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University of Iowa News Release

Nov. 24, 2003

UI Child Protection Program Augments Services

In an ideal world, there would be no need for programs to protect children from abuse or neglect. But with thousands of cases annually statewide, the Child Protection Program at Children's Hospital of Iowa has strengthened its ability to help children who are suspected of being abused or neglected.

The program includes a diagnostic clinic (Child Assessment Clinic), which provides consultation and educational services for both the public and professionals. Housed in a new location in the University of Iowa Center for Disabilities and Development, the program includes a "child- and family-friendly" play area to allow children to feel safe.

The program also has added new educational brochures and the services of a clinic social worker, Kathy Lowenberg, who has experience interviewing children in a child-friendly way. In addition, the Iowa Department of Human Services (DHS), law enforcement, other health professionals and the UI Department of Social Services -- in particular, social workers Suzanne Witte, Joan Pieper and Joyce Kilgore -- collaborate with the program and contribute to the team approach used in assessing children admitted to Children's Hospital of Iowa.

The Child Protection Program sees children of all ages and adults who function at pediatric levels due to developmental disabilities.

"Most cases are referred to the Children's Hospital of Iowa by the Department of Human Services or parents and professionals, including physicians, psychologists or guidance counselors," said Resmiye Oral, M.D., assistant professor of pediatrics in the UI Roy J. and Lucille A. Carver College of Medicine and program director.

"Our responsibility is to evaluate children in a setting that minimizes trauma for them and ensures safety for the family," she said. "We either diagnose various categories of abuse and neglect, or rule out these conditions and diagnose a medical condition that explains the child's presentation."

An assessment begins with the social worker taking a history and talking with the child alone in a DVD-recorded "forensic interview." The findings are shared with Oral, who completes a physical examination that may include an examination of the child's genitalia.

"In the majority of cases we assess both at the Child Assessment Clinic and other units of UI Hospitals and Clinics, various categories of abuse and/or neglect can be medically diagnosed with high accuracy. In those cases, DHS workers usually provide supporting evidence of abuse or neglect," Oral said. "However, our job is not to prove abuse but to raise concerns in good faith. DHS and the courts have the responsibility to gather more information to either rule out our concern or reinforce our concern and confirm abuse."

If high suspicion of abuse or neglect is raised after an assessment, the clinic or inpatient team files a report of suspected abuse and neglect with DHS. The report recommends referrals for the child and non-offending family members to community agencies that provide family therapy or play therapy.

"Neglect cases are on the rise, possibly due to economic difficulties," Oral said. Statewide, nearly seven of every 10 substantiated cases of neglect are due to medical, nutritional or supervision neglect.

Because UI Hospitals and Clinics is a referral site for the region, all severely injured children in the area are treated at Children's Hospital of Iowa. Abuse includes injury that is physical, sexual, emotional or caused by exposure to illicit drugs. Oral said most cases of shaking and fractures involve children under age 3. Sexual abuse occurs more frequently in children ages 4 and up.

The program's educational efforts include six new brochures for adults and children to prevent and/or recognize child abuse and neglect, including shaken baby syndrome. The brochures are available online in Adobe Acrobat pdf format at:

Oral also provides expert testimony in court and organizes educational opportunities for health care professionals who handle child abuse cases.

Educational efforts include lecture series for medical students and health care professionals at UI Hospitals and Clinics; statewide training courses for health care, law enforcement and social service professionals and day care providers; international training to professionals in Turkey; and lectures for the public through community clubs. Oral, Witte, Lowenberg and Scott Fedler, program secretary, work as a team to offer these activities.

A task force on which Oral serves has established a child abuse and neglect clinic at the UI Child Health Specialty Clinic in Ottumwa, one of the rural areas in Iowa with high child abuse and neglect rates. Oral also participates in Prevent Child Abuse-Johnson County, a local chapter of Prevent Child Abuse-Iowa, which works to reduce the incidence of child abuse and neglect and provides resources to children in need.

To reach the Children's Hospital of Iowa Child Protection Program, call 319-353-6128 (voice mail) or toll-free at UI Health Access 800-777-8442 or visit the program web site at

Parents who need support in providing safe homes for their children, can call Parents Anonymous of Iowa at 515-255-9490 or visit online at

Concerned individuals who want to report child abuse or dependent adult abuse can call the Child Abuse Hotline at the Iowa Department of Human Services at 800-362-2178.

Children's Hospital of Iowa at UI Hospitals and Clinics in Iowa City is the state's longest-serving children's hospital. More than 100,000 children receive care at Children's Hospital of Iowa and its statewide network of outreach clinics each year.

STORY SOURCE: University of Iowa Health Science Relations, 5137 Westlawn, Iowa City, Iowa 52242-1178

CONTACTS: Child Protection Program: 319-353-6128 (voice mail) or call UI Health Access 800-777-8442. Media Only: Becky Soglin, Writer, 319-335-6660,