CARE is there when children need it the most

03/31/2023

Occurring across all demographics, child abuse and neglect are significant issues nationally and in Arizona. Each year in the United States, nearly 4 million reports of child abuse are logged, while each day, more than five children die from maltreatment. Two children die each week in Arizona from neglect or abuse—a higher mortality rate than childhood cancer. However, these are only the known cases; untold numbers likely go unreported.

Experts believe that every child death due to abuse or neglect is preventable.

Banner Health is passionate about identifying and protecting vulnerable children in our communities. We do this by making prevention of child maltreatment our guiding principle, inspiring our medical professionals to reach out to the fully-staffed Children at Risk Evaluation (CARE) team for support when they see warning signs.

"The Banner CARE Team is dedicated to evaluating child victims of inflicted harm, to collaborate with our community partners to prevent further harm to these children and their siblings," said Shawn Singleton, M.D., F.A.A.P., Pediatric Physician and Medical Director of the CARE Team, Banner Children's at Desert Medical Center. "The CARE Team tirelessly works with Banner and Community health care providers to strengthen families in efforts to reduce known risk factors associated with inflicted trauma additionally CARE provides high quality monthly and on-demand education to these same providers to improve their understanding and recognition of child maltreatment."


At just 5 months old, Hannah arrived at a Banner Children’s Urgent Care with a fever and fussiness – like many other children in the Urgent Care that day. While the Medical Assistant was taking her vital signs, she noticed a small bruise on Hannah’s belly and that she was very thin for her age.

Hannah was transferred to Banner Thunderbird Medical Center for further care, including a consult with the Children at Risk Evaluation (CARE) team. She was found to have multiple abusive injuries, hidden from sight. However, because the abuse was identified early, it did not escalate and her injuries were not catastrophic.

Later, Hannah’s young mother admitted to hurting the baby and relayed her own history of trauma and abuse.

Child Protective Services placed Hannah in a safe and loving home with relatives and provided her mother with services she desperately needed to improve her life. Hannah was ultimately adopted by relatives, and Hannah's mother is able to maintain some contact with her as she grows.

Fortunately, Hannah is now a cheerful and healthy 2-year-old.


Without an understanding of their role and what to screen for, health care providers and other professionals run the risk of overlooking injuries that may raise suspicion of abuse. The CARE team was created in 2013 to support health care professionals within the Banner Health system, the largest single provider of health care to children in Arizona. The CARE team identifies and supports children subjected to possible maltreatment, including neglect, physical and sexual abuse, for the Banner Health system. The program’s multi-disciplinary team of specialists provide evaluation, education and prevention services through in-person consultation and telehealth support. The CARE team, specializing in child abuse prevention, offers consultation and phone guidance to other medical providers seven days a week; contributes to policy and practice guides; and communicates with multiple community organizations as an advocate and educator.

Arizona state law requires any professionals responsible for the care or treatment of children to report suspected abuse or neglect to authorities. Because Banner provides primary, emergency, and inpatient to services to more than half the children in our state, it is critical that our teams are fully able to recognize possible signs of abuse and neglect in children and to respond appropriately.

The CARE team protects children by being a sentinel for identifying abuse that would otherwise be missed, reporting suspected abuse, and supporting families by making appropriate referrals to support services. Their primary goal remains to prevent abuse before it happens, so the team works diligently to reduce the incidence of child abuse and neglect and keep children and families from suffering these in the first place.

“The CARE team is passionate about prevention, so children are not harmed and families thrive,” explains Shayla Paap, LMSW, who leads the CARE team. “We don’t believe people who hurt their children are bad people. Likely, they just don’t have the best coping skills, get overwhelmed and react inappropriately, which results in harming their children.”

Philanthropic support for the CARE program ensures that all Banner Health providers understand and follow suspected abuse protocols to protect children and ultimately save precious lives. Recent gifts from the In-N-Out Burger Foundation and J. W. Kieckhefer Foundation strengthen this investment in the most vulnerable in our communities and empower our teams to be even greater custodians of care. 

Support the CARE Program

To add your support for the CARE team, click here and select the CARE Program from the gift designation menu.