Lilia Ramos, Forensic Interviewer

"I recently had the pleasure of attending the Pediatric Strangulation MDT Training hosted in Aransas Pass, TX, by Kelsey McKay and her team. Being a fairly young and new interviewer, I cannot even begin to express how much more prepared I feel to interview cases in which our children are subjected to or witness strangulation.

During the training I thought back to one particular interview where a little boy was describing to me that his father strangled him and his mother. In his words, he explained "daddy kept trying to kill mommy, but she wouldn't die." After attending this training, I now understand that he experienced his mother losing consciousness and regaining it over and over, a tactic that abusers often use to make a victim know they are capable of murder.

The wealth of knowledge Kelsey shared let me know that my job can consist of so much more than finding out if the child's breath was impeded during an incident. Sure, this is important knowledge our investigators need for their investigations. But what happens when a child, for fear of the perpetrator, states that their breath wasn't hindered? Not being medically trained, I was not aware that there are a lot of other sensations I can ask about that will help our investigators prove the severity of a strangulation. I feel confident that, armed with this knowledge, I will be better able to interview children regarding strangulation and, therefore, make our investigator's jobs a little easier."

"I had the pleasure of attending “Pediatric Strangulation MDT Training” presented by Kelsey McKay, JD, on January 11, 2018 in Houston, Texas. I originally signed up to take the training for my TCOLE hours with the benefit of learning something new related to my job as a Special Investigator for DFPS. The class exceeded my expectations.

Investigating the injury or death of children is very challenging. It is a balance of making sure that the injury or death is investigated objectively so the evidence can be ruled on as natural, accidental or homicidal death. Investigating an unknown injury or death of a child is a balancing act of thoroughly investigating the injury or death while taking into consideration the parent’s worst nightmare. Collecting and objectively evaluating the evidence is crucial in any investigation but it is especially important in a child’s injury or death. 

Ms. McKay brought to light many signs and symptoms of strangulation that, in all probability, have been overlooked in many investigations. Expecting to find overt external signs of strangulation and its apparent sequelae from what SHOULD be obvious strangulation injury is misleading. Strangulation and its effects are much more subtle, many times like finding the proverbial needle in the haystack. In medicine it is described as, “When you hear running hooves, you look for horses and not zebras.” Strangulation is the “Zebra” when you are looking for the horses. Ms. McKay’s training explains in plain terms how to see the “Zebras.”

David Durkop, DFPS Special Investigator

"I've worked cases in which I suspected asphyxia as the cause of death on child death Investigations, yet with these deaths ruled out as SIDS their is not much done. This course is an eye opener and I feel all Investigators need to take it so that we are all on the same page and we do not let these incidents go without a more thorough investigation."

Lionel Betancourt, Special Investigator

Kristie Puckett, Batterer Intervention




"As someone who works with men who have been convicted of Domestic Violence against the women and children in their lives, I can say that Kelsey is spot on.  I have also been the victim of intimate partner violence, and, during my abusive relationship, I was strangled many times resulting in permanent damage to my vocal cords, leaving me with hoarseness that never goes away.  The way she described the use of strangulation and its purpose in a DV situation was spot on.  Even though she was extremely sick, her presentation was flawless and I thoroughly enjoyed her tell-it-like-it-is style."

Ray Orth, Deputy Sheriff, Kansas City














"Before the training on strangulation by Ms. McKay, I only looked for the visible injuries on a victim.  The well-put-together class taught me to look beyond what I see, and learn to look for other clues of the crime.  My first case of strangulation came just a few months after my training.  I could see the bruising and that was all.  Remembering my training, I asked the victim to tell me more about what her body was telling her.  She was able to relate that she felt like throwing up (was nauseated), she had a raspy voice, and she felt like she was coming in and out of a dreamlike state.  Her abuser was arrested and placed on a 24 hour hold.  The prosecutor came through with the domestic assault 2nd degree that I requested.  I believe that without the training given by a qualified and interesting speaker, I may not have been as successful.  If you get a chance to go to Ms. McKay's training, I recommend it highly.  My peers are surprised that a deputy with my limited experience (2.5 years as a reserve, 90 days full-time) has this type of information."


