Dr. Karyn Patno knows the horrors of child abuse all too well.
"Ultimately the goal is not to get the bad guy, the goal is to protect the child," she said.
Patno is Vermont's first board-certified child abuse pediatrician, a sub-specialty that was developed by the American Board of Pediatrics in 2009. Before that, investigators relied on general pediatricians to evaluate children for child abuse.
"It is very stressful, emotionally draining to see the physical and sexual abuse that these kids have to go through," said Sgt. Mike Warren, the director of the Chittenden Unit for Special Investigations.
Police and DCF investigators say the science has become so complex and nuanced, that the sub-specialty could provide a more in-depth understanding of what's actually happened to the child.
And Vermont kids are being abused. The most recent numbers from the Department for Children and Families show more than 15,700 reports were made to Vermont's Child Protection Line. Of those, nearly 4,700 merited further investigation and assessment.
Child abuse is not a new problem, but professionals in the field are understanding more about it. The executive director of Prevent Child Abuse Vermont says in cases of sexual and emotional abuse with very little physical evidence, it's all about the quality of the interview with the child and their family. Quality that a specialist like Dr. Patno can provide.
"So I think that as all of this education becomes more prevalent, you know we start diagnosing it more. But it doesn't necessarily mean that there's more of it, it just means that we are more aware that there are problems and we don't take injuries for granted anymore," Patno said.
The investigation into child abuse allegations in Vermont is a team effort between doctors, law enforcement and the state.
"We will do the investigation on scene, where we'll go out to a specific scene, we'll get statements from people about how an injury to a child may have happened, but we don't have the ability to look at the injuries and say those injuries are consistent with the story they're telling. So that's where an expert like Dr. Patno would come in," Warren said.
The sub-specialty of child abuse pediatrics is slowly growing. Currently, there are a few hundred pediatricians board certified in child abuse throughout the country. Patno is number 305. She works out of Northeastern Vermont Regional Hospital, but has created two ChildSafe clinics, one at St. Johnsbury pediatrics and the other at Fletcher Allen Health Care in Burlington. Click here for more information.