Child Abuse Pediatrics Fellowship
Loma Linda University Medical Center - MurrietaChild Abuse Pediatrics Fellowship
Family Safety and Healing
The Child Abuse Pediatrics Fellowship Training Program, at Loma Linda University, helps prepare Pediatricians to become academic leaders in creating practice and policy initiatives that will improve the protection and health of abused children. As advocates for the well-being of children, fellows will be empowered to create safer communities for children.
With an emphasis on intervention and prevention, the Child Abuse Pediatrics Fellowship Training Program will expose fellows to a variety of patient-care experiences, research opportunities, and educational activities.
Program Overview
The Loma Linda University Child Abuse Fellowship Training Program has 5 main components
Out-Patient Clinics
The Children's Assessment Center, in San Bernardino County, is fully accredited by the National Children's Alliance. This clinic evaluates approximately 1600 child abuse cases annually, with about 60% being for allegations of sexual abuse and the remainder physical abuse, failure to thrive and severe neglect.
Resiliency Institute for Child Adversity (RICA)
Resiliency Clinic for Childhood Adversity (RICA) provides a welcoming environment that offers trauma informed holistic general pediatric care. RICA offers trauma informed pediatric and mental health services to build resilience. There is an educational advocacy and scholarship program for children 8th grade and older. RICA will supply emergency needs including a food pantry, toys, clothing, and blankets. Appointments for children who have been removed are scheduled within 72 hours of removal and the social worker will receive a summary of on-going needs, recommendations, and resources.
Foster children served by RICA will continue to be eligible to receive pediatric care after they leave the foster care system, thereby establishing this clinic as the primary clinic for the child’s care and treatment. Providing services after the child is no longer in the foster care system allows them to stay under the care of specialized medical providers who are trained in recognizing signs of trauma, abuse and neglect thus providing an avenue for prevention and early intervention for these at-risk children. Our goal is to continue to expand the number and type of services provided at RICA to include physical therapy, occupational therapy, speech therapy, dental care and psychiatry services.
Riverside Regional Medical Center
The Riverside Regional Medical Center, in Riverside County, is fully accredited by the National Children's Alliance. The medical center treats about 1200 new cases of abuse annually, with most children falling victim to physical abuse.
Fellow Training
The fellow will receive training under therapists who meet National Children's Alliance standards.
Throughout the fellowship, participants will receive training in crisis intervention and an overview of the various therapeutic modalities used when treating child victims of abuse.
Program participants will have the opportunity to observe forensic interviews, which often involve witnesses to crimes and domestic violence, as well as victims of physical and sexual abuse. The age of patients range from infancy to 17 years.
In-Patient Consults
The team responds to about 200 in-patient consults a year. The majority are for head trauma and fractures. At the Loma Linda University Children's Hospital, weekly meetings with forensic physicians and the hospital social workers are held to discuss these issues within the hospital. At any one time, there are at least 10 children in our hospital, under the supervision of Child Protective Services (CPS), who are experiencing issues resulting from physical abuse, general to severe medical neglect, drug-dependency, and more.
In-Patient Profiles
There are frequent cases of children, who are victims of abusive head trauma. Of these children, 10 will die from their injuries. In these instances, the fellow is encouraged to attend all relevant autopsies.
Surviving children may be brought to our Pediatric Traumatic Brain Injury clinic, where the children are followed by neurologists, neuropsychologists, occupational therapists and physical therapists. During this process fellows will have frequent contact with the neurosurgeons, neurologists, and the neuro-imaging department.
Multi-Disciplinary Team Meetings
Monthly multi-disciplinary team meetings (MDT) are held to review the entire range of our work. These meetings are well-attended by representatives from the District Attorney's Office, various Law Enforcement jurisdictions and CPS, as well as representatives from juvenile court and mental health institutions.
Research
Among Loma Linda University's many research activities is the Research Division of the Department of Pediatrics. All fellows in pediatric subspecialties receive grounding in research methodology through formal lectures, and support in choosing their research topic and negotiating with the Institutional Review Board (IRB).
Prevention Program
Given the large volume of abuse cases in our catchment area, we have instituted a hospital-based Prevention Program.
The prevention program includes two annual conferences aimed at educating best parenting practices and prevention of child abuse. Over 15,000 families have received this training through our program and we recently received funding for a prevention specialist who can carry the prevention message to the wider community.
Our Faculty
Physicians
We have three Child Abuse Pediatrics (CAP) board certified pediatricians, and another physician is forensically trained in Family Practice.
Nurses
There are currently three Forensic Nurse Practitioners.
Program Coordinators
We have a program coordinator for the Division of Forensic Pediatrics, who manages the fellowship program, and full-time managers who oversee, train and support the outpatient clinics.
For further information or to schedule a site visit please email CAPfellowship@llu.edu
Protecting Children in Our Community
For over 30 years the Loma Linda University Children's Hospital and our companion hospital, Riverside Regional Medical Center, have offered child abuse treatment and prevention programs.
The hospitals' out-patient child abuse clinics are the main resource for forensic evaluation within the child protection community of the Inland Empire. Last year, there were over 120,000 referrals to Child Protective Services in the Inland Empire and the Child Abuse Pediatric team is assigned to both facilities to cover the very large population of the Inland Empire.
Educational Goals and Objectives
The Division of Forensic Pediatrics is committed to finding and training child abuse pediatricians. To meet this need, the Loma Linda University Medical Center has the goal of training pediatricians to be outstanding physicians for victims of child abuse.
Our program focuses on developing a firm educational footing, providing extensive exposure and training in all modalities of abuse.
We strive to create a clear understanding of the causes of child abuse, the immediate and long term effects on children of such abuse. It is our hope that with this experience in evidence-based medical practice our physicians will learn to make the most effective decision when treating each and every child.
Our Mission
It has always been the mission of the Loma Linda University Medical Center to promote whole person care that encompasses body, mind and spirit. It is our belief that abused infants and children are especially in need of this all-encompassing care.
Competency-based Goals and Objectives
The 3 year program has the following broad areas of education:
- Epidemiology of child abuse
- Clinical competence in evaluating sexual abuse
- Clinical competence in evaluating physical abuse
- Recognizing child neglect and endangerment in all its forms
- Understanding the dysfunctional/abusive home environment
- Understanding the laws that pertain to child abuse and the legal procedures
- Child abuse prevention
- Understanding the need for evidence-based medicine and the importance of research
- Understanding the concepts of whole person care
Loma Linda University Health as an institution prioritizes resident wholeness. We encourage residents to build networks of support, develop habits that support their personal wellness and build personal resilience.
Each residency program designates a Chief Wellness Resident to serve on the GME Resident Wellness Committee. Chief Wellness Residents help build and enhance wellness initiatives and foster a community amongst residents.