Cries for Help

By Dr. Nancy Kellogg
Center for Miracles
CHRISTUS Children’s

For more than 10 years, CHRISTUS Children's  – Center for Miracles has served as the only child abuse center of its kind in South Central Texas. The caring team of physicians, nurses, and staff are specially trained to care for children who are at risk for, or traumatized by, abuse and neglect. We strive to provide timely medical and psychosocial care for children referred to our Center. Our physicians are some of the only child abuse specialists in the state.

The Center offers a comforting, family-focused environment in which to serve the children of San Antonio and beyond. Restoring a child’s health and peace is our main goal. Teachers, day care providers, social workers, nurses, extended family, and others who come into contact with children have a responsibility to report cases of child abuse and neglect.

April is designated as Child Abuse Awareness Month. As such, we offer these tips on how to help a child who may the victim of abuse or neglect.

Before you ask:

• Earn, don’t assume, the child’s trust. Be honest, informative, and respectful to the child.
• Give the child permission to talk to you about anything uncomfortable, confusing, or threatening. For example, you might say, “I talk with a lot of kids about problems they have. Sometimes kids tell me about things that have happened to them that they don’t like or that make them feel weird or uncomfortable. Often it’s hard for children to tell someone because they are afraid of getting into trouble or that no one will believe them. I want you to know that it’s OK to talk to me if something like this has happened to you.”

Asking the question: listen and look, don’t lead.

• Talk in a quiet, private place
• Sit and speak at the child’s level
• Keep the information confidential (inform only those who need to know)
• Be honest: tell the child why you are concerned

When a child discloses abuse:

• Be open, receptive, and supportive, NOT judgmental, analytical, shocked, or surprised
• Ask open-ended questions: “What happened to your arm?” NOT “Did Daddy hurt your arm?”
• Make no assumptions about what the child is saying: ask for clarification
• Verify information by repeating the child’s words back to them; do not paraphrase or interpret what they have said.
• Some children may prefer to write rather than say what happened
• Ask for only minimum information required to report and make an immediate safety plan, i.e. who the abuser is, when it happened (or most recent event) and what the abuse involved (hitting with an object, sexual contact, etc.). Leave detailed interviews to the investigator.
• Thank the child for talking to you. Acknowledge their feelings and their fears, however different they may be from your own feelings (they may still love the abuser!)
• Don’t make promises you can’t keep.

What to do:

• Report immediately to Child Protective Services: 1.800.252.5400 or local law enforcement. Do not wait to report until further investigation. Do not delegate responsibility for reporting.
• Write down what you asked and what the child said (exact words) as soon as possible.
• When appropriate ask the child if they feel safe going home. A parent who is non-supportive of non-believing may be unable to protect the child, or the child may fear punishment for revealing abuse. If the child does not feel safe or you are concerned for the child’s safety, call Child Protective Services.
• If you think the child may need an immediate medical evaluation for injury assessment or a forensic exam, call the Center for Miracles for more advice at 210.704.3800.

Find out more about the Center for Miracles.

The Center for Miracles is a collaboration of CHRISTUS Children's, the Department of Pediatrics at The University of Texas Health Science Center at San Antonio, and community agencies and individuals.

Dr. Nancy Kellogg graduated from Dartmouth College in 1978 and completed her medical school training and pediatric residency at the University of Texas Health Science Center at San Antonio (UTHSCSA) in 1988. Since 1988, she has been a faculty member at UTHSCSA and is currently Professor and Division Chief of Child Abuse in the Department of Pediatrics. She was the first Medical Director of CHRISTUS Children's — Center for Miracles which opened in May 2006, and has served as the Medical Director of ChildSafe since its inception in 1988. She has worked full-time in the field of child abuse for over 20 years.