Washington | Shaking a young child is capable of producing a life-threatening pooling of blood outside the brain, severe retinal hemorrhage, coma or death, researchers, including one of Indian-origin, have warned. Recent media reports and judicial decisions have called into question the general acceptance among physicians of shaken baby syndrome and abusive head trauma, researchers said.
General acceptance of concepts in the medical community is a critical factor for admitting medical expert testimony in courts. In cases of child maltreatment, courts often rely on medical expert testimony to establish the most likely cause of a child’s injuries, they said. Claims of substantial controversy within the medical community about shaken baby syndrome and abusive head trauma have created a chilling effect on child protection hearings and criminal prosecutions, said Sandeep Narang from Northwestern University in the US.
Our study is the first to provide the much needed empiric confirmation that multidisciplinary physicians throughout the country overwhelmingly accept the validity of these diagnoses, and refutes the recent contention that there is this emerging ‘groundswell’ of physician opinion against the diagnoses, said Narang.
Shaking a young child is capable of producing subdural hematoma (a life-threatening pooling of blood outside the brain), severe retinal hemorrhage, coma or death, survey data showed. The study examined survey responses from 628 physicians frequently involved in evaluation of injured children at 10 leading children’s hospitals in the US.
The represented specialties included emergency medicine, critical care, child abuse pediatrics, pediatric ophthalmology, paediatric radiology, paediatric neurosurgery, paediatric neurology and forensic pathology. As many as 88 per cent of respondents stated that shaken baby syndrome is a valid diagnosis, while 93 per cent affirmed the diagnosis of abusive head trauma.
When asked to attribute a cause of subdural hematoma, severe retinal hemorrhage, coma or death in a child less than three years of age, more than 80 per cent of physicians responded that shaking with or without impact was likely or highly likely to produce subdural hematoma, 90 per cent reported that it was likely or highly likely to lead to severe retinal hemorrhage, and 78 per cent felt that it was likely or highly likely to result in a coma or death.
None of the other potential causes, except high velocity motor vehicle collision, was thought to result in these three clinical findings by a large majority of respondents. Very few physicians selected a short fall as an explanation for each clinical finding. Our data show that shaking a young child is generally accepted by physicians to be a dangerous form of abuse, said Narang.
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