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 3 faculty physicians are the only board certified child abuse pediatricians in Indiana. Fellows will also have opportunities to work closely with a wide variety of 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 protection services (CPS), law enforcement officers or other professionals,
- Expert testimony in legal settings,
- Professional education,
- Parent education,
- 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. . Our physicians provide 150-250 such consultations per year at the inpatient units and emergency department of 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.
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. Between 300 and 500 children are seen each year, including both scheduled and acute examinations (many of the latter involving forensic evidence collection).
PEDS Program (Pediatric Evaluation and Diagnostic Services): Since 2008 in collaboration with the Indiana Department of Child Services (which houses CPS), CPP physicians have provided formal consultation for case managers for cases reported to the agency for suspected abusive head trauma. In 2013 this program was expanded to include cases involving fractures and burns in children less than 3 years of age. 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. For the current year we are on target to receive approximately 2000 PEDS consultations.
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 over the phone. 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 1500 families have received these services annually.
The Safe Sleep Indiana Program arose from our work with the Marion County Child Fatality Review Team, which has identified a high prevalence of unsafe sleep practices that have either contributed to or directly caused the death of young infants. Our goal is to educate families about Safe Sleep procedures and provide those that do not have one a safety approved crib. Our Safe Sleep Program staff work with partnering agencies to provide education and distribute cribs throughout Indiana. One hundred twenty eight agencies are now involved and 81 Indiana counties now have some form of coverage for access to cribs and safe sleep education. Eight hundred cribs were distributed statewide during the first three months of 2013, and last year in Marion County (Indianapolis) alone 624 cribs were distributed.
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, 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 2 weekly multi-disciplinary case review and educational sessions. One is a review of acute sexual assault examinations and the other for review of inpatient and emergency department consultations (primarily physical abuse and neglect cases). Team members also 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 trainings for professionals in various disciplines. During the past year several secondary level pediatricians around the state have been identified to assist with the medical evaluations of children reported to CPS, and our weekly case review meetings opened to those physicians and nurses with the Indiana Department of Child Services who can join remotely via internet/telephone.