Eight-year outcome of implementation of abusive head trauma prevention

Barr, Ronald G.; Barr, Marilyn; Rajabali, Fahra; Humphreys, Claire; Pike, Ian; Brant, Rollin; Hlady, Jean; Colbourne, Margaret; Fujiwara, Takeo; Singhal, Ash

doi:10.1016/j.chiabu.2018.07.004

Cited by 60 publications

(55 citation statements)

References 40 publications

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“…This program revealed a decrease in AHT incidence after implementation in British Columbia, but implementation in the state of North Carolina did not demonstrate a decrease in the incidence of AHT. 35,36 Although it has been difficult to consistently demonstrate a decrease in AHT rates with educational interventions, some prevention programs have found other worthwhile results, including parental reports of improved understanding of infant crying, parental reports of improved emotional self-regulation, and an increase in parental knowledge of AHT. 37 Similarly, although the Nurse-Family Partnership, an inhome visitation program, has not demonstrated an effect on AHT rates specifically, the program has demonstrated a long-term decrease in child maltreatment and may be a useful approach in addressing AHT.…”

Section: Preventionmentioning

confidence: 99%

Abusive Head Trauma in Infants and Children

et al. 2020

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Abusive head trauma (AHT) remains a significant cause of morbidity and mortality in the pediatric population, especially in young infants. In the past decade, advancements in research have refined medical understanding of the epidemiological, clinical, biomechanical, and pathologic factors comprising the diagnosis, thereby enhancing clinical detection of a challenging diagnostic entity. Failure to recognize AHT and respond appropriately at any step in the process, from medical diagnosis to child protection and legal decision-making, can place children at risk. The American Academy of Pediatrics revises the 2009 policy statement on AHT to incorporate the growing body of knowledge on the topic. Although this statement incorporates some of that growing body of knowledge, it is not a comprehensive exposition of the science. This statement aims to provide pediatric practitioners with general guidance on a complex subject. The Academy recommends that pediatric practitioners remain vigilant for the signs and symptoms of AHT, conduct thorough medical evaluations, consult with pediatric medical subspecialists when necessary, and embrace the challenges and need for strong advocacy on the subject. HISTORY The evolution of the abusive head trauma (AHT) diagnosis has a long and storied history. 1-3 Earlier nomenclature included whiplash shaken infant syndrome, shaken impact syndrome, inflicted childhood neurotrauma, and shaken baby syndrome. The current term, AHT, was adopted by the American Academy of Pediatrics (AAP) in 2009 in recognition of the fact that inflicted head injury of children can involve a variety of biomechanical forces, including shaking. That change in terminology (from shaken baby syndrome), however, was misinterpreted by some in the legal and medical communities as an indication of some doubt in or invalidation of the diagnosis and the mechanism of shaking as a cause of injury. The AAP continues to affirm the dangers and harms of shaking infants, continues to embrace the "shaken baby syndrome" diagnosis as a valid subset of the AHT diagnosis, and encourages pediatric practitioners to educate

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Section: Preventionmentioning

confidence: 99%

Abusive Head Trauma in Infants and Children

et al. 2020

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“…PURPLE Crying is a three‐dose, universal prevention program implemented through maternal and public health units to reduce the risk for abusive head trauma (AHT) by increasing knowledge of infant crying and the dangers of infant shaking (Barr et al., ; Reese, Heiden, Kim, & Yang, ). The most recent study on PURPLE Crying showed a decrease in hospital admissions for AHT and a reduction in emergency department visits for crying problems (Barr et al., ). A parent education child abuse prevention program similar to PURPLE Crying was recently developed in the U.K. called Coping with Crying (Richards, ).…”

Section: Intervention Approachesmentioning

confidence: 99%

“…In summary, interventions that target the infant's physiology may reduce crying for a small percentage of infants who cry excessively. Parent education interventions may also be effective, and it is particularly promising that a universal educational intervention, not specifically targeting excessively crying infants, may reduce risk for AHT (Barr et al., ). Interventions that target both the parent and the infant show promise in reducing infant crying and parenting stress and distress.…”

