Child Maltreatment Symposium 2022

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Kirsten Simonton, MD

Presentation: “Pride and Prejudice: LGBTQ+ youth in a complex social and legal landscape”

Description: Lesbian, gay, bisexual, transgender and queer (LGBTQ+) youth face a complex social and legal landscape in the United States.  These youth face unique medical, mental health and maltreatment risks, which contribute to their overrepresentation in out-of-home care including the child welfare system.   Within child welfare, LGBTQ+ youth encounter specific challenges related to placement decisions, screening practices and ultimate housing and educational outcomes.  While laws exist at federal and state levels to prohibit discrimination based on sexual orientation and gender identity, there has been a surge of anti-LGBTQ legislative attacks in recent years, broadly threatening the rights and access for LGBTQ+ youth.  Understanding the state of the current and historical legal landscape for LGBTQ+ youth can inform best practices for the medical and social service professionals who serve them.

Biography: Dr. Simonton is an Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine and Attending Physician in the Division of Child Abuse Pediatrics at Lurie Children’s Hospital of Chicago.  She completed graduate education in the Department of Genetics at Case Western Reserve University followed by medical training and child abuse fellowship at Cincinnati Children’s Hospital.  In her fellowship foster care clinic, she became interested in the experiences of maltreatment and the foster care system among marginalized populations, including LGBTQ+ youth.  As a faculty member at Northwestern University, she received grant support to conduct community-based participatory research among LGBTQ+ youth in DCFS custody.  She works with community and state-wide committees advocating for improved identification and treatment of LGBTQ+ youth in care, and has spoken on this topic at local and national meetings.

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Michael Baxter, DO

Presentation: “Toxic Stress in Children”

Description: Children who are traumatized or have adverse childhood experiences can have immediate, short-term, and long-term negative consequences. Children who have repeated traumatic events often have an accumulative effect, or “toxic stress.” Anyone working with traumatized children should understand the connection between developmental, biological, and ecological factors and toxic stress. It is also important to understand protective factors against toxic stress, such as HOPE & Resiliency, and how they relate to outcomes in traumatized children.

Biography: Dr. Michael A. Baxter is an Associate Professor of Pediatrics in the Department of Pediatrics, at the Oklahoma University-Tulsa University School of Community Medicine. He received his D.O. degree from Oklahoma State University College of Osteopathic Medicine in 2005 and completed his pediatric residency at the University of Oklahoma, Tulsa in 2008, and a Child Abuse Pediatric fellowship in 2010. He is the medical director of the child abuse pediatric team at the Children's Advocacy Center of Tulsa and the program director for the University of Oklahoma, School of Community Medicine Child Abuse Pediatric Fellowship. Dr. Baxter is a diplomate of the American Board of Pediatrics and is board certified in General Pediatrics and Child Abuse Pediatrics. He is also a Fellow of the American Academy of Pediatrics, is a member of the AAP Section on Child Abuse and Neglect and a Member of the Helfer Society.

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Pak Kouch, JD

Presentation: “The ABCs of Testifying in Court: How Medical Providers Advocate for Truth”  

Description: “Doing justice” in suspected child abuse and neglect cases requires vigorously seeking the truth about what happened to our victims. The best evidence in a complex child physical abuse case is the medical evidence. Therefore, medical providers are the front-line truth seekers as they meticulously examine patients. They are also advocates for the truth in the courtroom. This presentation will help attendees prepare for testifying as experts in court, and better understand the dynamics of direct and cross examination. By working through a case example, we will also discuss how to respond to opposing expert opinions.

Biography: Pak Kouch is the Deputy-in-Charge of the Complex Child Abuse Section of the Family Violence Division of the Los Angeles District Attorney’s Office. The unit was created in 2016 to handle cases involving suspected abusive head trauma in children and child deaths involving medically complex causes or time of death issues. Experienced trial deputies work with law enforcement, child protective services, and child abuse pediatricians as a multidisciplinary team to maximize the potential for holding abusers accountable. Ms. Kouch has been a Deputy District Attorney since 2000 with various trial assignments. She has conducted numerous complex jury trials including a triple-murder death-penalty case, multiple-murder special-circumstances cases, murder, attempted murder, child abuse, sexual assault, gang, robbery, and domestic violence cases. Ms. Kouch has trained locally, nationally, and internationally on child abuse, child homicides, no-body homicides, jury selection, motions, sexual assaults, domestic violence, multidisciplinary teamwork, courtroom testimony for experts, and the nexus between child abuse, intimate partner violence, and elder abuse. She graduated from Occidental College with a degree in public policy and received her law degree from Southwestern University School of Law School

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Karen Farst, MD, MPH

Presentation: “Children affected by parental substance mis-use: Marijuana and More”

Description: Parents with substance use disorders face unique challenges and barriers in their caregiver role. While a pediatric provider may not be caring for the parent as a patient, the provider needs to be aware of the risks associated with this issue as it pertains to the health and safety of the child. A child abuse pediatrician will provide case-based scenarios to discuss identification and evaluation of risks faced by the child as well as limits and usefulness of toxicology testing of child(ren). The presentation will conclude with a brief overview of the changes CARA brought to CAPTA in 2016 and challenge to pediatric providers to find time and opportunity to advocate for better/more comprehensive services and resources to families impacted by this problem

Biography: Dr. Farst has worked as a child abuse pediatrician with the Team for Children at Risk at Arkansas Children’s Hospital since 2004. She completed undergraduate and medical school training at Texas Tech University. Following residency training in internal medicine and pediatrics, she was in primary care private practice for 3 years before completing a fellowship in child abuse pediatrics at Cincinnati Children’s Hospital. She is currently the medical director for the Team for Children at Risk at AR Children’s Hospital and a professor of pediatrics with the Department of Pediatrics of the University of Arkansas for Medical Sciences.

