Did you know that a report of child abuse is made very 10 seconds? We never want to believe that child abuse can happen to us or our children, but the reality is that the chances are more than we believe. TWL Working Moms has interviewed health professionals from Providence Health Care to help keep you informed on child abuse, what are the signs, and what to do when it happens. Statistically 1 in 3 girls and 1 in 7 boys will be sexually assaulted by the time they reach 18. Those are some scary statistics. We need to be prepared with what to do in case this ever arises in our own home with our children.
Read on to see specifically designed questions for our moms out there and answers from knowledgeable health officials from Dr. Joyce Gilbert, the Medical Director of the Providence St. Peter Sexual Assault Clinic and Child Maltreatment Center in Olympia.
Children exposed to drugs
What do health professionals do once they identify an infant exposed to drugs during pregnancy?
Dr. Gilbert: When health professionals in a hospital setting are aware of a history of prenatal drug exposure, we obtain a urine drug screen on the mother, and a urine drug screen as well as a sample of the umbilical cord on the baby when it is born. The urine drug screen will identify the most common drugs of abuse in the system during the past 72 hours; the umbilical cord will identify 13 different drugs of abuse that were used any time after 24 weeks gestation by the mother. In the hospital we have our social worker involved with the family and set them up with any community resources not already in place. If we obtain a positive urine or cord toxicology on the baby a referral to CPS is made for the assessment of the safety of the baby and the environment the baby will be discharged to.
What information can you provide to teachers about how to stop child abuse?
Dr. Gilbert: Teachers receive considerable training during their education about normal development and safety of children. The staff at any school are aware of many of the needs of the children in their building and work closely with those families. Recognition of child abuse and child neglect is not the issue; supporting the families and the educators as they help these children is a community process. Many children live in homes with few resources, unavailable adults, violence and drug use. The teachers and school are their safe place. Teachers and all school personnel who establish a relationship with the child are building that child’s resilience, so the child is better equipped to survive outside of the school setting.
Types of Trauma
Can you give some examples of what is considered trauma for children?
Dr. Gilbert: Trauma can be a move, a divorce/separation/death of a parent or primary caregiver, physical abuse, sexual abuse, food insecurity, exposure to violence at home or in the near environment—anything that makes the child feel unsafe or uncared for.
When trying to adopt children, can you give some tips or advice to families in the process?
Dr. Gilbert: Every child deserves a safe, nurturing caring adult(s), a safe home with adequate food and clothing, and developmental stimulation. Every child who will be adopted has some baggage—something has happened to put them in the position to need to be adopted. The family needs to have as much knowledge as possible about the child’s past traumas. The family needs trauma education so they can provide nurturing in a manner that supports the child at each stage of their development. The family needs support from community agencies and counselors/therapists to assist both the child and the family in working towards harmony and understanding. The family needs to be committed to provide all the support and structure each child needs to succeed. The family must advocate for their children in all arenas—school, public places, sports, etc.
Living in a toxic environment
Can you give some advice to mom’s who live in toxic situations and ways to get help?
Dr. Gilbert: The mother has to recognize she is in a toxic situation. She then has to be able to ask for help and be able to get her children to safety. This may seem so simple, but these are the hardest steps for a woman to take. Once she is able to ask for help, there are many community resources that can be put into action to keep her and her children safe. CPS and law enforcement, safe homes and shelters, food banks and clothing banks, schools and churches are all willing to support a family in crisis.
Where you can get help
Where can women who have been sexually abuse go for help? What options do they have for getting help?
Dr. Gilbert: An acute sexual assault can be reported to law enforcement, and the woman should have a medical exam at the closest hospital staffed by SANE nurses. A SANE (Sexual Assault Nurse Examiner) can provide medical evaluation and treatment for any injuries that occurred, and prophylactic medications to prevent infections. A SANE has specialized training in collecting forensic evidence to aid law enforcement in their investigation of a crime. This is done voluntarily if the woman desires to make a police report. If a woman is disclosing sexual abuse that has occurred in the past, she will need to be believed and supported in this disclosure process. All women who have experienced a sexual assault should have a relationship with a counselor/therapist for ongoing needs.
Was your child abused? Now what do you do
If you suspect that your child might have been sexually abused, what are the steps you need to take?
Dr. Gilbert: Most importantly, when the child makes a disclosure they should be believed. If a parent or caregiver is concerned about sexual abuse, the adult should seek assistance with their family and potentially the child’s medical provider. Warning signs of possible sexual abuse are very similar to the warning signs of any trauma that is affecting a child and can be found on the website “National Child Traumatic Stress Network”. Sexual abuse of a child at any age is a crime and must be reported to law enforcement. If the child is in an unsafe environment, CPS should also be involved. The child may need a forensic interview and a medical exam, which should be completed at a Child Advocacy Center.
How you can protect your child
Please provide tips you can give moms on how to protect their children from being abused.
