Our major emphasis is the provision of specialized medical services to children, youth and families where there is a question of abuse or neglect.

Who are we?

• We are a hospital-based, consulting, multidisciplinary health team.
• We are pediatricians, a nurse, a social worker, and an administrative assistant. 
• We also have a liaison worker from the Children’s Aid Society of Ottawa, and we work closely with the Emergency Department Sexual Assault/Abuse Program.

What do we do?

• We provide specialized health assessments, medical opinions, and care for children, youth and families when there is a question of maltreatment (physical abuse, sexual abuse, or neglect).
• We provide consultation on medical aspects of maltreatment to healthcare providers, child welfare agencies, police, lawyers, and others.

How do we do this?

• We assess children and families for urgent and elective consultation (as in-patients, in our clinic, and in the emergency department).
• We consult to health professionals to provide support and guidance in possible maltreatment cases.
• We consult to non-health professionals to review cases, provide health opinions and educate on health aspects of child maltreatment cases.
• We review ALL cases that CHEO staff and physicians report to a child welfare agency.

When should you consult CYP?

• You are looking for a medical assessment regarding possible child maltreatment (physical abuse, sexual abuse, neglect). 
• You are looking for an opinion on medical aspects of possible child maltreatment (eg injuries and their causes, underlying medical conditions).
• You are looking for general information about medical aspects of child maltreatment.
• You would like to partner with CYP for the purpose of case management, research, education, or advocacy. 

The division's services are based at the Children's Hospital of Eastern Ontario (CHEO), which not only serves Ottawa but also Eastern Ontario, Western Quebec, Nunavut, and parts of Northern Ontario. The Children's Aid Societies in Ontario, the Ministry of Health and Social Services of Quebec, and the Department of Family Services in Nunavut are the legal child welfare authorities in CHEO’s catchment area to which suspected abuse and neglect must, by law, be reported. These agencies are responsible (sometimes with police) for the investigation of the reports.

Faculty members within the division teach medical undergraduates, medical residents, practicing physicians, allied health professionals and others. Faculty also conduct research and contribute to publications related to child abuse and neglect.

The Division of Child and Youth Protection's major emphasis is the provision of specialized medical services to children, youth and families where there is a question of abuse or neglect. The division provides care for patients in consultation with the emergency department, inpatient units, and ambulatory clinics. CYP also runs a specialized clinic where patients with non-acute concerns for maltreatment can be assessed and cared for. 

The Division of Child and Youth Protection consults on the following topics: 

• Physical injuries and abuse
• Sexual abuse
• Neglect (including medical neglect) 
• Other forms of maltreatment
• Medical documentation in a legal context
• Communication with child welfare, law enforcement and legal personnel
• Psycho-social assessments and support for CYP patients
• Medical case management for maltreatment cases
• Medical expert court testimony for child maltreatment cases
• Teaching, research and advocacy on topics related to child health and child welfare

The Division of Child and Youth Protection faculty are actively involved and interested in a range of research and publications in the following areas:

• Child maltreatment including head injuries, bruises and abdominal injuries
• Pediatrics
• Health of children involved with the child welfare system
• Medico-legal opinion formulation
• Model of care and assessments in child maltreatment cases
• Education of health professionals relating to child maltreatment 

Undergraduate medical education

We offer two-week mandatory electives to University of Ottawa, Faculty of Medicine students and two- to four-week electives to visiting medical students if space is available. Medical students work on the consultation service, participate in outpatient clinics, attend multi-disciplinary review committee meetings and are exposed to the sexual assault program. Objectives of the learning experience include:

• Understand the epidemiology and risk factors for child abuse and neglect/maltreatment
• Be familiar with the definitions of abuse and neglect
• Know how to identify cases of suspected child maltreatment
• Understand how to approach a case of possible child maltreatment with an appropriate history and physical examination, with a differential diagnosis
• Know the possible short and long-term sequelae (impact) of child maltreatment
• Understand the medical, child welfare, police and judicial role in the identification, reporting, investigation, management, treatment and prevention of child abuse and neglect.
• Understand the medico-legal and ethical implications of caring for these patients 

Because the Division of Child and Youth Protection does not have as high of a clinical patient load as some other services, the expectations of the students are somewhat different on this rotation than other pediatric areas of study. Students participate in clinical cases and are expected to attend and present at multi-disciplinary meetings. Some independent learning is required. 

Clinical learning opportunities include:

• Inpatient consults
• Emergency Department consults
• Child and youth protection clinics
• Historical sexual assault cases
• Attendance at multi-disciplinary review committee

Other learning opportunities include structured teaching cases, teaching sessions from multidisciplinary team members and peer review. Additional opportunities may include: meeting with other professionals involved in child welfare and court proceedings, other combined rounds or teleconference sessions, and community multi-agency meetings.

If students have an interest in pursuing research in child maltreatment, or have an idea for a research project, they are encouraged to discuss it with one of the child and youth protection pediatricians.

Postgraduate medical education

There is no certified postgraduate program in child abuse pediatrics in Canada at this time. 

Additional postgraduate training

We offer mandatory four-week rotation to University of Ottawa Faculty of Medicine Pediatric residents and two- to four-week rotations for external residents if space is available. Learning objectives are available on request. 

Because the Child and Youth Protection Program does not have as high a clinical patient load as some other services, the expectations of the resident are somewhat different on this rotation than other pediatric areas of study. Residents participate in clinical cases and are expected to attend and present at multi-disciplinary meetings. Some independent learning is required and residents give one presentation during their time on the rotation. 

Clinical learning opportunities include:

• Inpatient consults
• Emergency Department consults
• Child and youth protection clinics
• Historical sexual assault cases
• Attendance at multi-disciplinary review committee 

Other learning opportunities include structured teaching cases and peer review. Additional opportunities may include: meeting with other professionals involved in child welfare and court proceedings, other combined rounds or teleconference sessions, and community multi-agency meetings. 

If residents have an interest in pursuing research in child protection, or have an idea for a research project, they are encouraged to discuss it with one of the child and youth protection pediatricians.