Thursday, 21 October 2010

SBS: Repeated and missed signs of child abuse|

October 12, 2010

In the September 2010 issue of Pediatrics, Catherine Adamsbaum,M.D., Sophie Grabar, M.D., Ph.D., Nathalie Mejean, M.D. and Caroline Rey-Salmon, M.D. published a retrospective observational study entitled “Violent and Repetitive Shaking is Common in AHT”, Pediatrics, Vo. 126, No. 3. The interesting study examined 112 cases. 29 included confessions by the perpetrator, and 83 did not. In the confessed cases, previous signs of child abuse were found in the medical records of 27% of the children - 93% of whom were under one year of age. The most common sign of abuse was bruising in non-ambulatory infants - found in the records between 1 week to 2 months before infliction of the acute catastrophic abusive head trauma. The authors reported that in none of these cases did the presence of the bruising lead to suspicion of the diagnosis of child abuse. Also, with respect to the act of shaking the infant (as opposed to inflicting previous abuse such as tissue damage which resulted in bruising, etc.), 55% of the confessed perpetrators described repeated episodes of violent shaking. The mean number of shaking episodes for the repeat shakers was 10. 62% of those repeat shakers described immediate periods of exhaustion in which the child would go to sleep after they shook the infant. All of the repeat shakers reported that they shook the babies to stop them from crying.

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