Pediatric Abusive Head Trauma Prevention Initiatives: A Literature Review

Lopes, Nahara Rodrigues Laterza; Williams, Lúcia Cavalcanti de Albuquerque

doi:10.1177/1524838016675479

Cited by 29 publications

(35 citation statements)

References 36 publications

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“…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. 38 Providing economic support for families may be another prevention approach.…”

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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“…Most prevention programs focus on raising awareness about normal infant crying and the dangers of shaking a baby, as well as improving caregivers' response to crying. 37 Results from these programs are promising, suggesting that prevention programs can improve parental knowledge about crying behaviors and may help reduce emergency department visits for prolonged crying. 38 The Period of PURPLE Crying, for example, is a prevention campaign designed by the National Center on Shaken Baby Syndrome and well known for its empirical support.…”

Section: Discussionmentioning

confidence: 99%

Trends in Shaken Baby Syndrome Diagnoses Among Young Children Hospitalized for Abuse

Conrad

Butcher

Oral

et al. 2020

Preprint

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Objective To investigate national trends of SBS diagnosis codes and how trends varied among patient and hospital characteristics. Methods We examined possible and confirmed SBS diagnoses among children age three and younger who were hospitalized for abuse between 1998 and 2014 using a secondary analysis of the National Inpatient Sample, the largest US all-payer inpatient care database ( N = 52,562). A baseline category logit model was used based on a quasi-likelihood approach (QIC) with an independent working correlation structure. Results The rate of confirmed SBS diagnoses increased from 3.8 (± 0.3) in 1998 to 5.1 (± 0.9) in 2005, and decreased to 1.3 (± 0.2) in 2014. Possible SBS diagnoses were 0.6 (± 0.2) in 1998, and increased to 2.4 (± 0.4) in 2014. Confirmed SBS diagnoses have declined since 2002, while possible SBS diagnoses have increased. Possible SBS diagnoses were more common among urban teaching hospitals and small to medium hospitals than for other hospital types. Conclusions We investigated seventeen-year trends of SBS diagnoses among young children hospitalized for abuse. The discrepancy between trends in possible and confirmed SBS suggests differences in diagnostic norms for SBS and related conditions. Researchers should examine diagnostic processes for SBS and investigate why cases are diagnosed as SBS or a related diagnosis. We propose that researchers and pediatric medical providers agree to a standardized definition and diagnostic guidelines for SBS, much like the AHT guidelines proposed by CDC, which may help reduce discrepancies in diagnosis and improve options for surveillance.

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“…Given that the subject technically exceeds the medical realm, with legal, sociological, and psychological implications [ 43 ], the author also emphasises society's duty to ensure prevention via education and assistance.…”

Section: Also In This Issuementioning

confidence: 99%

Protecting the blossoming brain – Neurocritical care in children

Häfner

2020

Biomedical Journal

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This special issue of the Biomedical Journal is entirely dedicated to the latest updates regarding the medical efforts to preserve the fragile young brain after injury. Thereby, we learn about symptoms and diseases such as different forms of epilepsy, acute encephalopathy, increased intracranial pressure, and posthaemorrhagic hydrocephalus, as well as about their origins, such as infection, autoimmune diseases, preterm birth, or abusive head trauma. Moreover, diagnosis and surveillance techniques are discussed, including ultrasound of the optic nerve sheath diameter and multimodal monitoring. Finally, we discover various established and emerging therapeutic approaches, comprising target temperature management, ketogenic diet, and immunomodulation.

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Pediatric Abusive Head Trauma Prevention Initiatives: A Literature Review

Cited by 29 publications

References 36 publications

Abusive Head Trauma in Infants and Children

Abusive Head Trauma in Infants and Children

Trends in Shaken Baby Syndrome Diagnoses Among Young Children Hospitalized for Abuse

Protecting the blossoming brain – Neurocritical care in children

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