Awareness: Educating High School Students at Broken Arrow HS, Oklahoma

The The Tulsa World reports on great work by Erin Thomas, a 17 year old student at Broken Arrow HS, to raise awareness of the danger of shaking young children. She is working with Amber and Daniel Brafford, the parents of Davis Brafford, a one year old who died when shaken by his stepmother.

17-year-old promotes Never Shake a Baby program at school

BROKEN ARROW - After their 1-year-old son died of a severe head injury at the hands of his stepmother three years ago, it was difficult for Amber and Daniel Brafford to trust anyone again to care for their other children.

Then they met Erin Thomas, a 17-year-old Broken Arrow High School senior.

Now the couple not only have a baby sitter to help out, but they have teamed up with her to promote awareness of the dangers of Shaken Baby Syndrome to other teenagers.

"I'm grateful that Erin has brought awareness to the younger crowd because people just think it's common sense not to do that," said Amber Brafford to about 120 students who piled into the choir room Thursday after school. "I still have four other children, so there are times that they don't stop crying. I would never shake my child, but I know that if I can't get them to stop I put them in their crib and I walk away."

Thomas met the Braffords by chance after searching for a trainer to help her work through a knee injury. At Gold's Gym she met Daniel Brafford, who convinced his wife that Thomas was someone she should at least meet.

Soon the Broken Arrow student, the couple and their four children got to know one another, and on the three-year anniversary of Davis Brafford's death, Thomas was told the tragic story.

For Thomas, the effort became personal when she heard the Braffords' story, and she dedicated herself to raising awareness among her peers.

"A lot of girls are becoming pregnant or they baby-sit or have younger siblings," Thomas said.

Thomas went to her teachers and principals to see if they would allow The Parent Child Center of Tulsa to bring the "Never Shake A Baby" program to the school.

Karen Harvey, program coordinator, told students that babies are much more susceptible to injury by shaking because their brains do not yet fill out the space inside their skulls.

"We're talking about violent shaking," she said. "This isn't caused by bouncing a baby on your knee."

Comparing a baby's brain to a raw egg inside a plastic bowl, Harvey showed how the egg becomes much more damaged when it is shaken as opposed to being dropped.

If the injury doesn't result in death, babies who have been violently shaken can still have lifetime disabilities including impaired cognitive skills, blindness and hearing loss.

A crying baby is the No. 1 trigger in SBS, Harvey said.

"Babies cry for lots of different reasons, but mainly it's the only way they can communicate with the world. That's how they let us know they're there, they're hungry, they're tired, their clothes are too tight, whatever it is," she said.

Crying helps a baby's lungs adjust to breathing air and is an expected period that all babies go through, Harvey stressed. It typically starts at 2 weeks, peaks at 2 months and goes away about 4 to 5 months, and some cry more than others, she said.

"This is a normal phase. It's going to be frustrating, but it's going to be OK. There is an end to it," Harvey said.

Studies show the majority of perpetrators are men, typically the biological father or mother's boyfriend, but babies have been seriously injured or killed by all types of caregivers or family members.

Stepmother Shiloh Brafford is serving a life sentence for a first-degree murder conviction related to Davis Brafford's death.

Students guessed that men injure babies more often because they lose their patience easier and are stronger. Harvey said women typically have had more experience with nurturing activities, such as playing with dolls at a young age.

"I know a lot of you guys think it's common sense - you wouldn't shake a child," Amber Brafford said. "But my son was 14 months old. We were told he fell. Two days later he died in the hospital. He was severely brain dead, and I had to bury my 1-year-old, which is probably the hardest thing I'll ever have to go through in my life.

"It's been really hard for all of my family, my parents, my older children. I think it will affect all of us the rest of our lives, and I hope that by bringing awareness to you guys, we can save other children because it should never happen."

Read more from this Tulsa World article at http://www.tulsaworld.com/news/article.aspx?subjectid=11&articleid=20111028_78_A15_CUTLIN998126

Resources: 2011 Missouri DVD on SBS, Safe Sleep

I like that these subjects are paired up so parents will know two things that they can do to help keep their baby safer.

Missouri CTF (@missouriCTF) does good work, so check out their new DVD!

PS Let's hope the observation on the CTF site that the "DVD will satisfy State Statute 191.748 RSMo that requires all delivering hospitals to offer information to new parents about the prevention of Shaken Baby Syndrome (SBS)" doesn't give rise to the notion that all that's needed is to offer the DVD to parents on their way out of the hospital.

