APA SIG: Child Abuse | Filling the “CAP Gap”: Innovative Solutions to Providing Child Abuse Pediatrics Care to Resource-Limited Communities

Sunday, April 27, 2025

10:45am – 12:15pm HST

Location: Convention Center: 303

CE: 1.5

SIG Chair(s)

Henry Puls, MD

Associate Professor of Pediatrics
Children's Mercy Kansas City
Kansas City, Missouri, United States

Disclosure(s):

Henry T. Puls, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Since subspecialty formation in 2009, Child Abuse Pediatricians (CAP) have become a bridge between child health care and child welfare in most major population centers in the U.S. CAP consultation may improve accuracy of child abuse diagnosis and reliability of child abuse response through evidence-based evaluation and multidisciplinary engagement in their communities. Unfortunately, the demand for CAP evaluations far exceeds the CAP workforce, with only about 350 CAPs in the US, or 0.5 per 100,000 children, with some states having no CAP at all. A recent assessment by the AAP found that CAP remains the smallest pediatric subspecialty, with the lowest growth projections, and retention challenges. This reality may result in disparities in under- or over-diagnosis of child abuse on the basis of geography alone. Authors of a recent commentary in JAMA Pediatrics suggested that CAPs could “…expand their availability with supervised trained advance practice practitioners and fellows.” Easier said than done.

This session will explore innovative solutions for filling the “CAP Gap” in resource-limited communities. Presenters will share experiences with intensive training programs for community-based pediatric providers and implementation of robust telemedicine programs to improve access to CAP consultation. A Gen-CAP will share her experiences with expanding child abuse medical services and collaborating with local agencies in a rural Intermountain community. Finally, we will host an interactive panel discussion of opportunities to improve CAP engagement with clinicians working with rural populations across the U.S., including unique legal, cultural, and financing barriers to providing evidence-based, collaborative care in these settings.

Learning Objectives:

Identify core components to a child maltreatment training curriculum for general pediatric practitioners, namely curriculum development, recruitment, and maintaining ongoing remote support/collaborations.
Identify unique elements of telemedicine implementation in child abuse pediatrics, including concerns for comprehensive evaluation in community settings, confidentiality protections, and legal concerns.
Identify clinical, financial, and cross-sectoral collaboration challenges when incorporating expanded child abuse pediatrics services into under-resourced communities in their regions.

Presentations:

10:45am – 10:50am HST

Introduction
SIG Speaker: Henry T. Puls, MD – Children's Mercy Kansas City
10:50am – 11:25am HST

Building, Recruiting, Training, and Supporting a Network of General Pediatricians to Expanded Child Abuse Services
SIG Speaker: Kristine A. Campbell, MD, MSc (she/her/hers) – University of Utah School of Medicine
11:25am – 11:50am HST

Telemedicine as an Innovated Solution for Filling the “CAP Gap” in Resource-limited Communities
SIG Speaker: Natalie Laub, MD – University of California, San Diego School of Medicine
11:50am – 12:15pm HST

Experiences Providing Child Abuse Expertise as a General Pediatrician in Resource Limited Settings
SIG Speaker: Louisa Mook, MD (she/her/hers) – Wind River Family and Community Health Center