Tuesday, April 28, 2009
Sunday, April 26, 2009
However, Vaughan at Mind Hacks speaks well of an article in today's Boston Globe by Jonah Lehrer, who has done some excellent science writing. Link to Boston Globe article.
It reminds us we have much to learn about the way a baby's brain functions. In the Mind Hacks review, this caught my eye:
And reading the BG article, I thought this was interesting...
Newborns start with fewer synapses than adults but this number rockets, so by six months of age we have approximately twice as many connections. This tails off as the brain prunes connections on a 'use it or lose it' basis.
I'm always slightly awestruck whenever I view that graph as it is a vivid illustration of the incredibly rapid changes changes that take place as we grow and learn to make sense of the world.
By using new research techniques and tools, they've revealed that the baby brain is abuzz with activity, capable of learning astonishing amounts of information in a relatively short time. Unlike the adult mind, which restricts itself to a narrow slice of reality, babies can take in a much wider spectrum of sensation - they are, in an important sense, more aware of the world than we are.Finally, how many times do parents almost get their infant to sleep, only to have the slightest noise or motion startle them into wide-eyed awareness?
This hyperawareness comes with several benefits. For starters, it allows young children to figure out the world at an incredibly fast pace. Although babies are born utterly helpless, within a few years they've mastered everything from language - a toddler learns 10 new words every day - to complex motor skills such as walking. According to this new view of the baby brain, many of the mental traits that used to seem like developmental shortcomings, such as infants' inability to focus their attention, are actually crucial assets in the learning process.
They might be better prepared if they knew this:
While adults automatically block out irrelevant information, such as the hum of an air conditioner or the conversation of nearby strangers, babies take everything in: their reality arrives without a filter. As a result, it typically takes significantly higher concentrations of anesthesia to render babies unconscious, since there's more cellular activity to silence.
Link to MassKids page on the Stroll.
Link to article about the Stroll.
As part of the lead up to the Stroll, WBZ interviewed Shannon Byron, the mother of a shaken baby, and ex-husband Sean Forant, the man who shook his child. It's worth a listen...
Link to WBZ interview
Friday, April 24, 2009
Her story is testimony to the ability of life to endure against all odds, and an apt story to consider at the end of SBS Awareness Week 2009.
A month ago, Lily was allegedly shaken by her mother's 18 year old boyfriend, and was not expected to survive.
However, she's returned home, blind and partially paralyzed, just a week before her first birthday.
It will likely be a bittersweet celebration.
According to the news article, her mother and grandmother will be working to increase awareness of Shaken Baby Syndrome. Let's hope Lily will be able to join them and tell her story for years to come.
When Philadelphia Business Today reported on the controversy about the Apple "Baby Shaker" app, it went to Cindy Christian, a pediatrician at Children's Hospital of Philadelphia for comment.
Two things bother me about the resulting story:
First, Dr. Christian is quoted as saying that shaking causes 1,000 fatalities a year. That's a bit surprising, since the general consensus is that there are 1400-1600 cases a year that come to medical attention and about 20-25% of those cases result in death.
That estimate of incidence is based in part on research by Keenan et al., published in the JAMA in 2003. When the results found in that study were extended nationwide, it was estimated that there are 300 deaths a year due to shaking. Link; Link to JAMA PDF of Keenan article.
But misquotes happen...
Second, while there are sound reasons to prefer the use of AHT in the medico-legal contexts that follow an inflicted injury, it's a step backwards in the context of prevention.
Prevent Child Abuse America has advocated the reframing of prevention messages about SBS from the context of child abuse to the world of injury prevention and safety that most parents inhabit. When the very name presents it as "abusive" action, that will anchor it firmly in a world parents don't want to acknowledge, let along inhabit. Link to PCAA White Paper.
Plus, "baby" just gathers up the attention of parents in a way that a term focused on the injuries that result from shaking/impact can't...
Prevention education is not about medicine: it's about human behavior, cognition and marketing (now, that's where Apple could really make amends). In significant respects, it's about telling stories that engage people at a teachable moment in ways that change behavior, not about engaging their logical minds.
