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The practice has become sadly necessary: Every time pediatric specialist Helen Britton examines a patient, she looks for evidence of physical or sexual abuse.

Britton, director of Primary Children's Medical Center's child protection team, also looks for the absence of evidence."Sometimes people look at us like we're the SWAT team or something," Britton confided with a laugh. "I always try to tell parents that we're there to be neutral in evaluating what happened and to help figure out if, medically, there is an indication that what happened was an accident or was not an accident."

Britton has 20 years of experience evaluating childhood injuries. She is one of two Child Protection Team physicians and serves on the advisory board of the Salt Lake Children's Justice Center.

As a medical resident, Britton served a fellowship under the late Dr. Henry Kempe, among the first to recognize chronic abuse in children, calling it "battered child syndrome." He initiated a child protection team at the University of Colorado Medical Center in Denver.

In the past two decades, the specialty has made strides thanks to technology. Today, experts can transmit images to each other for immediate consultation and discussion on physical and sexual-abuse cases. The technology also lets nurse practitioners and doctors in rural settings conduct exams and send images to abuse experts for diagnostic help.

It's another way to help decrease the trauma and limit repeat exams for young victims of abuse, Britton said.

That philosophy also is embraced by Utah's Children's Justice Centers, founded on the premise that child sexual-abuse victims were being retraumatized by uncoordinated investigative efforts.

The first justice centers in Utah opened in Weber and Utah counties in 1991, followed by the Salt Lake County Children's Justice Center in January 1992. The latter facility has served nearly 3,000 children.

The centers serve hundreds of sexual-abuse victims every year by bringing each child for a single, videotaped interview with law enforcement officers and child protection workers, said Susanne Mitch-ell, director of the Salt Lake County center.

If a child discloses information about sexual abuse, the video can be used as evidence in a criminal investigation.

Britton, who helped develop similar centers in Louisiana before she moved to Utah five years ago, said Primary Children's Child Protection Team and the Children's Justice Centers routinely refer children to one another.

Britton is often called to testify as an expert witness when criminal child abuse cases go to trial. She also has been subpoenaed in cases outside of Utah.

"In one week last year, I got seven subpoenas. That has to be more than any lawyer goes to court," Britton said. "Luckily, they didn't all happen."