Kids Day

Rising cases of horrific abuse push Valley Children’s Hospital to increase care

Dr. Philip Hyden has seen a lot over nearly 30 years of treating abused children, but nothing like what is happening to kids in the Central Valley.

“I’ve lived in New York City; I’ve lived in L.A.; I’ve lived in Hawaii; I’ve lived in Denver; I’ve lived in Florida and Illinois,” he says, “and I’m telling you that the amount of time I’ve been here and the amount of cases I see per year is bewildering. It’s just overwhelming, what I see.”

And Hyden, who took the helm of The Guilds of Valley Children’s Hospital Child Abuse Prevention and Treatment Center in 2010, says he has seen “everything you can think of.”

“I’ve seen children sold for sex that are less than a year old. I’ve seen children sold for drugs. … I’ve seen kids tortured, tied in garbage bags, deprived of food to where they are actually skeletal, multiple contusions on them like hanger marks and extension cord marks, burns from cigarettes and other objects … burns from hot water and flames.”

These horrors are behind Valley Children’s recently expanded child abuse program. Officials say that of 483,000 reports of suspected child maltreatment made in California in 2013 – the most recent data available – 90,000 came from areas traditionally served by the hospital.

Many victims previously were sent to other facilities before Hyden joined Valley Children’s in 2010. His arrival marked the beginning of a new program with staff solely focused on evaluating and treating abused children. The work is largely funded by a $5 million endowment awarded by guilds that raise money for the hospital. The $5 million goal set in 2009 was reached last year.

The number of abused children seen at Valley Children’s continues to grow. The year before Hyden’s arrival, the hospital saw 159 abused children – 65 of them hospitalized for more severe injuries. Last year, the child abuse prevention and treatment center saw 974 children – 135 requiring hospitalization.

Hyden credits the growth to expanded services, along with a growing awareness of these services, but added that it “doesn’t look like child abuse is decreasing in the Valley at all.”

Hyden says four or five abused children who were treated at Valley Children’s die each year, on average.

“It may not sound like that many,” Hyden says, “but I remember every one of them.”

He often looks to words that sit in a frame on his desk:

“A hundred years from now it will not matter what my bank account was, the sort of house I lived in, or the kind of car I drove. But the world may be different because I was important in the life of a child.”

The title of this, printed in large, bold letters: “PRIORITIES.”

More tortured children, drug abuse

While cases of abuse in the Valley are not so unique, Hyden says, “the frequency of them appears to be more.”

“I’ve seen more tortured kids here. I’ve seen more children here that are failure to thrive, only due to the lack of diet or nutrition. It’s not because they don’t have the ability to feed the children. It’s either the knowledge or the bonding or the care is lacking in some of these parents.”

Alongside Hyden, who serves as medical director, the center employs a nurse practitioner, social worker, medical liaison, program coordinator, part-time nurse practitioner and two part-time nurse examiners. Someone is available at all hours for emergency evaluations and treatments.

Drug use is often connected to the abuse they see.

“I’ve never seen so many cases connected to someone in the family using methamphetamine. … The other thing that goes along with methamphetamine is the socioeconomic factor, generally poverty that we see in a lot of our families. The level of poverty in the Valley seems higher than anywhere else I’ve ever lived,” Hyden says.

Hyden and his staff treat abused children for things like sexually transmitted diseases, and connect victims with other specialists and services. They follow-up with victims – with appointments continuing for at least a year for children exposed to drugs.

“We not only are a clinic that sees kids that are abused both physically and sexually, but also neglected in all kinds of ways. We see kids that have been emotionally neglected, children that are failure to thrive because they haven’t had enough to eat at home. You’ll see parents come in and there is no social bonding with the children.”

Hyden says they sometimes see toddlers with internal bleeding from organs that are lacerated, fractured and ruptured, although the child may not have bruises on the outside of the body. Fractured bones from being squeezed and shaken is also common, and head trauma is the most common cause of death for infants.

A precursor to the child abuse prevention and treatment center was a Suspected Child Abuse and Neglect Team, formed in 2000 to better identify, monitor and intervene in cases of child abuse seen at the hospital. It’s comprised of members who work in the fields of medicine, social work, psychology, child protection and law enforcement.

The networking continues. Hyden and his staff serve as community educators, provide medical evidence to investigators, and testify at no cost in dependency and criminal court regarding child abuse cases. Most of the children seen at the center are referred by Child Protective Services across more than 10 counties.

“I really deal with the case workers and law enforcement, especially the detectives, quite frequently,” Hyden says. “Many of them have my cellphone number.”

Sgt. Clayton Smith, supervisor of the Fresno Police Department’s Child Abuse Unit, says Hyden and his staff are “without question” a great support to investigators by providing expert medical opinions about injuries that appear non-accidental.

The Police Department conducted investigative reviews on 923 reports of child abuse in Fresno last year and 531 reports of sexual assault against a child. Of those, Smith says 71 child abuse cases and 343 cases of sexual assault against a child were extensively investigated.

Smith says Hyden and his team are “very professional, knowledgeable and experienced” and go “above and beyond” to provide the best care for victims.

‘We all have a responsibility to protect children’

On average, Hyden says more than 100 children that his center sees each year are also hospitalized for their injuries.

Child life specialist Marian Facciani sees many of these children in Valley Children’s pediatric intensive care unit. She says she has seen “everything and anything you can think of” throughout 35 years with the hospital.

“It’s things you can’t even fathom. … To be honest with you, those are the things I try my hardest to put out of my head, because I don’t want to remember it.”

She says parents’ lack of knowledge about normal child development can lead to abuse. For example, when a toddler throws something off a high chair 25 times, the child isn’t “being bad,” she says, the child is just “practicing gravity.”

“And there’s a lot of modeling of bad behavior, too: ‘Well, my mom slapped me, so why can’t I slap them? I survived!’” Facciani says. “Yeah, but maybe you don’t have all the brain cells you are supposed to have.”

Hyden also believes more education is crucial in curbing the problem.

“I believe a lot of parents that commit child abuse don’t really mean to get the results that they get. I think they are angry and frustrated and have low impulsivity, and they do things that they deeply regret.”

Hyden and Facciani say more people should be aware of child abuse, intervene and report it.

“What we see here is the worst,” Facciani says, “but it goes on every day. … We all have a responsibility to protect children.”

Carmen George: 559-441-6386, @CarmenGeorge

Reporting child abuse

Report child abuse by calling 911 or law enforcement. In Fresno County, there is also the Child Protection Hotline: 559-600-8320. The Guilds of Valley Children’s Hospital Child Abuse Prevention and Treatment Center can be reached at 559-353-6022.

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