A New, National Collaborative to Improve the Practice of Child Abuse Pediatrics

Megan Letson
Megan Letson, MD, medical director of The Center for Family Safety and Healing.

In 2009, the American Board of Pediatrics offered board certification for child abuse pediatrics for the first time, officially recognizing the field as a medical specialty and highlighting the need for children who have experienced abuse to receive specialized care.

Even as the field of child abuse pediatrics has grown, child abuse-related research has faced challenges, including relatively low numbers of patients at any single hospital, inconsistency and bias in clinical evaluation, and a lack of standardized data measures. Robust and reliable data are needed to improve the medical evaluation of suspected child physical abuse.

To address this lack of data, Nationwide Children’s Hospital has become one of the founding sites of the Child Abuse Pediatrics Network (CAPNET), a new multi-center research network collecting standardized, reliable data on child abuse. The mission of CAPNET is “to make the care of potentially abused children more effective, safe, and fair.”

CAPNET is a collaboration of ten pediatric hospitals collecting de-identified data, or data free of information that could identify the patient. The data is then made available to credentialed researchers to develop tools that will help doctors make decisions regarding diagnosis and treatment.

“Child abuse is something where everyone wants to help, but it is a hard thing to diagnose or define,” says Rachel Stanley, MD, a senior advisor for CAPNET and the division chief for Emergency Medicine at Nationwide Children's.

Those working with CAPNET are seeking to change that.

At Nationwide Children’s, child abuse pediatricians are part of a multidisciplinary team which includes social workers and medical providers who are called in to evaluate patients when there are concerns of abuse. The Center for Family Safety and Healing at Nationwide Children’s has worked to create a streamlined process, making sure children do not have to tell their stories over and over again, adding to the trauma they have experienced.

“The goal is to create coordinated care for the child,” says Megan Letson, MD, medical director of The Center for Family Safety and Healing.

CAPNET is focused on enhancing evidence-based care for the identification and treatment of child abuse. Collecting reliable, standardized data can improve the science of detecting and treating abused children. This research will also create data-driven approaches to improving population health by identifying the issue and investigating the drivers behind the problem.

“Child abuse is very much a key population health issue,” says Lynn Rosenthal, president of The Center for Family Safety and Healing. “We know that family violence and child abuse have both physical health and mental health impacts as children become adults.”

In addition to creating research-based practices that will improve population health, CAPNET will play a crucial role in the prevention of child abuse by identifying at-risk children as well as the trends that place children at risk.

“We need to know as much as we can about the problem to develop and implement best practices,” says Rosenthal.

“CAPNET aligns with our mission and vision, which is focused on patient-centered outcomes,” says Dr. Letson, who is Nationwide Children’s primary investigator for CAPNET. “If we can improve the identification of child abuse and family violence and work to break the cycle of violence through evidence-based interventions, we can help change long-term outcomes for the general population.”

By being involved with CAPNET from the beginning, Nationwide Children’s is leading the effort to improve health outcomes for all children by enhancing evidence-based care that will inform the identification, diagnosis and treatment of child abuse.

“We have the infrastructure, resources and brainpower,” says Dr. Stanley. “We can make a difference nationally.”