Under current reporting laws, when a child shows up to an emergency room with subdural hematomas and retinal hemorrhages, there is an immediate referral to child protective services and a default diagnosis of Non-accidental Trauma (NAT), or Shaken Baby Syndrome (SBS).
If there are multiple witnesses, or one disinterested witness, the caregiver is not likely to be charged. If the history given at the hospital is that of a motor vehicle accident or a high fall, the case is unlikely to be charged. However, if the parent reports a short fall or some other event less likely to result in death, the case is quick to be charged as a “shaken baby case”, and the child is not screened further for precipitating or contributing factors.
When looked at through the SBS lens, doctors see what may be precipitating or contributing factors (such as an old subdural, thrombotic disorder, or a tendency to bruise easy) as evidence of prior abuse. In actuality, these may be indicators of systemic problems or red flags for high-risk babies. The problem is diagnosing in this manner allows these cases to be charged based on statistical probabilities; cases that are improbable are deemed child abuse.
Though it is less likely than other scenarios, and agreeably not the norm, children do sometimes die from falls of less than six feet. Therefore, to charge someone for child abuse, simply because it is a statistically improbable scenario or lacks corroboration, is a great misuse of probabilities to allocate justice. Charging these cases in this way obscures the constitutional requirement of proof beyond a reasonable doubt and relies on the “reasonable suspicion” standards set for doctors by mandatory reporting laws.
One of the most frustrating things about defending a childhood head trauma case is that the theories on nonaccidental head injuries have been developed in the void of any reliable scientific data. On one side of the controversy sit pediatricians and child abuse experts who were trained that babies do not suffer the degree of neurological damage seen in these cases without force commensurate with that of a 2-3 story fall or a 35 mph unrestrained auto accident. On the other side of the debate are biomechanics experts, ophthalmologists, neuropathologists, neurosurgeons, neurologists, and forensic pathologists who say some children can and do suffer these types of injuries from accidental traumas, short falls, or systemic disorders.
Are there really more children who suffer abuse by violent shaking, or are there underlying illnesses or other possible explanations for the infant’s injuries and/or death?
Our goal is to provide the defense attorney, medical expert, concerned family member, or the falsely accused with a user-friendly look at the diagnosis and prosecution of cases involving allegations of Shaken Baby Syndrome. We have provided a tutorial on childhood head trauma with glossaries and references to some of the best articles for fighting fiction with fact. We have now consulted on over 500 cases charged as “Shaken Baby Syndrome” (also called non-accidental trauma, abusive head trauma, and non-accidental head injury). It is our wish to disseminate information that will dispel some of the myths about childhood head trauma and to help to further accurate medical diagnosis and testimony in these cases.