A Structured Review of the Literature on Abusive Head Trauma Prevention

Abstract

We searched the US National Library of Medicine's PubMed, Google Scholar and the American Psychological Association's Psychinfo databases during September 2019 for citations and abstracts on abusive head trauma (AHT) and shaken baby syndrome prevention dated 1 January 2000 to 31 August 2019. We identified 53 empirical studies and performed a structured review to identify the effects of prevention, if any, on AHT. We identified three lines of investigation that have focused on: (i) strategies which teach parents how to respond to newborn crying and the dangers of shaking babies; (ii) community and public health factors; and (iii) professional education and practice. Most studies were observational, although a small number used sophisticated designs such as prospective or randomised controlled trials. We note other strengths and weaknesses of these articles and suggest future directions for research in each of these areas based on the current level of scientific inquiry. Key Practitioner Messages Research on AHT prevention is limited, although a growing research base supports teaching parents how to respond to newborn crying and about the dangers of shaking babies. Social care systems addressing provision of material and other support have positive effects on AHT rates. Professional education should improve practitioners' identification of families with increased risk and enhance AHT identification and treatment. Those wishing to prevent AHT should consider multilevel approaches and their own community needs, practice setting, and patient/client risk profiles when designing strategies.

The Importance of Evaluation of Hemoglobin and Hematocrit Values in 0-2 Age Group Patients with Head Trauma

“…Shaken baby syndrome is a term frequently used by physicians and the general public to describe nonaccidental abusive head trauma to infants and young children. In such trauma, it is undoubtedly important to determine the etiology of the injury as well as informing and educating the parents (10,11). Injuries under 2 years of age may sometimes be di cult to detect.…”

The Effectiveness of Parenting Programs in Preventing Abusive Head Trauma: A Systematic Review and Meta-Analysis

“…Parenting programs on the awareness of AHT are the most common preventive interventions (Lopes & Williams, 2018; Roygardner et al, 2021). Several well-known programs have been implemented nationwide or worldwide for decades, such as The Period of PURPLE Crying ® (Barr, Barr, et al, 2009; Barr, Rivara, et al, 2009; Runyan et al, 2009), Prevent Shaken Baby Syndrome!…”

“…While a few reviews have summarized the content of AHT preventive programs (Lopes & Williams, 2018; Roygardner et al, 2021; Stoll & Anderson, 2013), no study has systematically examined the effectiveness of parenting programs in preventing AHT. Lopes and Williams (2018) searched 21 databases and reviewed 20 AHT prevention initiatives among 34 studies.…”

“…Detailed information on the strengths, limitations, and empirical evidence of each initiative (i.e., three types of initiatives: reduction in infant crying, targeting caregiver’s emotional regulation, and raising awareness about AHT) were reported, and a summary of implications for research and practice was provided. The other two reviews on AHT prevention conducted by Roygardner et al (2021) and Stoll and Anderson (2013) identified three critical components of AHT prevention, including parental education, community services involvement, and health professional education. However, the effectiveness of parenting programs in preventing AHT was not integrated and analyzed.…”

“…The review conducted by Lopes and Williams (2018) did not appraise the research quality. The study design and level of evidence rather than a critical appraisal of study validity were used to judge the research quality in the remaining two reviews (Roygardner et al, 2021; Stoll & Anderson, 2013). With the external validity of the individual studies being limited by their small sample size, especially the randomized trials, a systematic review and meta-analysis that integrates and appraises the existing evidence and increases the sample size is crucial to improving the rigor of the review and the precision of the estimates of intervention effects (Akobeng, 2005).…”