UVM Children’s Hospital Publishes Comprehensive Manual on Child Abuse and Neglect Guidelines and Resources

Burlington, VT – Doctors, nurses, members of law enforcement and child protective service professionals have a new tool to help them navigate the often-challenging work of identifying, assessing and responding to child abuse and neglect. 

University of Vermont Children’s Hospital recently published Vermont Child Abuse and Neglect: Guidelines and Resources for Healthcare Professionals. The guide is the result of years of collaboration between the hospital’s Child Safe Program with experts and providers across a broad spectrum of national and state services focused on identifying and responding to child abuse and neglect. 

“This manual, which is organized for easy use, contains up-to-date information on what to do and not do when abuse is suspected,” said Lewis First, MD, chief of pediatrics at UVM Children’s Hospital. “Health care professionals will be better equipped to know how to evaluate and refer a child who may have experienced physical, sexual or psychological abuse and neglect. It will be an essential reference for all clinicians who care for infants, children and adolescents.” 

This is the first time the hospital has published the guidelines, which bring together national consensus guidelines from physicians on best practices for clinical evaluations with state-level guidelines and requirements for identifying, assessing and reporting suspected abuse or neglect. It is the first time such information has been laid out together in a single, comprehensive manual.  

Members of the Child Safe Program who spearheaded the effort say their goal is to provide information, resources and transparency about a process that is often complex, poorly-understood and confusing amid numerous national and state guidelines and best practices.

“The guide is a resource for medical providers to use and feel reassured that they are doing the right thing when they see a child with a concern for maltreatment,” said James Metz, MD, director of the Child Safe Program at UVM Children’s Hospital.

He urged health care providers and child welfare professionals to reach out to the Child Safe Clinic if they have questions or concerns. The Clinic provides about 10 consultations per week to providers seeking input and guidance around identifying, assessing and reporting suspected abuse. It partners with health professionals across Vermont and northern New York.

While the 74-page manual is designed for use primarily by clinical teams, it also includes resources for members of law enforcement, child protective services and others, Dr. Metz said, adding that the Child Safe Program wants to work in partnership with providers, pediatricians and professionals across a wide spectrum of services that impact and support the welfare of children.

“It’s really intended for those folks who are working within the child welfare system at-large, so they have a better understanding of the medical piece of the puzzle,” he said. “We’ve come a long way in our understanding of the mechanisms and pathophysiology of injury, and how accidental versus abusive injuries look differently.”

Dr. Metz added that the guide will be a living document on the hospital’s website. It will be updated in real time to reflect the current science, best practices and national and Vermont state requirements around identifying, assessing, reporting and treating child abuse and neglect.

“The goal is to reduce variation and ensure every child receives appropriate treatment based on the concerns they present with,” said Dr. Metz. “The goal is to support the work people are doing and ensure every child, regardless of their family circumstances, background or the color of their skin, gets the same workup for the same injury or concern.”

Tracey Wagner, RN, SAN-P, a pediatric forensic nurse at the Child Safe Program who also worked on the manual, said providing information, clarity and transparency is crucial, due to the “ever-evolving” nature of child abuse medicine.

“The ability to have a standardized approach is really important, so we can make sure all kids get the right care by the right people,” said Wagner, who also works with the Vermont Forensic Nursing Program, where she has served as the pediatric clinical coordinator since 2018.

“It’s not like we have new science,” said Dr. Metz. “It’s an evolution of our understanding of the science and the understanding we have of the toxic effect abuse and neglect has on individual children, and the global effect it has on families.”