Child abuse: we have problems

Strouse, Peter J.

doi:10.1007/s00247-016-3551-9

Cited by 26 publications

(34 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Their testimony is based on clinical expertise and peer reviewed evidence in the medical literature. In some legal AHT cases, defense arguments (frequently supported by opinion testimony provided by a small group of medical witnesses) have offered a scientific-sounding critique of the AHT diagnosis, by offering a laundry list of alternative causation hypotheses [5]. Efforts to create doubt about AHT include the deliberate mischaracterization and replacement of the complex and multifaceted diagnostic process by a near-mechanical determination based on the "triad"the findings of subdural hemorrhage, retinal hemorrhage and encephalopathy [1].…”

Section: Introductionmentioning

confidence: 99%

Consensus statement on abusive head trauma in infants and young children

et al. 2018

View full text Add to dashboard Cite

Abusive head trauma (AHT) is the leading cause of fatal head injuries in children younger than 2 years. A multidisciplinary team bases this diagnosis on history, physical examination, imaging and laboratory findings. Because the etiology of the injury is multifactorial (shaking, shaking and impact, impact, etc.) the current best and inclusive term is AHT. There is no controversy concerning the medical validity of the existence of AHT, with multiple components including subdural hematoma, intracranial and spinal changes, complex retinal hemorrhages, and rib and other fractures that are inconsistent with the provided mechanism of trauma. The workup must exclude medical diseases that can mimic AHT. However, the courtroom has become a forum for speculative theories that cannot be reconciled with generally accepted medical literature. There is no reliable medical evidence that the following processes are causative in the constellation of injuries of AHT: cerebral sinovenous thrombosis, hypoxic-ischemic injury, lumbar puncture or dysphagic choking/vomiting. There is no substantiation, at a time remote from birth, that an asymptomatic birth-related subdural hemorrhage can result in rebleeding and sudden collapse. Further, a diagnosis of AHT is a medical conclusion, not a legal determination of the intent of the perpetrator or a diagnosis of murder. We hope that this consensus document reduces confusion by recommending to judges and jurors the tools necessary to distinguish genuine evidence-based opinions of the relevant medical community from legal arguments or etiological speculations that are unwarranted by the clinical findings, medical evidence and evidence-based literature.

show abstract

Section: Introductionmentioning

confidence: 99%

Consensus statement on abusive head trauma in infants and young children

et al. 2018

View full text Add to dashboard Cite

show abstract

“…During the last 40 or so years, a number of studies have been conducted on ‘shaken baby syndrome’ (SBS), which is currently a subset of more general labels such as abusive head trauma, nonaccidental head injury and similar terms (2, Box ). It has been maintained by paediatricians and child protection teams (CPTs) that there is a scientifically robust body of knowledge supporting the general assumption that when the triad is observed, the infant has been violently shaken . The criteria used to identify shaken baby cases have also been used in criminal trials in order to prosecute and convict suspected perpetrators with the help of expert testimony.…”

Section: Introductionmentioning

confidence: 99%

Insufficient evidence for ‘shaken baby syndrome’ – a systematic review

et al. 2017

View full text Add to dashboard Cite

Shaken baby syndrome has typically been associated with findings of subdural haematoma, retinal haemorrhages and encephalopathy, which are referred to as the triad. During the last decade, however, the certainty with which the triad can indicate that an infant has been violently shaken has been increasingly questioned. The aim of this study was to determine the diagnostic accuracy of the triad in detecting that an infant had been shaken. The literature search was performed using PubMed, Embase and the Cochrane Library up to October 15, 2015. Relevant publications were assessed for the risk of bias using the QUADAS tool and were classified as having a low, moderate or high risk of bias according to predefined criteria. The reference standards were confessions or witnessed cases of shaking or accidents. The search generated 3773 abstracts, 1064 were assessed as possibly relevant and read as full texts, and 30 studies were ultimately included. Of these, 28 were assessed as having a high risk of bias, which was associated with methodological shortcomings as well as circular reasoning when classifying shaken baby cases and controls. The two studies with a moderate risk of bias used confessions and convictions when classifying shaken baby cases, but their different designs made a metaanalysis impossible. None of the studies had a low risk of bias. Conclusion: The systematic review indicates that there is insufficient scientific evidence on which to assess the diagnostic accuracy of the triad in identifying traumatic shaking (very low-quality evidence). It was also demonstrated that there is limited scientific evidence that the triad and therefore its components can be associated with traumatic shaking (low-quality evidence).

show abstract

“…The publications by Geddes and coworkers during 2001-2004 presented a new mechanism theory which made the infant-must-have-been-shaken-theory unnecessary in triad cases without external signs of trauma Geddes, Vowles, Hackshaw, Nickols, Scott, & Whitwell, 2001;Geddes, Tasker, Adams, & Whitwell, 2004 scientists were negative or ignorant. Pediatric researchers criticized (Punt, Bonshek, Jaspan, McConachie, Punt, & Ratcliffe, 2004;Richards et al, 2006;Jenny, 2014) and still criticize the theory (Choudhary et al, 2018;Jenny, 2014;Strouse, 2016). This non-shaken baby theory has even been banned in UK courtrooms and classified as a "premature hypothesis" (Supreme Court of Judicature Court of Appeal (Criminal Devision)., n.d.)!…”

Section: Implications Of the Non-shaken Baby Theory By Geddes Et Almentioning

confidence: 99%

Do Child Abuse Pediatricians Search for a “Pediatric Vulcan Planet”? Comparison of Controversies about the Vulcan-Must-Exist-Theory and the Infant-Must-Have-Been-Shaken-Theory

Lynøe¹,

Juth²,

Eriksson³

2020

JRPH

View full text Add to dashboard Cite

We argue that there are similarities between the Vulcan-must-exist-theory, derived from the Original Unrestricted Newtonian Gravitational (OUNG) theory, on the one hand, and on the other hand the infant-must-have-been-shaken-theory, derived from the Original Unrestricted Abusive Head Trauma (OUAHT) theory. Although the Vulcan-must–exist-theory was apparently supported by observations over a period of 50 years, after the introduction of Einstein’s general relativity theory in 1915 and its corroboration in 1919, the alleged planet was subsequently neither observed nor needed. In analogy with the Einstein/Vulcan reasoning, we suggest that the introduction of the non-shaken baby theory by Geddes et al. in 2001-2004 indicates that in cases where an infant displays no external signs of trauma, the infant-must-have-been-shaken-theory is no longer needed. Moreover we argue that the two new theories -Einstein’s and Geddes et al.’s- have relevant similarities in terms of the effect on the respective original, unrestricted theory. Just as acceptance of Einstein’s general relativity theory led to the abandonment of the Vulcan-must-exist-theory, it is reasonable to claim that the infant-must-have-been-shaken-theory should also be abandoned. We finally argue that while the consequences of abandoning the Vulcan-must-exist-theory were restricted to some scientific and astronomical issues, the infant-must-have-been-shaken-theory has not yet been abandoned because of the societal and legal consequences.

show abstract

Child abuse: we have problems

Cited by 26 publications

References 39 publications

Consensus statement on abusive head trauma in infants and young children

Consensus statement on abusive head trauma in infants and young children

Insufficient evidence for ‘shaken baby syndrome’ – a systematic review

Do Child Abuse Pediatricians Search for a “Pediatric Vulcan Planet”? Comparison of Controversies about the Vulcan-Must-Exist-Theory and the Infant-Must-Have-Been-Shaken-Theory

Contact Info

Product

Resources

About