The Department of Pediatrics in the College of Medicine at the University of Arkansas for Medical Sciences (UAMS) has provided specialized medical evaluations for physical and sexual abuse since 1981. The result of this experience is a collaboration of UAMS and Arkansas Children’s Hospital (ACH), integrating a medical, social and psychological health care system for the whole family that has experienced child abuse. The Section for Children at Risk consists of two functional components, both of which incorporate health care, teaching, clinical research and community service. They are the Team for Children at Risk Medical Clinic and the Family Treatment Program located in the Clark Center for Safe and Healthy Children on the campus of ACH.

Background

Dr. Jerry G. Jones was the first pediatrician in the state to dedicate his career to developing a coordinated medical and mental health approach to children and families impacted by abuse. He joined the Department of Pediatrics at UAMS in 1978. By 1986, he was focusing the majority of his clinical and academic time to the care of maltreated children and their families. In 1992, a group of concerned citizens, touched by his dedication and care for abused children, garnered financial assistance to create a family-centered clinic on the campus of ACH called the Arkansas Children’s House for identification, medical and psychosocial evaluation, and treatment of children impacted by abuse.

Dr. Jones recognized in the 1990s what is now common knowledge that abused children and their families suffer a special kind of emotional trauma. He understood it was imperative to address the long-term needs of abused children, as well as those in their families who are struggling to provide support for their children. The Family Treatment Program was developed in response to that vision. Dr. Karen Worley, a trained psychologist with extensive experience in working with sexually abused children, was recruited to direct the Family Treatment Program the same year that Arkansas Children’s House opened its doors. While trauma-focused therapy is a standard of care now in the field of child abuse, this was one of the first programs in the country to develop a coordinated medical and mental health response to child sexual abuse.

Jan Church, Ph.D., later joined the program and has distinguished herself a national leader in educating and mentoring other professionals in the now standardized treatment modality called Trauma Focused Cognitive Behavioral Therapy (TF-CBT).

Dr. Jones was joined by Dr. Karen Farst in 2004. Dr. Farst had completed a fellowship training program in child abuse pediatrics following three years as a primary care practitioner. She became the first pediatrician in the state to be board certified as a Child Abuse Pediatrician when that designation became available in 2009. She assumed leadership of the section in 2014 following Dr. Jones’ retirement.

The programs shared administrative management but were not co-located on the campus of Arkansas Children’s Hospital to complete Dr. Jones’ collaborative vision until two years after his retirement in 2014. A major philanthropic endeavor spearheaded by the Arkansas Children’s Hospital Foundation and Auxiliary raised the support needed to build the David M. Clark Center for Safe and Healthy Children on the hospital campus. The programs have been co-located since 2016 and benefit from collaborative relationships with the other programs in the building (UAMS Child Study Center and the Children’s Protection Center of Pulaski County).

group at a SHIPS conference

Group at a SHIPS conference

The section for Children at Risk has also been a leader in bringing evidenced-based responses to child abuse cases to local communities in partnership with the children’s advocacy centers (CAC) in the state. In 2007, Act 703 tasked the program with providing continuing education and examination review support to the medical providers affiliated with the CACs in the state. This resulted in the formation of the Support for Health Involved for Professionals at Safety Centers (SHIPS) program in 2009.  The program is designed to facilitate access to resources to allow the medical providers at the CACs in the state to be able to meet the national standards for CAC accreditation as outlined by the National Children’s Alliance. The number of CACs has grown from five in 2009 to 17 in 2021. There are currently over 30 specially trained medical providers working in affiliation with CACs across the state. The program provides an average of 300 reviews of medical exam findings on request by the providers. The support is provided by:

  • Telemedicine linkage for the member sites to allow for review of examination findings when needed
  • Quarterly group meetings held via telemedicine for de-identified case review and discussion of emerging topics
  • Annual, two day conference offering continuing education credit for core and emerging topics in the area of child sexual abuse/assault
  • Periodic publication of the SHIPS’ log with summaries of pertinent journal articles, case presentations and topic reviews

Find a Children’s Advocacy Center in Arkansas:

http://cacarkansas.org/find_a_cac.php

National Children’s Alliance

https://www.nationalchildrensalliance.org/ncas-standards-for-accredited-members/