I have nearly 15 years of experience in clinical care, research, and quality improvement efforts related to child abuse. I am board-certified in pediatrics and child abuse pediatrics and am an attending physician at Dayton Children’s Hospital in Dayton, Ohio. I am the Chief Medical Community Health Officer of Dayton Children’s Hospital and the Vice-Chair (Community Health) of Pediatrics for the Wright State University Boonshoft School of Medicine. My research has focused on various aspects of violence, including domestic violence, child physical abuse, and child sexual abuse.

My recent area of study has been leading a statewide quality improvement collaborative of six children’s hospitals in Ohio with a focus on improving the pediatrician’s ability to identify and respond to relatively minor injuries in young infants. This work builds upon foundational studies looking at risk factors and predictors of recurrent injury from an accountable care organization of nearly 350,000 covered lives. These minor injuries are often the antecedent to more severe injury or death and early identification and response may have a role in the secondary prevention of abuse. Using the Institute for Healthcare Improvement’s Breakthrough Series Collaborative Model as a framework to engage pediatricians, child protective services workers, and others, we have advanced our understanding of how and why infants with minor injuries are often overlooked in the pediatric healthcare setting. Recognizing that children with suspected abuse pass through the healthcare system as part of a longer journey across multiple systems, I have led and participated in studies to better understand the multi-disciplinary approach to child abuse, from prevention to diagnosis to treatment, as well as the effects of the maltreated child who interacts with the foster care system.

 

I have also explored the intersections between child maltreatment and other forms of violence in the home, specifically domestic violence (DV). Early work to better understand the impact of screening for DV led to a study funded by the National Children’s Alliance to identify gaps in the assessment for DV in child advocacy centers (CAC). In addition to a publication that demonstrated a significant gap in knowledge related to the co-occurrence of DV and child abuse, we produced a toolkit that was distributed to nearly 800 CACs to improve identification of DV in the CAC setting. I was asked by the American Academy of Pediatrics to be lead author on the 2010 clinical report on DV and the role of the pediatrician and am currently serving as lead author on the revision of this clinical report.