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Kelsey Gregory, MD

Presentation: “The Intersection of Pediatrics and Intimate Partner Violence: The First Step Is Identification”

Description: The association between child maltreatment and intimate partner violence (IPV) is well supported. Universal IPV screening has been recommended by the American Academy of Pediatrics and the United States Preventative Task Force, and many children’s hospitals have established screening protocols.  However, the yield and best screening method in families undergoing a child maltreatment evaluation have not been fully explored. During this lecture, IPV screening opportunities, benefits and limitations will be explored. Dr. Gregory’s recent study evaluating the discrepancy in IPV disclosures between universal IPV screening completed during pediatric emergency department (PED) triage screening and IPV screening by a social worker in families of children who were evaluated for PA will be discussed.

Biography: Dr. Kelsey Gregory is a Child Abuse Pediatrician at the University of Kentucky Health Center. Dr. Gregory completed her medical training at the University of Louisville School of Medicine. She went on to complete her pediatrics residency at Vanderbilt University and her child abuse pediatrics fellowship at Ann & Robert H. Lurie Children’s Hospital of Northwestern University McGaw Medical Center. Dr. Gregory has specific interests in transgenerational abuse, intimate partner violence, and community and medical education.

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Miller Shivers, PhD

Presentation: "Protective Intervention for Infants and Young Children"

Description: Dr Shivers will outline common behaviors and behavioral health concerns in infants and young children, their potential impact on the caregiving relationship and the risks for maltreatment. Intervention strategies for the infants and young children that incorporate caregivers will be discussed, as well as mental health concerns in caregivers and the impact on parenting and risk. Case examples will be used to illustrate key points.

Biography: Miller Shivers, PhD is a pediatric psychologist and the director of Lurie Children’s Little Ones in the Pritzker Department of Psychiatry and Behavioral Health at Ann & Robert H Lurie Children’s Hospital of Chicago. Her interests include, infant mental health, developmental psychopathology, early childhood anxiety, feeding and sleeping issues in infancy and early childhood, NICU psychology and perinatal mood concerns and anxiety.

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Emily Roben, MD

Presentation: "The Dermatology Differential: Common Disorder or Child Maltreatment?"

Description: A full, detailed skin exam is a critical part of the physical exam for all children, no matter their chief complaint or medical history. There are a number of features of the skin exam that have been shown to be highly suspicious of child maltreatment; practitioners should be familiar with these skin exam features and should feel comfortable describing skin findings in broadly accepted and objective terms. During this presentation, participants will learn and practice dermatology vocabulary, review skin findings known to be associated with inflicted injury, and see many examples of skin findings in children that represent benign, common, typical, and unusual etiologies.

Biography: Emily Roben is an attending physician, associate professor, and Director for Quality Improvement at UCSF Benioff Children's Hospital in northern California. She has only just recently started working at UCSF; prior to these roles her entire medical career has been in Chicago! She attended Northwestern University's Feinberg School of Medicine, completed residency and fellowship training at Children's Memorial Hospital/Ann & Robert H. Lurie Children's Hospital of Chicago, and received her master's degree in Healthcare Quality and Patient Safety from The Graduate School of Northwestern University. Dr. Roben served as the co-Director for the division of Emergency Medicine at Lurie Children's for nearly five years, during which time she participated in and coordinated countless quality and process improvement projects in the division and hospital-wide. Dr. Roben is also interested in medical education and trainee mentoring, and has built a reputation as a dynamic lecturer, teacher, and workshop leader at local and regional conferences.

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Meta Carroll, MD

Presentation: "The Dermatology Differential: Common Disorder or Child Maltreatment?"

Biography: Dr. Meta Carroll is a faculty member in the Division of Emergency Medicine, Department of Pediatrics, at Northwestern University Feinberg School of Medicine. She provides clinical service in the Pediatric Emergency Departments at Ann & Robert H. Lurie Hospital for Children and Northwestern Medicine/Central DuPage Hospital. Dr. Carroll also serves as a writer/editor for the American Academy of Pediatrics’ PREP EMed Self-Assessment program, and creates case-based educational content for Doximity, the largest online community of healthcare professionals in the U.S. She recently completed Northwestern’s two-year Bioethics Clinical Scholars Program and continues her educational work in the ethical underpinnings of emergency care delivery. She is grateful for the mentorship she received during fellowship at St. Christopher’s Hospital for Children (and continues to receive at Lurie Children’s) and vows to keep “paying it forward” through education of those dedicated to the health of children and families.