Dr. Margaret McHugh, center, with a young patient.
	Dr. McHugh with Kermit the Frog, a puppet the team uses to help children relax and open up.

A little 4-year-old girl named Sally, a child in foster care, was brought to Bellevue Hospital some time ago after adults became concerned about her inappropriate sexual behavior. With the help of puppets and a doll house, Sally was soon able to open up and explain where she was when she was abused by the son of a previous foster care family.

Thanks to a room with one-way glass, Sally was interviewed only once by a trained expert from the Frances L. Loeb Child Protection and Development Center at Bellevue Hospital, while other members of the healthcare team and social service officials learned her sad and shocking story.

Led by Dr. Margaret McHugh, the Loeb Center staff worked with professionals from the city Administration for Children's Services to identify the family, and uncovered other victims. The offending son and foster care mother were prosecuted. And the interdisciplinary team of doctors, psychologists and social workers continued to provide little Sally with the treatment and counseling she needed to help her move on.

The Loeb Center marked its 10th anniversary in November, but Dr. McHugh and the Child Protection Program at Bellevue have been providing comprehensive medical, psychological and social intervention to abused and neglected children and their families for more than 30 years. Dr. McHugh is the director, founder and driving force behind the center.

"She recognized that abuse was a problem and that doctors were in a unique position to identify and treat abused children," said Barbara Paxton, Chief Development Officer for Children of Bellevue, a non-profit organization that advocates for children and their families at the hospital and partially funds the center. "She also recognized that abuse was not just one incident in a child's life, but something that would impact their whole life."

"The challenge is to devise an intervention so these youngsters don't get stuck developmentally," Dr. McHugh said. "You help them cope with the child abuse and move on. You help them heal themselves."

The team includes Dr. McHugh and two other doctors, two social workers, two child life development specialists, and two clinical psychologists. They also work with Children's Services, law enforcement agents and prosecutors to provide training on how to interview and work with young victims.

Dr. McHugh first developed and initiated the practices at Bellevue that became statewide protocols for the identification and treatment of child abuse and neglect in hospital settings. She worked with the prosecution in two notorious child abuse cases, testifying as an expert witness in the death of Lisa Steinberg in 1987 and serving as a consultant in the death of Nixmary Brown in 2006.

Dr. McHugh said the outlook is better today because there is more awareness and training about child abuse than there was decades ago. Still, the center performed 244 medical evaluations of children in Fiscal Year 2010. Most children are abused by a parent, other family member or a person known to the child. At the center, among those whose abuser was known, 60 percent were abused by the father or father figure, 10 percent by the mother, and 15 percent by another family member.

Dr. McHugh's next goal is to implement a parenting program focused on prevention that includes putting a parent and child on one side of the one-way glass, with the parent wearing an earpiece that allows a professional to coach the parent as she or he interacts with the child.

"We want to help the parent. Not wait until they do something wrong and take the kid away," Dr. McHugh said.

"It should be part of every pediatric service. If I can refer you for a cardiac murmur, why can't I refer you for preventive parenting?"

January 2011