Delaware County Medical Society Summer 2017 - 18

FEATURE
Babies with NAS are more likely to be abused and to die
than their non-dependent counterparts. Sometimes we know
why they die and sometimes we don't. Knowing this fact,
shouldn't we put an added layer of protection around these
high-risk infants? Doctors are forced to send NAS babies
home to parents who sometimes don't even bother to visit
their child during the hospitalization, and some of them who
do show up sleep for the entire time they are visiting because
they are active users. We have to work together to do something differently to help these children.
As physicians, we have limited time that we can devote to
administrative work. Going to court repeatedly and sitting
for hours as court is continued again and again is abhorrent.
Protecting children in this current system is very difficult and
frankly discouraging to even the most dedicated child abuse
professionals. So, what do we do? What should we do?
Well, we have to get involved and stay involved. Over the
years, many disciplines have taken note of ACEs. There are
many multidisciplinary groups that have been assembled in
counties (including Delaware County) to address adverse
childhood experiences. You many have heard the words
"Trauma-informed Care" and wondered what it means. To be
considered trauma-informed one must understand the impact
of trauma and the potential for healing. You must have the
ability to recognize the signs and symptoms of trauma. Once
you recognize these signs, you must be able to respond to
this appropriately and in doing this, ensure that the patient

is not re-traumatized during this process. Trauma Informed
Care, if done correctly, should help survivors rebuild a sense
of control and empowerment. It should ensure the physical,
psychological and emotional safety of both the patient and
provider.
As physicians, we each have an important role in providing
trauma informed care. Even if you don't have the time to
understand, recognize, respond and avoid re-traumatization in
victims, plan to understand, recognize and then refer patients
to a trauma-informed provider. Try to ensure that every child
who crosses your path who has a need for counseling gets
referred and if possible, assign a staff member to follow up
to ensure compliance. Consider co-locating a therapist. If
you are interested in this, please reach out to our Executive
Director, Mr. David McKeighan, at (610) 892-7750.
In my office, whenever I have a child sexual abuse evaluation, a representative from Women Against Rape (WAR)
is usually present on site to support the victim and family
members and they continue to provide support for victims
and their families as they walk through the difficult investigative and court process. I am working on having a similar
set-up for my physically abused and neglected patients. In
the future, working together across disciplines (including the
judicial system) is essential if we are going to make a dent in
this devastating problem and begin to improve the short-term
and long-term outcomes of these vulnerable children.

Resources
https://www.cdc.gov/violenceprevention/acestudy/about.html
https://vetoviolence.cdc.gov/
https://acestoohigh.com/got-your-ace-score/
The American Academy of Pediatrics: Addressing Adverse Childhood Experiences and Other
Types of Trauma in the Primary Care Setting.
The National Center for Trauma-Informed Care
66 Canal Center Plaza, Suite 302
Alexandria, VA 22314
NCTIC@NASMHPD.org
http://www.cdc.gov/ViolencePrevention/childmaltreatment/essentials/index.html

16 DELAWARE COUNTY MEDICINE & HEALTH

summer 2017


https://www.cdc.gov/violenceprevention/acestudy/about.html https://vetoviolence.cdc.gov/ https://www.acestoohigh.com/got-your-ace-score/ http://www.cdc.gov/ViolencePrevention/childmaltreatment/essentials/index.html

Table of Contents for the Digital Edition of Delaware County Medical Society Summer 2017

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