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      Sibling screening in suspected abusive head trauma: a proposed guideline

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          Abstract

          Abusive head trauma (AHT) is the leading cause of death from child abuse in children younger than 5 years. It is well documented that the infant contacts of children presenting with suspected AHT are at an increased risk of abuse when compared to the general infant population. Despite this association, a paucity of literature stratifies this risk and translates it to the clinic such that this high-risk group is stringently screened for abusive injuries. In this light, the authors propose a standardised screening method for all contact children of the index case and call for further consensus on the subject.

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          Most cited references21

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          An increasing risk of family violence during the Covid-19 pandemic: Strengthening community collaborations to save lives

          Andrew Campbell (2020)
          Though necessary to slow the spread of the novel Coronavirus (Covid-19), actions such as social-distancing, sheltering in-place, restricted travel, and closures of key community foundations are likely to dramatically increase the risk for family violence around the globe. In fact many countries are already indicating a dramatic increase in reported cases of domestic violence. While no clear precedent for the current crisis exists in academic literature, exploring the impact of natural disasters on family violence reports may provide important insight for family violence victim-serving professionals. Improving collaborations between human welfare and animal welfare agencies, expanding community partnerships, and informing the public of the great importance of reporting any concerns of abuse are all critical at this time.
          Article 0 comments Cited 361 times – based on 0 reviews     Review now
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            Consensus statement on abusive head trauma in infants and young children

            Vincent J. Palusci, Gary L Hedlund, Sandeep K Narang … (2018)
            Abusive head trauma (AHT) is the leading cause of fatal head injuries in children younger than 2 years. A multidisciplinary team bases this diagnosis on history, physical examination, imaging and laboratory findings. Because the etiology of the injury is multifactorial (shaking, shaking and impact, impact, etc.) the current best and inclusive term is AHT. There is no controversy concerning the medical validity of the existence of AHT, with multiple components including subdural hematoma, intracranial and spinal changes, complex retinal hemorrhages, and rib and other fractures that are inconsistent with the provided mechanism of trauma. The workup must exclude medical diseases that can mimic AHT. However, the courtroom has become a forum for speculative theories that cannot be reconciled with generally accepted medical literature. There is no reliable medical evidence that the following processes are causative in the constellation of injuries of AHT: cerebral sinovenous thrombosis, hypoxic-ischemic injury, lumbar puncture or dysphagic choking/vomiting. There is no substantiation, at a time remote from birth, that an asymptomatic birth-related subdural hemorrhage can result in rebleeding and sudden collapse. Further, a diagnosis of AHT is a medical conclusion, not a legal determination of the intent of the perpetrator or a diagnosis of murder. We hope that this consensus document reduces confusion by recommending to judges and jurors the tools necessary to distinguish genuine evidence-based opinions of the relevant medical community from legal arguments or etiological speculations that are unwarranted by the clinical findings, medical evidence and evidence-based literature.
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              Child deaths resulting from inflicted injuries: household risk factors and perpetrator characteristics.

              B Ewigman, P G Schnitzer (2005)
              To determine the role of household composition as an independent risk factor for fatal inflicted injuries among young children and describe perpetrator characteristics. A population-based, case-control study of all children < 5 years of age who died in Missouri between January 1, 1992, and December 31, 1999. Missouri Child Fatality Review Program data were analyzed. Cases all involved children with injuries inflicted by a parent or caregiver. Two age-matched controls per case child were selected randomly from children who died of natural causes. Inflicted-injury death. Household composition of case and control children was compared by using multivariate logistic regression. We hypothesized that children residing in households with adults unrelated to them are at higher risk of inflicted-injury death than children residing in households with 2 biological parents. We identified 149 inflicted-injury deaths in our population during the 8-year study period. Children residing in households with unrelated adults were nearly 50 times as likely to die of inflicted injuries than children residing with 2 biological parents (adjusted odds ratio: 47.6; 95% confidence interval: 10.4-218). Children in households with a single parent and no other adults in residence had no increased risk of inflicted-injury death (adjusted odds ratio: 0.9; 95% confidence interval: 0.6-1.9). Perpetrators were identified in 132 (88.6%) of the cases. The majority of known perpetrators were male (71.2%), and most were the child's father (34.9%) or the boyfriend of the child's mother (24.2%). In households with unrelated adults, most perpetrators (83.9%) were the unrelated adult household member, and only 2 (6.5%) perpetrators were the biological parent of the child. Young children who reside in households with unrelated adults are at exceptionally high risk for inflicted-injury death. Most perpetrators are male, and most are residents of the decedent child's household at the time of injury.
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                Author and article information

                Contributors
                Kshitij Mankad: kshitij.mankad@gosh.nhs.uk
                Journal
                Journal ID (nlm-ta): Pediatr Radiol
                Journal ID (iso-abbrev): Pediatr Radiol
                Title: Pediatric Radiology
                Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )
                ISSN (Print): 0301-0449
                ISSN (Electronic): 1432-1998
                Publication date (Electronic): 17 May 2021
                Publication date (Print): 2021
                Volume: 51
                Issue: 6
                Pages: 872-875
                Affiliations
                [1 ]GRID grid.420468.c, Department of Radiology, , Great Ormond Street Hospital, ; Great Ormond Street, London, WC1N 3JH UK
                [2 ]GRID grid.83440.3b, ISNI 0000000121901201, University College London Medical School, ; London, UK
                [3 ]GRID grid.415246.0, ISNI 0000 0004 0399 7272, Department of Radiology, , Birmingham Children’s Hospital, ; Birmingham, UK
                [4 ]GRID grid.11835.3e, ISNI 0000 0004 1936 9262, Academic Unit of Child Health, , University of Sheffield, Western Bank, ; Sheffield, UK
                [5 ]GRID grid.241054.6, ISNI 0000 0004 4687 1637, Department of Radiology, , University of Arkansas for Medical Sciences, ; Little Rock, AR USA
                Article
                Publisher ID: 4917
                DOI: 10.1007/s00247-020-04917-5
                PMC ID: 8126595
                PubMed ID: 33999232
                SO-VID: 93bbe486-abd4-4bb7-ad2f-67b99ace1e6d
                Copyright © © Springer-Verlag GmbH Germany, part of Springer Nature 2021
                License:

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                Date received : 22 July 2020
                Date revision received : 29 September 2020
                Date accepted : 16 November 2020
                Categories
                Subject: Child Abuse Imaging
                Custom metadata
                issue-copyright-statement © Springer-Verlag GmbH Germany, part of Springer Nature 2021

                ScienceOpen disciplines: Pediatrics
                Keywords: abusive head trauma,child abuse,children,infants,screening,siblings
                Data availability:
                ScienceOpen disciplines: Pediatrics
                Keywords: abusive head trauma, child abuse, children, infants, screening, siblings

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