There's a number of reasons why hospital based education, not hospital based distribution, works; not least among them is the fact that the hospital is the last organized experience many new parents will have for months.

Everything changes when they get home, and whether a brochure or a DVD is offered, there's a good chance that it will tucked away for the trip home and put aside until far in the future...

New Prevention DVD Released to Prevent Shaken Baby Syndrome and SIDS Newborn and Childbirth Programs Across Missouri to Utilize Materials

The Children's Trust Fund of Missouri (CTF) recently announced the availability of its new DVD entitled Never Shake: Preventing Shaken Baby Syndrome and Safe Sleep for your Baby.

The DVD will be distributed to all Missouri hospitals to incorporate into their newborn and childbirth programs. “This DVD addresses two major issues related to keeping babies and children safe,” said Patrice Mugg, CTF chair. “We are happy to provide this DVD and are appreciative to those who helped create it.”

The DVD includes English and Spanish versions of the videos. It was funded in part by the Missouri Department of Health and Senior Services (DHSS).

The DVD includes the most current information about the dangers of shaking and abusive head trauma. An additional chapter on safe sleep provides information to prevent the ever increasing issue of infants being injured or dying in unsafe sleep environments.

The DVD will satisfy State Statute 191.748 RSMo that requires all delivering hospitals to offer information to new parents about the prevention of Shaken Baby Syndrome (SBS).

“We must increase awareness in the state about what a safe sleep environment is” said Department of Health and Senior Services Director Margaret Donnelly. “Babies should sleep alone, on their backs, in a safe crib. We hope the DVD is a valuable resource for new parents on safe sleep practices and will have a positive impact on the health and safety of our youngest Missourians.”

The DVD will be available at no cost for Missouri hospitals, child care providers, safe crib programs, schools and other child serving agencies to use as an educational tool to share with new parents and other caregivers.

The videos will help increase awareness about how new parents and caregivers can keep children safe by gaining knowledge, reducing their stress levels and providing safe sleep areas.

“Parents truly want the best for their babies,” said Kirk Schreiber, CTF executive director. “The more knowledge they have, the better choices they can make to prevent injury.”

The Children's Trust Fund, Missouri's Foundation for Child Abuse and Neglect Prevention, provides grant distribution, education and awareness. CTF does not receive general revenue funding, but receives funding from general donations, specialty license plate sales, marriage licenses and vital records fees, state income tax check-off, a federal grant and interest on the fund.

For additional information or to inquire about obtaining a DVD visit www.ctf4kids.org.

Transatlantic calculations | Prevention Action

From the UK, by way of Prevention Action, an interesting way to help legislators understand the costs and benefits of investing in prevention. Transatlantic calculations | Prevention Action

Awareness: An Instant, and Everything Changed - Erhard Loretan

PlanetMountain.com brings word of the death of Erhard Loretan, an accomplished Swiss mountaineer.

In 2001, he shook his son, who died. Loretan received a suspended sentence of four months in prison.

Some apparently condemned him for losing control of his emotions.

The commentary below notes he made the decision to publicize his action to increase awareness of the vulnerability of young child to shaking injuries.

So, let's think well of him for that...

On 28 April Erhard Loretan, on the most successful alpinists and Himalayan mountaineers of all times, lost his life in a fall in the mountains. At the time one wrote that, on the Grünhorn horn, Loretan was "working" as a Mountain Guide: he was tied to a "client" who, after the accident, had been airlifted in serious condition to hospital. In truth the climbing partner was Xenia Minder, his partner in life. Now, for the first time, Xenia talks about the dramatic accident and above all how she is coming to terms with it in a beautiful article published in Le Temps. Hers is a profound reflection, emotional, sincere and dense with questions.

* * *

A decade ago Erhard also made headline news, once again for tragic reasons. On 23 December 2011 left alone in his chalet at Crésuz, in Gruyère, with his seven month old child, he shook him, briefly, to stop him crying. The baby died. Erhard was sentenced to four months suspended sentence for negligent manslaughter.

In the light of his son's death, Erhard confronted the loss of his son with courage and dignity. At that time Shaken baby syndrome (SBS) was largely unknown, but he decided to disclose his name to the press in the hope that other parents might avoid a similar drama.

As he explained to me on various occasions, Erhard felt relieved for having been condemned by human justice even if - according to his own words on the day of the trial - the sentence was nothing compared to his suffering right to the end of his life.

However, during and after the trial Erhard became the target for violent public attacks. How could a man who had come head-to-head with death so often during his incredible ascents so easily lose his nerves of steel with his own, innocent and defenceless flesh and blood?

