Year after year, Sally Duncan compiles the sad statistics that tell of the children who have come to Memorial Hospital with serious and often deadly brain and spinal injuries from being shaken, beaten or tossed. Last year, she documented 15 cases of abusive head trauma - six in the first quarter alone.
In fact, not a year has gone by since 2007 when she hasn't recorded at least one first-quarter case of what is also known as Shaken Baby Syndrome.
So it's understandable that she and others who have been working to prevent child abuse and neglect in the Pikes Peak region are cheering the numbers - or lack thereof - for the first three months of 2013. Not one case of abusive head trauma ended up at Memorial in that period, and if there had been any, Duncan would know. All such cases end up at Memorial, where Duncan is the trauma outreach and injury prevention specialist.
Duncan credits the pronounced drop in abusive head trauma cases on the extensive work that the military, human services providers, law enforcement officials and others have done to combat abuse and neglect since 2011, when 10 children in El Paso County died at the hands of a parent or caregiver.
'I feel very confident that we're making headway, ' she said. 'I'm getting community information that tells me people are more informed overall, so I think there's a connection. '
One project that came out of the 2011 spike in child deaths is Not One More Child, launched in January 2012 by El Paso County Commissioner Sallie Clark and District Attorney Dan May. The group - made up of representatives from about 50 nonprofits, law enforcement agencies, military installations, church groups and other organizations - has undertaken a number of initiatives that include training first responders, creating educational materials and enlisting the help of faith-based groups.
Another effort that gets credit for a drop in cases goes back to 2009, when Memorial began targeting a captive audience: new mothers in the hospital. Using a program proven to reduce abusive head trauma cases in children, Memorial provides bedside education to the moms and their partners on how to cope with a crying baby, and what can happen if they shake, toss or strike a child out of anger or frustration. The capstone of the program involves parents signing a document saying they've received the education, an action that Duncan says creates buy-in.
Since the program began, abusive head trauma rates at Memorial have dropped 75 percent. The area's two other hospitals with birthing centers, including Evans Army Hospital, have adopted the model as well.
'We're really so pleased that the other hospitals have launched their programs to mirror ours, ' Duncan said.
Another likely reason the number of cases has declined is that Fort Carson beefed up its programs to help parents cope with stress and learn better parenting skills. In 2011, seven of the 10 children who died of abuse or neglect were in military families. Four of the perpetrators were active-duty military; the others were caregivers or spouses.
Fort Carson started a boot camp for new fathers and specialized training for soldiers returning from combat, added abusive head trauma education to physical training that's required of pregnant soldiers, and hired six home visitors to meet with struggling families.
The efforts have led not only to a drop in abusive head trauma cases, Duncan said, but a decline in all child abuses cases requiring hospitalization.
'The military has done a huge amount, ' Duncan said. 'We're still having some military cases come in, but there are fewer cases overall. '
While the efforts have apparently reduced the worst of the worst incidents of child abuse, the number of founded cases of neglect and abuse overall in El Paso County are up slightly for the first quarter of 2013 - 272 this year, compared with 261 in 2012, according to preliminary data from the El Paso County Department of Human Services.
And Duncan is under no illusion that children suffering from abusive head trauma won't show up this year at Memorial.
'We will have cases; there will be no doubt, ' Duncan said. 'We'll just keep holding our breath and keep up the effort. '
By the numbers
First-quarter numbers for child abuse/neglect reports, assessments and founded cases in El Paso County:
3,285 in 2013
3,271 in 2012
1,334 in 2013
1,342 in 2012
272 in 2013
261 in 2012