Term Paper on "Crimes Against Children Shaken Baby Syndrome"

Term Paper 12 pages (4585 words) Sources: 1+

[EXCERPT] . . . .

Crimes against Children - Shaken Baby Syndrome

The Shaken Child Syndrome is considered to be an acute form of violent head disturbances. It is attributed as the most common reason of the severe neurological damage as a consequence of child violence. This is more common particularly among the infants exhibited by the specific anatomic characteristics. The Shaken Child Syndrome gives rise to an acute magnitude of death and illness. (James; MacKay; Sirnick, 2003) Every year it is estimated that about 2,086,000 children are susceptible to the child abuse or negligence. The enhancement in the rate of understanding and response to child abuse have attracted more attention on the intensity of the harm occurred as a result of the forceful shaking of the infants previously ignored for consideration as a type of physical abuse. (Spaide; Swengel; Scharre; Mein, 1990)

The infants are susceptible to severe injury when shaken. The muscles of the infant at neck are not considered powerful to resist the head movements, and quick movement of the head may cause the brain to be hurt by clashing with the skull wall. This may cause bleeding in and encircling the brain behind the eyes entailing serious damage. This may give rise to blindness-complete or in part, paralysis, mental disability or may even be fatal according to the susceptibility of the child and intensity of the shaking. The less severe but chronic shaking of infants may cause in the long run deficiencies with regard to attentiveness, and impairment of learning capabilities. (Showers, 1992)

Some of the damages caused by shaking include subdural, retinal or subarachnoid hemorrhages. (James; MacKay; Sirnick, 2003) the families of children those are victims of subdural hemorrhages are subjected to intense examination by the social welfare agencies. (Blumenthal, 2002) the maintenance of these children entails much dependence on the medical system, caretakers and the society as a whole. (James; MacKay; Sirnick, 2003) Most of the sufferers are too young, less than six months and their ailments are due to quick angular slow down of the brain movement and potential fatal effects. The American radiologist John Caffey at first brought out the possibility of multiple long bone fracture and subdural hematoma as a consequence of severe shock and shaking of the infants. He could indicate the severe subdural and subarachnoid hemorrhage, retinal hemorrhages and periosteal new bone formation at the metaphsysial regions of long bones by introducing the terminology Whiplash Shaken Infant Syndrome in 1974. (Smith, 2003)

Caffey attempted to narrate the characteristics of six babies of below 13 months old suffering from subdural haematomas and 'bone lesions of battering'. As his Abraham Jacobi Awards Address in 1972 Caffey narrated about the theory and practice of the shaking infants. Taking sufficient evidence of his 25 years of study he afforded to establish that the whiplash-shaking and jerking of the victimised infants are most common reasons for the skeletal and cerebra-vascular lesions. Prior to Caffey, Hess in his book 'Scurvy, Past and Present' detailed on many peculiar symptoms of scurvy associating many forms of hemorrhages that may take place in any organ and differ from small petechiae to very extensive extravasations. (Scheibner, 2001) it was a British neurosurgeon- Guthkelch who first narrated subdural haemorrhage in infants as a consequence of shaking. Its effects were later considered as having significant role in giving rise to the brain damage. The hypoxic ischaemic encephalopathy has been indicated by the advanced neuropathology and imaging tools as the significant cause of the brain damage. (Blumenthal, 2002)

The corporal violence among the children is considered to be the crucial reason for severe head wound among the infants. About 1.9 million children are estimated to be the victims of such physical abuse that gives rise to the physical injury. The Shaken Baby Syndrome - SBS is considered to be an acute form of child abuse that is commonly associated with the children below 2 years and some times extend to impact the children up to 5 years. The wound inside the cranial of the infants below 6 months of the age as a result of the physical abuse has been analyzed with sufficient data in this regard. The analysis depicts the difficulties confronted in finding out the victims of abusively shaken and the relationship between the intensity of shacking and variations in the syndrome. It is essential that the medical practitioners should be of utmost cautious while dealing with the brain damages among infants and should be well conversant with the radiologic and clinical outcomes favorable to the SBS diagnosis. Even though the detection of SBS is dependent upon the clinical and radiographic symptoms, it refers more particularly to a process of damage caused as a result of a shacking evident from the averments made by a nurse who inflicted several damages to the infants while shaking to belch them.

The process of injury normally associated with the abused infants is due to whiplash-shaking. The terminology 'shaken baby syndrome' is widely used as the diagnostic concept for such injury. This also indicates the cause of the sustenance of the injury as the intracranial hurt identified by the intensified observation of the victimized infants revealing of the faint impact on the head at the initial investigation. The concept of SBS gives rise to the general perception that the injury is caused by the caretakers inadvertently in the course of their play. Dunhaime and his associates consider the Shaken Impact Syndrome to be more appropriate in narrating the observable clinical and radiologic observations. It has however been found out that the insignificant forces associated with routine play, swings or fall from a low height are not considered stronger enough to give rise to the Shaken Baby Syndrome. Rather such damages are results of the injuries caused by major rotational forces that definitely surpass the normal child care activities. (Smith, 2003)

The basic feature that is brought out by analyses so as to differentiate the accidental from entailed head hurting is the biomechanics of injury. According to Fulton the pathophysiology in shaken impact syndrome is initiated at the very instance the shaking starts. Aggressive shaking of the baby with quick angular slowing down and its potential fatal effects results in a different type of wound. The angular slowing down of the head after a movement makes the brain to continue its rotation in comparison to the fixed skull and dura. Such angular forces exerts influence on the bridging cortical veins often causing cracks and consequently giving rise to the mental impairments and seizures and promotes cerebral edema. The real process of damages in respect of the SBS is quite hard to indicate since most of the attacks are not visible. The babies are susceptible to shaking not only once but are prone to shaking over a period of days, weeks and months. The shaking injuries are inflicted on the infants on their efforts to make them stop crying and the shaking force is associated with the irritation that the caregiver demonstrates. (Smith, 2003) large number of parents and other attendants are blamed for shaking their small babies and entailing severe corporal damage and death. Most of the hospitals in USA and also in other countries have the SBS squads that catch the worried care providers coming to the emergency units with the severely injured babies even prior to conducting any test. The victimized are kept away from their parents even though not indicted of any criminal offence, yet find it difficult to prove their innocence. (Scheibner, 2001) in many occasions the shaking of babies resulted in fatal injuries and caused death attracting criminal action against the delinquents. Recently a father was indicted for causing death to a baby and imprisoned for 51 years. The baby named Alex who was only 5 weeks old, died in October 2000; within 18 months of being shaken. (Burke, 2004)

According to Caffey, the pathogenic whip-lash shaking is being effected to in several means, under varied environments, by various types of persons and for different causes. He observed the most usual objective of such an action is an attempt in mending very insignificant misbehavior. He has also observed that the difference between the pathogenic and non-pathogenic shaking is not so clear. To him the interpretations of such injuries are to be made of the radiographic variations specifically due to absence of the systematic analysis of surgical exploration or necropsy. (Scheibner, 2001) in most of the cases of SBS there are common symptoms. The impetuous reason behind the incident is most frequently leveled as the crying of the infant.

The culprit mostly vindicate by saying that hurting the baby was not intentional but as an outcome of an effort to stop crying. Most are laying emphasis on high levels of stress. Even though there is illustrations of childcare nurses being the delinquents more often the cases occur by shaking of babies by the family members, relatives and friends assigned with the responsibility to sit with the baby. Most of the delinquents accused of baby shaking constitute… READ MORE

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