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


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


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.










Kempe Cares for Kids – 2014 Annual Report


Over the past year, Kempe has taken incredible strides to share our expertise and knowledge worldwide. Our work is having a positive impact on the lives of children and families.

We want to express our gratitude to the entire Kempe team for their wonderful support and work – for without their dedication and commitment, our efforts to end child abuse and neglect would not be possible.

We also want to say thank you to our partners for believing in us and for your support.

Lastly, we want to extend a special thank you to our funders, donors and supporters for your passionate commitment. Your support is vital in advancing Kempe’s work to prevent and treat child abuse and neglect.


  • Treated 1,306 Children
  • Served 641 Parents and Caretakers
  • Trained 4,971 Child Welfare Professionals
  • Published 32 Research Papers
  • Raised awareness of how to calm a crying baby in partnership with Children’s Hospital Colorado and Kohl’s Cares
  • Outreached in 48 Colorado Counties, 12 States and Washington D.C
  • Completed Global Work in Japan and Singapore
  • Bestowed with 12 honors and awards

We invite you to read the Kempe 2014 Annual Report in its entirety.

Posted by: By John Faught: President & CEO of The Kempe Foundation, and Dr. Runyan, The Kempe Center Executive Director

2015: A Year of Health

This year is shaping up to be a year of health for Kempe.

One of the greatest health factors today is the long-term health risks many child abuse and neglect victims face as adults. These health impacts are known as adverse childhood experiences and toxic stress and are defined when a child is subjected to stressful or traumatic experiences growing up. Many abused and neglected children are a greater likelihood of these health problems as adults:

  • Heart disease
  • Hepatitis
  • Depression
  • Suicide
  • Teen Pregnancy
  • Early Paternity
  • Autoimmune Disease
  • Lung Cancer

Kempe intends to take this foundational knowledge and advance the research and conversation around adverse childhood experiences and toxic stress this year by:

  • Applying for grant funding opportunities that enable us to create a collaborative movement to effectuate a game-changing paradigm shift
  • Traveling to Belgium and the Netherlands to examine how these countries ‘health-based’ child welfare systems differ from the U.S. ‘social-work’ child welfare system.
  • Exploring a public education campaign that informs people how child abuse and neglect impacts individuals long after the physical scars are gone.

In addition, we are continuing our vital work around clinical care, advocacy, research and education. We are continuing our important work:

  • Provide vital medical and behavioral health services to children and families
  • Share our knowledge with professionals and community’s throughout the world
  • Offer helpful tips to calm a crying baby through the Kohl’s Cares: Shaken Baby Prevention Campaign

We encourage to learn more about Adverse Childhood Experiences and Toxic stress in 2015, and invite you to support our efforts of preventing and treating child abuse and neglect.

Posted by: By: John Faught, President & CEO, The Kempe Foundation