4 ms·

New book on the scientific controversy surrounding Shaken Baby Syndrome

12 points by rossant 3y ago

rossant 3y ago
After a personal ordeal, I directed my research career towards Shaken Baby Syndrome (SBS), a highly controversial but fascinating topic at the intersection of medicine, science, and law. I just co-edited a book published by Cambridge University Press (Shaken Baby Syndrome: Investigating the Abusive Head Trauma Controversy, Findley et al 2023). AMA.
- torstenvl 3y ago
  Have you served as an expert witness in child abuse/child DV cases? Most of the research focuses on intracranial injuries, especially subarachnoid hemorrhaging. Do you have a generic sense of the specificity of something like subconjunctival hemorrhages or rib fractures in the absence of other intracranial injuries?
  - rossant 3y ago
    No, I have not served as an expert witness. Based on the available literature, it is challenging to definitively determine whether certain findings are specific to abuse. There are limited options to reliably assess true positive and true negative rates in such cases. Rare diseases are more common than one might think, particularly in the pediatric population, and they can have a significant impact on injury thresholds. Therefore, it is important to consider that any given finding may or may not be attributed to trauma or an underlying medical condition. I believe that determining abuse is a legal matter rather than a medical one. From a scientific perspective, it may be limited to stating that the likelihood of abuse increases with the number of different injuries. Anything beyond that should perhaps be left to the discretion of the courts.
cbsks 3y ago
This is fascinating to me, thank you for posting it. I had no idea about the controversy around Shaken Baby Syndrome. My only knowledge of SBS is from a pamphlet my wife and I got in the hospital during delivery. I remember it said “It’s easy to prevent Shaken Baby Syndrome… DON’T SHAKE THE BABY!”, which I thought was funny. I guess that was an oversimplification.
- rossant 3y ago
  Thanks! Exactly, most people only know the prevention side of SBS (which is obviously critically important) and not the controversial side. It is uncontested that one should never shake a baby, which can cause lasting damage. What is contested is whether you can reliably infer that shaking occurred solely by observing a couple of supposedly specific intracranial lesions (subdural and retinal hemorrhage, bridging vein thrombosis) when you can't find any other plausible explanation.

12 points by rossant 3y ago

After a personal ordeal, I directed my research career towards Shaken Baby Syndrome (SBS), a highly controversial but fascinating topic at the intersection of medicine, science, and law. I just co-edited a book published by Cambridge University Press (Shaken Baby Syndrome: Investigating the Abusive Head Trauma Controversy, Findley et al 2023). AMA.

torstenvl 3y ago
Have you served as an expert witness in child abuse/child DV cases? Most of the research focuses on intracranial injuries, especially subarachnoid hemorrhaging. Do you have a generic sense of the specificity of something like subconjunctival hemorrhages or rib fractures in the absence of other intracranial injuries?
- rossant 3y ago
  No, I have not served as an expert witness. Based on the available literature, it is challenging to definitively determine whether certain findings are specific to abuse. There are limited options to reliably assess true positive and true negative rates in such cases. Rare diseases are more common than one might think, particularly in the pediatric population, and they can have a significant impact on injury thresholds. Therefore, it is important to consider that any given finding may or may not be attributed to trauma or an underlying medical condition. I believe that determining abuse is a legal matter rather than a medical one. From a scientific perspective, it may be limited to stating that the likelihood of abuse increases with the number of different injuries. Anything beyond that should perhaps be left to the discretion of the courts.

cbsks 3y ago

This is fascinating to me, thank you for posting it. I had no idea about the controversy around Shaken Baby Syndrome. My only knowledge of SBS is from a pamphlet my wife and I got in the hospital during delivery. I remember it said “It’s easy to prevent Shaken Baby Syndrome… DON’T SHAKE THE BABY!”, which I thought was funny. I guess that was an oversimplification.

rossant 3y ago
Thanks! Exactly, most people only know the prevention side of SBS (which is obviously critically important) and not the controversial side. It is uncontested that one should never shake a baby, which can cause lasting damage. What is contested is whether you can reliably infer that shaking occurred solely by observing a couple of supposedly specific intracranial lesions (subdural and retinal hemorrhage, bridging vein thrombosis) when you can't find any other plausible explanation.