Suspected Trauma and Abuse Response Team (START)
A voice for children
The IWK Health Centre Suspected Trauma and Abuse Response Team (START) is a hospital-based, child-focused team. When allegations or concerns of physical, sexual, emotional abuse or neglect of a child are identified, we work hard to provide compassionate and rapid assessment, management and treatment.
Although we’re separate entities, we work closely with community child protection agencies like the Department of Community Services (DCS) and the Children's Aid Society (CAS). It’s our role to provide comprehensive care for suspected and confirmed victims of child abuse and neglect, and to their families, through direct service, consultation, advocacy, education, collaboration and research.
We provide a range of services aimed to help children who are suffering from abuse. These include:
- reviewing all cases of actual and suspected child maltreatment presenting to the IWK
- consulting on medical examinations of children suspected of having been maltreated
- educating physicians, nurses and other professionals with regards to child maltreatment
- collaborating with local, provincial and federal committees and agencies organized to prevent, investigate and deal with the issue of child maltreatment
- running treatment groups for individuals impacted by child maltreatment
What do I do if I suspect child abuse?
If you become aware that a child is being abused, you’re legally required to report it. If you don’t—even if it’s only suspected—it’s a punishable offence. The duty to report also overrides patient confidentiality.
If you are at all concerned that a child has been or is at risk for abuse, you need to report it immediately to the child protection agency serving the community where the child usually resides.
Contact information for child protection agencies by province:
The agency will determine if and when to involve the police. When appropriate, it is the mandate of the child protection agency to conduct an investigation.
What’s the difference between START and a Child Protection Agency?
The IWK START has no legal authority, and cannot remove children from their family or investigate concerns of child maltreatment. We work in collaboration with child protection agencies by providing a comprehensive assessment of children. If you call START, you are still legally obliged to contact a child protection agency.
What happens if I refer a patient to START?
Each case is reviewed and prioritized using information provided by the referral source. Some children may require a medical examination, some may require medical evaluation and others may not require a visit to the IWK Health Centre at all.
When we assess a child, we also write a consultation report for the referring physician or social worker. A copy of the report is also kept in the child's medical chart.
If a child is referred for psychotherapy, we’ll gather relevant information during the initial telephone contact. Any referrals that require follow-up will be added to the wait list.
START members do not assume that all children referred have been maltreated.
The following links may be helpful if you’re looking for more information:
- Avalon Sexual Assault Centre
- Nova Scotia Youth Help Line: 1-800-420-8336
- Adsum House (for women)
- Bryony House (for women and children, victims of family violence)
- Phoenix Centre for Youth (for homeless youth)
- Nova Scotia Department of Community Services
- Family and Community Services of New Brunswick
- PEI Child and Family Services
Maltreatment statistics/definition of maltreatment
- APSAC (American Professional Society on the Abuse of Children)
- ISPCAN (International Society for the Prevention of Child Abuse & Neglect)
- Child Welfare League of Canada
- National Center of Shaken Baby Syndrome (USA)
Resources for parents/caregivers
- Child Trauma Institute
- American Academy of Child and Adolescent Psychiatry
- Canadian Paediatric Society
Child maltreatment conferences
Amy E. Ornstein, MDCM, MSc, FRPC, FAAP
Robyn McLaughlin, MD, FRCPC
Alfhild Larson, MD, FRCPC
Donna Best, BAASW, RSW
Shireen Singer, MSW, RSW
Kathy Bourgeois, MSW, RSW
Clinical nurse specialist:
Angela Arra-Robar, RN MSN
Kathryn Copp (administrative assistant)
Christina Shaffer (project coordinator)
Getting in touch
Before you send a child to the IWK Health Centre to see START, be sure to call ahead to prevent unnecessary waits for the child and their family. Whenever we can, we’ll arrange to have the child assessed the same day. If the request is not urgent, we’ll set an appointment up as soon as possible.
If you’re a physician or other professional (child protection personnel or school personnel), you can refer a child for a medical examination or psychotherapy by contacting our intake social worker.
During regular office hours: 902-470-8222
After office hours: 902-470-8888
Urgent, after-hour referrals:
Please bring the child directly to the IWK Emergency Department for urgent, after-hours assistance. Signs that urgent assistance is required include:
- a child with a changed level of consciousness
- any injury needing immediate treatment
- acute sexual assault
- severe emotional distress in a child or family following disclosure of abuse