Recognising Limitations: Author's Response

Laurent-Vannier, A.

doi:10.1002/car.2712

Child Abuse Review

2021

DOI: 10.1002/car.2712

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Recognising Limitations: Author's Response

A. Laurent-Vannier

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“…First, Edwards (2021) points out that 'the determination of the mechanism of an inflicted head injury is often difficult' (p. 300) as the clinical findings of shaking, impact or a combination of the two may overlap. As Laurent-Vannier (2021) points out in her response, however, their diagnosis was based on the rigorous clinical criteria of the HAS-SOFMER guidelines with shaking being considered 'the main and constant mechanism' for all cases (p. 303). Indeed, both authors are clear that shaking, with or without impact, is the main admitted mechanism of AHT (Edwards et al, 2020).…”

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confidence: 99%

Pitfalls, Paradox and Perplexity

Sidebotham

2021

Child Abuse Review

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The original research presented in this issue of Child Abuse Review explores some of the pitfalls, paradoxes and perplexity of working in child protection. We draw on work from Australia, France, the UK and USA covering issues ranging from abusive head trauma (AHT) in infants through to the criminal exploitation of young people. Working in child protection is never going to be easy, but these papers highlight some of the very real and complex challenges facing practitioners. They also suggest ways of navigating some of these difficulties. The papers in this issue deserve careful, reflective reading, so I would encourage you to grab a good cup of coffee (or whatever your favourite tipple might be), sit back and dip in … Abusive Head Trauma: Navigating the Pitfalls AHT is consistently reported as one of the commonest causes of serious and fatal child maltreatment, with a reported annual incidence between 14.2 and 33.8 per 100 000 live births in different international studies (Otterman and Palusci, 2020). The diagnosis and management of suspected AHT is, however, fraught with difficulties for clinicians, child welfare and criminal justice practitioners, and the courts, not least because the event leading to the injury is typically not independently witnessed.The first paper in this issue, from Anne Laurent-Vannier and colleagues (2021), reports on a case series of 100 infants diagnosed with AHT through shaking in the French courts. This complements another paper from these authors published in last year's special issue on AHT (Laurent-Vannier et al., 2020). The authors applied a rigorous approach to diagnosis using the evidence-based national HAS-SOFMER guidelines (Haute Autorité de Santé and Société Française de Médecine physique et de Réadaptation, 2017). The authors argue that by thoroughly analysing all the clinical and forensic data on these cases, they were able to determine when the symptoms that led to the diagnosis had occurred in 93 of the 100 cases.The most striking finding was that the onset of symptoms invariably occurred in a private home in the presence of a single adult carer. These symptoms were either a sudden loss of consciousness (in 72%) with associated hypotonia (floppiness), breathing difficulties, severe pallor and eye rolling, or 'an obvious change in the child's behaviour and competences, observed at the end of a period of custody by an adult' (in 27%), with the child presenting as

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confidence: 99%

Pitfalls, Paradox and Perplexity

Sidebotham

2021

Child Abuse Review

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Recognising Limitations: Author's Response

Cited by 1 publication

References 9 publications

Pitfalls, Paradox and Perplexity

Pitfalls, Paradox and Perplexity

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