"I wanted to update you on my first strangulation case. The victim decided not to testify and the prosecutor was going to drop the case. My partner and I convinced him to give it a try for the Preliminary Hearing. When I testified the PA asked about my specialized training. I explained what the training consisted of, and how I was trained to determine strangulation with out visible injuries. Even when the victim lied about the strangulation, my testimony was enough to move the case to arraignment and closer to a trial. This has everything to do with the training I received from your 7 hour class."

Jessica L. Pearson, Investigator 




I wanted to personally thank you for enlightening me yesterday. I am an investigator for the Missouri Department of Senior and Disability Services. The information you presented yesterday was so helpful. I was fully engaged from the time you started talking all the way until the end. Your efforts to hold perpetrators accountable for these violent crimes and preventing horrific future incidents from occurring is incredibly inspiring. I came into the office this morning pumped up and ready to share my experience with my team. You did an amazing job presenting and if the opportunity ever presents itself for me to attend future trainings developed by you, I would jump at the chance!

Holly Owens, Treatment Provider in Idaho




"Ms. McKay, your training was phenomenal! I've often wondered at the correlation between strangulation and intense violence. After your training, the details that connect the pieces were very clear for me. I always wondered how this form of violence is different than other types of abuse. I feel better prepared and more knowledgeable as I go forward with my career facilitating treatment programs and ensuring that they are an effective component in creating change. Thank you for all you do to ensure that people understand and recieve training regarding this crime."

Karen Traylor, Travis County Counseling & Education Services

“Kelsey tells it like it is!!  A refreshingly honest & true-to-life presentation on a dangerous & lethal behavior.  I require all my counseling staff who work with domestic violence offenders to attend this training.   They walk away with a greater understanding of the offender who comes to our office with a strangulation charge and are better equipped to assess these offenders and refer them to appropriate services.  Kelsey is a dynamic speaker who will change the way you think about all aspects surrounding strangulation.  This training helps participants to see what type of offender we are really dealing with.  She examines the crime itself as well as the personality of those who commit them. This is one training you will not want to miss if you work with violent offenders!    She has spent years researching and staying on top of statistics and trends.  I trust her facts totally. I’ve been in this field for 17 yrs.  After attending Kelsey’s training, I was able to understand strangulation and the persons who commit such acts at a deeper level than ever before!  Everyone who works with violent offenders should be required to take this training!”

Michael Heidingsfield, Director of Police, The University of Texas Systems Police

 “We are the third largest state law enforcement agency in Texas, and with a complement of 567 sworn officers and 899 civilian support staff, we deliver police services across the state to a daily population that exceeds 330,000—As you might imagine, intimate partner violence and sexual assault are a significant concern for us—The Office of Director of Police has partnered for the past two years with the Institute on Domestic Violence and Sexual Assault and that collaboration produced “The Blueprint for Campus Police:  Responding to Sexual Assault,” which has now become a fundamental element of our training both here in Austin at our police academy and regionally across the state—The work of ADA McKay in the area of Strangulation was yet another dimension of our future training that we wanted to better understand and ultimately adopt—Through her presentation last week, that process is now well under way! McKay was passionate in her presentation, clearly a subject matter expert and she brought with her a compelling case to understand this topic—We are grateful to her and her commitment to understand and prosecute these kinds of offenses and for providing us with someone as experienced and dedicated as ADA McKay to learn from.”

Mark Spacht, Pretrial Services

“Kelsey’s strangulation training helped me to better understand all aspects of strangulation. From the nuances of physical injuries to the horror experienced by the victim and the importance of gathering evidence correctly, her comprehensive training increased my knowledge of this subject tremendously. Systemically, all of Travis County benefitted from her training, as demonstrated in the increasing sophistication of probable cause affidavits since Kelsey started providing this training for local law enforcement.”

