Perpetrator accounts in infant abusive head trauma brought about by a shaking event

Biron, Dean; Shelton, Dinah

doi:10.1016/j.chiabu.2005.05.003

Cited by 73 publications

(41 citation statements)

References 29 publications

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“…This exhaus-tion reported after shaking may well be considered an immediate symptom, similar to those cited in previous reports. 12,14 In our study, in 4 cases of single shaking, the perpetrator clearly indicated immediate symptoms after the shaking. In the other cases, the timing was unclear because the child was put to bed immediately after the shaking, with symptoms discovered after a delay that was usually Ͻ3 hours.…”

Section: Discussionmentioning

confidence: 92%

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Abusive Head Trauma: Judicial Admissions Highlight Violent and Repetitive Shaking

et al. 2010

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OBJECTIVE: Confessions are uncommon in abusive head trauma (AHT) cases, and there is debate over whether shaking alone can cause the injuries characteristic of AHT. The objective of this article is to correlate legal statements by perpetrators with medical documentation to offer insights into the mechanism of injury. METHODS:In this retrospective observational study we examined forensic evidence from 112 cases referred for AHT over a 7-year period. We compared 29 cases in which a perpetrator confessed to violence toward the child with 83 cases in which there was no confession. Inclusion criteria were subdural hematoma (SDH) on computed tomography and perpetrator admission of a causal relationship between the violence inflicted and the child's symptoms. Groups were compared by using Student's t test for age and Fisher's exact test for gender, death, fractures, retinal hemorrhages, ecchymoses, symptoms, and SDH patterns. All medical records from birth to diagnosis, imaging studies, and written investigation reports were reviewed. RESULTS:All confessions came from forensic investigations. There was no statistically significant difference between the 2 groups for any of the variables studied. Shaking was described as extremely violent (100%) and was repeated (55%) from 2 to 30 times (mean: 10) because it stopped the infant's crying (62.5%). Impact was uncommon (24%). No correlation was found between repeated shaking and SDH densities. CONCLUSIONS:This unique forensic case series confirms the violence of shaking. The high frequency of habitual AHT is a strong argument for reporting suspected cases to judicial authorities and helps to explain the difficulty in dating the injuries.

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Section: Discussionmentioning

confidence: 92%

“…This unique series of confessions confirms the pathogenic nature of shaking in and of itself, even without final impact. 12 We have provided excerpts from perpetrator statements to avoid interpretation. 13 On the basis of the presence of a skull fracture or perpetrator statement, there was head impact in only a few of the cases (7 of 29).…”

Section: Discussionmentioning

confidence: 99%

Abusive Head Trauma: Judicial Admissions Highlight Violent and Repetitive Shaking

et al. 2010

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“…18 In 1 study, 5 of 7 people who admitted shaking an infant cited crying or screaming as the trigger. 19 In another study of 32 infant deaths caused by abuse, 58% of the perpetrators reported that the infant's crying triggered the fatal outburst. 8 Finally, the age-specific incidences of abusive head injuries resulting from shaking exhibit a pattern similar to the normal infant crying curve, which is a graph showing the number of hours per day an infant cries as a function of age.…”

Section: Discussion What Causes An Adult To Shake An Infant?mentioning

confidence: 99%

Parent Education by Maternity Nurses and Prevention of Abusive Head Trauma

et al. 2011

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WHAT'S KNOWN ON THIS SUBJECT:Approximately 20 per 100 000 infants per year experience abusive head injuries resulting from shaking, typically triggered by a caregiver's inability to stop the infant's crying. Hospital-based parent education immediately after the infant's birth has shown promise as a prevention strategy. WHAT THIS STUDY ADDS:Results of this study provide strong corroborating evidence that a low-cost prevention program delivered by maternity nurses can substantially reduce newborns' risk of sustaining an abusive head injury resulting from shaking during the first year of life.abstract OBJECTIVE: A consortium of the 19 community hospitals and 1 tertiary care children's hospital that provide maternity care in the New York State Hudson Valley region implemented a program to teach parents about the dangers of shaking infants and how to cope safely with an infant's crying. This study evaluated the effectiveness of the program in reducing the frequency of shaking injuries. METHODS:The educational program, which was delivered by maternity nurses, included a leaflet explaining abusive head trauma ("shaken baby syndrome") and how to prevent it, an 8-minute video on the subject, and a statement signed by parents acknowledging receipt of the information and agreeing to share it with others who will care for the infant. Poisson regression analysis was used to compare the frequency of shaking injuries during the 3 years after program implementation with the frequency during a 5-year historical control period. RESULTS:Sixteen infants who were born in the region during the 8-year study period were treated at the children's hospital for shaking injuries sustained during their first year of life. Of those infants, 14 were born during the 5-year control period and 2 during the 3-year postimplementation period. The decrease from 2.8 injuries per year (14 cases in 5 years) to 0.7 injuries per year (2 cases in 3 years) represents a 75.0% reduction (P ϭ .03). CONCLUSIONS:Parent education delivered in the hospital by maternity nurses reduces newborns' risks of sustaining an abusive head injury resulting from shaking during the first year of life. Pediatrics

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“…In a study conducted on 52 patients, it was reported that parents of 5 SBS cases confessed that they had shaken their babies at the beginning. 18 In another study, parents of 5 cases admitted that they had shaken their babies on the later interviews. 12 It was reported that 65% of the children under one year of age who were admitted to hospital due to cranial trauma were victims of child abuse.…”

Section: Discussionmentioning

confidence: 99%

“…However, there was no information about the long term followup of the other cases. 18 In another study, 60% of the children with SBS admitted to hospital in coma either lost their lives or developed mental retardation, quadriplegia or severe motor retardation. In the same study, it has been also reported that SBS cases admitted to hospital with mild symptoms and without severe cerebral damage displayed mild neurological symptoms and epilepsy in the followup period.…”

Section: Discussionmentioning

confidence: 99%