So, that's why I think I will continue to favor use of the term "Shaken Baby Syndrome" in the context of prevention and that's why I will decline to use the term AHT - in that context.
Of course, as Dennis Miller used to put, I could be wrong.
It would be great if some psychology, education and marketing students and faculty combine on a study to evaluate the way that parents respond to these terms, and most importantly, how the terms affect their real-world behaviors.
For instance, would new parents be more forthcoming in talking to their child care provider about coping behaviors to prevent SBS or AHT? Can the AHT terminology coexist with reframing prevention messages to promote the prevention of injury and the opportunity to help keep a child safe?
Inquiring minds want to know...
Outrage over iPhone 'Baby Shaker' app
By Marie McCullough- Inquirer Staff Writer
In the latest example of the dicey line between the virtual world and the real one, Apple Inc. yesterday apologized for selling Baby Shaker, an iPhone application that let users silence an imaginary crying infant by shaking the multimedia device.
The 99-cent "app" was removed from Apple's online store on Wednesday, two days after it debuted (although it endures on YouTube). Outraged child-welfare groups that decried it as "horrifying" and "reckless" demanded an apology - which they finally got.
Apple spokeswoman Natalie Kerris said in a statement that the software was "deeply offensive" and should not have been approved for sale.
Searching for a silver lining, pediatrician Cindy Christian, co-director of the Center for Child Protection and Health at Children's Hospital of Philadelphia, thanked Apple for finding "an unfortunate way to raise awareness" of child abuse.
"Unfortunately, more than 1,000 babies die each year from being shaken and countless more are left with permanent brain damage," she said. "I'll use any way we can get the message out: It's not OK to take your frustrations out on a crying baby."* * *
Coincidentally, the American Academy of Pediatrics on Monday will issue an updated policy statement, coauthored by Cindy Christian of Children's Hospital, urging doctors to abandon the well-known "shaken baby syndrome" terminology in favor of "abusive head trauma."
The change, Christian explained, reflects the fact that injury is often a combination of shaking, beating and throwing an infant.
"Shaking is a very important mechanism, but not the only mechanism," she said. "To call all of it 'shaken baby syndrome' is not accurate. A lot of these cases go to court, where mechanisms need to be accurate."
"This area is really quite controversial," she added. "There is a small group of professionals who don't believe you can do harm by shaking a baby."
Wednesday, April 22, 2009
With estimates that as many as 13 million children age 5 and younger may be in child care for all or part of the week, it's good to hear that Minnesota is taking this action.
Representatives voted 122-12 to require child-care workers to be trained about sudden infant death and shaken baby syndromes, including that such problem can affect children up to age 5.
“This bill simply helps make sure child-care providers have accurate information about the risks of shaking a small child up to the age of 5, which in turn may help avert a tragedy,” Rep Phillip Sterner, DFL-Rosemount, said.
Shaken baby syndrome can result in serious injury or even death.
Minnesota law now has different training standards for child-care workers. Sterner's bill would clarify the law so all such workers get adequate training.
Tuesday, April 21, 2009
KEARNEY - Ethen Frerichs looks like any other 6-year-old.
He watches cartoons, listens to music, dances, talks on the phone, tickles his little brother Trevor and loves being a host. He can write his name, knows his colors and letters, and loves riding the bus to school.
Not bad for a kid using just the right side of his brain.
At 8 months old, Ethen was shaken by his in-home baby sitter in Bellevue. The injury caused traumatic injury to the left side of his brain, which controls the right side of the body, understanding and use of language, detailed analysis of information, and memory.
Now, Ethen's a vivacious kindergartener, and his mother, Kristen Frerichs is sharing her son's story with medical professionals and social workers.
Friday, April 17, 2009
Thursday, April 16, 2009
Wednesday, April 15, 2009
Frequently, people ask whether throwing a child up in the air might cause SBS.
The answer: not according to the AAP advisory (see below), but what happens if you drop him/her?
Shaken baby syndrome awareness programs that erroneously state that shaken baby syndrome may be caused by bouncing a child on a knee, by tossing him in the air, or even by rough play are to be discouraged, because they are inaccurate and may cause parents who have not abused their child to feel guilty.
