Yesterday, I attended something called a Care Team Meeting. The weather was frigid and snowy, more suited to February in Minnesota than the lower Midwest, so most participants Zoomed in from under a pile of heated blankets in their living rooms. A child abuse specialist pediatrician chaired the meeting, attended by representatives from the district attorney’s office, various social service agencies, law enforcement, and medical professionals. The topic of this meeting was a freckled six-year-old girl who sat unaware in her fifth-floor hospital room, watching the movie Trolls with her aunt. The girl was admitted to the hospital three days earlier with bruising on her body that suggested abuse, and we had all gathered to discuss how to make her future safe.
Care Team Meetings function in my city as a way for medical and social service teams to ensure they don’t release the child into an unsafe environment. In this case, the child was medically cleared to leave the hospital the same day she was admitted (her bruises, fortunately, were only that), but they kept her there because her father was the perpetrator. They had no authority to release her to anyone besides her parents.
As I listened from under my own mound of warm fleece, I learned from everyone who spoke. I didn’t just learn about this specific child but also about the functions of each cog in the complex machine that fires up when one of these cases is reported. I have attended dozens of Care Team Meetings over my years as a detective in the Exploited and Missing Child Unit, and almost every time, I come away with new knowledge. While my expertise has grown as a result of listening to these professionals, so too has my realization that child abuse cannot be investigated by one person or even one agency.
The US Department of Justice, Office of Justice Programs, published a guide titled Forming a Multidisciplinary Team to Investigate Child Abuse. A passage in that guide aptly sums up the complexity of abuse investigations:
“More information than ever before—in the areas of specialized child development issues, victim and offender dynamics, diagnostic imaging, traumatic memory, linguistics, forensic pathology, and others—is available to help practitioners discover the truth of a report. Moreover, to meet the competing demands of child protection, due process, and family preservation, laws have been repeatedly changed and refined in the areas of evidence, procedure, and definitions related to abuse and neglect. The existence of such abundant yet diverse and technical data and legal requirements places significant demands upon professionals who investigate and prosecute these increasingly difficult cases.”
Here are some details from my Care Team Meeting to prove the point. The child was from Oklahoma, where this incident occurred, and she was here visiting the family who noticed the bruising. One obvious solution to her safety was to place her with her protective family in our state, but the social services professionals from Oklahoma said that would violate their laws. Oklahoma requires that the child be placed with someone in Oklahoma. Further, I learned from the assistant district attorney who attended the meeting that, while a Kansas family could be granted guardianship, the father (perpetrator) would have to hand over that guardianship, and he could easily revoke it when he chose. And on and on…
Tucked in with this essential but mind-numbing legal gobbledygook was a gem that helped advance this case and the hundreds like it that I have and will investigate in my career. The pediatrician casually said, “This is a beating disguised as a spanking.” Yes, of course it was. But how often have I tried to think of ways to communicate in affidavits and to prosecutors, defense lawyers, judges, and juries that what happened is abuse, not discipline? I was spanked as a child, but I was not abused. There is a difference, and the doctor captured that difference in one elegant sentence.
The Care Team Meeting is a component of a multidisciplinary team (MDT) approach to child abuse investigations. Housed in my building, a child advocacy center, are the following: therapists, advocates, state social workers, an assistant district attorney, detectives from the police department, detectives from the sheriff’s office, an FBI special agent, task force officers (TFO), a Homeland Security Investigations (HSI) special agent, translators, forensic interviewers, computer forensics experts, a SANE/SART nurse, and more. The overarching purpose of these professionals is to serve vulnerable children, and the center has staff that coordinate the components so the resources flow where needed. The center also provides outreach and education, organizes peer reviews for forensic interviews, and organizes MDT meetings, which function as a juiced-up version of a care team meeting for the most challenging cases.
Having worked as part of an MDT, I don’t know how agencies that go it alone can effectively handle these investigations. The required expertise is too vast, the cases are too complicated, and the stakes are too high. In 1996, after a high-profile child abuse death case, a commission in New York State examined their child welfare and abuse investigations machinery and published a report on what they found. That report, Secrets That Can Kill: Child Abuse Investigations in New York State, concluded: “It is beyond the power of government to prevent this from being a world in which children suffer and die, but it is the responsibility of government to protect children and bring those responsible for mistreating them to justice.” We must do our best, and when it comes to child abuse investigations, the MDT approach is the best.
Ells, M. (2000). Forming a multidisciplinary team to investigate child abuse. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.2518713
New York State Temporary Commission of Investigation. (1994). Secrets that Can Kill: Child abuse investigations in New York State neglect (C-0340–93).
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