Eismann, EA; Theuerling, J; Maguire, S; Hente, EA; Shapiro, RA. Integration of the Safe Environment for Every Kid SEEK Model Across Primary Care Settings. Clinical Pediatrics. 2019; 58(2):166-176.
The Safe Environment for Every Kid (SEEK) model was developed to assist pediatricians in preventing child maltreatment through screening for psychosocial risk factors at well-child visits, brief motivational interviewing intervention to engage caregivers, and referral to community resources and supports. The SEEK model was successfully implemented across multiple primary care settings (a pediatric practice, federally qualified health center, and family medicine practice). Providers found SEEK worthwhile for improving their knowledge, skills, and ability to address social determinants of health. Barriers included limited time and resources, incomplete resource knowledge, and lack of follow-up.
Hoehn, EF; Overmann, KM; Fananapazir, N; Simonton, K; Makoroff, KL; Bennett, BL; Duma, EM; Kurowski, EM. Improving Emergency Department Care for Pediatric Victims of Sexual Abuse. Pediatrics. 2018; 142(6).
Evidence-based medical care of sexual abuse victims who present to the pediatric emergency department is necessary to facilitate forensic evidence collection and prevent pregnancy and sexually transmitted infections. Quality improvement efforts, including targeted education and integration of an electronic order set, increased adherence to testing and treatment guidelines from 57% to 87%.
Eismann, EA; Pearl, ES; Theuerling, J; Folger, AT; Hutton, JS; Makoroff, K. Feasibility study of the calm baby gently program An educational baby book intervention on safe practices related to infant crying. Child Abuse and Neglect. 2019; 89:135-142.
Infant crying has been identified as a trigger for abusive head trauma. Pediatricians within three primary care practices gave the Calm Baby Gently educational baby book to caregivers at the 1-month well-child visit to teach safe practices related to infant crying in an effort to prevent abusive head trauma. This brief intervention was found feasible, with most (78%) caregivers receiving the book, and most reading it (92%) and then sharing it with another caregiver (51%). Caregivers considered the book approachable, understandable, validating, and helpful for improving knowledge and skills related to infant crying. Caregivers who read the book were more confident and had more knowledge on how to respond appropriately to infant crying than caregivers who had not read it.
Antommaria, AHM; Shapiro, RA; Conard, LAE. Psychological Maltreatment and Medical Neglect of Transgender Adolescents The Need for Recognition and Individualized Assessment. The American Journal of Bioethics. 2019; 19(2):72-74.
This paper discusses the recognition and management of psychological maltreatment and medical neglect among transgender adolescents. As with any psychological child maltreatment or neglect, providers must report concerns to child protective services. However, neglect or psychological maltreatment can be difficult to determine in cases where a parent refuses medical transition for their transgender child. While sufficient dysphoria and suicidal ideation can represent an imminent risk of serious harm, identifying the causes and effective interventions may be difficult. Cases require individual adjudication.
Brownell, AD; Shapiro, RA; Hammerschlag, MR. Caution Is Required When Using Non-Food and Drug Administration-Cleared Assays to Diagnose Sexually Transmitted Infections in Children. The Journal of Pediatrics. 2019; 206:280-282.
Using validated tests with US Food and Drug Administration (FDA) clearance to test for sexually transmitted infections is especially important in children because identification of these infections in prepubertal children, beyond the neonatal period, can be indicative of sexual abuse. Three pediatric cases are discussed in which non-approved tests were used and resulted in probable false-positive results.