Two months before her seventh birthday in 1995, Elisa Izquierdo was killed. Over a period of months, she had been physically and emotionally abused, repeatedly violated with a toothbrush and a hairbrush, and finally beaten to death by her mother. Elisa's mother told police that before she smashed Elisa's head against a cement wall, she made Elisa eat her own feces and used her head to mop the floor. The police told reporters that there was no part of the 6-year-old's body that had not been cut or bruised. Thirty marks initially thought to be cigarette burns turned out to be the imprints of a stone in someone's ring.

An investigation after her death revealed that Elisa had been the subject of at least eight reports of abuse and that several government agencies had investigated the reports. Nonetheless, Elisa Izquierdo was left with her abuser and eventual killer.

Unfortunately, this failure to respond to reports of child abuse in a timely and appropriate manner has happened many times — and is continuing to happen — in probably every State in the country, and almost always for the same reason: As the investigation into Elisa's death revealed, there had been an appalling lack of communication and coordination among the agencies investigating reports of possible abuse. The first recommendation of the New York State commission mandated to find out how to prevent another such tragedy was to adopt legislation to authorize child protection agencies to provide complete information to all members of a county's designated multidisciplinary team (MDT) or child advocacy center.

An MDT is a group of professionals who work together in a coordinated and collaborative manner to ensure an effective response to reports of child abuse and neglect. Members of the team represent the government agencies and private practitioners responsible for investigating crimes against children and protecting and treating children in a particular community. An MDT may focus on investigations; policy issues; treatment of victims, their families, and perpetrators; or a combination of these functions. This Portable Guide deals with the investigative function of MDT's.

The MDT approach promotes well-coordinated child abuse investigations that benefit from the input and attention of many different parties — especially law enforcement, prosecution, and child protective services — to ensure a successful conclusion to the investigation and to minimize additional trauma to the child victim.

Key to the formation of successful investigative MDT's are:

• Committed members who have the support of their agencies for the multidisciplinary approach.
  
  
• An initial meeting during which each member's role and previous experience in investigating child abuse and neglect are respectfully heard.
  
  
• The development of a mission statement that clearly sets forth the purpose of the team, the scope of its activities, and its guiding principles.
  
  
• The subsequent creation of a team protocol that specifies the types of cases that will be investigated, the responsibilities of the members, and the procedures for conducting investigations.

Key to the successful operation of an MDT are:

• Confidentiality policies that accord with legislative mandates, agency policies, professional practices, and the best interests of the abused children.
  
  
• Conflict resolution practices that ensure core issues are aired and resolved satisfactorily based on mutual respect and recognition that child abuse investigations are complex, demanding, and frustrating but that they are also important, meaningful, and rewarding.
  
  
• Periodic self-analysis and outside evaluation of how the team is working so that it continues to achieve the purposes for which it was formed.