Topic: Child Abuse and Neglect

SafeCare Colorado Program Expands to Nine Counties

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Efforts to provide critical supports to at-risk families with children ages five and younger received a boost today with the expansion of SafeCare Colorado to nine additional counties.

The new counties served are: Alamosa, Conejos, Costilla, Mineral, Rio Grande, Saguache, Weld, El Paso, and Douglas.

SafeCare Colorado offers proactive in-home, voluntary services that support at-risk families in understanding the health, development and safety needs of young children. The Colorado Department of Human Services (CDHS) program is one piece of Gov. John W. Hickenlooper’s multi-faceted approach to child welfare, called “Keeping Kids Safe and Families Healthy 2.0.”

“We are very excited about the opportunities that this voluntary program offers,” said Mary Anne Snyder, Director of the Office of Early Childhood for the CDHS. “Many families referred to the child welfare system are either screened out, or closed after assessment, without receiving services. We continue to be more proactive in helping families by expanding preventative programs throughout the state.”

SafeCare Colorado uses a nationally recognized, evidence-based, in-home parent education program to provide direct skills training to caregivers in the areas of parenting, home safety, and child health. Staff at the newly selected SafeCare Colorado sites will be trained in the fall and can take referrals from community-based organizations, child welfare services, and even parents seeking help.

New SafeCare Colorado Sites:

  • La Llave Family Resource Center – in partnership with Alamosa County Department of Human Services, Conejos County Department of Social Services, Costilla County Department of Social Services, Mineral County Department of Social Services, Rio Grande County Department of Social Services, and Saguache County Department of Social Services
  • Northeast Behavioral Health  – in partnership with Weld County Department of Human Services
  • Lutheran Family Services Rocky Mountains – in partnership with El Paso County Department of Human Services.

Expanded SafeCare Colorado Site:

  • The Family Tree (currently serving Adams County) – in partnership with Douglas County Human Services

CDHS is continuing its partnership with The Kempe Center for the Prevention and Treatment of Child Abuse and Neglect to administer SafeCare Colorado throughout Colorado. With the addition of these three new sites, the SafeCare program is now offered in 39 Colorado counties and two American Indian tribes.

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SafeCare Colorado Success Stories
Karla was struggling with communication with her son, especially when he was sad or upset. SafeCare Colorado helped Karla and her son by providing her with education and insights on her child’s behavior, health/illness and home safety. Since being a part of the program, Karla’s son’s school has noticed a positive improvement in how well he’s doing, and Karla says that all the tools she gained from SafeCare Colorado help her every day as a parent. She loves SafeCare Colorado and thinks every family should use it.

Peg agreed to participate in SafeCare Colorado because she wanted insight on how she could raise her two and half year old son and better handle his tantrums and defiant behavior. During a SafeCare Colorado session, the home visitor discussed the need for rules and consequences, which was a new concept for her. Peg had been in and out of foster care growing up and therefore did not want to enforce rules upon her son.

Peg was also surprised to learn that she could give out positive consequences; she only knew of negative consequences. For her homework assignment over the next week, Peg was to establish the rules that she wanted for her home, and provide positive consequences. Her plan was put into place over the next four weeks. Over that time, Peg reported a decrease in the number of tantrums and was pleasantly surprised by the outcome.

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This press release was released by the Colorado Department of Human Services Office of Children Youth and Families.

Advancing the Work to Identify Abdominal Injuries and Abusive Head Trauma in Child Abuse Victims

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Abdominal and head injuries are significant indicators of child abuse, but often go undetected by emergency room doctors. In fact, an estimated 30% of children with abusive head injuries are sent away without a diagnosis.1 Even more, of all child abuse cases, an estimated 3% of child abuse victims have injuries to the liver.2

These startling statistics have prompted Kempe to take action to educate and share knowledge and tools with doctors to help them better identify abdominal injuries and abusive head trauma when a child first visits an emergency room or doctor’s office. By empowering doctors with this knowledge, we can keep children from suffering recurring abuse.

Abdominal Injuries

Liver lacerations and other injuries to abdominal organs are often a clear indicator a child has been abused. Unfortunately, doctors often miss these hidden signs of abuse because the injuries are not visible to the naked eye.

Dan Lindberg, Associate Professor of Emergency Medicine and Pediatrics at The Kempe Center and University of Colorado Anschutz Medical Center shared significant findings related to abusive abdominal injuries in Clinical Pediatric Emergency Medicine. His research shows that while abdominal injuries are generally uncommon in children, many abused children often suffer from abdominal injuries. And, frequently doctors miss screening for abdominal injuries.

Since publishing this research, Dr. Lindberg has been working to share these findings with pediatricians and emergency room doctors across the country. One tool doctors can use to identify an abdominal injury is a blood test. This blood test can immediately alert doctors to the possibility of an abdominal injury – and raise concern for missed abuse.

This simple blood test could make the world of difference in keeping children safe and prevent them from suffering recurring abuse.

Abusive Head Trauma

Abusive head trauma is the leading cause of death among abused kids, killing one in five children who have this type of injury. Of those who survive, 8 in ten are left with permanent injuries.3,4

Dr. Lindberg and the team at Kempe are also making significant strides helping doctors identify children who have suffered abusive head trauma.

Because child abuse is hard to assess, doctors sometimes mistake abusive head trauma for the flu or illness, as the child’s only symptom is vomiting. Small signs like these often deter doctors from running more extensive tests like CAT scans or MRIs, even when there are other reasons to think about abuse.