Shaken Baby Syndrome: Rotational Cranial InjuriesTechnical Report
So, what do you think: safe play or not?
PS. Beckham is cited as a role model for some other strange things...
The new state budget provides $180,000 for the statewide awareness campaign that was part of Cynthia's Law...
While it's good news that some money is still appropriated, the initial proposal was $360,000. Now, it's roughly 75 cents per birth in NY State.
Hawaii just reported that the average cost of hospitalization for an infant who survives SBS is $80,000. Scheider Hospital just reported 6 SBS cases within the last six months: if the cost is comparable, that's $480,000 - just on Long Island.
One wonders why we count out pennies for prevention while spending thousands of dollars on the consequences.
Link to Hawaii DOH report to the Legislature on implementation of SBS program.
Monday, April 13, 2009
While Schneider deserves kudos for its effort to increase awareness of the vulnerability of children to inflicted head injuries, it's surprising that there's no mention of education efforts at local maternity hospitals.
Doctors at Schneider Children's Hospital say for the first time in 25 years, the hospital has created a campaign focused on shaken baby syndrome. They say the reason it comes now is due to fear that stress from the economy may add to an increase in this type of child abuse.
The ad, which features a father with his son, reads: "Real men have a soft touch. Never shake a baby." If you haven't seen it yet, there's a good chance you will. The full page ad is running in newspapers. It's also prominently displayed on jumbotrons in Times Square and on posters on Long Island Rail Road and Metro-North trains. In addition, a radio spot is airing this month with the same message.
The massive campaign is sponsored by Schneider Children's Hospital, and it's an attempt to curb the increase in shaken baby syndrome.
"We've had five or six cases in six months. Last year we had one. We need to look into why?" Dr. Fred Bierman said.
Since 2004, New York has required that hospitals offer new parents the opportunity to watch a SBS prevention video.
Of course, that prevention initiative is based on the program developed by Dr. Mark Dias at Children's Hospital of Buffalo. The Upstate New York SBS Prevention Project has reduced the incidence of inflicted head injury in the Buffalo area by 50%. A counterpart program at Westchester Medical Center was scheduled to start serving hospitals on Long Island in 2008.
General awareness is good, but educating new parents so they have the opportunity to help protect their child is even better.
Resource: Link to NYSBSPP article on nurses' role in prevention.
Resoure: Link to Pediatrics report by Dias et al.
Friday, April 10, 2009
The article points out that the evidence of incidence is almost all anecdotal.
Some hospitals report seeing more than twice as many shaken babies as a year ago. Deaths from domestic violence have increased sharply in some areas.
Calls to domestic-violence hotlines have risen too, and more than half the callers said their families’ financial situation has changed recently.
Across the country, these and other signs point to another troubling effect of the recession: The American home is becoming more violent, and the ailing economy could be at least partially to blame.
The need is also increasing:
Nationwide government data will not be compiled for months, so the evidence suggesting an uptick in child abuse and domestic violence has been largely anecdotal.
But the Child Welfare League of America, a coalition of public and private agencies, has been surveying state child welfare agencies to determine whether the numbers reflect a spike in violence.
"I think a lot of people are very concerned that we are in the early phases of this," said Linda Spears, vice president for policy and public affairs.
Interestingly, the economic downturn may also be responsible for a different kind of family impact: the New York Times reports on an uptick in vasectomies...
Just as the need appears to be growing, the recession is drying up funding to many agencies that fight domestic violence.
"This period of time may well be our perfect storm: a struggling economy, an increase in stress and a decrease in funding of programs," said Fagin, the Long Island child abuse prevention advocate.
Wednesday, April 08, 2009
Now, with her family, she's helping educate students to prevent other children from suffering those injuries. The Victorville Daily Press Link and the Hesperia Star (Link) report on a visit to a local high school...
There were statistics, graphics and numerous handouts.
But the primary teaching tool that Royane Walker used to warn about shaken baby syndrome is her grand-daughter, an angelic-faced, wheel-bound 8-year-old girl named Madison.
