Addressing the Long-Term Health Consequences of Childhood Abuse

Ariel Ward

Mary Hale

Mary Hale is the Director for Safety Net Clinics, Director of the Inova Ewing Forensic Assessment and Consultations Teams (FACT). She oversees the day-to-day operations of FACT, including policies, staffing and community engagement.

Ariel Ward is a Forensic Nurse Examiner and recently became a Clinical Nurse Educator (CNE) for the department.  As a CNE, she focuses on the orientation process, clinical oversight, outreach and education. 

Forensic Nurse examiners specialize in taking care of patients who have experienced sexual assault and domestic violence.  

“Kids are resilient, they’ll bounce back“

“Talking about it will make them feel worse“

“Once they grow up, they’ll get over it.”

For years, this was the prevailing wisdom when it came to dealing with adverse childhood experiences such as abuse and neglect. But a growing wave of research has revealed that these ideas are myths – children do not simply “get over” traumatic events as they mature. In fact, there is overwhelming evidence that children exposed to domestic violence, sexual abuse, or a parent with drug or alcohol addiction are much more likely to develop poor health outcomes as adults. Children who do not receive appropriate trauma-informed care are at risk for all sorts of medical problems, including early-onset heart disease, diabetes, cancer, addiction and depression.

It’s imperative we put protective factors in place. At the Inova Ewing Forensic Assessment and Consultation Team (FACT) Department, our medical doctors and forensic nurses provide medical evaluation, evidence collection, and interpretation based on training, experience and medical data to meet the needs of abused children and adults. Our Child Life Specialist ensures that the forensic examination is completed without re-traumatizing our already vulnerable patients.

We provide the initial medical care, but we do more. Our medical directors, William Hauda, MD, and Katherine Deye, MD, are uniquely trained to address the long-term consequences of adverse childhood events. In fact, Dr. Deye is one of roughly 350 child abuse and maltreatment subspecialists in the country. Because of her expertise, she can educate parents about the potential for lasting repercussions, and articulate the importance of following through with mental health services, family therapy and other necessary resources.

In addition, we collaborate closely with our community partners to support children and families and ensure that continuing care needs are met. Dr. Hauda and Dr. Deye maintain close ties with Child Advocacy Centers (CAC) throughout the region. Each month, our staff joins a team of law enforcement, child protective services and CAC staff to review every reported case of child abuse in multiple local jurisdictions. This multidisciplinary approach allows providers to educate other first responders about long-term health implications and the importance of necessary treatment to off-set lasting damage. By bringing everyone to the table, we reduce the risk that a case will fall through the cracks.

April is National Child Abuse Prevention Month and Sexual Assault Awareness Month. It’s a time to increase understanding of the link between childhood abuse and adult mental and physical health, and focus on a comprehensive approach to both prevention and long-term outcomes. Children, families and communities must be empowered to take action to protect the health and well-being of this and future generations.

Located on Inova Fairfax Medical Campus, the FACT Department includes two medical directors, five full-time and two part-time forensic nurses, a Child Life Specialist and a Clinical Nurse Educator, in addition to 13 on-call nurses. In May, a second clinical location will open in Loudoun County. Learn more at www.inova.org/inova-in-the-community/fact.

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