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.” 

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Each of the 1,540 pinwheels in Fort Worth represents a visit to the Cook Children's Child Advocacy Resources and Evaluation (CARE) Team where a child was evaluated for concerns of abuse or neglect in 2024. A referral to the CARE team for suspected child abuse does not automatically mean that abuse is confirmed. For example, about half of the children referred to the CARE team for physical abuse are substantiated.

The 1,148 wheels in Prosper represent the number of child abuse cases in Denton County in 2024. 

The purpose of the pinwheels is to show the scale and impact that child abuse and neglect has on our community, while also exemplifying the resources available to victims.

“It is tragically beautiful,” said CARE Team Nurse Manager Stacey Henley.

Henley says the CARE Team uses the time spent planting the pinwheels on each campus “to reflect and pray for each child who they have seen over the past year, which can be very therapeutic for the staff.”

The pinwheels are only one part of Cook Children’s efforts to raise awareness, prevent and care for those affected by child abuse and neglect. Across North Texas, Cook Children’s is part of a vast support network for families to not only help children when abuse happens, but also to step in beforehand and prevent it.

Across eight counties, Cook Children’s Center for Community Health (C4CH) partners with community groups to determine on a grass-roots level what different areas need to prevent child abuse and neglect. 

“During the month of April, we observe National Child Abuse Prevention Month to emphasize the importance of communities and organizations working together to support families and prevent child maltreatment,” said Frances Wampler, program coordinator with C4CH.

“Together, we can make a difference,” Wampler said. “By supporting families, recognizing signs of abuse, and reporting concerns, we help ensure every child has the opportunity to thrive.”

Go to saynotoabuse.org for additional prevention and support resources.

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

This April, during Child Abuse Prevention Month, the Cook Children’s C.A.R.E (Child Advocacy Resource and Evaluation) Team celebrates its 30-year anniversary. For the last three decades, this department has played an invaluable role in helping child abuse victims and their families heal while providing preventative education to the community at large. 

About the C.A.R.E. Team

Led by pediatricians who are board-certified in child abuse medicine, the Cook Children's C.A.R.E. Team provides medical and forensic evaluations for victims of physical and sexual abuse, neglect, and drug exposure. All C.A.R.E. Team patients are referred from Child Protective Services (CPS), law enforcement agencies, or another medical provider.

“Our job is to make sure the child is okay, and if they’re not, to provide the necessary medical treatment and help them heal,” said Nurse Manager and forensic nurse examiner, Stacey Henley, MSN, RN. 

The C.A.R.E. Team does the critical work of providing a medical diagnosis—whether it’s found to be child abuse, an accident, or another underlying medical condition—and facilitating a treatment plan for the patient.

“Everything we do, we do because we care about these kids,” said C.A.R.E. Team Medical Director, Jamye Coffman, M.D. 

Helping Children Heal

The C.A.R.E. Team helps victims of all types of child abuse and neglect begin to heal physically, mentally, and emotionally. 

The team is trained to recognize the dynamics of trauma and fight-or-flight, which means they have an evidence-based understanding of why children don’t always report abuse.

“A lot of people think abuse looks like what happens in the movies, where someone gets attacked by a stranger in a dark alley,” Henley explains. “They don’t understand that over 95% of the time, a child's abuser is a family member, a close family friend, or someone else the child knows.”

The C.A.R.E. Team provides comprehensive psychosocial assessments of each patient’s physical, mental and emotional health to ensure they receive the care they need. They also work with numerous advocacy centers in the community—listed on their website under Prevention, help and support resources—that are dedicated to helping child abuse victims and their families find hope, healing, and justice. 

“Our job is to protect these kids,” Henley said. “We make sure their body is okay first, and then we help them start their healing journey.”

A Collaborative Approach

The C.A.R.E. Team collaborates with multiple different specialties, including hematology, orthopedics, pediatric radiology and more, to provide multidimensional care for patients. 

“I think it’s our superpower that we have such a great group of specialty services that are willing to work together to make a diagnosis of potential abuse,” Dr. Coffman said. “We need a lot of different perspectives because a medical diagnosis holds great ramifications for the child and the family.”

Beyond Cook Children’s, the C.A.R.E. Team is part of a larger multidisciplinary network involved in child abuse cases—including law enforcement, CPS, advocacy centers, and the District Attorney’s office. The C.A.R.E. Team ensures all other parties involved in a child’s case understand their medical diagnosis and its consequences.

Community Education and Partnerships

“We try to provide education to pretty much anybody who asks us because we want to make sure everyone has the appropriate medical information about abuse,” Henley said. 

Throughout the year, the C.A.R.E. Team hosts workshops and conferences with attendance from hundreds of other medical providers throughout the country. The team also provides community education for its advocacy center partners, school districts, daycares, churches, law enforcement, CPS, and more—ensuring all organizations are familiar with the medical symptoms of abuse and know when and how to report.

Several of the C.A.R.E. Team’s initiatives are also aimed at preventing and thwarting specific types of abuse. They commonly host workshops on The Period of PURPLE Crying, teaching parents how to navigate the frustration that can lead to severe and potentially life-threatening abuse. The team also participates in case reviews during which juvenile offenders or those with problematic sexual behaviors can be referred to counseling programs. 

“If they meet the qualifications, offenders can go into a program that helps them learn about why their behavior is inappropriate,” Henley said. “These are kids in our community and we need to help them, too.”

For more information on the signs of child abuse and prevention, visit saynotoabuse.org. To report abuse, neglect, or exploitation, contact the Texas Department of Family and Protective Services at 1-800-252-5400. If the child is in immediate danger, call 911.

