Pediatrics

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Child Protection Clinical Care

The Child Protection Program offers consultation to health care providers, child protection services, law enforcement and other professionals in cases of suspected child maltreatment. Services include consultation by phone, a record review of a case, or seeing the child in consultation, depending on the request. Consultations are objective and evidence-based with the goal of providing objective assessment to determine the extent of injury and ascertain if a medical cause or accidental mechanism accounts for the injury pattern.

One of the most rewarding issues in child abuse pediatrics work is finding the balance, working to ensure that every child gets an appropriate evaluation and ensuring the evaluation for injuries is complete, reasonable. Medical conditions are evaluated and accidental mechanisms of injury are considered. Over the past five years, the Child Protection Program has expanded to include five board certified child abuse pediatricians. The volume of consultations has increased from just over 1400 consultations per year to 6000 consultations and growing, reaching areas throughout the state.

Clinical Services

Crisis counseling services are an extension of the Pediatric Center of Hope and bridge the gap in services from the time a child is identified as a possible child sexual abuse 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 by telephone. Follow up is provided for children examined in the Pediatric Center of Hope. Consultation is also provided for community professionals and for children and families that have been seen at other facilities. The crisis counseling service 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. More than 1,500 individuals receive these services annually.

Trauma treatment services provide cognitive behavioral therapy for victims of child maltreatment.

The consultation service provides comprehensive medical evaluations for children alleged to have been physically abused or neglected. For the year ending June 30, 2017, this program received more than 6,100 consultations. Included in these were a total of 470 patient examinations performed by child protection physicians at Riley Hospital for Children at IU Health. In addition, Child Protection Programs physicians, social workers and nurses regularly receive telephone calls and requests for consultation from state child protection agencies, law enforcement, attorneys and other professionals seeking guidance on cases they are handling. These consultations include the Pediatric Evaluation and Diagnostic Services program.

The Pediatric Evaluation and Diagnostic Services (PEDS) program provides 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 (DCS), Child Protection Programs physicians have provided formal consultation for case managers for specific types of cases reported to the agency.  Currently these cases are focused on suspected head trauma in children less than 6 years of age and fractures and burns in children less than three years of age.  DCS case managers may also consult the PEDS program with medical related questions they have about any case.

Partnerships

Liaison Child Abuse Forum

This forum is a community coordination effort founded and directed by the IU School of Medicine Division of Child Protection. The forum brings together Marion County Child Protective Services, law enforcement, the prosecutor’s office 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.

Marion County Child Fatality Review Team

The Marion County Child Fatality Review Team was developed in 1994 under the leadership of the IU School of Medicine Division of Child Protection. 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 Child Protection Programs physicians, social workers and other professionals, the team includes representatives from the county coroner’s office, Child Protective Services, juvenile court, law enforcement, prosecutor’s office, county health department, emergency medical services, mental health and the city’s public school system.