Pediatricians design child abuse identification tool

SAN ANTONIO (Dec. 6, 2011) — The call comes in that no one wants to hear — a small child is injured. Far too often the injuries are inflicted by an adult.

Identifying whether abuse has occurred begins at the scene when first responders, police and case workers gather information. Later, child abuse pediatricians will study all the puzzle pieces to make the crucial determination — was the injury accidental or abuse?

A computer program developed by child abuse experts James Anderst, M.D., of Children’s Mercy Hospital in Kansas City, Mo., and Nancy Kellogg, M.D., of UT Medicine San Antonio and CHRISTUS Santa Rosa Children’s Hospital, is bridging the gap between the professionals on the scene and the child abuse pediatricians. UT Medicine is the clinical practice of the School of Medicine at the UT Health Science Center San Antonio.

The program is available via smart phone to workers in the field.

“What happens is we get a child in a medical setting and are left with trying to find out what happened when the injury occurred,” said Dr. Kellogg, division head of child abuse pediatrics in the School of Medicine and medical director of the CHRISTUS Santa Rosa Children’s Hospital Center for Miracles. “Often the best information comes from law enforcement and CPS investigators, but because they aren’t physicians and don’t know the mechanisms of injury, they often don’t know what information is important to us to make a determination of abuse or neglect.”

The computer program uses animation sequences, text, radiographs, CT scans and MRI scans to help these workers. “This tool does not prevent abuse, but it can prevent repeat abuse,” Dr. Anderst said. “Minor injuries often are inflicted first, then more severe. That’s why early identification of abuse is so critical.”

The program will also prevent accidental injuries from being called abusive and thereby prevent innocent caregivers from losing their children or going to jail, he said.

This is the first Web-based license agreement brought to the public by South Texas Technology Management (STTM), a regional technology-transfer office that serves four University of Texas institutions, including the Health Science Center, as well as Texas State University-San Marcos.

“Purchasers of the tool simply enter their information on a Web-based form, click through a series of screens, pay the license fee and download the tool,” said STTM Executive Director Arjun Sanga, J.D., assistant vice president for technology transfer at the Health Science Center.

The tool is a not-for-profit collaboration of Children’s Mercy Hospital and UT Medicine. The organizations own the rights to the product and money earned is used to update it.

Hospitals can buy it in an institutional license and seven hospital systems have done so, Dr. Anderst said. The entire state of Maryland purchased the license, as did the Joplin, Mo., Police Department. The program also is in use in Australia, Belgium, Canada, Japan and The Netherlands.

The child abuse pediatrics fellowship in the School of Medicine at the Health Science Center is the only accredited fellowship of its type in a multistate area. Others are applying for accreditation. Nationally 17 such fellowships are accredited.

“Dr. Anderst was our first child abuse fellow,” Dr. Kellogg said. “He obtained funding for this project as a faculty member in the School of Medicine and has continued to revise the program at Children’s Mercy Hospital.”

A second version of the program is geared to medical professionals to help them identify abuse.

“The animations are very realistic,” Dr. Kellogg said. “For example, when you see the one of a fall down the stairs, the injuries begin to make sense. The animations give a very powerful depiction of what goes on, not only with accidental injuries but with inflicted abusive injuries.”

UT Medicine San Antonio is the clinical practice of the School of Medicine at the UT Health Science Center at San Antonio. With more than 700 doctors – all faculty from the School of Medicine – UT Medicine is the largest medical practice in Central and South Texas, with expertise in more than 60 different branches of medicine. Primary care doctors and specialists see patients in private practice at UT Medicine’s clinical home, the Medical Arts & Research Center (MARC), located in the South Texas Medical Center at 8300 Floyd Curl Drive, San Antonio 78229. Most major health plans are accepted, and there are clinics and physicians at several local and regional hospitals, including CHRISTUS Santa Rosa, University Hospital and Baptist Medical Center. Call (210) 450-9000 to schedule an appointment, or visit the Web site at for a complete listing of clinics and phone numbers.

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