This month, you may see a sudden proliferation of pinwheels at Cook Children’s Fort Worth Medical Center and Prosper campus. They represent an awareness and prevention campaign that Cook Children’s undertakes each April during Child Abuse Prevention Month.

Each of the 1,604 pinwheels in Fort Worth  represents a visit to the CARE where a child was evaluated for concerns of abuse or neglect in 2023. Not all of those visits are confirmed cases of child abuse; about half of the children referred to the CARE team for physical abuse, for example, are confirmed as physical abuse cases. The 1,148 wheels at Prosper represent the number of child abuse cases in Denton County in 2023. The purpose of the pinwheels is to show the scale and impact that child abuse and neglect has on our community, while also exemplifying the resources available to victims.

“It really kind of highlights that childlike, whimsical view, and it also represents for us a child that was seen in our care team due to child abuse and neglect reasons,” said Frances Wampler, MA, LSSGB, Program Coordinator with the Cook Children’s Center for Community Health. “But it's also our hope for the future for children to be able to live a safe and happy life free of child abuse and neglect.”

The pinwheels are only one part of Cook Children’s 24/7 efforts to raise awareness about, prevent and care for those impacted by child abuse and neglect. Across North Texas, Cook Children’s is part of a vast support network for families to not only help children when abuse happens, but also to step in beforehand and prevent it.

Across eight counties, Cook Children’s Center for Community Health partners with community groups to determine on a grass-roots level what different areas need to prevent child abuse and neglect. Child abuse and neglect is often associated with different risk factors, like mental health issues, domestic violence and addiction.

“I think when you think about child abuse and neglect, sometimes it sounds really scary. There are those instances that are really intense and severe,” said Frances. “But then there are also cases like neglect that you might not see or think of as child abuse.”

This year for Child Abuse Awareness month, the network is focusing on two specific elements of child abuse: neglect and protective factors.

Protective factors are conditions that can help prevent a problem or negative outcomes; community support for families, proper health care and mental health care all are tools that can help prevent child abuse and neglect. For example, the Center for Community Health gives parents and caregivers support while encouraging positive parenting skills, and teaching child development and behavior management.

Neglect is another focus of this year’s Child Abuse Prevention Month. Neglect is the most common form of child abuse, Wampler said, but it can at times be less apparent than other forms of abuse. Neglect of a child may look like malnourishment, dirty clothing and living quarters, child left alone for long periods of time and/or frequent absences and tardiness at school. 

This year’s campaign ties those two focus areas together, Wampler said, to not only raise awareness about what neglect looks like, but also provide resources to struggling families in order to prevent neglect from happening. 

“So not just the awareness piece, but also what to do,” Wampler said. “So as a mom, for example, if you're not too sure what to do with a crying baby, we can educate on how to soothe your baby and put out some tips related to that. 

Working with community partners

Cook Children’s and its partners work to raise awareness about what abuse and neglect looks like and create support systems for families. That support includes education and awareness of what abuse and neglect is and providing opportunities for families to interact in a positive way. For example, Cook Children'sCenter for Community Health coordinates with the Children’s Advocacy Center of North Texas to host Family Fun Nights, where families have access to community resources while attending a fun event.

Kristin Howell, CEO of the Children’s Advocacy Center of North Texas, said that activity night is one example of the ways in which Cook Children’s and its partners engage the community. Awareness of those resources is important, she said, because child abuse and neglect is not as rare or distant as some people might want to believe. At least eight times a day, she said, a crime happens against a child.

“This is not something that a parent prepares for, but it does happen frequently,” she said. “And the amazing thing is that once it happens, there is a remarkable team in place in your community who jumps into action. And we know exactly how to solve this problem and help you navigate it. Cook Children’s has been a huge partner with us in that effort.”

About eight times a day, Kristen said, a child comes into the Advocacy Center due to possible neglect or abuse. When that happens, the “team envelopes them.”

“One of the most important partnerships we have is that with our medical providers,” Howell said. “And Cook Children’s steps up to the plate for kids every day in that way.”

The C.A.R.E. Team

When a child might be abused or neglected, they need a wellness exam and possibly other medical care; Cook Children’s has a team of experts who can help provide or coordinate those healing services.

The C.A.R.E. Team, or Child Advocacy Resource and Evaluation Team, is a team of experts, led by pediatricians who are board certified in child abuse medicine, who can provide medical and forensic evaluations, sexual abuse screening and preventative education.

Dr. Jamye Coffman, MD, MPH, has been a member of the C.A.R.E. team for 24 years. The clinic is on call 24/7 for concerns of neglect and abuse. If a child comes into the ER who may have been neglected or abused, the ER staff can call the C.A.R.E. team to assist in their care. The team evaluates a plethora of factors in each case such as if the child has a medical condition that can mimic child abuse or neglect symptoms. They can also review medical records and referrals to CPS and law enforcement.

However, their services extend beyond Cook Children’s walls. Often, they go to advocacy centers across a dozen counties to discuss cases through the lens of their medical expertise with case workers and advocates. They also help coordinate care for families in need through the network Cook Children’s has helped create, connecting families with women’s centers, early childhood intervention services, physical therapy and other resources.

The multifaceted network of child abuse and prevention is a collaborative effort that “connects the dots,” Wampler said, across various Cook Children’s departments, community organizations and partners across North Texas.

“I think it's important for our children to (create this network) because we are a big voice in our community,” Wampler said. “And our promise talks about how every child's life is sacred. We're helping bring other partners together to help meet that need as well and to be aware of what's happening in our community and protective of those that are the most vulnerable.”