It is vitally important that abuse and neglect be accurately diagnosed when the child is brought into the care of CPS. A careful history, physical exam, x-rays, photographs and other studies must be done to confirm or rule out the diagnosis. We are fortunate that this expertise is available to us at the CARE clinics. Not every doctor’s office, clinic or emergency room is capable of doing these assessments.
In addition to the need for an accurate diagnosis, the children coming to CARE present a special problem. Often they come to us with no recorded history of past health and illnesses, no social history and no family history. There is no documentation of their physical or developmental growth. This information, along with physical examination and appropriate laboratory studies, are basic to making a sound service plan for the future care of the child. To complete the assessment, psychosocial referral may be necessary.
With this assessment completed, we have an invaluable tool to make an effective service plan for the future which can lead to healing the damaging effects of child abuse and neglect on the child and family. Without it we are stumbling in the dark, solving problems with band-aids with the possibility of making matters worse rather than better.
To create such an assessment is very time consuming. We have to be patient, going from one source to another to collect all the information we need. But when the assessment is completed we have a document which can help the child and family in a very positive way, perhaps for the first time in their life.
In the 1980's we did these assessments but we were scattered about. I was on the faculty of the Department of Pediatrics so we could use the examining room on the 7th floor of KMCWC. But CARE has established an on-going KCMC clinic with the staff and facilities to do a much better job of serving the families and CPS. We are fortunate to have such a clinic. I support developing CARE clinics on the Neighbor Islands if that is possible.
There is nothing better than getting off to a good start. That is what CARE does for the children brought to it who have sustained abuse and neglect.
February 23, 2005 |
