Child abuse, also known as maltreatment, is common. About ​4 million cases of child abuse and neglect involving almost seven million children are reported each year. The highest rate of child abuse is in babies less than one year of age, and 25 percent of victims are younger than age three. Physicians are legally obligated to report all suspected cases of abuse or neglect to state authorities.

The major reasons for physical and psychological maltreatment of children within the family often are a parent's feelings of isolation, stress, and frustration. All Nevada families are encouraged to connect with The Children’s Cabinet to access a wide array of free virtual and in person classes and support groups. You are not alone.

I have been in practice for over 20 years and in Las Vegas for the last six of those. Las Vegas is a wonderful city and I love being part of the community, but I have found that one of the needs of the community that is not being adequately addressed is coordinated diagnosing and prosecution of child abuse. Child abuse has always been a part of my practice but I have never taken an active role until last year when I participated in UCARE training program offered by Dr. Toni Lasky at University of Utah. This was an intensive course involving several weeks of remote Continuing Medical Education (CME) followed by an in-person weekend of training in Salt Lake City. The program was designed to help practitioners in remote isolated regions of the Mountain West become more proficient in Child Abuse Pediatrics. Las Vegas is considered a "remote isolated region" in relation to Child Abuse because we do not have an established child abuse care team here.

“We Have All Been Working in Our Own Little Silos Forever: Exploring a Cross-Sector Response to Child Maltreatment” by Dr. Kristine Campbell at University of Utah addresses a common problem in child abuse care: the lack of collaboration between all of the entities involved. In January of 2024 a coalition of Nevada leaders launched a child abuse working group to address this problem. The coalition is led by the Nevada Chapter of the American Academy of Pediatrics and brings together pediatricians, pediatric emergency physicians, Child Protective Service (CPS) workers, police and the district attorney’s office. The goal of this group is to improve the coordinated care we provide to victims of child abuse and to encourage continuity between everyone involved to make sure every child has effective care. Improving communication is the first step to improving the care that we provide our community.

We are all mandated reporters and there is a system in place for us to make initial reports to CPS. However what is missing are effective systems to enable communication from the emergency departments to primary care to facilitate appropriate follow up and closure with CPS. Getting through the phone tree at a busy pediatric office is always difficult and is an obstacle to good communication. I know, from personal experience, that the best way for me to reach a pediatric subspecialist is by contacting them directly on their cell phones. Many (if not all) of our local subspecialists are happy to share their numbers and this allows us quick answers to questions and access to care for our patients. I would like to make a similar process available to our emergency department colleagues. I will be collecting numbers, either a back line to your office or your cell phone if you are willing to share it, and sharing this with the directors or our community Emergency Departments (EDs) – Sunrise, UMC, Valley Hospitals, and Dignity Hospitals. This will allow better communication about our patients in the ED who need follow up. Any Las Vegas pediatrician (or other provider who cares for pediatric patients) who wants to be on this list please reach out to me at TRMcAllister46@gmail.com or 508-685-2149 (I live and work in Las Vegas but still use my long-established Massachusetts cell number).

To all of my colleagues in Reno: I am sorry that this is a very Las Vegas centered project at this time. I will be giving grand rounds at UNR on Feb 14 discussing Child Abuse Recognition and Response, and am eager to identify a pediatrician in Reno who wants to take the lead in forming a similar working group in Northern Nevada with the Nevada AAP Chapter support.