Each of the 1,528 pinwheels represents a visit with Cook Children’s Child Advocacy Resource and Evaluation (C.A.R.E) team due to suspected child abuse in 2025. In Prosper, 1,287 pinwheels illustrate the victims of child abuse in Denton County in 2025.

April is National Child Abuse Prevention Month. The pinwheels help draw attention to the issue and remind caregivers, families and parents they are not alone. Each pinwheel isn’t just a case or a number, it represents a child.

“We see kids who are referred to us from other medical providers, law enforcement, or CPS,” explained Erica Bohmer, M.D., a physician with the C.A.R.E. Team. “Anytime there's a concern for any kind of abuse or neglect they are referred to us.”

Dr. Bohmer clarifies that a referral to the C.A.R.E team does not automatically mean abuse is confirmed. In 2024, less than half of the children referred were substantiated.

Protecting the Child, Supporting the Caregiver

The C.A.R.E. Team consists of social workers, nurses, nurse practitioners, doctors and medical assistants who focus not only on the physical well-being of the child but also the family’s holistic care.

“We know that kids are most at risk (for child abuse) when their caregivers are going through really stressful or traumatic times in their own life, and they have a lower threshold of tolerance for being frustrated or they just don't have the right resources,” said Dr. Bohmer. “By providing help to caregivers we can have the biggest impact in preventing child abuse and neglect.”

Dr. Bohmer says abuse is usually identified during physical exams. The C.A.R.E. team most commonly receives outpatient referrals due to sexual abuse and most evaluations from inpatient referrals is due to physical abuse. Across the health care system and nationwide child neglect is often the biggest form of child abuse. The C.A.R.E team also performs neglect evaluations when there are concerns for illicit drug exposure.

A majority of referrals to the C.A.R.E team for suspected child abuse are due maltreatment and concerns for drug exposure.

Child abuse is preventable with the right tools and resources. The C.A.R.E. team understands the stresses of everyday life can take a toll, but it’s important for caregivers to know there is help available.

“We try to help identify resources that we can help families with, whether it's connecting them with food banks or if they need help filling out applications for a WIC or touching base with local, advocacy centers or even clothing, transportation, just anything that we can do to help the families, even down to working with electricity and water companies,” said Carla Davis, RN, nurse manager for the C.A.R.E. team

 In Texas any person who suspects child abuse or neglect must report it to law enforcement or the Texas Department of Family and Protective Services Abuse Hotline. Health care professionals are mandated reporters who must report suspicions of abuse within 24 hours. 

“We care about protecting the children and the entire family,” said Davis, “We want to try to support and help as best we can so that it can be a successful situation where the families can stay together.” 

Related Stories

• Cook Children's Center for Community Health Collaborates with Community Partners to Raise Awareness about Child Abuse Prevention

• Empowering Families through Mental Health Conversations

The school nurse has long offered an escape from the classroom… and as many Band-Aids as a kid could need. But the responsibilities of a school nurse stretch far beyond their tiny office walls. They are the keepers of care for hundreds, if not thousands, of students. Their duties range from administering CPR to managing insulin pumps and blood sugar levels. In between all of that, there is another heavy responsibility they are tasked with: recognizing and reporting suspected abuse and neglect.

“We want our nurses to have the updated knowledge, skills and resources they need to keep our kids safe and to do their job effectively,” said Cindy Parsons, Director of Health Services at Keller ISD. “The school nurse has an important role in education about child abuse. Teachers and other school staff members may not be as familiar with subtle signs of neglect, and the school nurse is often the person who helps to educate them.”