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Nursing Excellence

The Online Newsletter for Children's Nurses
e-Edition, Volume 1, Issue 2

LeeAnn Kozub

Child Abuse and Maltreatment in the Central Valley

By C. Leanne Kozub, ADN, BHCA - Child Advocacy Coordinator

Child abuse is on the rise. We often hear about it in the media – children who have been harmed at the hands of those who are supposed to protect them. There were 78,847 referrals to Child Protective Services from Oct. 1, 2007 to Sept. 30, 2008 in the Central Valley.  With financial strains on government and community organizations, support for families and children in need is falling victim to budget cuts.

Child maltreatment is not a new phenomenon. It has existed since the beginning of recorded history.  The first child abuse case heard in U.S. Court in 1874 was based on animal cruelty laws. There were no written laws to prohibit the abuse or neglect of children. The advancement of children’s rights continues to grow in the form of child protective services, foster care, child protection laws and medical evaluations.Nursing Excellence

Children's Hospital Central California continues to be committed to making a difference in the lives of abused and neglected children. The Child Advocacy Department at the Hospital was formed in response to the rise in child abuse cases in the Valley. There is no other program like it in the state. It includes a follow-up clinic for patients hospitalized with suspected abusive injuries, physician consultation service available 24/7, Suspected Child Abuse and Neglect (SCAN) Team, and case coordination with a multidisciplinary and multi-agency team. These Child Advocacy programs are supported by the Child Abuse Prevention & Treatment Endowment, established through a $1 million pledge from the Guilds of Children’s Hospital.

Child Advocacy, in conjunction with Social Work and Trauma, is providing community education and outreach in every county within our service area. Educating our community partners helps build collaborative relationships that strengthen the ability to protect children. Classes are offered on Shaken Baby Syndrome (SBS), or abusive head trauma; child maltreatment; pediatric trauma; and Munchausen Syndrome by Proxy.

Shaken baby demonstrationCommunity education about SBS has been a priority for Child Advocacy. A proven model of prevention from upstate New York has given us the framework to implement this efficient model in our Neonatal Intensive Care Unit.  In New York, they decreased the incident of SBS by 50 percent. Current efforts in Child Advocacy and Injury Prevention are underway with local birthing hospitals to implement this program in newborn nurseries.

Outreach to high risk groups, such as first-time parents and teen parents, has expanded this year. Infant safety and positive parenting models address the stressors that can lead to abuse or neglect. Informational tables at teen pregnancy prevention conferences and community events offer tips on safe sleeping, coping with crying, infant safety, child abuse prevention and parenting resources. Raising awareness in the community keeps the issues of abuse and neglect in the open. The more knowledgeable our community is about child abuse, the better the identification and collaboration will be for these children.

Children's Hospital is committed to providing a voice to the voiceless. The Child Advocacy Department is a united voice that reaches out to abused and neglected children to see that they have proper identification and treatment of injuries. Through collaboration and education, we are providing a service, like none other, in the Central Valley.

For more information, e-mail the Child Advocacy Department at Children's Hospital.

For more information on child abuse and neglect at the national level, please visit:

Prevent Child Abuse America
Shaken Baby Coalition
National Association of Children’s Hospitals and Related Institutions
Safe State California


1. California Department of Social Services, Child Welfare Dynamic Report System. (2009), Child Abuse Referrals.  Retrieved May 1, 2009 from Centers of Social Science Research, Cal Berkeley Project.

2. Helfer, E. & Kempe. R. (1997) The Battered Child.  Chicago: University of Chicago Press.

3. Women & Children’s Hospital of Buffalo.(2009) Upstate New York Shaken Baby Syndrome Education Program.  Retrieved May 6, 2009 from Kaleida Health


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