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

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

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

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

12. 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

13. 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

14. 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