The Child Protection Program embraces six elements:
children referred to Childrens Hospital Boston for suspected abuse or neglect
and referring them to appropriate services within the hospital and in the
Educating and providing services for parents and caretakers
Consulting with staff about protective issues, coordinating with the Department of Social Services (DSS) and law enforcement, and providing courtroom testimony, when necessary
Providing services to battered women and their children
Training hospital staff to recognize and respond to child abuse and neglect
Community outreach and prevention efforts
Children can be referred to the Child Protection Clinical Services (outpatient) clinic by staff in the hospitals Emergency Department, DSS, community physicians, or family members (self-referrals). The clinic staff includes physicians, social workers, psychologists, a nurse and administrative/intake staff trained to deal with children in a sensitive manner. After the evaluation, staff may recommend further evaluation or refer children for treatment. Referrals for treatment may include counseling. Clinicians may also communicate with the childs pediatrician or other professionals as indicated. If necessary, Childrens Hospital staff may file a report of suspected abuse or neglect with DSS, as required by law. If a report has already been filed, we coordinate closely with DSS to provide information and assistance. We may also work with the district attorneys office in cases which are criminal in nature.
In some cases, children may be better served by evaluation with professionals who can see them more quickly or who are located closer to the childs home. Thus, the hospital refers some children and families to any number of outside agencies.
In addition to accepting referrals from community physicians, professionals on the Child Protection Program also consult with outside professionals and agencies who have child protection concerns.
When a child who may be abused or neglected is admitted to Childrens for medical or social reasons (most often through the Emergency Department), members of the Child Protection Team coordinate efforts with hospital social workers, medical staff, and other clinical caregivers. We also help to formulate a safe discharge plan, often in conjunction with DSS.
For parents and other primary caretakers of abused children, staff may make referrals for counseling to therapists with expertise in child maltreatment and/or child trauma.
Members of the Child Protection Program are available 24 hours a day to consult with hospital staff about protective issues concerning their patients. Consultation may include the provision of clinical and legal information as well as guidance in the filing of the mandated 51A report, facilitating the tracking of cases, and helping to assure child protection and safety. To maintain uniform and effective practice standards, and to assure compliance with Massachusetts law, Childrens Hospital requires that the Child Protection Program be consulted on all cases in which a 51A report is anticipated or filed.
The AWAKE Project is considered a national model for domestic violence intervention within a pediatric healthcare environment, and has been replicated in a myriad of healthcare settings. AWAKE advocates provide individual and group domestic violence intervention services for adolescent patients, parents/caretakers of patients, and also employees at Childrens Hospital and The Martha Eliot Health Center. AWAKE staff members advocate on behalf of battered women with local, state, and federal agencies. All AWAKE services are offered in English and Spanish by AWAKE staff members, and interpreters are used for other linguistic needs, including American Sign Language. All AWAKE services are offered free of charge. In addition to these clinical services, AWAKE also provides case consultation and educational sessions for hospital and health center staff, and community and state agencies.
Childrens has undertaken a hospital-wide program to train all staff and employees to recognize signs of family violence and to educate them about available resources and support services for families affected by violence. Training covers historical contexts that have fostered family violence and its prevalence today, indicators and symptoms of family violence, myths and misconceptions, diversity and its implications in practice, screening skills, response to disclosure, legal mandates and documentation standards. Sessions are designed to help staff become comfortable with the language and techniques used to screen for abuse. Staff also learn how to respond sensitively to a disclosure in ways that ensure the safety of the victim, as well as other family members, hospital patients and families, or staff who may be placed at risk by the disclosure. There is also ongoing training for Emergency Department staff specific to their needs.
Members of the Child Protection Program provide information on child abuse and family violence at scheduled teaching conferences in all clinical departments. Typically, training systematically covers the range of knowledge, diagnostic and therapeutic techniques, and complexities of case management essential in understanding and responding to different types of child abuse.
Childrens Child Protection Program members serve as the sole consultants on protective issues to Dana Farber Cancer Institute; along with the AWAKE team, we also consult with staff at Martha Eliot Health Center. The CPP also supports and works with the Childrens Advocacy Center of Suffolk County, a public-private partnership of child service agencies dedicated to providing multidisciplinary services to children of Suffolk County who have been allegedly abused or who have witnessed violence. In addition, the CPP works closely with other Massachusetts child welfare agencies. Members of the Child Protection Program also frequently speak in the community to educate service professionals and families about child abuse and neglect. We hope that this website will be an integral part of our community outreach efforts.
April 17, 2004