Copyright © 2014 Albuquerque Journal
A father shakes his infant daughter from side to side so violently that the child requires surgery to relieve bleeding in her brain. She dies three months later.
A man acting as a caretaker for a toddler tells police he was playing the “body slam” game with the girl, who, when tossed onto a bed bounced off and hit her head on the floor. She died the next day.
A Rio Rancho man who had just smoked heroin holds the head of his girlfriend’s son under scalding water. The boy suffers disfiguring second-degree burns on his face and hands. The child’s mother tries to cover up her boyfriend’s involvement.
All of these incidents occurred just this year and, if current trends continue, the number of child abuse cases submitted to the District Attorney’s Office will reach an all-time high by year’s end, said DA Kari Brandenburg.
And it’s not just more incidents, said one child abuse expert. Many of the cases involve injuries of extreme severity.
The University of New Mexico Hospital is active in the battle against child abuse.
One program is the Child Abuse Response Team, or CART, led by a specially trained doctor who examines and treats child abuse victims, and provides evidence for law enforcement agencies.
Another is the Child Abuse Prevention Partnership that provides education and resources to children and families with the intention of staving off child abuse down the road.
Yet another UNM program, Para Los Niños, focuses exclusively on child sexual abuse.
CART was formed in 2004 “in recognition that children who come to the hospital with injuries possibly due to abuse need an objective and thorough medical evaluation,” said Dr. Leslie Strickler, one of only 265 board-certified child abuse pediatricians in the country and one of only two in New Mexico.
Strickler is called upon by other doctors, law enforcement agencies, and the Children, Youth and Families Department when they encounter a child who may have injuries from child abuse or children who may not be receiving required medical treatment.
The evaluation is done only in the setting of the UNM Hospital or a UNMH outpatient clinic, Strickler said. “A child may need X-rays or lab work or access to other specialists, such as an orthopedic surgeon or a neurosurgeon, and a hospital is the best place to get those things quickly.”
Other CART members include a forensic pediatrician, a part-time forensic dentist, and part-time outpatient, inpatient and Emergency Department social workers.
During an average year, up to 350 children are sent for a CART evaluation. Child abuse is confirmed in about 50 percent of those cases, ruled out in about 40 percent of the cases and cannot be determined in the remaining 10 percent of cases, Strickler said.
Where child abuse has been diagnosed, “my job as a doctor is to figure out what happened; it’s the role of CYFD or law enforcement investigators to figure out who did it and how to keep the child safe.”
The number of child abuse cases Strickler sees is only a small portion of the 34,000 reports of child abuse or neglect fielded annually statewide by the Children, Youth and Families Department.
Strickler, an associate professor of medicine at the UNM School of Medicine, also spends time testifying in child abuse cases. Her salary is paid by the Department of Pediatrics, which also funds the program with an allocation of $10,000 a year.
More help needed
The need for CART is so great, she said, that to implement it fully would require four more full-time doctors and full-time positions for a nurse, social workers and administrative assistant – as well as dedicated space. “I’m working out of the urgent care clinic now,” she said.
The state Legislature will be approached next year and asked for $500,000 to fund an expanded version of the program to serve more children, she said.
CART member Dr. Karen Campbell, a forensic pediatrician and chief medical director for CYFD’s Child Protective Services, travels around the state checking records kept by social workers, law enforcement agencies and medical personnel as part of the child abuse evaluations she conducts.
CYFD has experienced a spike in the number of reported cases of child abuse and neglect since the high-profile December death of 9-year-old Omaree Varela, allegedly at the hands of his mother. Nevertheless, said Campbell, child abuse and neglect are still underreported. In addition, there appear to be more cases of child abuse involving life-threatening injuries and death.
CART, being a crisis-oriented program that responds after the fact, rather than a preventive program, is not likely to dramatically reduce the number of incidents.
“Perhaps we can identify children who have been abused and prevent it from happening to that child in the future, or perhaps we can identify families in need of community resources and direct them toward those resources,” Campbell said. “Really, the way to make things better is to provide those resources, which is easier said than done because we’re one of poorest states in the nation.”
Susan Miller, a clinical and pediatric psychologist at UNMH, is the founder and director of the Child Abuse Prevention Partnership. The 2½-year-old program is primarily about prevention and providing resources.
“What we’re trying to do is get to the mommies before they’re even pregnant, and get to the girls and boys while they’re still in high school and talk to them about parenting skills, teach them what child abuse looks like and how it affects a child,” said Miller, who is also an assistant professor in the Department of Pediatrics, UNM School of Medicine.
Miller also noted the increase in the level of violence against children. A decade ago, only 5 percent of the perpetrators were women, she said. Today, about 20 percent are women. Common to these abusers is that they’re mostly young, between 16 and 25, poor, stressed, have addictions and no support system from their families or communities.
“What we try to do is get help for people before they go over the edge,” Miller said. To do that, the program has created volunteer partnerships with more than 200 organizations, agencies and individuals, including medical professionals.
“We have grandparents who go into homes to read to kids, groups that go into prisons and talk to moms and dads about anger management and depression. There are parenting coaches and nutritionists and gardeners. Some sew clothes and others go to court as advocates. People often don’t even know they have talents that can be used to help others. It really is a grass-roots kind of effort.”
As part of that effort, Miller said, the Child Abuse Prevention Partnership is producing a documentary it hopes to screen at sites around the state in conjunction with panel discussions to inform people about the program, learn what the needs are in the community and “find out what skills they have that they’re not using.”
Because of the emphasis on volunteering, the partnership is creating a network of resources that don’t rely on governments and often don’t cost anything, “except a commitment,” Miller said.