Child Advocacy and Assessment Program

CAAP provides medical assessments for children and youth when there is a concern for any type of possible maltreatment.

• Acute significant injury (e.g. bleeding, head injury, fractures, toxic ingestion, medical instability) – children with these types of concerns should be taken to the nearest emergency department immediately. In these cases, a CAAP referral can be made after the initial emergency department assessment by either a child protection worker or physician.
• Urgent concerns – urgent assessment for children who are generally well and there are concerns about current inflicted injury or acute sexual abuse. Acute sexual abuse is defined as known contact within the preceding 72 hours or current significant symptoms.
• Non-urgent concerns – this may include previous suspected physical abuse with no current injuries, concerns for neglect with possible medical manifestations, or concerns for historic sexual abuse (where the child is asymptomatic and last contact was more than 72 hours prior). These children can also be referred directly to CAAP by either a child protection worker or physician.
• Indirect consultations – with caregiver consent, child protection workers can contact CAAP with a request for indirect consultation by one of our pediatricians, such as a case discussion or a photograph review.

Child Maltreatment Medical Assessment Referral Form

The Social Pediatrics and Resiliency Clinic (SPARC) is an ambulatory clinic operated by the Division of Child Maltreatment at McMaster Children’s Hospital. The clinic is supported by CAAP physicians, nursing, child life and social work. The focus is on caring for children and youth with a history of exposure to maltreatment, who have medical, developmental, learning and/or behavioral needs, and who are not involved with other comprehensive health or developmental services. The target population includes children and youth with current child protection involvement. SPARC is not intended for children with acute health needs who require urgent assessment, or to replace a child’s primary care physician.

SPARC Referral Form

Case conferences offer virtual consultation to clinicians and agencies for complex patients who may have experienced or been exposed to maltreatment where the primary reason for consultation is not a physical medical assessment.

Case consultations involve a multi-disciplinary discussion with CAAP team members in order to assist the consulting team in conceptualizing the case and formulating a plan.

Case consultation may result in recommendation for assessment in SPARC or medical consultation.