Shaken-baby syndrome questioned

A growing body of medical and legal experts, nationally and internationally, are casting doubt on what became known as shaken-baby syndrome, reported the Arizona Republic.

The idea that violent shaking of infants could cause brain injury was first proposed in a medical-journal article in 1971. Not only did it gain acceptance in the medical community over the next two decades, it also seeped into popular culture. Child-abuse prevention groups started awareness campaigns; the phrase "shaken-baby syndrome" entered the Random House dictionary in 1996.

By 2001, the American Academy of Pediatrics produced a position paper on shaken-baby syndrome, saying that doctors should presume abuse in any baby under a year old who had head injuries absent obvious trauma, such as a car accident. The paper, published in the journal Pediatrics, said the "constellation" of injuries in a shaken baby could not result from an accidental trip or fall.

The article also offered a psychological profile of adults who shake a child. "Such shaking often results from tension and frustration generated by a baby's crying or irritability," the journal article said, "yet crying is not a legal justification for such violence." It went on to warn that shaken babies were often misdiagnosed, meaning doctors needed to be extremely vigilant to spot them.

New research indicates that the symptoms associated by shaken-baby syndrome can be caused by other maladies. The long-held triad of symptoms -- bleeding on the brain, swelling of the brain and bleeding in the eyes -- thought to indicate a baby was violently and intentionally shaken could also be caused by a host of diseases, including infections according to the Republic.

DePaul University law professor Deborah Tuerkheimer, who wrote a 2009 study on the use of shaken-baby syndrome in courtrooms, said the easily spotted symptoms became not only a medical diagnosis but also a legal tool adopted quickly and used convincingly in courtrooms nationwide.

Physicians would testify that a shaken child would become unresponsive or go limp almost immediately after the abuse. So the last adult with the child would be the primary suspect. And the shaken-baby diagnosis also provided a motive: a frustrated caregiver looking to quiet a crying child.

Some shaken-baby cases included other signs of violent abuse, such as broken bones, bruises or fractures. But others have no outward signs of injuries. Cases were built solely on the symptoms of shaken-baby syndrome.

"(The syndrome) did all of the work," Tuerkheimer told the Republic. Jurors would hear the experts testify with certainty and couple that with an "inclination to want to convict and hold someone responsible for such an awful outcome," she said

In 2009, Tuerkheimer published a paper, "The Next Innocence Project: Shaken Baby Syndrome and the Criminal Courts" in the Washington University Law Review.

"In its classic formulation, SBS comes as close as one could imagine to a medical diagnosis of murder," Tuerkheimer wrote. "Prosecutors use it to prove the mechanism of death, the intent to harm, and the identity of the killer."

Also in 2009, the American Academy of Pediatrics revised its position paper on shaken-baby syndrome. It urged physicians to stop using that term and instead describe injuries as "abusive head trauma." The group said it urged adoption of the "less mechanistic term" to stop the focus on shaking. Instead, the journal said, doctors should look at a wider range of possible causes, according to the Republic.

To read more: http://www.azcentral.com/news/articles/20120904shaken-baby-fatalities-doubts.html#ixzz26gnBBJLh