Jackie Borcherding, Assistant District Attorney

“I have heard Kelsey McKay speak eloquently over a dozen times on strangulation and expert witness testimony. From my perspective as a felony prosecutor, Kelsey's presentations are very practical, knowledgeable and cutting-edge on the topics of the investigation, prosecution and trial of strangulation cases.  Because of her experience in trying felony strangulation cases successfully to juries, she has developed an incredible reputation in the legal community, especially for presenting expert scientific and medical evidence of strangulation cogently and succinctly. I am very impressed with the role-playing aspect of her strangulation presentations, where she direct-examines a medical expert to prove up elements of strangulation. Better than her speaking about it is to watch her in action! Moreover, she thoroughly explains the usefulness of a separate strangulation supplement that she developed for law enforcement, as well as the evidence-based research that supports the supplement. She then shows how the evidence gathered from the crime scene, summarized in the strangulation supplement, can be organized into a persuasive closing argument for prosecutors.  Because of the practicality of her presentation and the dynamic and passionate style in which she presents, I highly recommend Kelsey McKay.”

Kurt Mechals, Deputy District Attorney, San Diego County

“San Diego has been a leader for years on evidence based domestic violence prosecution but Kelsey McKay’s presentation last August to a large multidisciplinary group of law enforcement patrol officers and detectives, prosecutors, dispatchers, medics, SANE nurses, and doctors from across our county helped us motivate to improve how we identify, investigate, and prosecute strangulation cases.  Moreover, Kelsey’s presentation brought into better focus how each discipline plays a critical role in the collective effort to intervene and save lives.  Less than six months later, on February 1, 2017, San Diego County law enforcement agencies adopted San Diego County’s first countywide strangulation protocol, which includes a ‘Strangulation Documentation Form’ similar to the one Kelsey helped develop in Travis County, Texas for use by law enforcement agencies to identify and then fully investigate and document strangulation cases.  Kelsey is a dynamic, knowledgeable, and entertaining speaker who is well worth the price of admission.”   

Detective K. Oldham #4940 Austin Police Department

"Kelsey McKay is a great asset to the Law Enforcement profession; she explains the importance of law enforcement’s role for the successful prosecution of dangerous offenders and emphasizes the seriousness of domestic violence. As trainer, she always has a special aptitude to speak to all perspectives within the criminal justice system including first responders, victim services, detectives and all the other links in the chain of the criminal justice system. At the heart of domestic violence is the need for power and control,  and these offenders often are threatened by law enforcement because of law enforcement’s authority to take away their freedom.  In particular, Kelsey has opened the eyes of many law enforcement professionals to demonstrate the connection between offenders with a record of domestic violence and those who murder police officers.   For the Austin Police Department, Kelsey directs her training to describe and teach the importance of law enforcement’s response, investigation, and then safety planning for victims and/or children in the home. She has taught out officers about the need to collect evidence at the scene, when the victim is able and willing to provide the value details that will help convict the abuser. Kelsey always goes above and beyond to contribute to the success of the law enforcement team.”

Cheryl Bakhtiari, Austin/Travis County EMS

"My name is Cheryl Bakhtiari and I have been in EMS for 37 years. It has only been in the past 5 years that more attention has been focused on the particulars of strangulation. The first training I took in strangulation, which was provided by Kelsey to our department, really opened my eyes to the lack of information presented to and/or available to EMS in recent years. After attending the training, I searched all of my old paramedic books, PHTLS, BTLS, my nursing books and many online EMS sites, only to come up with next to nothing on strangulation. This lack of information meant that we (EMS) have been missing signs and symptoms of strangulation injuries for years. We have also been missing opportunities to look for other injuries and better inform patients of the risks associated with those injuries and the importance of seeking medical evaluation and treatment beyond EMS. The thought that I have likely missed many opportunities to better identify a patient’s injuries and therefore their health was adversely affected, was sobering indeed.

