Suspected Trauma and Abuse Response Team

The Suspected Trauma and Abuse Response Team (START) helps by providing compassionate and rapid assessment, management, and treatment to Maritime children and youth up to age 18 where allegations or concerns of physical, sexual, or emotional abuse or neglect are identified.

How we help

Our role is to provide comprehensive care for suspected and confirmed victims of child abuse and neglect, and their families through direct service, consultation, advocacy, education, collaboration and research. We strive to find the “right” combination of supports and services to best meet the needs of children, youth, and their families. These supports and services may be offered by the START or other teams at the IWK, or by government departments, community groups or a combination. The team works closely with community child protection agencies such as the Department of Community Services, Child Welfare and the police. Our team is made up of pediatricians, a registered nurse, a social worker, and clinical therapist.  You may meet some or all of these people when you come to visit our team.

Child abuse or child maltreatment is any kind of harm inflicted upon a child’s or youth’s body and or emotional well-being. There are five main types of abuse: physical, sexual, emotional, neglect, and exposure to family violence. Signs and symptoms of abuse can range from the obvious such as bruises, to the not so obvious, such as sleep disturbance or change in behaviour. 

It’s important to call the Suspected Trauma and Abuse Response Team before sending a child to the IWK to avoid unnecessary waits for both the child and their family. Whenever possible, the team will arrange to have the child or youth assessed the same day, or if the request is non-urgent an appointment will be made as soon as possible.

What to expect

Referrals for a medical examination or psychotherapy can be made by physicians or other professionals by contacting the intake office. Urgent after-hour referrals are seen in the IWK Emergency Department. Urgent referrals may be needed in the case of:

• 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 a disclosure of abuse

When a referral is made to the Suspected Trauma and Abuse Response Team, each case is reviewed and prioritized based on information provided by the referral source.  Some children may require a medical examination and others may not require a visit to the IWK.

When children and youth are medically assessed by the START a consultation report is written to the referring physician or social worker. A copy of this report is also kept in the medical record. In the case of referrals for psychotherapy, relevant information will be gathered during the initial telephone contact. Referrals that require follow up will be added to the wait list to be screened for an assessment regarding the need for therapy. 

START members do not assume that all children referred have been maltreated, has no legal authority, and cannot remove children from their family or investigate concerns of child maltreatment. The team works in collaboration with the child protection agencies by providing a comprehensive assessment of children. Calling START with your concerns does not mean you do not have to contact a child protection agency.

The Nova Scotia child protection legislation states that the reporting of child abuse by all citizens is mandatory. Failure to report abuse, even when only suspected, is a punishable offence. The duty to report overrides patient confidentiality. If you're 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. Ask to speak to an intake worker or on-call duty worker. In addition, in Nova Scotia physicians and health care providers must complete the Medical Report of Abuse. 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.