A little girl gives Pope Francis a letter Wednesday at the end of his weekly general audience in the Paul VI Audience Hall at the Vatican. (Alessandra Tarantino/AP)

Cardinal Daniel DiNardo, the president of the U.S. Conference of Catholic Bishops, didn’t hide his shock in November as he addressed a gathering of the heads of the Catholic Church in the United States. The bishops had assembled that morning with a plan to refine and implement detailed procedures for addressing sexual abuse. Instead, DiNardo told them, he had just gotten word from the Vatican: The Holy See wanted the Americans not to take any action.

Amid the wave of surprised murmurs, DiNardo explained that the Vatican planned for the world’s leading bishops to discuss the issue together, at a global meeting in February.

Today, DiNardo is in Rome along with Cardinals Sean O’Malley of Boston and Blase Cupich of Chicago — the three American bishops among about 190 participants at a landmark conference on sexual abuse. There, they will advocate reforms American Catholics are clamoring for — although Pope Francis has already hinted those hopes might be too high. “We have to deflate expectations,” the pope said in January.

For Americans battered by a trying year, from a Pennsylvania grand jury investigation that inspired nationwide criminal investigations into the church to the disgrace of one of the country’s most prominent cardinals, a summit without serious steps toward reform is sure to be disappointing.

“I’ve looked at some of the agenda for the meeting. There’s no way they’re going to be able to hammer out anything at this gathering . . . I don’t think they’re going to be able to do anything that’s extremely concrete or detailed,” said Christopher Ruddy, a theology professor at the Catholic University of America who researches the modern priesthood.

If the meeting ends with a pronouncement about the evils of child abuse but no defined steps for changing the church, Ruddy said, that will be a particular problem for American Catholics. “I know the American bishops as a whole, even with their internal differences, have been disappointed or even extremely frustrated at what they see as failure to have papal or Vatican support for what they want to do . . . If we don’t see any sort of constructive action, or permission from the Vatican for American bishops to go forward, I think we’ve got a real problem, and I think that’s a failure of Vatican leadership.”

An event earlier this month in Washington underscored the demand among American leaders for action. More than 200 attendees, including abuse survivors, O’Malley and Cupich, discussed what they called “twin crises” — the abuse itself, and the failure of church leadership to handle it properly.

More than 50 American dioceses have reached out for guidance on confronting abuse to Leadership Roundtable, the D.C.-based Catholic nonprofit organization that arranged the meeting, according to the group’s CEO Kim Smolik. “This needs to be addressed, people recognize,” she said.

Bishop Shawn McKnight of the Diocese of Jefferson City in Missouri said at the event that when he met with his fellow recently appointed bishops at a conference in Rome last year, they were in agreement. “All of us, 17 of us, were very much of the same mind-set about the need to aggressively address these twin crises.” He called for more involvement of lay Catholics as a major step.

That’s what the American bishops had proposed in November; they were prepared to create a national lay council with the power to investigate misconduct by the bishops themselves. In Rome, it is a less popular idea. And it remains to be seen whether the Vatican will allow American bishops to implement the proposal if it doesn’t come up at the global summit.

“I heard a lot of encouragement of bishops to move forward on their own, even without a comprehensive strategy,” McKnight said. He said he and others were doing just that, creating their own forums in their dioceses for lay councils to investigate bishops.

The U.S. Conference of Catholic Bishops said Wednesday that DiNardo and other leaders were not available for interviews.

Some Catholic faithful in the United States have taken heed of Francis’s warning that this summit might not produce the sort of concrete steps they had hoped to see from their bishops.

“I’m starting to personally lose some hope,” said Jason Miller, who works for the Franciscan Action Network, a Catholic social justice group. “I’m holding my breath and saying some prayers, and we’ll see what happens. I’m losing faith, more so in the institution. Lately it’s been a real struggle.”

Miller, a parishioner at Our Lady Queen of Peace in Arlington, ticked off a long list of problems in the church, some of them just emerging this month: recent reports of nuns raped or molested, secret documents in the Vatican about what happens when priests father children. Those topics won’t be raised at this summit, which focuses only on child abuse. “It’s not about the hierarchy or saving face, which sometimes I think is first. The survivors should come first,” he said.

Winnie Obike said she is watching how the church deals with bishops when the leaders themselves have committed sexual abuse or covered it up. When Washington’s Cardinal Donald Wuerl ended up in the spotlight for how he handled abuse cases in Pittsburgh years ago, Obike created a petition that drew thousands of signatures demanding he step down; Wuerl retired early in October following months of criticism.

She said she was pleased that the church over the weekend took the step of defrocking ex-cardinal Theodore McCarrick for sexual misconduct with minors and adults. “They’re not pretending there’s not a crisis,” she said. “Our trust has been shattered. Our faith has been shaken . . . I would like those who are active, who have allegations made against them, for them to be [defrocked] now, not in 20, 30, 40 years when they are out of active ministry.”

Michelle Boorstein contributed to this report.