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An EPIC way to fight child abuse

November 23, 2003|by BOB MAGINNIS

Last year the Washington County Child Advocacy Center treated 302 serious cases of physical and sexual child abuse, at what Washington County Health Officer Bill Christoffel called "the end point of abuse."

In many of those cases, Christoffel said, it wasn't the first time the parent or guardian had abused the child. There's a point at which abuse begins, he said, sometimes with something as simple as a slap. Then it escalates.

"We want to try to identify it before it leads to serious medical injury and get the parent counseling," Christoffel said.

To do that, Christoffel and a partnership of local agencies have borrowed a program called EPIC, developed about seven years ago by the Pennsylvania Academy of Pediatrics.

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EPIC, which stands for Educating Physicians in the Community, involves meeting with pediatricians and their office staffs to educate them about what they're legally required to do and what they need to look for in the patients they see.

I sat in on one of these presentations recently at the Smithsburg Family Medical Center and learned why it's so important to detect patterns of abuse early on. Convictions aren't easy to obtain and even after a life-threatening episode of child abuse, the abuser's spouse or significant other will often continue to claim their partner was not to blame.

Using slides with the children's faces obscured, the medical staff saw some harrowing images of child abuse, including burns, broken ribs and the mark a belt can make when whipped up against a child's cheek.

After explaining the legal definitions of abuse and neglect, Susan Butts, a screener with Child Protective Services, told the group that by law, the following people are required to report suspected child abuse: Law enforcement officers, health practitioners, educators and human service workers.

Maryland law provides immunity from criminal or civil liability for reports made in good faith, Butts said, adding that the name of a person making a report can't be revealed, except by order of the court.

"You need no proof, only suspicion" to make a report, she said.

Reports of suspected sexual or physical abuse must be turned in within 24 hours, Butts said, and must contain the child's name, age and address, their whereabouts, the name of the parent or guardian, any past incidents and any safety concerns or risk factors.

Melissa Kline, with the Child Advocacy Center, told the medical staff that they need to remain non-judgmental when talking to parents or guardians about the report.

"Make parents aware that it's their legal responsibility to report," she said.

But it's not the medical staff's responsibility to investigate incidents, said Dr. Ronald Keyser, a clinical specialist with the health department. That's up to the Department of Social Services and law enforcement, he said.

Keyser asked the staff to consider using the questionnaire developed as part of a program called SEEK - a Safe Environment for Every Kid.

It asks parents questions on a variety of subjects, including whether or not the dwelling has smoke alarms, whether there's enough food in the house and whether they have been threatened or abused by their partner.

"If we can identify high-risk situations, you may be able to do something about it," Keyser said, adding that the questionnaires can be helpful because victims of abuse are often too embarrassed to volunteer that information.

Watch how parents interact with children in the waiting room, too, Keyser said, for indications that something isn't right.

At the program's end, all medical staff were given binders with information on child abuse, courtesy of the Parent-Child Center, a United Way agency that fights child abuse with a variety of programs.

Seeing these slides of helpless children with terrible injuries would lead most people to believe that the parents are monsters. In most cases, they're not, because child abuse is learned behavior.

If your father beat you with a belt, that's what you know. And when your children begin to stress you out - and most children eventually do - you'll most likely take off your belt, too, maybe without even thinking.

Christoffel said that the Smithsburg program was the fourth presentation of the EPIC program to local medical practices this year. He hopes to eventually get it to every local pediatrician's office.

"Where the EPIC program has been brought it, there's been a substantial reduction in the number of serious cases," he said.

If you're a doctor whose practice hasn't scheduled a session, you can call the Parent-Child Center at 301-791-2224 to do so. If you're a citizen concerned about what you can do about child abuse, please consider volunteering with that agency. That doesn't necessarily mean working with abused children or troubled families, though help certainly is needed in those areas.

If you're not up to that, the center has a clothes closet for infants and toddlers and the shelves always need re-stocking and straightening.

That may seem insignificant, but consider that if a mother who doesn't know where the next meal is coming from can get some free clothes, she might not take her frustration out on her child.

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