Press Room

June 4, 2018

Pediatric Practices to Start New Interventions to Prevent Repeat Child Abuse


AG DeWine, OCHA, Ohio AAP announce third phase of Ohio children’s hospitals’ collaboration

June 4, 2018

COLUMBUS, Ohio –Today Ohio Attorney General Mike DeWine and the Ohio Children’s Hospital Association (OCHA) announced a new collaboration to further spread interventions and findings to reduce the occurrence of child abuse in infants six months and younger by enlisting pediatric practices.

Eight large pediatric practices across Ohio, representing more than 30,000 patients and families and recruited through a partnership with the Ohio Chapter of the American Academy of Pediatrics, will be joining children’s and community hospitals in implementing proven interventions to identify potential signs of abuse and prevent further abuse in Ohio’s youngest and most vulnerable children.

Ohio Attorney General Mike DeWine funded the Timely Recognition of Abusive Injuries (TRAIN) Collaborative with a $1 million grant from settlement funds to OCHA in 2015. The purpose of TRAIN is to prevent repeat child abuse in the most vulnerable population, infants six months and younger.

The TRAIN Collaborative analyzed what the medical community refers to as “sentinel injuries.” Sentinel injuries are minor injuries known to the medical provider that should prompt concern that the child is being abused. Unfortunately, sentinel injuries are often missed by medical providers placing the infant at risk for further abuse. The TRAIN Collaborative identified the specific injuries that should be suspect and developed a specific process – or “bundle of care” that reduces repeat instances of child abuse.  If a medical provider discovers a sentinel injury, they use the prescribed “bundle,” to assist in the identification of abuse and to ensure the infant receives appropriate follow-up care. The “bundle” includes a skeletal survey of the infant, psychosocial assessment of the caregivers and pediatric consultation.

In 2016, children’s hospitals in Ohio determined that one in 10 Ohio children seen for child abuse has been seen previously with a sentinel injury and less than one in three receives the necessary physical examination and follow-up. They worked together to create and test the “bundle” within their own hospitals, and then spread the process to 19 community hospitals across the state. This third phase will teach 8 pediatric practices about the “bundle” and help them implement it within their practice.

“We have some of the best minds in pediatric healthcare in the country right here in Ohio. I am proud that we could bring these minds together to identify a proven process to help children who are too young to understand their injuries or even to speak for themselves,” said DeWine. “Spreading this important process to more pediatricians throughout Ohio will mean more children are spared from further abuse – and that has been my goal with this program from day one.”

The learning here in Ohio has been spread beyond the state’s borders, as leaders from TRAIN have been asked to present their findings at national conferences, including the Court Appointed Special Advocate/Guardian Ad Litem conference.

“Attorney General DeWine has always been a strong advocate for Ohio’s children, and this initiative would not have been possible without his commitment and support. We are grateful to be able to take our learning into a third phase to spread this valuable process even further in our state and beyond,” said Nick Lashutka, President and CEO of OCHA.

More information about TRAIN is available at


Contacts:  Ohio Attorney General Mike DeWine’s Office: Lisa Peterson: 614-466-3840;  Ohio Children’s Hospital Association: Angela Krile, 740-974-3948,,  T: @angkrile