Dr. Cathy Ayoub
speaker
148 appearances
1 recordings
1 series
first heard Dec 2024
last heard Dec 2024
Dr. Cathy Ayoub’s voice in public audio — every appearance, attributed to the second.
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My name is Catherine Ayou, usually called Kathy, and I'm an associate professor at Harvard Medical School, and I'm a counseling and consulting psychologist and a nurse practitioner. So I come at all the work that I do from my basic interest and work in working with children and their families.
I actually got started as a nurse practitioner, nurse clinical specialist, and I wanted to work in a hospital with young children and families. I actually wanted to work with children who were ill. So I wanted to work with chronically ill children. And we moved to Tulsa, Oklahoma for my husband's job many years ago.
And I convinced the director of nursing that I could be the mental health consultant to their pediatrics and obstetrical unit. And while I was there, I not only worked with chronically ill children, but the chief of pediatrics said to me, Hey, there are these new things we've heard about, and they're called hospital child abuse teams.
how about if you start one along with the other things you're doing? Cause I think we probably see four or five cases a year. And I said, well, okay, let me see what I can find out. And I had the tremendous, um, luck in working with a couple of great pediatricians who had trained with Dr. Henry Kemp in Colorado. And, but, uh,
He was one of the first people who really talked about child abuse and helped get the child abuse legislation through in all 50 states for mandated reporting. And he really wrote about child abuse first and foremost. And so I said, okay, very naively, I'll start this child protection team.
And we saw 150 children in the first year and about 200 or more in the second year and realized the other hospitals in town didn't have teams and work on building those teams. And so I saw my first case of medical child abuse in Tulsa when I was part of the child abuse team.
And most of that, all of the pediatricians and the nurses were really very willing to have folks on the child abuse team go ahead and talk to the parents, understand what happened to the child and really try to understand any forms of abuse or neglect we were seeing and whether we should report to child welfare. for example, except for one case.
And the chief physician who had really helped start the team and actually circulated, rotated through the team said, I have a case and I'm not referring it. And there is a mother here and her baby almost died because the baby's bottle was full of salt. And I'm going to handle this case myself. and I'm gonna work with child protection.
I'm gonna work with referring it and she's very sorry and you're not gonna touch this case. And I was really curious. And I think my curiosity led me to then after I moved to Boston and went back to school, In my clinical work, both as a pre-doctoral and post-doctoral, I was really interested in working through the courts and with child protection agencies and hospitals around child abuse neglect.
And I was always curious about this, by then this Munchausen by proxy.
It was in the late 1970s. Very long ago, really around the time that Roy Meadows actually wrote the first paper on Munchausen by proxy. And I found the paper and even tried to say, I wonder if this is what's going on. And it was just, again, our whole team was really shut out of the process.
I believe his conception was really that this was a very remorseful mother who had made a big mistake. And he was very connected to her. I mean, that was the other thing that really, really got my attention because he was so connected to her. that he really needed to, he not only kept us out of the situation, but he really worked with the child protective workers to keep them out in a way too.
I'm gonna see her, I'm gonna see this baby, I'm sure this isn't gonna happen again. And he made a lot of assertions and was incredibly protective around the whole reporting system.
That was my entry point. And then when I went back and got my doctorate in psychology, I was lucky enough to be both as a pre-doctoral student and then to do a postdoctoral fellowship. in child forensics and I worked at the Boston Juvenile Court Clinic as part of that experience and also did a lot of work in family court. And I was handed a case, and they said, well, you're a nurse.
You should understand these medical things. And you're a psychologist, so you should understand the mental health issues. Here's this really unusual case. At the Boston Juvenile Court Clinic, this was a court clinic that sits within the juvenile courthouse. And judges would refer to us directly around any kind of juvenile cases, but in particular cases I was really interested in young children.
I was really interested in child abuse and neglect. So they used to give me those cases. And it was really there at the Boston Juvenile Court Clinic that I began to be the person who ended up seeing these cases. And we also, at the same time, I did work in family court.
And this is through the Law and Psychiatry Service at Massachusetts General Hospital, which is where I still practice my forensic work, but ended up seeing those cases once they got to court and then at the same time doing some work with a number of hospitals about how to set up child protection teams in hospitals.
And these were always what a number of my colleagues called the black holes of child abuse and neglect because there was so much information and it was so complicated.
Daily Munchausen by proxy cases in particular, yes.
Absolutely. And, you know, again, I'm old. So I've had the opportunity to really see this develop Again, I remember talking to Dr. Henry Kemp at the University of Colorado, and he was saying, you know, you're a young thing. You don't remember when there were no protections for children.
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