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This article was written by Diane Merlevede for the inaugural issue of Izaak Magazine – an in-depth, behind the scenes, all-access publication highlighting the incredible, everyday happenings at the IWK Health Centre.  The IWK’s Child Protection Team is meticulous in tracking down the answers associated with children and suspected abuse.

AmyDr. Amy Ornstein loses sleep at night. As a general paediatrician with specialized training in child abuse and neglect, Dr. Ornstein works through her fair share of emotionally-charged and difficult cases. As a mother of young children, she says it’s never easy to see a child in peril. “The reason I lose sleep isn’t because of what I see, but more because of what I do,” she explains. “I don’t want to be wrong. There are implications if I don’t recognize the right signs or if I over interpret a situation. “I am meticulous about my work, so if someone is waiting longer than they’d like for my report, they’ll just have to keep waiting, because I am going to be certain of my recommendations before I move forward.”

Dr. Ornstein’s days are spent working with care teams at the IWK, looking into cases of potential abuse — while at the same time, developing and running programs that she hopes will prevent such abuse from ever happening in the first place. After completing her paediatric residency training, she completed a fellowship at Sick Kids in Toronto in the area of child abuse paediatrics. While the sub-speciality isn’t designated in Canada, Dr. Ornstein became sub-boarded with the American Board of Paediatrics, and tested with the first class of certified physicians in 2009. She has been medical director of the IWK Health Centre Child Protection Team for eight years. Her team includes three physicians, a clinical nurse specialist, social worker, therapist, and psychologist. “I was drawn to this speciality because it’s so multi-disciplinary in nature,” she says. “We always need to think outside the box with the unique challenges we are presented.”

Together, the team reviews cases that may involve physical, sexual or emotional abuse, neglect or exposure to family violence, and provides consultation to doctors in other areas of the province and beyond. Examples of children who may be referred to Dr. Ornstein are those who have an unexplained injury, like a broken bone or burn. “We don’t always make a diagnosis of child abuse. The most rewarding days are when there is another medical explanation and after looking at all the information we say, ‘I don’t think this was a child-abuse-related injury.’ ”

In her work, Dr. Ornstein sees the impact that abuse can have on the child and family, not only immediately afterward, but in the months and years that follow. This, she explains, is where her passion for her work comes from. “After seeing the same patterns of cases again and again, you can’t help but think that there must be a better way. Preventing abuse in the first place is the best outcome.” Through her research focusing on the importance of prevention, Dr. Ornstein identified a need to support new parents who may often feel frustrated and unprepared to deal with their new baby’s crying.

BabyThe Period of PURPLE Crying Program, which the IWK started to offer in February 2012, educates parents and caregivers about normal infant crying and healthy ways of coping. The ultimate goal is to prevent infant abuse. PURPLE is an acronym for the specific characteristics of infant crying. Every family who has a new baby at the IWK receives a DVD and booklet to watch and read in the hospital, then can ask a nurse any questions, and take the materials home. The IWK Auxiliary has provided financial support and also has collected purple caps, knitted and crocheted by volunteers throughout the Maritimes, so that every baby gets a cap as a reminder that their crying, though distressing, is a normal part of being a newborn. “We’ve had great feedback from families so far,” Dr. Ornstein says. “If this program helps just one family who is feeling frustrated and overwhelmed by their baby’s crying, I’ll be happy.”

When abuse does happen, it’s important to respond in a way that doesn’t cause further trauma to the child and family. That is the idea behind a major project underway to develop the SeaStar Child and Youth Advocacy Centre, the first centre of its kind in the Atlantic provinces. A small-scale trial version began at the IWK this fall. The vision is for SeaStar to ultimately deliver all of the services required to respond to an allegation of abuse or neglect in a more efficient and co-ordinated way that also is more child- and family-centred. This model provides the family and child with an advocate
to help them through the process, and puts the services all in one place. “We want this to be a comfortable place that’s easily accessible to families. As part of our project plan we also are looking to create a tool kit that other regions can use to create their own smaller satellite centres,” says Dr. Ornstein.

To read the full issue of Izaak Magazine visit www.iwkfoundation.org/izaak.

Make a gift to the IWK Foundation.


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