Child Abuse Pediatric Team

Keeping our community’s children healthy includes protecting them from the horror of intentional abuse and neglect. This is the focus of the Texas Children’s Hospital Child Abuse Pediatrics Team (CAP), a multidisciplinary team of pediatricians, social workers, nurse practitioners and nurses who evaluate children and adolescents suspected of having been physically or sexually abused or neglected.

View a pie chart of Child Abuse by Age

Created in 1978, CAP is integrated with the Texas Children’s Emergency Medicine Department, consulting with patients who are suspected victims of physical abuse, sexual abuse and/or neglect. Referrals often come from sources outside the hospital, including physicians, psychologists, counselors, state Child Protective Services (CPS), law enforcement and parents.

The CAP team also provides advisory and medical services for The Children’s Assessment Center, a local organization that serves and advocates on behalf of sexually abused children. CAP members frequently collaborate with other individuals and agencies who work on behalf of abused and neglected children, including CPS, law officers, district attorneys, children’s and family attorneys and volunteers with Court-Appointed Special Advocates (CASA), and in 2010 established a formal multidisciplinary team that meets on a monthly basis to advocate, review and coordinate cases with these agencies.

Community Impact 2013

In 2014, the CAP team evaluated 1595 children at Texas Children’s Hospital for physical and sexual abuse and neglect and conducted 999 sexual abuse evaluations and follow-ups at the Children’s Assessment Center Clinic.

In addition, the team also developed and managed community programs to educate physician practices, community hospital emergency room physicians and staff, school nurses, emergency medical technicians, firefighters, teen mothers and others about management and prevention of child abuse and neglect, including: 

  • Suspect Child Abuse and Neglect (SCAN): A free program that trained more than 9,000 medical professionals and first responders, teachers and early childhood educators and foster parents since its inception in 2009, about child abuse and neglect indicators and the medical exam used to evaluate suspicious injuries and a training series of CPS supervisors which focused on enhancing their knowledge of serious abusive injuries such as head injuries, fractures and burns.
     
  • The Period of PURPLE Crying: This program seeks to educate parents of newborns on the normalcy of infant crying, and urges parents to understand that crying, when not associated with hunger, dirty diapers, illness, or the need for social interaction, is not necessarily a reflection on the child or the parenting, but rather normal human behavior in infancy. The goal is to reduce the incidence of abusive head trauma (formerly known as Shaken Baby Syndrome) a devastating injury in infants that is increasingly seen to be a result of caretaker’s inability to manage stress relating to a crying infant. The effort to bring the program to Houston has led to a partnership with Children’s Memorial Hermann Hospital and others to further protect our children. This program is currently being implemented through our Pavilion for Women, Neonatal Intensive Care Unit, The Centers for Children and Women, and Texas Children’s Health Plan, with plans to expand to our Pediatric Practices and partnerships with Houston area birthing hospitals.
     
  • Happy Baby: A public program for expecting and new parents taught by nurses and social workers that focuses on aspects of normal infant crying development, techniques for soothing a crying baby, and self-care for the prevention of abusive head trauma. The program also includes information on Sudden Infant Death Syndrome (SIDS) and safe sleep environments for infants.
     
  • Adverse Childhood Experiences (ACE) Coalition: Members of the CAP team participate in the ACE Coalition with the aim to mobilize health and community leaders in the greater Houston area to confront and reduce adverse childhood experiences by their identification and development of proactive, timely, and evidence-based strategies to be implemented at the individual, family, and community levels. The ACE Coalition started as a partnership between representatives from the Child Abuse Pediatrics Departments and the Trauma Departments at both Children’s Memorial Hermann Hospital/University of Texas Health Science Center at Houston Medical School and Texas Children’s Hospital/Baylor College of Medicine. This coalition has grown and is continuing to grow to include multiple community stakeholders with the same vision. The coalition is working to establish measures of observable and identifiable outcomes to evaluate that children and families in Houston have improved mental and physical wellbeing. Prevention target areas are postpartum depression, intimate partner violence, and child abuse.
     
  • The CAP team also works with St. Elizabeth Hospital in Beaumont, TX to provide guidance and support in enhancing their ability to recognize and treat victims of child abuse. In addition to providing training, sharing protocols and practices, the CAP team recently began formal monthly case reviews of children seen at their facility providing feedback and recommendations for evaluations. 

Goals:

  • Continue outreach efforts to targeted populations; medical, education and child care professionals.
  • Enhance collaboration with community partners for the prevention and reduction of children’s exposure to all forms of child maltreatment, which is related to injuries in childhood and poor physical health, social, cognitive and mental health outcomes as children and later in adulthood.
  • Fully implement the Period of PURPLE Crying at Texas Children’s, and work with partners to implement this program and identify other evidence informed programs aimed at reducing child maltreatment in our community.

Community Partners:

  • The Bridge Over Trouble Waters
  • Children at Risk
  • Children’s Memorial Hermann Hospital
  • Harris County Children’s Assessment Center
  • Harris County District Attorney’s Office
  • Houston Police Department and Harris County Sheriff’s Office
  • Children’s Protective Services
  • National Center on Shaken Baby Syndrome
  • Houston Fire Department
  • Harris County Child Fatality Review Team
  • United Against Human Trafficking