Thesis on "Shaken Baby Syndrome"

Thesis 8 pages (2610 words) Sources: 7 Style: MLA

[EXCERPT] . . . .

Shaken baby syndrome, a type of child abuse, is investigated by law enforcement officials as a criminal assault in the United States and in many countries around the world

("Shaken Baby…," ¶ 3).

Shaken Baby Syndrome Statistics/Symptoms

Each year, approximately 1,000 to 3,000 cases of SBS occur in the United States (U.S.), according to Centers for Disease Control and Prevention (The Face of…). Ann Blake, Contributing Editor, and Jennifer Michael, Managing Editor of Children's Voice report that every day in the U.S., eight children suffer serve injuries or die from Shaken Baby Syndrome (SBS). In the article, "Saving Babies from Shaking," Blake and Michael report that SBS, constitutes a 100% preventable "severe head injury caused by violently shaking an infant or child for as little as five seconds" (¶ 1). Reports during 2006 noted SBS as the leading cause of child abuse deaths in the U.S.; stressing that this contemporary malady afflicts up to 1,400 children yearly. Later reports, however, as the start of this study examining SBS notes, indicate the number of children experiencing SBS may more than double that number and that in the U.S., more than 300 babies die each year die from SBS.

During 2009, Childfind, a leading U.S. non-profit organization for victims of child abuse and neglect, reports the following statistics regarding SBS:

One out of every 3-4 shaken babies (25-33%) dies from injuries, usually within hours or days. Of survivors, only 15% escape permanent damage.

Young males: fathers and mom's boyfriends account for 67% of SBS. Paid caregivers account for 14%, mothers 9%.

The problem occurs in families of all races, incomes and educational levels.

SBS most often occurs prior to age one and seldom occurs after 2, though may occur to age 6 if extreme violence is used. Infants 2-4 months are most at risk.

Twins are at higher risk than singletons to receive a shaking assault.

Guilty caregivers may weave a trivial story of a fall or minor mishap into their story to try to cover their tracks. (Childfind)

Natalie K. Isser, Ph.D., and Lita Linzer Schwartz, Ph.D., both Professor Emeritas of Pennsylvania State University, assert in the article, "Shaken baby syndrome," that experts do not always agree on symptoms of SBS. The following symptoms, however, according to Childfind are commonly noted in victims of SBS.

Lethargy/decreased muscle tone

Extreme irritability

Decreased appetite, poor feeding or vomiting for no apparent reason

Grab-type bruises on arms or chest

No smiling or vocalization

Poor sucking or swallowing

Rigidity or posturing

Difficulty breathing

Seizures

Head or forehead appears larger than usual or soft-spot on head appears to be bulging

Inability to lift head

Inability of eyes to focus or track movement or unequal size of pupils (Childfind)

Figure 1 portrays two noted symptoms of SBS.

Figure 1: Two Noted SBS Symptoms (A.D.A.M.)

When a perpetrator shakes an infant or toddler, the victim's brain bounces back and forth against his/her skull. In turn, due to the resulting pressure and bleeding in the victim's brain, this may cause his/her brain (cerebral contusion) to bruise and swell. Isser and Linzer explain that:

The large veins along the outside of the brain may tear, leading to further bleeding, swelling, and increased pressure. This can easily cause permanent brain damage or death. Shaking an infant or small child may cause other injuries, such as damage to the neck, spine, and eyes. Eye damage is very common and may result in loss of vision (retinal hemorrhage). Shaken baby injuries usually occur in children younger than 2 years old but may be seen in children up to the age of 5. (Isser and Linzer, What are the…section, ¶ 2).

SBS History

In the study, "Baby Syndrome Education: A Role for Nurse Practitioners Working With Families of Small Children," Carrie Walls, MSN, RN, CPNP, summarizes research on SBS, along with relating state and federal efforts aimed to educate citizens about SBS…. Walls reports that during 1946, instead of describing SBS injuries as occurring as a result of unexplained metabolic processes, as was the practice/thought during that time, Dr. John Caffey first described children "with long bone fractures and intracranial bleeding as victims of trauma" (Walls, History section).

