SCAN Clinic: The Medical-Forensic Evaluation of Child Abuse & Neglect

SCAN Clinic CMH Division of Child Abuse and Neglect Multidisciplinary team with expertise in medical evaluation and treatment of the maltreated child: Child Abuse Pediatricians Nurse Practitioners Social Workers Registered Nurses Child Life Specialists Mental Health Professionals

What is a Child Abuse Pediatrician Pediatrician with 3 year fellowship training on Forensic identification of abuse Prevention Coordination/development of therapy programs Less likely than non-Child Abuse Pediatrician to diagnose abuse

Purpose of Medical Evaluation: Ensure the health and well-being of the child Identify and interpret forensic significance of exam findings Identify and begin treatment of underlying medical problems Provide education and reassurance to the child and family

Services Provided by SCAN Clinic: SAFE Exams - Sexual Abuse Forensic Exam Photo/Video documentation Forensic Evidence Collection STI and pregnancy prophylaxis treatment Acute and non-acute exams SANE-P Exams Sexual Assault Nurse Examiner Program Specially trained pediatric and adolescent nurse examiners Provide expert forensic and medical care to with acute sexual assault (within the last 5 days) 100% peer review by SCAN Team Physicians Exams performed 24 hours a day in the Emergency Department

Services Provided by SCAN Clinic: CARE Exams - Child At Risk Exam Photo documentation of skin findings Forensic interpretation of findings Radiographic assessment (if needed) Skeletal Survey CT Scan Laboratory assessment (if needed) Hospital Consultations Case review Children not seen at CMH

Need for the Foster Care Medical Exam US General Accounting Office foster children do not receive adequate preventive health care while in placement, many significant problems go undetected, or, if diagnosed, are not evaluated and treated. Untreated medical needs 44% have an identified health problem, including infections The Foster Care population becomes the homeless population

Services Provided by SCAN Clinic: Mental Health Services/Programs: CARE Workshops - Child Adult Relationship Enhancement PCIT - Parent Child Interaction Therapy SAFE - Stabilization and Family Empowerment Program TF-CBT - Trauma Focused Cognitive Behavioral Therapy

SCAN Clinic Referral Sources: Parent/Caregiver Child Protection Services Law Enforcement Primary Care Medical Providers Outside Medical Facilities

Total Patients 2016-17 3032 total patients 50% Therapy 21% Physical abuse 16% Sexual abuse/rape 13% Foster care

Why a Pediatric Hospital? 5 board certified child abuse pediatricians, 2 child abuse fellows No others in the KC metropolitan area Pediatric Nurse Practitioners with specialized training in child abuse and neglect Dedicated Child Life Staff in the clinic to assist with every exam

SCAN Team Responsibilities: Communicate medical and forensic findings May request further scene investigation Collaborate to establish a safety plan Coordinate follow up medical appointments Participate in Case Review

After the Exam: Tell the child that his/her body is ok Tell the child that what happened is not his/her fault Tell the child that what happened doesn’t define who he/she is They are in control of how they are defined They will be defined by how they move forward