|
|
|
|
SBS Prevention Plus featured in Virginia Child Protection NewsletterThe Summer, 2004 - Volume 71 issue of the Virginia Child Protection Newsletter which is sponsored by the Child Protective Services Unit of the Virginia Department of Social Services is focused on prevention. We wish to thank the Editor, Joann Grayson, Ph.D. for her support of education about Shaken Baby Syndrome. SBS Prevention Plus is honored to be spotlighted in their feature of our company's prevention materials and in their review of our video, "Crying...What Can I Do?' (Never Shake A Baby) on page 13. To order a copy of the newsletter, click on the link below: Virginia Child Protection Newsletter
Recent SBS Research Update:SHAKEN BABY SYNDROME Jacy Showers, EdD. Status Report: November 2003* In the past two decades, research has revealed that head trauma is the leading killer and disabler of abused children, and that shaking, with or without impact, is involved in many of these cases. Although a critical need persists to conduct research on issues related to abusive head trauma (AHT), including Shaken Baby Syndrome (SBS), below is a summary of current knowledge. Victims and Perpetrators Shaking as a mechanism of injury has been reported most commonly in babies less than six months of age, although reports are not unusual in children between the ages of six months and five years. Men outnumber women as perpetrators, with biological fathers constituting the largest group, followed by boyfriends of mothers, female child care providers/babysitters, and mothers. Although the most common age of perpetrators is 20-24 years, the documented range in age of perpetrators in preteen to 80-year olds. In most cases, the person with the child when he or she becomes symptomatic is the person who inflicted the injuries. The most common false history is a short fall. When there is an admission of shaking, the most frequent reason given is frustration or anger in response to a crying baby. Symptoms and Outcomes Symptoms associated with AHT/SBS range from subtle to obvious. They may include fussiness, extreme irritability, lethargy, vomiting, feeding difficulties, seizures, difficulty breathing, altered consciousness, and coma. Research suggests that approximately one-third of AHT cases have been missed or misdiagnosed the first time a child was taken to the doctor or emergency department, leaving a significant number of children at high-risk for re-abuse. The fact that early signs of SBS may be very subtle, and often mirror symptoms associated with common illnesses in children, can make the diagnosis difficult. The most common findings in SBS cases are intra-cranial hemorrhages and diffuse, multi-layered retinal hemorrhages. Associated injuries often include bruises and skull, rib or long bone fractures. To date, spinal cord injuries have not been commonly associated with SBS, but can occur. Brain swelling is the most life-threatening finding. In cases of death, diffuse axonal injury is an important element of proof that an onset of symptoms occurred immediately after shaking. CT and MRI scans, and indirect ophthalmoscopy are important tools in making the diagnosis of AHT. Two of the most confounding issues in SBS cases are the precise timing of injuries and determination of forces involved. In life threatening or lethal injuries, the onset of symptoms is immediate, although the exact number of shakes, amount of force, or length of time required to inflict injury on an individual child is not known. Research suggests that approximately one-fourth of SBS victims dies, and the majority of those who survive live with permanent impairment. Long-term consequences of shaking commonly include blindness, feeding difficulties, seizure disorders, sleep difficulties, motor impairments or paralysis, and learning difficulties. An injured child means an injured family; parents and siblings of the victims find their lives altered permanently whether the child survives or dies. The ability to find professionals who are willing to work with children who have extraordinary behavioral, motor, and learning problems is very difficult. Among victim families, a sense of justice in both fatal and non-fatal cases is rare. Investigation The successful investigation and prosecution of AHT cases depend greatly on law enforcement officers and prosecutors understanding the medical aspects and how to refute false histories. Most importantly, professionals must understand that the constellation of finding that occur in SBS cases do not occur with short falls, seizures, or vaccinations; these histories are often used as defense strategies. The importance of maintaining the same investigator and prosecutor on a case from beginning to end can be crucial. The most difficult cases to prosecute have been those in which there has been a change of child care providers during the time when the injuries could have been inflicted, and in nonfatal cases in which outcomes for children appear to be good. A carefully documented time line of the child's behaviors and health status is crucial in determining when the injuries likely occurred, and in whose care. There is a trend toward filing more serious charges, and more convictions have been obtained in recent years for murder rather than manslaughter. Unfortunately, there are still cases that are never prosecuted. Conflicting testimony by physicians in some SBS cases, with a few doctors even denying the existence of SBS, can cause decision making by juries and judges to be very difficult. Pediatric specialists who are clinically experienced in evaluating abusive head trauma in children are instrumental in the successful prosecution of SBS cases. These include pediatric ophthalmologists, neurologists, neurosurgeons, radiologists, and forensic pathologists. Education and Training Training of professionals and education of the general public about SBS has increased dramatically in the past decade. Physicians, nurses, first responders, attorneys, law enforcement officers, child protection workers, child care service providers, and child abuse prevention specialists have been targeted for training by numerous local, regional, and national conferences and seminars. In addition, child abuse prevention agencies have developed and implemented many approaches to educating the public about SBS. Strategies have been primarily targeted to parents in maternity units of hospitals and students in middle schools, but include a wide array of audiences using a a broad spectrum of materials. The most popular methods of education include videotapes and print material. Education often includes not only specific facts about SBS, but guidance about how to cope with a crying baby, and how to manage anger and stress associated with child care. Proof that an alleged perpetrator has received education about SBS can be used in successfully prosecuting a case. * Update of The Challenges of Shaken Baby Syndrome published by the National Association of Children's Hospitals and Related Institutions and authored by Jacy Showers, EdD, April 1999. |
|
Other website links: The Shaken Baby Alliance Prevent Child Abuse Illinois Miranda Joy Foundation 1000 Trade Show Giveaways Baby Bedding Town Baby Photos Town Quid Baby Pumpkin House children's books Baby Supermall A Baby Zone
Send mail to
sbspp@aol.com with
questions or comments about this web site.
|