“We'll never be sure what happened,” said Walker, who has legal guardianship of Madison. “My daughter was at work. Her father was frustrated and shook her. It only took three seconds. She was nine weeks old. She'll be nine weeks old for the rest of her life.”
Walker and another adult daughter, Maggie Kershaw, presented a 90-minute program on Monday to teacher Thomas Howe's class at the I Avenue Community Day School, a program for at-risk teens who don't fit into a typical high school environment.
Tuesday, April 07, 2009
It is interesting that there is no mention of shaken baby prevention efforts, either in the Sacramento area or elsewhere, especially given California's budget problems.
Fresno family fights for 'Adam's Law' - Family backs a tough bill for those who inflict serious injuries on a child younger than 8.
By Pablo Lopez / The Fresno Bee
It was supposed to be a happy time in Adam Carbajal's life. He had just turned 1.
But a day after relatives celebrated the Fresno toddler's first birthday in November 2004, he was shaken so violently by his mother's boyfriend that he still can't walk or talk today. Relatives say Adam, now 5, needs around-the-clock supervision and a wheelchair for the rest of his life.His attacker, Ramon Curiel Jr., will be out of prison in about five years.Adam's family says that's not justice -- and that is why they're fighting for a state law that would increase punishment for anyone who inflicts serious injuries on a child younger than 8.
Present sentencing guidelines call for up to six years in prison for child abuse, although more years can be added for additional charges. Adam's family wants to make sure child abusers will receive 15 years to life in prison if the child suffers permanent brain damage or paralysis."I want to believe Adam's injury happened for a reason," Adam's grandmother, Maria Alvarez-Garcia, said recently as she fought back tears.
But the family's mission has hit roadblocks.
Clovis lawmaker tries to help
A year ago, Assembly Member Mike Villines, R-Clovis, introduced what he calls "Adam's Law," but the bill stalled in a Senate subcommittee. A Democrat-led Public Safety Committee stuck to a policy of shelving crime bills until the state reduces costly prison crowding.
Villines has introduced the bill again this year. He has again asked Adam's grandparents -- Alvarez-Garcia and Alfredo Garcia -- to testify in front of state leaders. "It's not that big of a cost, especially when we're talking about protecting children," Villines said. "It's our job to make room for these types of criminals."
The number of defendants who would be affected by Adam's Law statewide is unclear.But Esther Franco, executive director of the Fresno Council on Child Abuse Prevention, said children like Adam who suffer shaken-baby syndrome cost California taxpayers tens of millions of dollars every year because they require such intensive medical care. California hospitals treat about 150 shaken babies every year, at an average cost of about $300,000 per child, she said. "Most of these children will never again lead normal lives," she said.* * *California's Adam's Law also would help protect children, Franco said. Under current law, child abusers can receive the same sentence whether they break a child's finger or inflict brain damage and paralysis.
"Shouldn't the punishment fit the crime?" she asked.But the proposal has its critics. Some defense attorneys say the bill might result in life prison sentences in cases of accidental injury."Babies are so fragile," said San Francisco attorney Grace Lidia Suarez, who handled Curiel's appeal. "What happens if a baby accidentally falls on someone's lap and hit his head and suffers a serious brain injury? Should that person be sentenced to life in prison?"5% chance of survival
Adam's injuries were no accident, authorities say.
In 2004, Adam was living with his mother, Mari Delgado, and her boyfriend, Curiel. They had been living together for about eight months. Adam's family said they were unaware then of Curiel's juvenile record of burglary, drug possession, auto theft and arson.
A Fresno police report said Curiel was baby-sitting Adam on Nov. 8, 2004, while Delgado was at school. Adam was a healthy baby who was learning to walk and was saying words like "mommy," "no" and "sock," Delgado said recently.
About 20 minutes after she left home, Delgado said, Curiel made a frantic phone call to her and said: "Adam fell and he's acting funny." She told him to call 911.
An ambulance rushed the 24-pound youngster to a hospital, where doctors cut into Adam's head to relieve pressure around the left side of his brain. "They gave him a 5% chance of survival," Delgado said.
