Child Protection Program
The Child Protection Program currently offers comprehensive medical evaluation for children suspected of being abused or neglected, provides crisis counseling services to families, provides consultation to social, medical and legal professionals dealing with child abuse issues, and provides educational programs to professionals from a variety of disciplines dealing with child abuse. We offer expert medical evaluations to help differentiate medical conditions, accidents, and child maltreatment.
The Child Protection Program was founded in 1985 with the initial Statewide Educational Program on Child Sexual Abuse. This multi disciplinary educational program that reached over 1500 Indiana professionals in the first three years resulted in the rapid realization that Indianapolis and Indiana needed a center for expertise in the medical issues related to child sexual abuse and the coordination of care needed for best outcomes for children. As such, the Child Sexual Abuse Clinic was founded in 1986 to develop and provide that expertise. Further development of those services lead to the development of a community based mechanism for ongoing problem identification and solving, and continuing education, the Hospital and School Liaison Child Abuse Forum. As the programs grew additional expertise was requested and developed in the evaluation of physical abuse and neglect, and the relationship of domestic violence to child abuse.
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. The majority of children are referred by child protection services and law enforcement (70%); health care providers are the second most common source of referral (20%). The clinic has become a major source of expertise and consultation for Indianapolis and much of central Indiana with requests from throughout the entire state. Between 300 and 500 children are seen yearly in this clinic: almost 80% are girls, 72% are Caucasian, the average age is seven years, and 60% of children are from Marion County. In 2003 the program was expanded to provide 24/7 service for acute child sexual assault victims – an additional one hundred children have been seen yearly in this expansion component.
The Crisis Counseling Services are an extension of the Pediatric Center of Hope/Child Sexual Abuse Clinic and bridge the gap in services from the time a child is identified as a possible victim to the four to eight week time frame in which formal ongoing counseling may become available. This program serves children and families in person and over the phone. Follow up is provided to all children seen for suspected sexual abuse in the child sexual abuse clinic, pediatric clinic, urgent visit center and emergency room. Consultation is provided to community resources. This program has served a tremendous need in providing support to families in the early stages of an allegation and investigation when there is so much turmoil and families are not sure what to do. In the first year of this project, more than 800 child victims and 1100 parents of victims of child sexual abuse were served. There were over 1100 telephone contacts for information and referral. Therapy services were provided to 1100 victims. In subsequent years, over 1500 families have received these services annually.
The Child Abuse Consultation Service provides comprehensive medical evaluations for children alleged to have been physically abused or neglected. The majority of physical abuse evaluations actually turn out to be inpatient and emergency room consultations at Riley Hospital. Approximately 150 alleged physical abuse cases are seen per year, many of whom spend sometime in the pediatric intensive care unit. Additional consultations are provided as expert review for Child Protection Services, law enforcement, attorneys, and hospital administration. Beginning in 2008 in collaboration with the Indiana Department of Child Services, child abuse pediatricians will review all cases of suspected abusive head trauma reported to child protection services.
The Liaison Child Abuse Forum is a community coordination effort founded and directed by the Child Protection Program. This forum brings together Marion County Child Protection Services, 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 somewhat uniform hospital guidelines for child abuse cases, and initiating the battered women’s domestic violence training protocol. In 2000, The Marion County Child Protection Team asked the Liaison Child Abuse Forum to address the problem of educational neglect and recommend a protocol to address this problem. This community wide protocol was completed and implemented in the fall of 2002.
The Marion County Child Fatality Review Team was developed in 1994 as a subcommittee of the Marion County Child Protection Team, under the leadership of Dr. Hibbard. This team was charged with reviewing child fatalities in Marion County to assess 1) the epidemiology of child deaths not due natural medical conditions and 2) the potential for interventions to better understand child deaths and possibly their prevention. This committee continues to meet monthly to review deaths, identify and solve community based issues in child death investigations, implement community protocols and develop efforts and initiatives to prevent future deaths of children. Dr. Hibbard and other team members have served as consultants to the State of Indiana in their initiatives to develop child fatality review throughout the state.
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