Department of Pediatrics
Department of Pediatrics
The Department of Pediatrics

Child Abuse Pediatrics

The CARE Center mission is to provide comprehensive care to child abuse and neglect victims, to educate future physicians, other medical providers, and the community about child abuse and neglect, and to study important clinical questions in the field.


Welcome!

The CARE Center encompasses four entities: The CARE Team, The CARE Clinic, The Harris County Child Protective Services Clinic, and The Forensic Assessment Center Network.

  • The CARE Team is an inpatient consultation service for suspected child abuse and neglect cases. The Team is available for consultation at both Children’s Memorial Hermann (CMHH) and Lyndon B. Johnson Hospitals. The Team is comprised of five child abuse pediatricians. The Team works closely with hospital social workers, the CMHH Pediatric Surgery Trauma Service, and the UT Division of Community and General Pediatrics.
  • The CARE Clinic is located in the Houston Medical Center, and the Harris County CPS Clinic is located in West Houston. All three clinics provide initial assessments as well as ongoing comprehensive medical care to child victims of abuse and neglect, as well as complete care for children living in foster care.
  • The Forensic Assessment Center Network (FACN) is a Texas-wide program that provides expert consultation and education to CPS workers and community providers concerning suspected cases of child abuse and neglect. The FACN mission is to: correct the disparities in Texas in the availability of quality medical assessments for suspected child abuse and neglect victims, and to improve the outcomes for all Texas child abuse victims. UT-Houston directs the FACN, which currently include child abuse pediatricians from UT-Southwestern, UT-San Antonio and UT-Medical Branch in Galveston. FACN physicians provide 24-hour support via telephone and a unique web-based system.

Background

The designation of the UT-Houston child abuse team as the CARE Center occurred in 2006, in recognition of the growing patient and teaching needs of the institution, and a need to coordinate the group’s various efforts. For several years, UT-Houston child abuse pediatricians have been active in providing expert clinical consultations for cases of child abuse/neglect in both hospital and outpatient settings. CARE Center physicians are recognized both locally and nationally for their clinical expertise, original research, and expert teaching in the field. The Center physicians are supported by a coordinator, an administrative assistant, and hospital and clinic personnel.

The CARE Center serves a high-risk population, with approximately 10% of children living in poverty in Fort Bend, and 20% in Harris County. Households in poverty are at risk for family violence, including child physical abuse and neglect. Coincident with its high poverty rates, Texas saw a drastic decline in the numbers of investigated reports of child abuse and neglect between the years 1986 and 1996 as the result of a grossly overburdened Child Protection Services system. This was reflected by an increase in the estimated rate of child abuse and neglect in the Houston area, from 72/1000 in 1990 to 137 children per 1000 in 2004, and a steady decline in percent of confirmed cases, from 50% in 1990 to just fewer than 23% in 2004.

In response to worsening child abuse statistics, the Texas legislature passed sweeping legislation in 2005 to provide additional support for the Child Protection and Foster Care systems throughout the state. One of the major provisions of the new legislation was the creation of the Forensic Assessment Center Network, which the University of Texas – Houston Medical School was chosen to lead. Since its inception in September, 2006, the FACN has made great strides in its effort to make expert child abuse assessments available to all Texas children. FACN physicians are available by telephone to CPS investigators 24/7 to answer questions and provide advice. The web-based system created for the FACN not only allows for more convenient case communication and tracking, but also serves as an education tool.

CARE Center Functions

Clinical care: The CARE Center clinical operations serve hospitalized children, children requiring follow-up care following hospitalization, children presenting in outpatient settings for initial forensic assessment, and children in foster care.

Research: Center physicians have published original research in the areas of diagnostic testing for STDs, unmet healthcare needs among sexually abused children, abusive brain injury, and emergency department evaluation of children exposed to methamphetamine.

Teaching: Center physicians provide clinical and didactic teaching to medical students and residents, and in the past have mentored fellows in Child Sexual Abuse and Public Health.

Leadership: Center physicians include a co-chair of the Texas Pediatric Society’s Committee on Child Abuse and Neglect; a member of the Board of Prevent Child Abuse America, the nation’s largest child abuse prevention organization; a member of the editorial board for The Quarterly Update, an academic journal focusing on child abuse and neglect; the Medical Director for the Texas-wide Forensic Assessment Center Network; a member of the Harris County Child Fatality Review Team; and a member of the Texas Child Fatality Review Team.


1Children at Risk, “Growing Up in Houston 2006 – 2008”.

2”Data presented at “Use of Psychoactive Medication in Texas Foster Children” Conference. January 19 – 20, 2007, Houston, Texas.