainees (pediatrics and other residents, medical students) on a case by case basis. Team members are regularly asked to provide training for professionals in various disciplines. Several secondary level pediatricians around the state have joined with us to assist with the medical evaluations of children reported to CPS, and our weekly case review meetings include those physicians as well as nurses with the Indiana Department of Child Services who join remotely via internet/telephone.