Since 30% of kids with abusive head injuries are sent away without a proper diagnosis, Kempe is working to address this need. One of the identification tools Kempe is currently researching is FAST MRI. The FAST MRI has the ability to scan a child’s head in 3-5 minutes versus the 20-30 minutes a traditional MRI takes. Additionally, children would not be exposed to radiation through the use of a FAST MRI.

Kempe believes the FAST MRI can reduce the number of children who are sent away without a proper diagnosis being made. Once a proper diagnosis is made, children can receive proper treatment and begin to heal. It can save lives.

The Colorado Clinical Translational Sciences Initiative and The Colorado TBI Trust Fund recently provided funding that will enable Kempe to find a solution to address this gap in diagnosis.

Kempe is also partnering with Kohl’s Cares and Children’s Hospital Colorado on a public awareness campaign to prevent shaken baby syndrome, a form of abusive head trauma, called the Kohl’s Shaken Baby Syndrome Prevention Campaign.

If you would like to support Kempe’s efforts in encouraging doctors to run blood tests to screen for liver lacerations or support our research to identify young victims with abusive head trauma through FAST MRIs, please consider making a donation to support our research and outreach.

Together, we are making a difference for children in Colorado and across the globe.

  1. Jenny C, Hymel KP, Ritzen A, Reinert SE, Hay TC. Analysis of missed cases of abusive head trauma. JAMA : the journal of the American Medical Association. Feb 17 1999;281(7):621-626.
  2. Lindberg DM, Shapiro RA, Blood EA, Steiner RD, Berger RP, for the ExSTRA investigators. Utility of Hepatic Transaminases in Children With Concern for Abuse. Pediatrics. Jan 14 2013.
  3. Barlow KM, Thomson E, Johnson D, Minns RA. Late neurologic and cognitive sequelae of inflicted traumatic brain injury in infancy. Pediatrics. Aug 2005;116(2):e174-185.
  4. Makoroff KL, Putnam FW. Outcomes of infants and children with inflicted traumatic brain injury. Dev Med Child Neurol. Jul 2003;45(7):497-502.

 

Kempe Fellowship in Child Abuse Pediatrics: Interview with Dr. Sasha Svendsen

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Child Abuse Pediatrics is a specialized field with a growing number of training sites across the nation.

As an organization that is committed to preventing and treating child abuse and neglect and educating other professionals, The Kempe Center, University of Colorado School of Medicine Dept. of Pediatrics, and Children’s Hospital Colorado offer a three-year post residency fellowship in child abuse pediatrics.

Dr. Sasha Svendsen began her fellowship in July 2014. She shares about her experience below:

Why did you decide to apply for The Kempe Center Fellowship in Child Abuse Pediatrics?

Child Protection Fellow (07) 2014After this fellowship, I intend to work as a child abuse pediatrician.  I believe all children have a right to grow safely and securely, and have long felt a strong commitment to give voice to and provide care for those who need it most.

Throughout medical school and residency, I chose rotations to gain exposure to this subspecialty.  Those experiences solidified my commitment to this work, and I was looking to find a fellowship program that would offer a full range of training, experience, and research in this field.

Kempe is recognized as an established leader in the field of child abuse pediatrics.

It has a comprehensive Child Protection Team that is comprised of various medical providers and mental health specialists.  I was honored to receive the news of my acceptance to this program.  I’m grateful for this opportunity and hope this fellowship guides my future clinical, community and public policy work, as well as research.

What is your background?

I earned my undergraduate degree from Colorado College and medical degree from Pennsylvania State University.  I completed my pediatrics residency training and was a Chief Pediatric Resident at the University of Massachusetts.  During residency, I was part of the global health track program and participated in a rotation at the John F. Kennedy Hospital in Monrovia, Liberia.

Why were you interested in becoming a doctor?

I’ve wanted to be a pediatrician ever since I was little.

In high school, I was involved in a peer advocacy group that mentored teens about dating violence. After high school, I assisted in a research project at Massachusetts General Hospital and also worked as a medical assistant in a local pediatrics clinic.  Throughout college, I was actively involved in a student organization responsible for educating the campus community on sexual assault and staffing a 24 hour rape crisis line.  Our work in this organization led to the establishment of a campus coordinator dedicated to sexual assault response and the first hiring of this position.

These experiences strengthened my desire and resolve to have a positive impact by directly working with children and their families in the medical field.

What has been your experience with the fellowship to date?

The learning curve has been steep. I have had hands-on experience with the acute and chronic evaluation and care for our patients, including addressing the physical, emotional, and psycho-social aspects of abuse.

The needs for attention, support, and resources in this area are great.  It has been important to learn about the various community organizations and agencies that are committed to this field of work, and to understand the many layers of communication and interaction necessary to provide effective care and support for children and families.

What have you learned about Kempe?

The Kempe Center is a valuable resource that not only reaches children and families in Colorado, but extends its services throughout the region.  It offers a variety of mental health services and training programs, as well as expert case review.  I have been able to observe the continuous interactions between the University of Colorado School of Medicine, Children’s Hospital Colorado and Kempe.

Tell us about your experience over the past few months.

This work is very intense due to the number and extent of cases.  In addition, the details and severity of many of these cases can be dramatic and disturbing.

While I learn significant things every day, I have really enjoyed working with our mental health providers and understanding how our services overlap.  In this way, we can offer more comprehensive care to our patients and families.

Final thoughts

While my work here at The Kempe Center has proved to be both challenging and demanding, I continue to find it very rewarding.  I feel privileged to work in this community with the dedicated and passionate professionals of the Child Protection Team.

You can support Kempe’s work to educate and train professionals by making a donation. Your support enables us to continue offering fellowships, share our knowledge and empower professionals to prevent and treat child abuse and neglect.