Child Abuse Programs mark 50 years of caring for children and families

On Oct. 3, YNHCH and Yale School of Medicine marked the 50th anniversary of their Child Abuse Programs with a reception. Attendees included (l-r): Mary Lou Gaeta, MD, director, Bridgeport Hospital DART program; Cynthia Sparer, YNHH senior vice president, Operations, and executive director, Women’s and Children’s Services; Andrea Asnes, MD, MSW, Child Abuse Programs associate director; Clifford Bogue, MD, chief of Pediatrics, YNHH; Margretta Seashore, MD, professor emeritus and one author of a 1970 New England Journal of Medicine article about the DART program; John Leventhal, MD, director, Child Abuse Programs; and Thomas Balga, PA, director, SRC DART program.

It’s one of the most difficult situations a healthcare professional will encounter: Children who have been abused or neglected. Fortunately, Yale New Haven Children’s Hospital and Yale School of Medicine have Child Abuse Programs staffed by specialists who can help.

In October, the Children’s Hospital and School of Medicine marked the 50th anniversary of the Child Abuse Programs, which began as one effort called Detection, Admission, Reporting and Treatment (DART).

“DART has evolved over the years into group of programs that provide detection, treatment, evaluation and referrals,” said pediatrician John Leventhal, MD, director of Child Abuse Programs at YNHCH and YSM. DART (which now stands for Detection, Assessment, Referral and Treatment) is one of the current Child Abuse Programs.

DART clinicians, all of whom are certified in child abuse, are called to assess patients who come to the hospital with questionable injuries. They interview parents, examine patients, review test results and consult with other specialists; and a pediatric social worker talks with family members. The DART team reports suspected abuse to the Department of Children and Families (DCF), and the child receives further evaluation and treatment.

Outside the hospital, YNHCH – YSM Child Abuse Programs staff conduct comprehensive evaluations of patients and family members and connect them with appropriate mental health, family education and other services. At the Child Sexual Abuse Clinic, YNHCH Child Life specialists prepare children for the evaluations. Specially trained forensic interviewers conduct interviews with the children, which DCF and local police departments' representatives observe. Specially trained APRNs or pediatricians conduct forensic medical exams.

“This collaboration with outside organizations differentiates us from similar programs,” said Paula Schaeffer, Child Abuse Programs coordinator. “It helps us identify what each child and family needs.”

She and Dr. Leventhal acknowledged that working with children who have suffered abuse can be challenging.

“What keeps us going is seeing how much we can help children and their families,” Schaeffer said.

“This is tough work, but we do it as a team, and we support one another,” Dr. Leventhal added. “We’re proud of the work we do.”

Each year, Child Abuse Programs staff:

• Provide 125 inpatient consultations at YNHCH; 200 phone consultations for the YNHCH Pediatric ED, other community EDs and community physicians; and 75 outpatient consultations for DCF.
• Conduct 450 evaluations of sexually abused children
• Hold weekly meetings with other YNHCH providers and representatives from DCF and sometimes police departments to discuss the most serious cases and ensure follow-up recommendations are implemented
• Participate with police, DCF, mental health and other community representatives in the South Central Child Advocacy Center
• Advise satellite DART programs at the Saint Raphael Campus and Bridgeport and Lawrence + Memorial hospitals.