Completed Tasks

Educational Webcasts

There were six CHAMP webcasts this grant year:

1. October 13, 2021, Keeping Up! New Literature in Child Abuse Medicine, presented by Stephen C. Boos, MD.
2. December 8, 2021, Navigating Treatment for Children Who Engage in Challenging Behavior, presented by Nicole DeRosa, PysD.
3. January 12, 2022, To Tell the Truth: Based on Forty Years of Clinical and Trial Experiences in Abusive Head Trauma, presented by Jamie Hoffman-Rosenfeld, MD, with author Robert M. Reece, MD.
4. February 9, 2022, co-sponsored by CHAMP/APSAC-NY/The NY Foundling, Trauma or Not Trauma? Teasing out traumatic stress from ADHD, Depression and Anxiety, presented by Brooks Keeshin, MD.
5. March 9, 2022, Mitigating the Impact of Institutionalized Racism on the Experience of Child Welfare-involved Black/Brown Families: What’s A CAP to Do?, , presented by Ingrid Walker-Descartes, MD, MPH.
6. April 6, 2022, Child Maltreatment in Children with Disabilities, presented by Lori Legano, MD.

Drs. Boos and Keeshin are nationally renowned experts in child abuse pediatrics. Drs. Hoffman-Rosenfeld, Legano, and Walker-Descartes are current or past CHAMP Mentors at Centers of Excellence and nationally recognized American Board of Pediatrics certified child abuse pediatricians. Dr. DeRosa is a dually licensed psychologist and behavior analyst and Director of Upstate Golisano Children's Hospital Center for Special Needs. All webcasts bring research-based information to the child abuse professionals of NYS and provide an opportunity for attendees to get answers from an expert.

Webcast attendees identified themselves as being physicians, nurse practitioners, physician assistants and registered nurses working in pediatrics, emergency medicine and family medicine, many with SANE/SART/SAFE designation, and also social workers and non-medical members of multidisciplinary teams. There was a total of 1,520 registrants for the webcasts. Of those who registered, 417 applied for Continuing Medical Education (CME) credit. Both the webcasts and CME credits (one credit per webcast) are free to participants.

Attendees evaluated all webcast presenters as excellent and the content as being clear and helpful. From the responses to the surveys at the end of the webcasts, attendees planned to make significant changes in their practice, including:

• Educate students, residents, attendings, investigators on TEN4FACES-P
• I will think more critically about literature I read
• Will be even more empathic and trauma informed when I take care of psych patients
• Aware of new literature for BESS in upcoming court case
• I will be better to identify bruising patterns
• I am better educated on the overlap symptoms of ADHD, depression and trauma and can understand this better for a clearer assessment
• Keep a broad differential and give time for a child to adjust before committing to a diagnosis
• Re-evaluate poly pharm kids in foster care
• Take racial bias test and work to eliminate it if there
• Utilizing evidenced based approaches to mitigate biases
• Including impact statements as collateral sources
• Reaffirming the importance of CAC evaluation prior to contacting ACS

The Evaluating Child Sexual Abuse Course

The online course Evaluating Child Sexual Abuse (ECSA) continues to be an effective educational tool for pediatricians, emergency department physicians, physician assistants, nurse practitioners and SANEs. This grant year 144 professionals registered for the course. By June 30, 82 had passed the 100-question test. Of those who passed the test, 10 applied for and received CME credit. Although the course is free, there is nominal charge for the 12 CME credits.

The ECSA course was originally created to be the first step for New York State medical professionals to become CHAMP Network Members. Its use has expanded to being part of child abuse training for medical residents and fellows, and self-preparation for certification examinations. Nineteen trainees from St. Joseph’s Hospital Health Center and SUNY Upstate Medical University, Syracuse, NY, including family medicine residents, pediatric residents and pediatric emergency medicine fellows completed ECSA as a part of their rotation in child abuse with the CARE clinic this year.

From the launch of the course in September 2011 through June 2022, there have been 1,820 registrants. Of those, 892 have passed the test and 342 have applied for and received CME credit.

Other CHAMP Website Resources

This grant year the CHAMPprogram.com website drew over 308,000 visitors. In addition to viewing web pages, visitors downloaded a significant number of resources. Tracking the number of downloads from the top 150 resources offered on the website, there were over 36,000 downloads. That total includes over 4,000 Practice Recommendations related to Triage, Testing and Treatment, Skeletal Survey, Photographic Documentation and Writing an Impact Statement; and over 1,600 Guidelines related to Evaluation of Physical Abuse, Evaluation of Sexual Abuse and Trauma-Informed Care. The 24 questions and answers of Test Your Knowledge were visited 59,000 times and the individual questions and answers of What Would You Do? regarding nine child trafficking cases were visited 3,300 times.

Statistics for the ChildAbuseMD.com website that posts the searchable webbook Child Abuse Evaluation & Treatment for Medical Providers had a total of almost 62,000 visitors.