Section: Intervention Approachesmentioning

confidence: 99%

Increasing parenting self‐efficacy: The Fussy Baby Network^® intervention

Gilkerson

Burkhardt

Katch

et al. 2020

Infant Mental Health Journal

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High levels of infant crying place families at risk for disrupted relationships, parenting stress, and even for child maltreatment. We conducted an evaluation of the Fussy Baby Network ® (FBN), a program supporting families struggling with infant crying and related concerns. The study contrasted 29 families who sought help from FBN with 27 families with excessively crying infants who did not seek services. Researchers measured parenting self-efficacy, depression, and stress in each group before and after the intervention. Results from hierarchical multiple regression analysis indicated greater improvements over time in parenting self-efficacy for parents receiving FBN services. Furthermore, the greater improvements in parenting self-efficacy in the intervention group were not directly attributable to reductions in infant crying. These findings provide preliminary evidence that the FBN approach may be effective at boosting the confidence of parents struggling with caring for their infants. Future research with larger samples with baseline equivalence and stronger research designs should explore this intervention further. This study also suggests that interventions for families with excessively crying infants should move beyond the focus of reducing infant crying to a broader strategy of supporting parents and strengthening relationships between parents and their infants to build parenting capacity. K E Y W O R D Sinfant crying, intervention programs, parenting efficacy, parenting stress, prevention programs 232

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“…Crying is discussed as a typical trigger for the violent shaking of a child [13][14][15]. The perpetrator has most frequently been identified as the father, the mother's new partner, the mother, or the female babysitter [16].…”

Section: Introductionmentioning

confidence: 99%

Abusive head trauma in court: a multi-center study on criminal proceedings in Germany

Feld

Feld²,

Karger

et al. 2020

Int J Legal Med

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The shaken baby syndrome (SBS) is a common variant of abusive head trauma (AHT) in infants and toddlers. Data on the legal outcome of such cases are still sparse. By means of a retrospective multi-center analysis, 72 cases of living children diagnosed with SBS/AHT from three German university institutes of legal medicine were identified. Forty-six of these cases with 68 accused individuals were available and could be evaluated with regard to basic data on the course of the criminal proceedings as well as the profile of the defendants (sub-divided into suspects, convicts, and confessed perpetrators). Criminal proceedings predominantly commenced with a complaint by the treating hospital (62%) and were found to be closed (without judgment) in 50% of the cases, mostly due to a “lack of sufficient suspicion.” Of the 23 cases with judgment, the court decided on acquittal in 4 cases (17%). Imprisonment was the most frequent sentence (16 out of 19 cases with conviction, 84%), whereby the sentence has been suspended on probation in 63% of the cases. Suspects and perpetrators were mostly male and derived from the close family environment of the injured children. All confessed perpetrators stated an “excessive demand” as the reason for the violent shaking of the child. The results of the present study are in line with data from other studies with other legal systems. As many criminal proceedings were closed and the 4 acquittals occurred because the perpetration could not be ascribed to a specific perpetrator, improving the forensic methods for such an unequivocal assignment would be desirable.

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Eight-year outcome of implementation of abusive head trauma prevention

Cited by 60 publications

References 40 publications

Abusive Head Trauma in Infants and Children

Abusive Head Trauma in Infants and Children

Increasing parenting self‐efficacy: The Fussy Baby Network^® intervention

Abusive head trauma in court: a multi-center study on criminal proceedings in Germany

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Eight-year outcome of implementation of abusive head trauma prevention

Cited by 60 publications

References 40 publications

Abusive Head Trauma in Infants and Children

Abusive Head Trauma in Infants and Children

Increasing parenting self‐efficacy: The Fussy Baby Network® intervention

Abusive head trauma in court: a multi-center study on criminal proceedings in Germany

Contact Info

Product

Resources

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Increasing parenting self‐efficacy: The Fussy Baby Network^® intervention