Child Maltreatment Symposium 2024

Presentations

• "Trauma-Informed Responses to Intimate Partner Violence in Pediatric Healthcare Settings"
  Dr. Tiyyagura will discuss how pediatric providers are aware of IPV, but a pathway to identifying the problem and then addressing it in a safe way is not clear. She will review three fundamental questions and controversies in IPV-related care while summarizing the evidence and suggesting best practices; What is the most family-centered approach to inquiry about IPV in the pediatric setting? When is an evaluation for abusive injuries indicated after child exposure to IPV? and When should providers report to CPS in the context of child exposure to IPV?
• "Improving Child Abuse Recognition in General Emergency Departments: Our Journey in Connecticut"

Biography

Gunjan Tiyyagura is an associate professor of pediatrics and emergency medicine at Yale University School of Medicine. She finished her residency and chief residency at Columbia University and went on to complete her fellowship in Pediatric Emergency Medicine and her Masters in Health science at Yale where she stayed on as a faculty member. To date, her research has focused on improving recognition of high-risk injuries associated with child abuse through the development and dissemination of programs and evidence to acute care settings especially community emergency departments using qualitative research, implementation science and quality improvement methodologies.  Over the past few years, she has focused on examining the prevalence of child abuse in young children living with IPV, understanding barriers and facilitators to evaluation of child abuse in children living with IPV, and developing an integrated care clinic model of care for children and caregivers living with IPV. She is currently funded by NICHD to develop and evaluate a trauma-and violence-informed care model for children and caregivers living with intimate partner violence.  Most importantly, she has had the privilege of developing and leading the amazing New Haven family violence Community Advisory Board, that advises and collaborates on all research and advocacy work she does related to IPV. 

She is the director of pediatric quality and safety education at Yale. She loves mentoring and teaching trainees and has been recognized with the Pediatric Educator award and the Mae Gaelani Clinical Research Award at Yale School of Medicine.

Presentation

"Epigenetic Advancements in Child Abuse Pediatrics"

Description

During this presentation, Dr. Raut will explore the biological impact of early life experiences via epigenetic mechanisms that influence short- and long-term health outcomes. 

Sharing examples from our own research as well as recent literature, we will discuss how epigenetic principles can be applied to clinical and medicolegal challenges in the field of child maltreatment. 

Biography

Audrey Raut is an Attending Physician and Co-Director of Research in Child Abuse Pediatrics at Ann & Robert H. Lurie Children's Hospital of Chicago, and an Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine. She earned undergraduate degrees in Neurobiology and Global Health + Health Policy from Harvard University before attending Feinberg School of Medicine and then completing her pediatrics residency and child abuse fellowship at Lurie Children’s. She was inspired to become a Child Abuse Pediatrician after studying the effects of early institutionalization on the socioemotional development of severely neglected children in Bucharest, Romania. Since that time, her research has focused on psychosocial risk factors for physical abuse, clinical characteristics differentiating abusive from accidental injury, and the biological impact of early adversity. 

Presentation

"Medical Child Abuse: A Multidisciplined Approach for a Successful Outcome"

Description

Munchausen by proxy (Medical Child Abuse) is one of the most misunderstood forms of physical child abuse in society today. This presentation will dispel myths and provide attendees with the basic tools necessary to identify, investigate, and prosecute criminal cases of medical child abuse. Those basic tools will include detailed investigative strategies and Illinois case law for child services, police, and criminal prosecutors to use in this very different type of criminal investigation.

Biography

Detective Weber has 39 years law enforcement experience, including 15 years as a crimes against children investigator. Detective Weber has investigated over 50 reports of Medical Child Abuse that have led to 13 convictions, 3 cases pending trial, and 3 cases currently under investigation. Detective Weber has consulted with numerous police agencies and district attorney’s offices nationally on cases of medical child abuse. Detective Weber co-authored the APSAC best practice guidelines on Medical Child Abuse titled Munchausen by Proxy: Clinical and Case Management (APSAC Advisor journal March 2018). Weber also authored a separate article in the same issue of the Advisor titled Investigation of Factitious Disorder Imposed on Another and Medical Child Abuse. Detective Weber authored Investigating Medical Child Abuse for the FBI Law Enforcement Bulletin journal (August 2018). Detective Weber was awarded the 2016 NCMEC Texas Hero for Children Award for the investigation of Geronimo Aguilar and Medical Child Abuse Cases. Weber is currently assigned to investigate crimes against children for the Tarrant County Sheriff’s Office and handles all reports of medical child abuse in Tarrant County. Detective Weber is a regular contributor on the true crime/educational podcast “Nobody Should Believe Me,” which examines medical child abuse through previous cases.