His broken heart never recovered from this loss and in the light of the media hounding, Erhard changed. He had obviously already lost many close friends in the mountains.

But as I witnessed during our two years of happiness, the loss of his own son was a tragedy from which he never recovered, even if he had now begun to imagine life once again, with me, with all projects possible.

Prevention: Incentives for Inventing Sustainable Prevention Strategies...

Incentives can be important.

Lindbergh flew the Atlantic, in part, to earn the $25,000 Ortieg Prize.

Nearly eighty years later, Dick Rutan created the first private manned spacecraft to win the $10,000,000 Ansari X Prize.

Those kinds of incentives are now being used to help solve problems on earth, not just above it. Scientific American reports a device that successfully cleans up oil spills has won the $1,000,000 Wendy Schmidt X Prize.

Now, wouldn't it be great if there was an X prize to help create successful, sustainable and translatable prevention strategies?

Maybe as part of a competition that brings together teams of students from business schools and public health programs, leavened with the real world experience of marketing and public relations professionals from ad agencies and PR firms.

For example, the Pacific Northwest could put together a regional team drawn Washington University's School of Public Health and the marketing program at Foster Business School, with advisor-members from Seattle Children's Hospital, Nike's Marketing Development Program, Microsoft's Social Marketing Program, and the Washington State Institute for Public Policy.

There's a good model for it right in the neighborhood: the social entreprenership competition that is sponsored by the Foster School of Business, with support from the Bill and Melinda Gates Foundation.

Each year, GSEC brings the world to UW: semi-finalist student teams from around the globe are invited to Seattle for GSEC Week. Teams visit regional companies, receive expert coaching, present their business ideas to 400+ professionals, and compete for monetary prizes. GSEC 2012 will award at least $30,000 in prizes, including a GSEC grand, global health, and Information & Communication Technology (ICT) prize! The professional support to GSEC is unparalleled: annually more than 200 experts participate as mentors, judges, and sponsors. We welcome this invaluable support, from individuals at organizations like Costco, Gray Ghost Ventures, Microsoft, PATH, the Bill & Melinda Gates Foundation, Smith Barney, Seattle International Foundation, the Grameen Foundation, and the Washington Global Health Alliance.

To paraphrase someone with a certain amount of experience in the field of communication, "oh, the places they could go..."

What Prevention Resources Should Be On the Congressional Reading List?

In 2009, Mikert/Butchart published an interesting meta-review of the literature about child maltreatment prevention. It's good for members of Congress and their staff to know what those in the field think is most effective, efficient and useful.

I've always thought an annual recommended reading list on prevention would be useful for Congressional staff, as they frequently change positions. Not just new readings, but those of enduring value.

With that in mind, if you had the opportunity to recommend three readings on prevention to your Congressional delegation - and their staff - to help them understand the causes, costs and consequences of child maltreatment, the opportunities for prevention, and the cost/benefits of prevention, so that they could help shape federal prevention stratgies and make informed federal funding decisions, what readings would you recommend?

Please use the comment feature to leave a list, or support recommendations. Links to the source are helpful.

In particular, I'd encourage recommendations that focus on the tipping point(s) - early intervention opportunities where a little leverage goes a long way.

(I assume, of course, there are such readings...)

NB. WHO has some good online resources on prevention, including this course book

Link to WHO prevention resources page:
http://www.who.int/violence_injury_prevention/violence/activities/child_maltreatment/en/index.html
Link to course book:
http://www.who.int/violence_injury_prevention/capacitybuilding/courses/child_maltreatment/en/

Resources: 2011 SBS/AHT Conference NYC

The Queens District Attorney's Office sponsored the 2011 Conference on AHT/SBS, as it's now denominated in medical and legal circles, last month, and it was an interesting conference indeed.

There was several excellent presentations on medical and legal issues, including Mark Dias and Carole Jenney.

There was also an excellent overview and analysis of the literature cited in support of the shaken baby "controversy" by Chris Greeley, a professor of pediatrics at the University of Texas. Link

One of the best things about this presentation was that, in the best tradition of science, it actually explored the strength of the scientific literature that is cited in support of the contention that there is a "controversy" in the medical community about the scientific basis of Shaken Baby Syndrome.

Summed up, his basic teaching point is that the "evidence" of controversy is drawn from scientific papers that are paraphrased by advocates: to know whether the cited science supports the contention, and, if so, how strongly, "you got to read the paper."

