Child abuse screenings at the doctor's office

[Perks]

I took my twelve year old to the pediatric orthopedist today for an evaluation for her scoliosis. Once in the exam room, a nurse came in with another woman in different colored scrubs (all the regular nurses wore blue scrubs, and this woman was in burgundy) and informed me that they had a new policy of asking the child a series of questions each time she came in to see the doctors.

She turned to my daughter and asked:

- Do you feel safe at home?

- Do you feel sad a lot?

- Do you have trouble sleeping?

- Do you have thoughts of harming yourself or others?

- Do you eat three meals a day?

- Is there food available when you're hungry?


Obviously, the questions relate to abuse and depression. I applaud all efforts to help kids who suffer. And since it's an orthopedist's office, they are going to see a greater number of kids with injuries and growth anomalies, so attempting to weed out accident from intent or neglect makes sense.

But I kinda couldn't figure out what they hoped to get from asking those questions with the parent present. So I was wondering if they weren't watching for things like the kid checking her parent's face before answering, and maybe watching the parent for reaction (maybe that's why they need two people in the room for that evaluation?) and maybe even just asking the question so that it puts a touchstone in the kid's mind for later, if she thinks she need help, that she'll have an idea of a place to start.

Anybody have anything other than guesses on this?

 

[SWest]

...


- Do you feel safe at home?

- Do you feel sad a lot?

- Do you have trouble sleeping?

- Do you have thoughts of harming yourself or others?

...

I could have answered all those questions how I knew I *should* have face-on, convincingly, at an early age. My mother would have been passive and unruffled.

Maybe you can catch a few Kid Monsters that way, but not many. IMO.

 

[soapdish]

So I was wondering if they weren't watching for things like the kid checking her parent's face before answering, and maybe watching the parent for reaction (maybe that's why they need two people in the room for that evaluation?) and maybe even just asking the question so that it puts a touchstone in the kid's mind for later, if she thinks she need help, that she'll have an idea of a place to start.

Anybody have anything other than guesses on this?

I think that both of your guesses are correct. More so the second thing.

If this is the first time they've asked, and she's 12?, then they could be trying to prep her (and you?) for the kinds of things they'll be asking her when she turns 13 and becomes more responsible for herself. It might be scary to be questioned like that without a parent around the first time. The way it works with our doctor's office is that at 13 they are expected to be more responsible for her own body in the doctor's office. Parents don't have to come in with them. Questionnaires should be filled out by the child and not the parent, and really with no help from the parent. And certain things like their online medical info is not visible (and is password protected, I think) to the parent anymore. Around 12 yrs old they start prepping the kid for this stuff, having them practice doing things on their own etc. Could it have something to do with this, I wonder?

 

[Perks]

I think that both of your guesses are correct. More so the second thing.

If this is the first time they've asked, and she's 12?, then they could be trying to prep her (and you?) for the kinds of things they'll be asking her when she turns 13 and becomes more responsible for herself. It might be scary to be questioned like that without a parent around the first time. The way it works with our doctor's office is that at 13 they are expected to be more responsible for her own body in the doctor's office. Parents don't have to come in with them.

Yeah, this is the first time they've asked that sort of thing, but what you're saying makes sense.

 

[heza]

But I kinda couldn't figure out what they hoped to get from asking those questions with the parent present. So I was wondering if they weren't watching for things like the kid checking her parent's face before answering, and maybe watching the parent for reaction (maybe that's why they need two people in the room for that evaluation?) and maybe even just asking the question so that it puts a touchstone in the kid's mind for later, if she thinks she need help, that she'll have an idea of a place to start.

soapdish seems to know a lot about it.

For what it's worth, I was once evaluated that way for spousal abuse. I'd been playing with my dog and she bonked me in the head, hard. I could barely walk, I couldn't form coherent sentences, so my husband rushed me to the ER. By the time we got there, the side of my face was blue and had swelled up huge. The doctor asked me what had happened, and I paused and then looked to my husband, who answered for me. The doctor immediately sent my husband out of the room to "fill out paperwork" and started asking me a bunch of questions. When I started just answering with random words, he realized what was going on and let my husband back in to communicate for me.

 

[Pup]

I've had to go to doctors a lot over the past year, and oddly enough, in the last few months they've started asking similar questions on a routine form at the start of each visit, very similar even across different practices. These are oncology visits for a middle age person, so it seems as if it might be tied to some sort of larger regulation or policy change.

