Diagnosis of 'Shaken Baby Syndrome' Accepted by Majority of Physicians

Despite recent reports that the medical community is divided on the validity of shaken baby syndrome, a new survey finds that a large majority of physicians believe it is a valid diagnosis, according to a new study published in The Journal of Pediatrics.

The findings show a very high medical consensus that shaking a young child can result in subdural hematoma (a life-threatening pooling of blood outside the brain), severe retinal hemorrhage, coma, or death.

“Claims of substantial controversy within the medical community about shaken baby syndrome and abusive head trauma have created a chilling effect on child protection hearings and criminal prosecutions,” says Sandeep Narang, M.D., JD, lead author on the study, Division Head of Child Abuse Pediatrics at Ann & Robert H. Lurie Children’s Hospital of Chicago, and Associate Professor of Pediatrics-Child Abuse at Northwestern University Feinberg School of Medicine.

“Our study is the first to provide the much needed empiric confirmation that multidisciplinary physicians throughout the country overwhelmingly accept the validity of these diagnoses, and refutes the recent contention that there is this emerging ‘groundswell’ of physician opinion against the diagnoses.”

Recent media reports and judicial decisions have called into question the general acceptance among physicians of shaken baby syndrome and abusive head trauma. General acceptance of such concepts in the medical community is a critical factor for admitting medical expert testimony in courts. In cases of child maltreatment, courts often rely on medical expert testimony to establish the most likely cause of a child’s injuries.

For the study, researchers analyzed the survey responses of 628 physicians who frequently evaluate injured children at 10 leading children’s hospitals in the U.S. The represented specialties included emergency medicine, critical care, child abuse pediatrics, pediatric ophthalmology, pediatric radiology, pediatric neurosurgery, pediatric neurology, and forensic pathology.

The findings show that 88 percent of these physicians believe that shaken baby syndrome is a valid diagnosis, while 93 percent affirmed the diagnosis of abusive head trauma.

When asked to attribute a cause of subdural hematoma, severe retinal hemorrhage, coma, or death in a child less than three years of age, more than 80 percent of physicians responded that shaking with or without impact was likely or highly likely to produce subdural hematoma. Ninety percent reported that it was likely or highly likely to lead to severe retinal hemorrhage, and 78 percent felt that it was likely or highly likely to result in a coma or death.

None of the other potential causes, except high velocity motor vehicle collision, was thought to result in these three clinical findings by a large majority of respondents. Very few physicians believed that a short fall could explain the symptoms.

“Our data show that shaking a young child is generally accepted by physicians to be a dangerous form of abuse,” says Narang.

Source: Ann & Robert H. Lurie Children’s Hospital of Chicago