Child Abuse and Neglect Service

Overview

Medical services to assess and treat abused and neglected children are rooted in the 1968 publication The Battered Child Syndrome by Drs. C. Henry Kempe and Ray E. Helfer. In the ten years following this publication, every state in the United States completed adoption of child abuse/neglect reporting legislation which mandates both lay persons and professionals to report suspected child abuse or neglect to a designated investigating agency. In the 1970’s, the medical community was faced with the significant dilemma of having essentially no published research and no national standards upon which to base medical opinions and recommendations regarding child abuse and neglect. Pediatric literature provided no evidence-based differentiation of accidental versus inflicted physical trauma, normal versus abnormal genital/anal findings, or specific radiological, microbiologic or hematological findings associated with various forms of physical or sexual abuse. Methods for interviewing children and techniques for examining and documenting findings were as yet undeveloped.

In the late 1970’s and 1980’s, the child abuse/neglect field began to rapidly expand, and medical centers began developing specialized clinical teams to assess and treat abused and neglected children. At Duke Medical Center, Drs. Peter English and Thomas Frothingham, Physician Assistant Marcia Herman-Giddens and clinical social workers Susan Quinn-Pierce and Nancy Berson pioneered the first Duke child abuse/neglect medical assessment teams. By early 1980, the Duke Child Protection Team (SCAN/CPT) had launched its mission:

to provide medical consultation and guidance to health care professionals referring child abuse and neglect cases,
to establish standards and clinical procedures for child abuse/neglect medical evaluations,
to provide teaching and training about medical, social, and legal aspects of child abuse and neglect,
to administer the NC Child Medical Evaluation program within the Duke Health System,
to record and maintain statistics of referred cases of child abuse and neglect,
to conduct child abuse/neglect research,
to develop resource materials for teaching education,
to provide expert medical testimony related to Duke child abuse/neglect cases,
to establish affiliations with mental health, domestic violence, drug rehabilitation and prevention programs which could impact child abuse and neglect outcomes.

Research and publications by members of the Duke Child Protection Team contributed significantly to the knowledge of the developing child abuse and neglect field.

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