Dr. Gilbert: The adult educational program called “Stewards of Children, Darkness to Light” is a thorough program to educate adults on how to recognize the warning signs of child sexual abuse and what to do when those signs are present. This program is facilitated by trained personnel and is presented in many communities nationwide for free. I always recommend that a parent trust their intuition/their gut—if they see something or something does not seem right, they should act on it or intervene. Parents need to be vigilant about what their children are exposed to in any and all environments. The relationship a parent has with their child will be the best way for the parent to know if something is not right.
I want to get involved and help
If you are interested in getting involved and helping in your local community, please tell us, how can people get involved and help?
Dr. Gilbert: Communities need passionate people about child safety. Volunteering where children are to keep them safe—schools, YMCA’s, camps and clubs, sports, churches, etc. Children need relationships with safe and caring adults throughout all of childhood—a child is never too old to have an adult around who truly cares about them and supports them.
Why was this your career path choice?
With everything involved in this career, what made you want to get into this field?
Dr. Gilbert: Early in my career as a pediatrician I became passionate about child safety. I have attended many trainings about child abuse; I present many trainings about the effects of trauma on children. Every child has the right to grow up safe, loved and nurtured. My goal is that we see that every child has what they need, and that when we become involved in their lives “the trauma ends, and the healing begins”. We now have the scientific knowledge and the ability to change the trajectory of a child’s life if we utilize trauma informed care. The future looks better every day!
Don’t hesitate to call, 1-800-4-A-CHILD (1-800-422-4453) https://www.
After having an amazing interview with Dr. Joyce Gilbert, we hope that you are better prepared for the future wellbeing of your children. Like we said before, we may never think something like child abuse will happen to our families, but we need to be prepared. With this statistic, more than 90% of child sexual abuse victims know their attacker, it is really important as a parent that we stay visual and advocates for our children. With these tips we can ensure that we are staying involved with the health of our children. Providence clinic covers the 5 counties of Thurston, Mason, Lewis, Grays Harbor, and Pacific Counties. The other counties listed are covered by the Salmon Creek Clinic in Vancouver.
Dr. Gilbert Bio
Dr. Joyce Gilbert grew up in the Denver and Chicago areas. She attended medical school and completed her Pediatric Residency training at the University of Iowa. She then spent 30 years in a primary care pediatric practice in Sandpoint, Idaho. Also, she cared for children from birth to age 18. While practicing in this small community, Dr. Gilbert received countless referrals from the local physicians for potential child physical abuse, sexual abuse, and neglect. She attended frequent trainings and seminars to become proficient in the diagnosis and management of abuse. She worked closely with Child Protective Services, law enforcement agencies, and the prosecutor’s offices in the two northern counties of Idaho and was an active member of the Bonner County Multidisciplinary Team (MDT). She also became involved in the statewide Drug Endangered Children (DEC) program, and gave presentations in both state and national arenas, including a DEC presentation to FBI trainees. She was instrumental in initiating the screening process at the local hospital to identify infants exposed to drugs of abuse during pregnancy.
Dr. Gilbert is passionate about understanding appropriate interventions for the best outcome in cases of child abuse. In Idaho, she collaborated with the mental health agencies in her community to provide education to the public around Adverse Childhood Experiences (ACEs) and toxic stress of children. Along with a trauma therapist, she was able to present scientific information and best practice techniques to every elementary school in Bonner County, with hands on involvement for educators to provide immediate care to children with trauma behaviors in their classroom.
In 2014, Dr. Gilbert had the distinct honor of being chosen as the Medical Director of the Sexual Assault Clinic and Child Maltreatment Center at Providence St. Peter Hospital in Olympia. This clinic serves five counties, providing both urgent and non-emergent medical interviews and physical examinations for any child up to 18 years of age who may have been physically or sexually abused. The clinic also provides SANE nurses for the medical care and collection of forensic evidence for adolescent and adult sexual assault victims at Providence St. Peter Hospital, Providence Centralia Hospital and Madigan Army Medical Center on Joint Base Lewis McChord. Dr. Gilbert is an active participant in the MDTs of Thurston County, Lewis County, Mason County, Pacific County, and Grays Harbor County.
Dr. Gilbert, with the support of the Providence system, has continued outreach education in the 5 counties she serves as well as throughout the State of Washington. At the last count over 2500 educators, more than 500 medical personnel, and countless community members have attended her presentations on ACE’s and recognizing child abuse.
Lastly, Dr. Gilbert understands childhood trauma from a variety of perspectives. She has maintained an active foster care license for 15 years, specifically for medically needy/severely trauma affected children. Gilbert has 5 adopted children herself: one from an international orphanage, two severely neglected and traumatized children for whom she provided daily trauma therapy, and one medically fragile child. These years of experience and expertise have made her even more passionate regarding the care of the most vulnerable.