Adam had severe head injuries. Authorities believe Curiel shook Adam and hurled him against a wall, which would explain why the boy's skull is now flat on the left side. Adam spent six weeks in the hospital, including two weeks in a coma. Alvarez-Garcia was by his side every minute.
"She lost her job because of her commitment to Adam," Franco said.
But losing a job was nothing compared to what happened next, Alvarez-Garcia said.
From the hospital, Adam was put into foster care while Child Protective Services investigated his mother. After a few months, Adam began living with his grandparents while his mother took parenting classes.
Throughout this time, Curiel was telling authorities that Adam fell while trying to walk, court records show. Eventually, investigators determined the injuries were not consistent with a fall.
Curiel was arrested in the fall of 2005, nearly a year after Adam was injured. But he posted bail and evaded authorities for more than a year.He was finally taken into custody in February 2007. A month later, he accepted a plea agreement with the District Attorney's Office. By pleading guilty to child abuse, he would receive six years in prison, court records show.Adam's family said prosecutors never told them about the deal. They found out in court. "I was furious," Alvarez-Garcia said. "They were going to give him a slap on the hand."The plea deal prompted Adam's family to take the case public. Television cameras began capturing their grieving moments with Adam at home and their tearful pleas for justice in Fresno County Superior Court. "They sure got the attention of the judge," said Suarez, Curiel's attorney.
On June 15, 2007, Judge David Gottlieb looked over Curiel's plea agreement and rejected it. Under current state law, Gottlieb said the crime was worth 12 years in prison -- six years for child abuse and six years for inflicting great bodily injury on Adam.
The judge offered Curiel 10 years in prison. Curiel accepted it -- and admitted that he had inflicted Adam's injuries, though he never said exactly what he had done. But he said he had lied to investigators and Adam's family. Because Curiel can earn good-time credits in prison, he can be paroled in late 2014 or early 2015.
Suarez tried to get a lesser sentenced for Curiel at the 5th District Court of Appeal, but her motion was rejected.
"My client didn't burst into the home and attack Adam," Suarez said. "He made a mistake. He snapped. That shouldn't be a life sentence."
Raw emotions fuel coupleA big scar on Adam's head is a painful reminder to Adam's grandparents that his chances at a normal life are slim.Adam suffers seizures and has no use of his right arm and leg. He grunts when he wants something and uses his left arm and leg to drag his body around his home. He sleeps on a mattress on the floor of his bedroom because his family can't afford a bed that is designed for children with severe disabilities.Alvarez-Garcia said she and her husband are fueled by three raw emotions: hate for Curiel, anger at the criminal justice system and guilt for not protecting Adam. "I pray something good comes out of Adam's injury so these feelings will go away," she said.She said she has found solace in others who are going through similar pain, like Tara Schoemer of Sacramento.Schoemer's niece, Lillyanna, was 6 weeks old when her father shook and squeezed her in July 2004. Daniel Cruz confessed and was sentenced to nine years and four months in prison.Schoemer later adopted Lillyanna, who can't walk, talk or feed herself. "My daughter is serving a life sentence," she said. "Adam's Law would be money well spent."Schoemer and Alvarez-Garcia connected after Schoemer came across a Web site promoting Adam's Law. Since then, they both have testified in the state Legislature in support of the law."We help each other because the journey to get justice has been long," Schoemer said.
Alvarez-Garcia said District Attorney Elizabeth Egan has called her several times to assure her that Adam's Law will be adopted."It's a glitch in the system," Egan said. "I told her we're going to fix it."
Sunday, April 05, 2009
Of course, the greatest resource is the ability to reach out and share the frustration...
Need a little white noise on a trip?
White NoiseNeed just a touch of light in the middle of the night?
Babies scream, toddlers pout, and parents can often lose their minds. Since the sound of crickets chirping has the same relaxing effect on children as it does on adults, White Noise is perfect for taking things down a notch. The portable calming solution is available as a free limited download (complete with rainstorm, ocean, fireplace, and five other soothing sounds) and can put peace at your fingertips. The full version is available for 99 cents and includes a library of 40 sounds, including frogs.
myLite FlashlightNeed to send photos from a long trip?