Examined objectively, it seems pretty clear that the claims exceed the evidence.

The Conference materials are available at the DA's site for a limited time and can be downloaded. Link

While I applaud the organizers for setting a session to discuss the "controversy", and Drs. Squier and Uscinski for their appearance to discuss it, I felt the formality of the panel made the discussion rather tepid. It certainly was less spirited that, say, Jerry Springer.

Unfortunately, the precaution of formal rules proved to be necessary: towards the end of the panel discussion, Uscinki read a letter from a person who thanked Uscinski for the testimony at his trial that helped get him acquitted of charges, then announced that the person was in the audience and wanted to address the Conference, presumably to say that not all innocent people are lucky enough to have an expert like Dr. Uscinki. The offer was declined.

I do have to say that I was disappointed by Emily Bazelon. She is the author of the article on SBS convictions in the New York Times Sunday Magazine earlier this year. She did not explain her article very well, and confessed to a superficial knowledge of the science. At the end, I was left with the impression that she did census research: talked to a lot of people about shaken baby syndrome and tallied up how many of those people told her the science was incomplete.

It was also disappointing that she never delved into the inconsistency between 1200-1600 reported reported cases of inflicted head trauma a year and her estimate that there are only 200 prosecutions a year. Unless she was excluding cases with pleas from the count, that means only 1 of every 6 reported cases involving children with inflicted injuries is prosecuted.

That is not such a good record.

The presentations are available at: http://www.queensda.org/SBS_Conference/2011_SBS_Conf.pdf

They're all worthy reviewing, but I would recommend Mark Dias' presentation on controversies and conspiracy theories in abusive head trauma: Link
http://www.queensda.org/SBS_Conference/Controversies%20and%20conspiracy%20theories%20in%20AHT%20NY%20Sept%202011.pdf

Study: In Times of Recession, Abusive Head Trauma Increases

The impacts of a recession are profound.

In a study appearing today in Pediatrics, Dr. Rachel Berger reports on the rise in the number of cases during the recent recession, which suggests that the rising tide of economic stress is causing a rise in the number of cases of Abusive Head Trauma/Shaken Baby Syndrome. Link to article

The story is receiving a lot of media attention, so it would be a good time to contact your elected officials and let them know that there are opportunities to help parents keep their children safe.

CBS; TIME; USA Today

As the coverage points out, if the rate reported in the study applies nationwide, it's now more likely that a child will be the victim of abuse head injury than pediatric diabetes.

CBS News includes a couple of tips from Dr. Peter Sherman at Montefiore Medical Center.

Sherman noted that most children studied were publicly insured even before the recession, suggesting that their families were already struggling financially.

Still, the recession affected many lower-income families, and Sherman said the study highlights "a very important issue."

He said pediatricians could help with prevention by asking families about difficulties paying for food or shelter and referring those in need to social service agencies. Just asking parents about stress and acknowledging their struggles can sometimes help, he said.

Most parents who abuse young children aren't "ill-intentioned," he said. "Most of it is kind of just snapping...maybe being sleep-deprived and just losing it. It's something that can happen to anyone."

Legislative Alert: Congressional Action on “Child and Family Services Improvement and Innovation Act” (S. 1542/H.R. 2883)

News and Analysis from the National Conference of State Legislatures...

Legislative Action: Child Welfare Waiver Restoration/ Reauthorization of the Promoting Safe and Stable Families Act (Title IV-B) Goes to House Floor,
Legislative Summary: “Child and Family Services Improvement and Innovation Act”
Link to Senate Bill S. 1542
Link to House Bill H.R. 2883

On September 12, 2011, Senators Max Baucus (D-Mont.) and Orrin Hatch (R-Utah), and Representatives Geoff Davis (R-Ky.) and Lloyd Doggett (D-Texas) introduced S. 1542/H.R.2883, the “Child and Family Services Improvement and Innovation Act”.

This bipartisan legislation would reauthorize child and family service programs under Title IV-B of the Social Security Act and renew Title IV-E state child welfare waiver authority for the U.S. Department of Health and Human Services (HHS). The legislation has two Titles; Title I-Extension of Child and Family Service Programs and Title II-Child Welfare Demonstration Projects. PSSF and the other programs in Title IV-B parts one and two expire on September 30, 2011.

