Pediatric Emergency Department at Strong Memorial Hospital

Childhood Abuse

By: Yosuke Aoyama & Dan Balk

April 18, 2007 was a normal day for Dr. Ann Lenane, associate professor of Emergency Medicine at the University of Rochester Medical Center in Rochester.  Lenane, who also examines and evaluates sexually or physically abused children, started her day by examining a 3-year old girl at the Bivona Child Advocacy Center located at 275 Lake Ave. in Rochester.  This young girl had fallen victim to her mother’s ill-fated decision to leave her in the care of her step-grandfather.  As a teenager, the girl’s mother had been raped by her stepfather, but for whatever reason this did not deter her from leaving her young girl with him.  “At first I thought, why would the mother leave her child with the step-grandfather, who had raped her before,” Lenane recalled.  “I believe people who have been abused or raped might not have the same sense of control in their life, and that could have caused the girl’s mother to leave her daughter with the step-grandfather.”

Shortly after the girl’s mother had dropped her off, her step-grandfather took her into a room alone and sexually abused her.  Several days later the girl informed her mother that she was experiencing pain as a result of the incident.  Her mother immediately contacted the New York State Register of Child Abuse and Maltreatment via the Child Abuse Reporting Hotline.  The Hotline then reported it to the Child Protective Services and referred the mother to the Bivona Child Advocacy Center. 

The case of this unfortunate young girl is surprisingly common.  According to a 2003 U.S. Department of Health and Human Services survey, 77,086 New York State children were abused or neglected, 17 of every 1,000 children in the state.  In that year, 62 children were known to have died as a result of child abuse or neglect.  In Monroe County, which has a population of 750,000, seven children were sexually abused every day in 2003 according to Monroe County Child Protective Services.  Moreover, someone the child knows and trusts – e.g. a parent, neighbor, teacher, coach, religious leader or peer – commits 90 percent of child abuse crimes.  

The Bivona Child Advocacy Center

Bivona Child Advocacy Center is an independent non-profit agency that opened on August 1, 2004.  “The center, by taking a multidisciplinary approach, tries to minimize trauma for children who were sexually or physically abused by adults,” Sue VanStrydonck, Program Director for the center, said.  “The center is the ultimate in working together.”  It provides a one-stop approach for interviewing and treating sexually and physically abused children in Monroe County.  “For children who were sexually abused, it really messes them badly,” Lenane said.  “So it is very important to treat these children so that they can overcome their trauma and be able to move on with their future lives.”

The center is especially important to this effort because it – like the other 600 child advocacy centers across the country – is a gathering point for numerous supporting agencies related to child abuse such as the Monroe County Child Protective Services, the REACH (Referral and Evaluation of Abused Children) at Golisano Children’s Hospital at Strong, Rape Crisis Services, Police Departments, and Monroe County District Attorney’s Office.  Twice a month, these agencies and professionals from the center meet and review ongoing and upcoming cases. 

Although the center has only been open for almost three years, the first advocacy center of this type was established in 1984.  For the first time, victims would no longer be forced to retell – and in so doing, relive – the horrible incident to many different types of social workers and law enforcement officials. 

An average of 6,000 child abuse reports are filed within Monroe County each year; however, about 500 cases are considered “truly” abused cases.  New York State law separates child abuse into three categories, child neglect or maltreatment, child abuse, and sexual abuse.  To be classified as “child abuse” there must be an instance of serious, permanent injury.  In fact, the law allows parents to discipline their children with corporal punishment.  “Unfortunately, children must be half dead for Child Protective to take them out of the home and to get them treatment at the center,” VanStrydonck said.  

The center only helps the cases, which are considered severe by the investigations conducted by police departments and Child Protective Services.  Since the center opened its doors, it has seen and treated approximately 1,600 children.  Because the center only can provide treatment and care to the “truly” abused cases, it is not open to the general public and either Child Protective Services or law enforcement officials must refer children to the center. 

Unlike many organizations in the field, Bivona was designed specifically to be a child advocacy center.  In order to make children feel comfortable and safe when they are brought into the center, it has several playrooms with toys and kid-sized furniture.  In addition, interviews are conducted in special rooms that have one-way mirrors that make it easy for a single interviewer to visit with a child while other professionals watch and contact interviewers if necessary.   

Despite the fact that the center receives government grants, more than half of its annual budget comes from private contributions and fundraising campaigns, which are organized throughout the year.  VanStrydonck emphasized the importance of volunteers in the community and financial contributors to the center, saying, “One person’s positive impact can make all the differences in the world.” 

The center gives a special teddy bear to each one of its patients.  The bear is called a “Jennie Bear” and is named after Jennifer Koon, a college student who worked to help people before she was murdered at age 18.  Donations, or purchases of bears, go to providing bears to children that have been sexually abused.  In one of the center’s playrooms, the wall reads, “Always remember, when you are hugging one of Jennie’s bears… someone loves you!”

Hopefully, the Bivona Child Advocacy Center will be very efficient in dealing with the case of the 3-year old girl abused by her step-grandfather.  The abuser will be tried and convicted for his crime, and the victim will be given the help she needs to recover emotionally and psychologically as she grows up.  When asked about children’s ability to recover from mental and physical trauma, VanStrydonck optimistically stated, “I put my money on kids.  Their abilities of recovery can truly surprise adults.”

Types of Maltreatment

Child neglect continues to comprise the largest portion of child maltreatment.  According to Child Maltreatment 2003, figures for the country and for New York State are as follows:

Note: Totals are more than 100% because a child may be victim to more than one type of maltreatment.

(Sources: Child Maltreatment 2003, U. S. Department of Health & Human Services)