"Do you feel safe at home?" is identical. I didn't even understand it and after a few times, asked what they meant. Was I worried about tripping on throw rugs or slipping in the shower? Was I worried about being burglarized? One nurse explained it had to do with family abuse which had never occurred to me. Then there are other questions, something about worry or distress, and similar things, then a more logical list covering appetite, constipation or diarrhea, actual potential symptoms like that.

No doctor has ever referred back to my answers. It feels like something forced or recommended by a higher power. Don't know if it's related, but it seems more than coincidence that there would be a new policy within the last few months at different locations, with at least one identical question for both children and adults.

 

[Write_At_1st_Light]

That is odd, Perks. I suppose it could be a CYA maneuver on their part, for legal reasons. Unusual that they'd ask these leading questions on abuse, with a parent right there in the room! If they expect veracity from the child's answers, I'd think you would not want the guardian(s) present. Rule # 1 when you are the recipient of child abuse and you feel completely helpless: Always protect the abuser. Always.

 

[Perks]

soapdish seems to know a lot about it.

For what it's worth, I was once evaluated that way for spousal abuse. I'd been playing with my dog and she bonked me in the head, hard. I could barely walk, I couldn't form coherent sentences, so my husband rushed me to the ER. By the time we got there, the side of my face was blue and had swelled up huge. The doctor asked me what had happened, and I paused and then looked to my husband, who answered for me. The doctor immediately sent my husband out of the room to "fill out paperwork" and started asking me a bunch of questions. When I started just answering with random words, he realized what was going on and let my husband back in to communicate for me.

Ha! That happened to me once, too. I had switched off the bathroom light on my way to bed and I guess my pupils didn't dilate fast enough, because I thought I had cleared the door, but instead, full steam ahead, I walked right into it and split my lip.

The next day, we were party to a bicycle accident involving a drunk guy on a bike on a Sunday morning, who ran into my bike on a trail. I was fine, didn't even fall over, but the guy busted his head and was being hauled off for DUI. (I didn't know you could get a DUI on a bicycle.) After all the fuss, the cop gave my husband a dark look and asked me if I was okay. I said, "Oh yeah, I'm fine. I didn't even fall over when we crashed." "No," he said, looking over at my husband again. "Are you okay." I had to think about it for a second. "Oh! Oh, this?! I walked into a door."

The cop looked so disappointed in me. Big sighs of regret with a tinge of disgust for my situation. My poor husband had no idea what was going on. "Wait. What just happened?"

Lol!

 

[soapdish]

soapdish seems to know a lot about it.

Heh. Well, actually I don't know much for certain, I've yet to have a 13 yr old and go through these changes in their medical care. But I'm close. And the doctor keeps sort of...warning(?) me that changes will be coming when the kid turns 13. I'm not sure what to make of it really.

I've had to go to doctors a lot over the past year, and oddly enough, in the last few months they've started asking similar questions on a routine form at the start of each visit, very similar even across different practices. These are oncology visits for a middle age person, so it seems as if it might be tied to some sort of larger regulation or policy change.

I have a feeling it's something to do with this, yep.

"Do you feel safe at home?" is identical. I didn't even understand it and after a few times, asked what they meant. Was I worried about tripping on throw rugs or slipping in the shower? Was I worried about being burglarized? One nurse explained it had to do with family abuse which had never occurred to me.

Exactly! I wonder if they pose these questions to the kids with the parents in the room so that the kid who ISN'T being abused has a chance to ask their parent (whom they trust and confide in) what the Dr. meant by that, to alleviate any confusion or scariness about it.

It feels like something forced or recommended by a higher power. Don't know if it's related, but it seems more than coincidence that there would be a new policy within the last few months at different locations, with at least one identical question for both children and adults.

Yep. Which doesn't make me feel exactly like it's coming from the heart, or even the right place, but..it's a start, I guess. It gets kids and parents talking maybe.

 

[regdog]

I've been asked those questions for years at my doctor's and my Aunt is asked as well.

 

[Pagey's_Girl]

My mom was recently in the hospital and then in rehab for a week - she has osteoporosis and had a minor, but painful, pelvic fracture. (It sounds scary, but it's pretty common, from what her orthopedist said. And she's fine now.) She mentioned the nurses repeatedly asking her the same sort of questions.

We also had a physical therapist come out to the house a couple of times. She sent me out of the room on some small errand the first visit and I overheard her going through the same list of questions. Given some of the elder abuse horror stories I've heard, it's good that they're looking out.

Like I told the therapist, the problem isn't getting my mom up and active - it's getting her to STOP being active and relax. She's in her eighties and has more energy than I do.