Presentation

"Looking Beyond Sex Trafficking of American Girls"

Description

In this presentation we will extend our view of child trafficking to consider forms beyond the realm of sexual exploitation, including labor trafficking and forced criminality. We will examine risk among relatively ‘invisible’ populations of children, including those who may not fit commonly accepted notions of child exploitation. Finally, we will discuss strategies for early identification of children at risk, review the benefits and challenges of screening for child trafficking and consider the need for careful assessment of the outcomes and impact of screening tools and intervention services.

Biography

Jordan Greenbaum is a physician specializing in the area of child protection. She is the senior vice president of survivor care at OUR Rescue, an international anti-trafficking NGO. She is a past medical director of the International Centre for Missing and Exploited Children, and of the Stephanie Blank Center for Safe and Healthy Children at Children’s Healthcare of Atlanta. Greenbaum is a board member of the International Society on the Prevention of Child Abuse and Neglect (ISPCAN). She has provided training and technical assistance to health and mental health professionals, as well as international school staff, social workers, law enforcement officers and prosecutors globally to improve the community response to child abuse, exploitation, and trafficking. She provides training and technical assistance regarding the trauma-informed, rights-based approach to interacting with children and families who have experienced trauma related to sexual, physical or community violence, and forced migration.

Presentation

"Exploring the lived experience of non-offending caregivers in Abusive Head Trauma (AHT)”

Description

In this presentation Dr. Ornstein will review the clinical and historical features of abusive head trauma using a case-based approach. Dr. Ornstein will highlight some of the challenges faced in the evaluation and recognition of AHT using current medical literature and review approaches that may facilitate evaluation in the future. Finally, Dr. Ornstein will discuss novel research that explores the lived experience of non-offending caregivers in abusive head trauma that can help inform our response to these difficult situations. 

Biography

A graduate of McGill University, in Montreal, Quebec, Canada, Amy Ornstein is a consultant pediatrician and medical director of the IWK Health Suspected Trauma & Abuse Response Team (START).  She is also Division Head of General Pediatrics at Dalhousie University and IWK Health.

Dr. Ornstein completed her residency in Pediatrics and a clinical fellowship focusing in child maltreatment at The Hospital for Sick Children and the University of Toronto.  She is Board Certified in the field of Pediatrics and Child Abuse Pediatrics by the American Academy of Pediatrics and is a Fellow and Diplomate of the Royal College of Physicians and Surgeons of Canada in Pediatrics and Child Maltreatment Pediatrics, respectively. She is a Professor in the Faculty of Medicine at Dalhousie University and completed a Master’s degree in Community Health and Epidemiology at Dalhousie University in 2013 with a research focus on the prevention of child maltreatment. 

She is active in education about child abuse and neglect and teaches a wide range of learners including medical professionals, law enforcement and social workers. Dr. Ornstein has been a leader in the vision and development of the SeaStar Child and Youth Advocacy Centre, the first of its kind in Atlantic Canada, which provides coordinated services children and families who have experienced violence and abuse.

Presentation

"Applying the Injury Equity Framework to Child Maltreatment”

Description

During this session, Drs. Kendi and Macy will present the Injury Equity Framework (Kendi & Macy, NEJM 2023), a theoretical basis for identifying and analyzing factors that influence who is injured and the contributors and countermeasures of injury severity and outcomes using an equity lens. The framework integrates the Cliff of Good Health (Jones et al, 2009) and the Haddon Matrix (Haddon, 1980), overlaying historical and current societal factors that intersect with community, family and individual factors to contribute to injury inequities. The companion Injury Equity Matrix is a practical tool for analyzing injury events and patterns of injuries within the context of the Injury Equity Framework. The Pediatric Injury Equity Review (PIER) process, developed by Dr. Kendi and colleagues, will be presented with an example scenario as a model for centering childhood maltreatment prevention and mitigation strategies in equity. Participants will gain skills in the application of these tools for the development of new approaches to prevent pediatric injuries at the local, regional, or state level. This process has potential to reveal novel insights that can be used to eliminate long-standing inequities in child injury.

Biography

Michelle Macy, MD, MS is practicing pediatric emergency physician-scientist. She is a Professor of Pediatrics at Northwestern University Feinberg School of Medicine and holds the Mary Ann and J. Milburn Smith Research Professorship for the Director of Child Health Research. She is the Scientific Director of Community, Population Health and Outcomes in Stanley Manne Children’s Research Institute at Ann & Robert H. Lurie Children’s Hospital of Chicago, and concurrently directs the Mary Ann & J. Milburn Smith Child Health Outcomes, Research and Evaluation Center. 

Dr. Macy obtained her BS in Biology with distinction of high honors from the University of Michigan where she continued on to Medical School and Pediatric Residency. She completed dual Pediatric Emergency Medicine and Pediatric Health Services Research fellowship training, earning her Master’s in Health and Health Care Research from Rackham Graduate School at University of Michigan. She stayed on faculty in the Department of Emergency Medicine at Michigan Medicine until joining Lurie Children’s in 2018.