Since ChildAbuseMD.com was launched in mid-2005 and CHAMPprogram.com was launched in mid-2007, there have been nearly six million visitors to the websites.

CHAMP Mentors, Faculty and Network Members

Three new Mentors joined CHAMP: Iram Ashraf, MD, a recent graduate of the SUNY Upstate Child Abuse Pediatrics Fellowship Program, is practicing at the Erie County Child Advocacy Center, John R. Oishei Children’s Hospital, Buffalo, and serves Erie and Niagara counties. Gillian Hopgood, DO, a recent graduate of the Maimonides Child Abuse Pediatrics Fellowship program, is practicing at the Suffolk County Child Advocacy Center, Stony Brook Children’s Hospital, Stony Brook, and serves Suffolk county. Aaron J. Miller, MD, MPA, an established CAP, is at Lincoln Child Advocacy Center, New York City Health + Hospitals, Bronx. He has an interest in hosting observerships to expand care in his hospital system.

There are two new CHAMP Faculty: Omawatie Gopee-Bonilla, FNP-BC, is at J.E. and Z.B. Butler Center for Children and Families, The Children’s Hospital at Montefiore, Bronx, and is working under CHAMP Mentor Mandy O’Hara, MD, MPH. Kristin Razawich, PNP, is at the CARE (Child Abuse Referral and Evaluation) Program, Upstate Medical University, Syracuse. Kristin is working under Alicia Pekarsky, MD. She replaces Nancy Mitchell, NP, who retired after 32 years of service in Onondaga County.

To remain on the Active Network Member roster, members must attend at least three CHAMP educational webcasts annually. There were 26 Active Network Members at the start of the year, July 1, 2021. Of those, three Network Members left child abuse practice this grant year, one retired and one became CHAMP Faculty. As a result, there were 21 CHAMP Active Network Members as of June 30, 2022.

There are now 22 New York counties that have one or more CHAMP Network Members. These counties are Albany, Broome, Cayuga, Dutchess, Erie, Fulton, Jefferson, Madison, Oneida, Orange, Otsego, Putnam, Rockland, Saratoga, St. Lawrence, Schenectady, Schuyler, Sullivan, Ulster, Warren, Washington and Westchester.

Other Educational Opportunities and Scholarly Activity

CHAMP education is an integral part of SUNY Upstate Medical University and the Maimonides Medical Center Child Abuse Pediatrics Fellowship programs. The educational webcasts, ECSA online course and weekly case conferences are part of the fellowship curriculum.

The CHAMP Evaluation Guidelines for Sexual Abuse and for Physical Abuse were updated this grant year. Heather Ross, MD, a CAP fellow, initiated this work as part of the quality improvement team at SUNY Upstate Medical University working on non-accidental trauma protocols and institutional policies to better standardize care.

The CARE program, a CHAMP Center of Excellence in Syracuse, provided scheduled learning experiences and rotations for 22 Pediatric and Family Medicine residents, 2 Pediatric Emergency Medicine fellows and 3 Child Psychiatry fellows. Eight other CHAMP Mentors at Centers of Excellence provide residents with an opportunity to complete the CHAMP Residency Training Program. Residents who complete this program can become CHAMP Members when they are licensed to practice in NYS by submitting three of their recent child sexual abuse cases for review by a CHAMP expert.

This grant year, Iram Ashraf, MD, a Child Abuse Pediatrics fellowship graduate and now practicing CAP and CHAMP Mentor, published an article on follow-up skeletal surveys: Ashraf, Iram J., et al. "Improving follow-up skeletal survey completion in children with suspected nonaccidental trauma." Pediatric Quality & Safety 7.3 (2022).

Recommendation

Collaborative Education

Collaborations add greatly to the success of CHAMP. For the fifth year, CHAMP has collaborated with the American Professional Society on the Abuse of Children-New York (APSACNY) to present a webcast. This year’s collaboration also included The NY Foundling, who sponsored and awarded 78 CEU credits to social workers. This collaboration supports increasing CME cost and expands the availability of speakers and the number of attendees. In February 2022, Trauma or Not Trauma? Teasing out traumatic stress from ADHD, Depression and Anxiety was presented by Brooks Keeshin, MD. Dr. Keeshin is a child abuse pediatrician and child psychiatrist, and delivers trauma focused psychiatric care as part of a multidisciplinary trauma treatment team. Dr. Keeshin is the Principal Investigator of Pediatric Integrated Post-trauma Services (PIPS), a Category II Center of the National Child Traumatic Stress Network.

Collaborations also enhance the educational process. CHAMP has continued involvement in planning discussions with the NY OCFS and the NY Children’s Alliance regarding the creation of back-up coverage for New York’s child abuse pediatricians (CAPs) and long-term planning to provide consistent, systemic regional coverage to areas that are currently lacking CAPs.