ETA - She didn't fall - but they kept asking "How did you fall?" and seeming not quite convinced by the response "I didn't." I kept pointing out that she lives with me and I would have known if she had. I think that was also setting off some alarm bells.

 

[heza]

"Oh! Oh, this?! I walked into a door."

Likely story....

My relative actually got that last year. She broke her arm doing something... risque, let's say. But she didn't want to explain that at the ER, so she kept saying she "fell down the stairs," which just made everything worse. And her husband was all, "STOP SAYING THAT!" Lol.

ETA - She didn't fall - but they kept asking "How did you fall?" and seeming not quite convinced by the response "I didn't." I kept pointing out that she lives with me and I would have known if she had. I think that was also setting off some alarm bells.

During the same dog-induced concussion, my insurance company kept doing something similar. They kept sending me workman's comp-ish type forms, insisting that I fill them out and explain exactly how I'd gotten this "on-the-job" injury. And I kept trying to tell them what happened and that I'm not employed by my dog. But they just kept on and kept on. Took forever to get them to drop it and pay the claim.

 

[juniper]

I've had to go to doctors a lot over the past year, and oddly enough, in the last few months they've started asking similar questions on a routine form at the start of each visit, very similar even across different practices.

No doctor has ever referred back to my answers. It feels like something forced or recommended by a higher power.

It's part of triage at my job. The triage nurse - the one asking the initial questions and getting medical history - has them as part of the long list of questions to ask.

The doctors here only get involved when there's an answer that's not expected - "Do you feel safe at home" - NO. That would open up another set up questions about domestic violence.

Likely story....

My sister actually got that last year. She broke her arm doing something... risque, let's say. But she didn't want to explain that at the ER, so she kept saying she "fell down the stairs," which just made everything worse.

Yeah, we get that "fell down the stairs" a lot. If there isn't any other indications of problems - alcohol / drugs withdrawal etc, or an assault - then it just passes. Amazing how many people "fall down the stairs." The real reasons are probably much more colorful.

 

[Fruitbat]

I think their guidelines get changed periodically. I'm guessing the guidelines du jour are to ask these questions and you were allowed to stay in the room because they didn't suspect anything but were just filling in the blanks. Now if your child had given an answer that raised red flags, they'd probably have sent you out of the room and questioned the child in more detail.

 

[Gilroy Cullen]

Yeah, we get that "fell down the stairs" a lot. If there isn't any other indications of problems - alcohol / drugs withdrawal etc, or an assault - then it just passes. Amazing how many people "fall down the stairs." The real reasons are probably much more colorful.

I think it was TLC that's created a unique show related to some of those "falls." Hysterically funny show -- Sex Sent Me to the ER.

 

[regdog]

My relative actually got that last year. She broke her arm doing something... risque, let's say. But she didn't want to explain that at the ER, so she kept saying she "fell down the stairs," which just made everything worse. And her husband was all, "STOP SAYING THAT!" Lol.

I think it was TLC that's created a unique show related to some of those "falls." Hysterically funny show -- Sex Sent Me to the ER.

They did.

Your relative should have said there'll be a video uploaded to the internet and it's $79.99 credit card required.

 

[calieber]

Obviously, the questions relate to abuse and depression. I applaud all efforts to help kids who suffer. And since it's an orthopedist's office, they are going to see a greater number of kids with injuries and growth anomalies, so attempting to weed out accident from intent or neglect makes sense.

But I kinda couldn't figure out what they hoped to get from asking those questions with the parent present. So I was wondering if they weren't watching for things like the kid checking her parent's face before answering, and maybe watching the parent for reaction (maybe that's why they need two people in the room for that evaluation?) and maybe even just asking the question so that it puts a touchstone in the kid's mind for later, if she thinks she need help, that she'll have an idea of a place to start.

Anybody have anything other than guesses on this?

When I last went to the ER (I had fallen in the street and needed a tetanus shot) they asked me if I felt safe at home etc. with my partner right there. They asked me again later when she was not.

For what it's worth, I was once evaluated that way for spousal abuse. I'd been playing with my dog and she bonked me in the head, hard. I could barely walk, I couldn't form coherent sentences, so my husband rushed me to the ER. By the time we got there, the side of my face was blue and had swelled up huge. The doctor asked me what had happened, and I paused and then looked to my husband, who answered for me. The doctor immediately sent my husband out of the room to "fill out paperwork" and started asking me a bunch of questions. When I started just answering with random words, he realized what was going on and let my husband back in to communicate for me.

Said partner has also told me about a time she went to the ER and her then-husband was insulted that they asked him to leave when they asked her those questions.