Dr. Macy’s research focuses on social, structural and behavior change strategies to address leading causes of unintentional injury death in childhood, motor vehicle collisions and drowning. She has received funding from the National Institutes of Health, Robert Wood Johnson Foundation and Illinois Indiana Sea Grant Program of the National Oceanic and Atmospheric Administration. She serves on the Equity Advisory Committee for Safe Kids Worldwide. 

Presentation

"Applying the Injury Equity Framework to Child Maltreatment"

Description

During this session, Drs. Kendi and Macy will present the Injury Equity Framework (Kendi & Macy, NEJM 2023), a theoretical basis for identifying and analyzing factors that influence who is injured and the contributors and countermeasures of injury severity and outcomes using an equity lens. The framework integrates the Cliff of Good Health (Jones et al, 2009) and the Haddon Matrix (Haddon, 1980), overlaying historical and current societal factors that intersect with community, family and individual factors to contribute to injury inequities. The companion Injury Equity Matrix is a practical tool for analyzing injury events and patterns of injuries within the context of the Injury Equity Framework. The Pediatric Injury Equity Review (PIER) process, developed by Dr. Kendi and colleagues, will be presented with an example scenario as a model for centering childhood maltreatment prevention and mitigation strategies in equity. Participants will gain skills in the application of these tools for the development of new approaches to prevent pediatric injuries at the local, regional, or state level. This process has potential to reveal novel insights that can be used to eliminate long-standing inequities in child injury.

Biography

Sadiqa A.I. Kendi, MD, MPH, FAAP, CPST is pediatric emergency medicine physician at Children’s National Hospital, and Chief Medical Officer of Safe Kids Worldwide. She is an expert in injury prevention and health equity. Dr. Kendi graduated from the Yale School of Medicine and received her pediatrics training from the Social Pediatrics Program at The Children’s Hospital at Montefiore, where she spent an additional year as chief resident. She completed her fellowship training in pediatric emergency medicine at The Children’s Hospital of Philadelphia, and her MPH training as a Bloomberg American Health Initiative Fellow at the Johns Hopkins University Bloomberg School of Public Health. Kendi is a certified child passenger safety technician and a member of the executive committee of the American Academy of Pediatrics Council on Injury Violence and Poison Prevention.

Presentation

"Psychological Maltreatment"

Biography

Dr. Ada Booth graduated with a BS in Interdisciplinary Studies from the University of Maryland, Baltimore County with a focus on Pediatric Psychology. She obtained her medical degree from Indiana University School of Medicine in Indianapolis. She then completed her pediatric residency training at University Hospitals and Clinics at the University of Missouri in Columbia. She completed a fellowship in child abuse pediatrics at Nationwide Children’s Hospital in Columbus, Ohio.

After completing her fellowship, she joined the Child Abuse Resource and Evaluation (CARE) Team at Driscoll Children’s Hospital in Corpus Christi, Texas where she practiced as a child abuse pediatrician until 2022 when Dr. Booth joined Connecticut Children's in the Division of Suspected Child Abuse and Neglect (SCAN). She is currently an Assistant Professor at the UConn School of Medicine in the Department of Pediatrics. Her professional interests include psychological maltreatment and child fatality review.

Presentation

"Perspectives and communication preferences of Spanish-speaking immigrant parents regarding child maltreatment"

Description

Effectively communicating concerns regarding child maltreatment and involvement of child welfare services to families can be challenging, especially when there are language and cultural differences. Despite the growing Spanish-speaking immigrant community in the U.S., there is very limited literature on Spanish-speaking caregivers’ perceptions and preferences regarding communication about child maltreatment in the medical setting. This presentation presents the work of a qualitative study exploring those issues. Attendees will have the opportunity to gain insight into what pertains to potentially unmet needs of Spanish-speaking immigrant families while in the medicolegal and child welfare systems. They will also analyze the rich and multilayered visions into the complexity of providing services to this population. Strategies would be also identified with the main aim to support effective, culturally sensitive communication to truly keep children safe and support families. 

Biography

Dr. Aldana Sierra completed her medical school at the University of El Rosario in Bogota, Colombia. After being certified by the ACGME as an International Medical Graduate, she completed her residency training in Pediatrics at Children’s Hospital of Michigan, Detroit Medical Center. Her passion to impact on the 20 years of life expectancy shortened by childhood trauma and a call from the field, made her set a new goal of becoming a Child Abuse Pediatrician. This took her to the Children’s Hospital of Philadelphia (CHOP) where she completed her fellowship in Child Abuse Pediatrics. She is certified as a pediatrician and as a Child Abuse Pediatrician by the American Academy of Pediatrics. She is currently a faculty member, Section Vice Chief, and the Designated Research Lead of the Child Protection Team at Phoenix Children’s.  She has been appointed as an Assistant Clinical Professor, Division of Child Protection at The University of Arizona College of Medicine, Assistant Clinical Professor at Creighton University School of Medicine, and Volunteer Faculty at Mayo Clinic Alix School of Medicine.