For the past two years, I have provided “expert witness” testimony in strangulation cases. The most important aspect of this, is teaching the court basic anatomy and physiology that allows them to then understand the seriousness of strangulation. I am not going to sugar coat this endeavor. It’s tough. I make mistakes. And I learn more every single time. I write better PCRs. I take better care of patients. I do a more thorough exam. I give patients necessary information so that they can make better decisions for themselves. I make a difference."

Michael T. Svoboda, RN, MSN, CPNP,
Dell Children's Medical Center of Central Texas

“I have been providing medical evaluation of child abuse victims for the past 5 years and in that time I have documented the physical findings of several children who have made outcries of strangulation.  I felt that my physical evaluations and documentation on these cases were excellent; however, after your training I realized I was only capturing a small portion of the physical symptoms of strangulation and have since included the assessment of these subtle, but significant, symptoms into my assessments.  As a result, my current evaluations include not only the physical findings (petechiae, bruising, etc.) but also a very thorough review of the symptoms of strangulation (ringing in the ears, seeing stars, inability to speak afterward, drooling, thoughts during the event, etc.) that make my notes more complete and my medical opinions more definitive when diagnosing child abuse from strangulation.”

 Jenny Black, SANE Nurse

"Kelsey brought strangulation education to our sexual assault nurse program in Travis County years ago. With her help, we trained our nurses how to recognize, document, and care for for patients who survived both sexual assault and strangulation. We wrote a two page supplement to our medical record so that we can capture information that helps us better understand appropriate medical treatment. That supplement can also be useful in investigating and prosecuting these crimes. None of this would have happened without Kelsey's generosity and vast knowledge. Kelsey is a great speaker and she's somebody you really want on your team."

Darrell Gibson, Detective, Travis County, Texas

"I've worked with Kelsey in a number of Domestic Violence cases that I investigated. She has a unmatched passion for prosecuting Strangulation cases and teaching medical professionals, law enforcement (first responders and investigators), paramedics and other prosecutors in developing an intelligent response to, investigation and prosecution of abusers who strangle their intimate partners. She has been able to correlate abusers who strangle and then go on to commit violent acts against police officers. She is a fantastic speaker and captivates your attention. Having survived my own Attempted Capital Murder by strangulation, her observation and instruction in what to look for in a strangulation victim is "Dead On!" She is equipping others with the tools to successfully investigate and prosecute these cases and is saving countless lives in doing so!"

Laurie Burks, Detective, Rockwall County, Texas

"I am a police detective who attended Kelsey McKay's training in 2015. I immediately knew I had to have her supplement form and try to implement it in my department. Once back at my department, I began taking the steps to get the form approved and put into place. After doing so, my DA's office loved the form and how it improved the quality of our cases. Since 2015, we have been able to get all agencies within our county to adopt the strangulation form as well. Our reports are drastically better and the officers now understand the dynamics of the offense and obtain the needed evidence at the crime scene, when it is available. I commend her for her spirit and desire to help victims and law enforcement understand this heinous crime!"

Charles Conrad, Reporter, Virginia

"Recently, I attended a domestic violence conference at which Kelsey McKay was the speaker. The topic of strangulation was of primary interest to me personally because my mother, who lived in an abusive marriage, died of strangulation in the 1970's when I was a young child. The jury found my father, who was charged with first degree murder, guilty of involuntary manslaughter after the defense presented a theory which cast doubt on his intent in the crime. All these years, I have wondered what the true story was in regard to my mother's death. Kelsey's explanation of strangulation, through her many years of experience as a prosecutor, has helped me to view the circumstances of my mother's death with a more clear understanding of what may have been involved. Although I was not present at the crime scene, this information on strangulation crimes helps me to connect the dots a little more. I am thankful for Kelsey's efforts in bringing the dangerous crime of strangulation to the forefront."