Caffey later expanded his 1946 report. In the expanded version, he "summarized the radiologic and physical findings associated with child abuse and the 'whiplash-shaking and jerking' of infants and young children as part of a syndrome he named parent-infant-stress syndrome or battered baby syndrome" (Caffey, quoted in Walls, History section). The battered-child syndrome, according

Caffey, consists of a condition portrayed when a baby or young child receives serious physical abuse. The parent or foster parent abuse typically administers the abuse which constitutes significant cause of childhood injury, disability, or death.

Walls reports Kempe et al. To note that the manifestation of the battered-child syndrome take place in children younger than 3 years. The symptoms reveal distinct discrepancies between the historical data the parents provide and the clinical findings, which includes "finding of subdural hematoma with or without skull fractures, and finding of a characteristic distribution of multiple fractures in different stages of healing along the long bones of the appendicular skeleton" (Walls, History section). According to Walls, Guthkelch reported that injuries such whiplash shaking to the biomechanical processes causes, consequently involve severe forms of head trauma. Frequently, "the phenomenon of long bone fractures, intracranial bleeding, and retinal hemorrhages" (Ibid.) does not reflect any noticeable outward signs of trauma. In time, these occurrences became known as shaken baby syndrome. Currently, a number of published reports, which primarily focus on the signs and symptoms of SBS, along with a number of risk factors related to SBS, aim to increase awareness of and strive to decrease the incidence of SBS.

In the book review of Silenced Angels by James R. Peinkofer, Marcie Parker, Senior Qualitative Researcher stresses that SBS does not happen accidently as a parent plays with his/her baby or young child. SBS rather depicts the perpetrator violently and repetively shaking an infant or toddler; causing brain injury and bleeding within the victim's head and the retinas. "a child falling from a third-story window has about a 1% chance of dying while in SBS there is a 25% risk of death" (Parker, ¶ 3). When SBS occurs, treating this leading causes of child abuse fatalities, Parker notes Peinkofer to report, typically costs a minimum of $100,000 to treat in the first year. More than monetary cost concerns, albeit, the community and society lose in the areas of the health, safety, well-being and future of their children.

SBS Perpetrators

The perpetrators of SBS often have been abused as children, and/or they may experience depression, anxiety or other psychiatric disorders. Other factors reportedly contributing to SBS include low self-esteem, which may make the perpetrator unable to endure the stress relating to the care for an infant, particularly when the child experiences colic or a chronic illness. The individual who practices SBS may not be educated in child rearing, parental expectations and/or responsibilities. Alcohol and drugs, forms of substance abuse, may also contribute to SBS. In addition: "Some researchers have cited social isolation and the absence of support for the new family. Domestic abuse may also be a factor in some of the mistreatment of small children" (Isser and Linzer, What are the…section, ¶ 2). Other risk factors include, but may not be limited to, the perpetrator possessing poor impulse control, being illiterate or mentally challenged, or having a low educational level, less than 12 years of formal education. he/she may also possess a noted dependency on others or extraordinary need to be nurtured (Isser and Linzer, What are the…section, ¶ 2).

Isser and Linzer explain that some experts have suggested a number of psychological characteristics appear common to the perpetrators of SBS. "Court records seem to show that family income levels are lower; there were more single parent households, and many more single mothers who have sleep-in boyfriends" (Isser and Linzer, What are the…section, ¶ 2). Even though not conclusive, the evidence indicates that approximately 75% of the time in SBS incidents, the "shaker" is male, with the biological father, mother's boyfriend, and stepfather being the most common perpetrator. The babysitter, the biological mother, the live-in boyfriend and sometimes even the grandparent, nevertheless may also abuse the child by shaking him/her. SBS Prevention

Isser and Linzer purport that a number of entities currently implementing preventive programs in various parts of the U.S. typically experience strong positive outcomes, reflecting a noted reduction in the number of shaken babies. The programs are likely to prove to be "most helpful when they include information about infant development and the nature of caretaking responsibilities, and are offered to new parents at the time of the child's birth, with reminders when the infant is taken for the first post-natal visit" (Isser and Linzer Legal ramifications section ¶17). These educational efforts, however, generally only reach the mothers, not the father or other male more likely to be the future abuse. More programs, however, have begun include… READ MORE

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