Exploring the controversy in child abuse pediatrics and false accusations of abuse

Gabaeff, Steven C

doi:10.1016/j.legalmed.2015.12.004

Cited by 17 publications

(9 citation statements)

References 27 publications

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“…Over the last decade, questions about the validity of the allegedly strong link between the triad and traumatic shaking have successively increased . Norman Guthkelch, and others, has questioned the manner in which his own original hypothesis, as well as the subsequent inverse version of the hypothesis, became dogma and has claimed that the evidence on which the hypothesis was based is poor .…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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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).

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Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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“…Then, again without scientific content, it was postulated that SDH and retinal hemorrhage were sufficient to the diagnosis of SBS-´´The main Hypothesis´´. The conviction to diagnose using this only signs was above 94% between medical doctors [13].…”

Section: Diagnosismentioning

confidence: 95%

“…The caregiver was found guilty if he had difficulty to explain the history under investigator´s pressure; assume violent shaking and, when he didn´t confess, he was declared as a liar [13].…”

Section: Diagnosismentioning

confidence: 99%

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Shaken Baby Syndrome: literature review in the last 5 years

Paula

Pereira²,

Rabelo³

2020

archpedneurosurg

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Background: The aim of this study was to perform a narrative review on what the literature about shaken baby syndrome brought us in the last five years. Methods: A search on PubMed and Scielo using the keywords ´´Shaken Baby Syndrome´´, ´´Abusive Head Trauma´´ and ´´Síndrome do Bebê Sacudido´´ found 842 articles. After apply the inclusion and exclusion criteria we defined the sample corpus in 54 articles. Results: In the last five years several medico-legal debates have taken place discussing the controversies in the pathophysiology and diagnosis of abusive head trauma. Despite this, it is still the most common cause of brain damage in child. Prevention methods were created and tested. Although some have been successful they need some adaptations to improve the effectiveness. Conclusion: The Shaken Baby Syndrome is a high incidence disease that involves several neurological, cognitive and motor impairments. Because of that new research needs to be done to improve our knowledge about this type of trauma and the effectiveness of the prevention methods.

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“…4, No. 1, 2021 faith in the flawed subspecialty of child abuse pediatrics, must continue (Gabaeff, 2016). False accusations are a destructive waste of money (Fang, Brown, Florence, & Mercy, 2012), a cause of unnecessary human misery (Hogberg, Eriksson, Hogberg, & Wahlberg, 2020), and societal disruption.…”

mentioning

confidence: 99%

Recognizing the Misuse of Probabilistic Language and False Certainty in False Accusations of Child Abuse

Gabaeff¹

2020

JRPH

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Probabilistic language is language used to convey mathematical probabilities in narrative form including terms like “highly likely”, “concerning for”, “suspicious of”, and many others). PL can be used in conformance with standards elucidated in Forensic Epidemiology or misused with intentional imprecision, when not justified, to promote a misdiagnosis of abuse, with dire consequences. The application of actual probability analysis using tested mathematical models, like Bayes Theorem, is essential to an analysis of the actual probability of abuse in a specific case to avoid false accusations of abuse. Consideration of the prior odds of abuse combined with calculations the reliability of nonspecific and/or unreliable criteria or “indicators”, is being disregarded by child abuse pediatricians to justify diagnosing abuse with statements of false certainty that depend on the misuse of probabilistic language. These suppositious statements of false certainty are the sine qua non of accusatory expert opinion. Currently, and unfortunately, false certainty is only detected by scientists and physicians with the requisite advanced knowledge of these issues. When probabilities and evidence based science are studied and applied, deep flaws in the fund of knowledge of child abuse pediatrics have been exposed. On balance, there is an emerging reality that the collective suffering of falsely accused families may dwarf the horrific impacts associated with real abuse. It also exposes iatrogenic abuse as possibly the most common form of prosecuted child abuse in the legal system. A false accusation of child abuse is child abuse. The misuse of probabilistic language to convey false certainty and its ramifications for innocent caregivers is discussed herein and must be prevented.

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Exploring the controversy in child abuse pediatrics and false accusations of abuse

Cited by 17 publications

References 27 publications

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

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

Shaken Baby Syndrome: literature review in the last 5 years

Recognizing the Misuse of Probabilistic Language and False Certainty in False Accusations of Child Abuse

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