The Child Advocacy Center at Children’s Hospital: Protecting Our Most Vulnerable Children

By Rachel Berger, MD, MPH, chief, Child Advocacy Center

Berger_RachelP_MD_9246webApril is National Child Abuse Prevention Month. As a pediatrician who cares for children who have been victims of abuse and neglect, I look forward to April as a time when my colleagues and I are given the opportunity to raise awareness about child abuse in the community, in the media, and in blogs such as this one.

Child abuse is more prevalent than we want to admit — one out of 111 children in this country are substantiated victims of abuse every year. And this almost is certainly a significant underestimate. By comparison, one in 10,000 children in the United States are diagnosed with cancer every year. But, how many times have you participated in fundraising walks to raise money to fight childhood cancer? How many times have you been asked to donate to childhood cancer research when you make a purchase in a store?

More than 1,500 children die every year from abuse; 80 percent of these children are younger than 4 years of age. That’s more than four children every day. Child abuse is the leading cause of death due to brain injury in young children. What’s killing our children is no longer infection. What is killing our children is injury, and a large percentage of those fatal injuries are from child abuse.

What does this mean for us in western Pennsylvania? At the Child Advocacy Center at Children’s Hospital of Pittsburgh of UPMC, a team of forensic specialists interviews close to 600 children every year who have made disclosures of sexual abuse. A team of physicians, social workers, and therapists have evaluated more than 400 children in the past 12 months who were admitted to Children’s with injuries due to physical abuse or neglect, including broken bones, brain injuries, toxic ingestions, and abdominal injuries. Our physicians, nurse practitioners, and nurses evaluate over 1,500 children every year in the outpatient clinic called ARCH (Advocacy Resources for Children). These are children with less serious, but still significant injuries, such as bruises, failure to thrive due to neglect or a poor environment, and children in foster care who often have many unmet medical needs.

I’ve been working in the field of child abuse for almost 15 years and unfortunately, I can say that the problem of child abuse and neglect is not getting better. What compounds the problem is that children who have been victims of abuse have no voice. They cannot advocate for themselves. Rarely do they have parents who can advocate on their behalf. Their parents are not going to Congress and asking for help. Their parents are not going to appeal for more funding for research to prevent and treat child abuse. We must be the voices for children who cannot advocate for themselves.

There is some good news. The Pennsylvania Task Force on Child Protection, which was established in large part due the Jerry Sandusky case, completed its work and submitted its recommendations to the Pennsylvania Legislature in November 2012. As a result of the recommendations, more than 10 new bills have been signed into law by the governor with several more expected to pass. These new laws will, hopefully, protect Pennsylvania’s children better than our previous, outdated laws. More recently, the Obama Administration established the National Commission to Eliminate Child Abuse and Neglect Fatalities. The commission met for the first time in February 2014 and will be making recommendations to Congress in late 2015 or early 2016.

People often ask what they can to do to help. The answer is “almost anything.” You can donate time and volunteer for one of the many wonderful nonprofits in our county who serve these children and their families. You can call your local legislators to advocate for the passage of laws that protect children and for funding to support agencies throughout the Commonwealth that serve children who are victims of abuse and those at highest risk of abuse. You can donate money to support research to determine how to recognize abuse as early as possible and to support education of the public, physicians, lawyers, emergency medical technicians, teachers, and police officers. Though education, we can ensure that everyone who interacts with children knows how to recognize abuse and how to intervene early because that’s when the outcomes are the best.

To learn more about the Child Advocacy Center at Children’s Hospital of Pittsburgh of UPMC, please visit and consider attending the 9th Annual Child Maltreatment Conference, which will be held April 24-25, 2014.