While there's nothing fancy about an iPhone application that uses the screen to emit white light, the practical uses for such an application are priceless. The free myLite Flashlight app provides a straightforward series of settings to control light color and brightness (plus some cool effects for those who desire it). You'll never lose a pacifier in a dark movie theater again.
Birthday parties, sporting events, and school plays are all perfect occasions to snap some extra shots with your iPhone. With the free AirMe application, you won't even need to wait until you get home to start sharing them with friends and family! Upload instantly to Photobucket, TinyPic, Flickr, Facebook, Twitter, or Picasa without the hassle of file transfer or e-mail, and without the cost of an external gadget. (Of course, this means you'll no longer have an excuse for not updating photos to your online baby book.)
Saturday, April 04, 2009
The focus seems to be mostly on the causes and consequences of SBS. The prevention page is brief, but it does emphasize the importance of educating caregivers about the need for prompt medical attention in the event shaking is suspected.
One (1.0) contact hour for nurses, and best of all, free for April...
This month's Free course Shaken Baby Syndrome
1 contact hour(s)
This one contact hour nursing education course provides important information about a potentially life threatening form of child abuse: shaken baby syndrome.
Thursday, April 02, 2009
If you've watched it, leave a comment and let us know what you think...
PS. They also offer a couple of video PSAs on this page:
You can see it in her shining blue eyes as she navigates the halls of Madonna Rehabilitation Hospital - always the center of attention, just as she likes it.
You can hear it in her voice, so full of energy, as a 2-year-old's is meant to sound.
Friday marks one year since Alexis Verzal, the daughter of Nebraskans Brandon and Tiffany Verzal, suffered life-threatening brain hemorrhages.
The injuries, according to a police report, occurred at her day care in College Station, Texas.Texas authorities believe medical evidence suggests that Alexis' injuries were consistent with shaken baby syndrome.Her daycare provider was arrested last June and charged with injury to a child, a first-degree felony punishable by up to 99 years in prison and a $10,000 fine.
Meanwhile, Alexis pushes forward.
The subject of a World-Herald story last May after her transfer to Lincoln's renowned Madonna center, Alexis continues to make unexpected and consistent progress.
Both states have adopted education laws, but Nebraska also provided an appropriation for prevention efforts. Iowa didn't, and is relying on efforts by private groups, such as the Shaken Baby Task Force at Jenny Edmonson Hospital in Council Bluffs and Prevent Child Abuse Iowa...
Madison's death, like the deaths and injuries of all shaken babies, could have been prevented if DeYoung had put Madison down and walked away, said Armstrong, a registered nurse and coordinator of the Council Bluffs-based Shaken Baby Task Force.
That message needs to reach more parents and caregivers, according to the Iowa Legislature, which asked the Iowa Department of Public Health to develop a shaken baby education program this year.
Child advocates hailed the new law, signed by Gov. Chet Culver last month. But the law was passed without funding, so state health workers don't know when it will come to fruition.
A similar law was passed in Nebraska in 2006. But that one came with an appropriation, allowing Nebraska health officials to implement a program.
Nebraska's Department of Health and Human Services has developed a program that includes a video on shaken baby syndrome, [Link] which is available on the department's Web site as well as in hospitals. Eventually, the Nebraska agency plans to make shaken baby education a requirement for licensed child care providers.
In Iowa, state health officials plan to work with several groups, including Prevent Child Abuse Iowa and Blank Children's Hospital in Des Moines, to develop a program that would educate caregivers. For now, Iowa relies on privately funded groups such as the Shaken Baby Task Force to educate people.
Since the program's inception in 1997, Armstrong has been meeting with students and new parents through hospitals, in-home visits and lectures at schools. Education needs to be widespread, because people from all walks of life shake their babies, said Amy Wicks of the National Center for Shaken Baby Syndrome.
The article has a sobering graphic: from 1995 to 2007, there were 108 homicides that involved children under 7 - nearly half (49) were the result of shaking/slamming. Link