It took three years, but NCSL succeeded this week in starting the renewal process for state child welfare demonstration projects. This state-friendly legislation is a compromise between the Senate and House and dropped a Maintenance of Effort (MOE) requirement, which was included previously. The MOE would have eliminated many states from participating in a waiver demonstration project due to difficult fiscal conditions. NCSL strongly supports this legislation and sent the House Ways and Means Committee a letter letting them know our stand.

To read the letter, click here: http://www.ncsl.org/default.aspx?tabid=23576

House: On September 14, H.R. 2883 passed out of the House Ways and Means Committee by a voice vote. The bill is scheduled for the House Floor to be voted on under suspension of the rules on September 21.

Senate: S. 1542 is referred to the Senate Finance Committee. We are currently waiting for the Committee to schedule at time for a hearing/vote on S.1542. Whether it heads to markup or Senate leadership decides to take action on a House-passed H.R. 2882 is uncertain at this time.

Title I: Extension of Child and Family Service Programs

As mentioned above, the first Title of S. 1542/H.R. 2883 would renew Title IV-B of the Social Security Act. Title IV-B programs include the Promoting Safe and Stable Families (PSSF) program. Title IV-B programs are the only federal programs focused on preventing child abuse and neglect as well as providing services to families once a finding of child abuse/neglect is substantiated. This bill would require states to make several changes to their child welfare state plans, require the Secretary of HHS to standardize the data collected, and broadens the substance abuse grants by expanding beyond methamphetamine abuse.

The legislation would require states to amend their state plans to include protocols regarding the appropriate use and monitoring of psychotropic medications and how the state will address emotional trauma associated with being a child that is maltreated and removed from their home. Additionally, states would need to describe the activities undertaken to reduce the length of time children under five do not have a permanent placement. The state plan would also need to include a description of data sources used to compile information on child maltreatment deaths, and if there are data sources not included, a plan to figure out how to include missing data sources in the future. Finally, states would be required to ensure the total number of visits caseworkers make to children placed in care is not less than 90 percent during the fiscal year. States would make this calculation by dividing the total number of visits made during the fiscal year to each child in foster care by the number of visits that should have been made to visit each child for the entire fiscal year. The legislation would require states to make 95 percent of visits to children placed in care starting in 2015.

Title I: Promoting Safe and Stable Families Program Reauthorization

The legislation would level fund PSSF at $345 million and would authorize Congress to appropriate up to $200 million in discretionary spending each fiscal year. Of the $345 million, $30 million is earmarked for the Court Improvement Program. Because of this earmark, some states may see a decrease of the PSSF funding not used for court improvement.

The bills propose several policy changes to the PSSF program. PSSF would be reauthorized through 2016. As mentioned above, the legislation would broaden the use of substance abuse grants by expanding beyond methamphetamine abuse. S. 1542/H.R. 2883 would not provide funding for the Mentoring the Children of Prisoners grant program.

Title I: Additional Changes

The legislation would strengthen adoption maintenance of effort requirements set forth in the Fostering Connections Act (P.L. 110-351) by requiring states to report on all money spent on adoption services, including post-adoption services spending. Additionally, the bills clarify that educational stability be a priority for each placement in foster care. States would also be required to assist each foster youth who is 16 obtain a credit report each year they are in placement to help prevent identity theft.

HHS would be required to establish by rule standard data elements to improve data matching. In developing the standard data elements, HHS would be required to consult with the Office of Management and Budget (OMB) interagency work group and would “consider state perspectives”. The new data standards would take effect October 1, 2012.

Finally, S.1542/H.R. 2883 would require the Government Accountability Office (GAO) to conduct a study on the additional federal funding services states are using to provide services similar to those provided by Title IV-B programs as well as the availability of services to families in need. Examples of services GAO will look into include the amount of time families need to wait for substance abuse and other preventative services and supports provided to caseworkers who investigate and manage child welfare cases.

Title II: Child Welfare Demonstration Projects

These bills would allow the Secretary of HHS to authorize ten waiver demonstration projects for three fiscal years (2012-2014), for a total of 30 waivers. Initially, a state would be granted a waiver to conduct a demonstration project for five years, unless the Secretary of HHS determines that it would be best to continue the demonstration project. This bill would sunset all waiver demonstration projects in 2019, including the demonstration projects authorized prior to the introduction of this legislation. If a tribe is operating a IV-E program, it is considered a state for purposes of applying for a waiver. This bill does not apply to current waiver demonstration projects, which can continue at the discretion of the Secretary (like they have before).

To be eligible for a waiver, states must take the following steps:

Identify one or more goals that the demonstration project is designed to accomplish. These goals include: Increase permanency for all infants, children and youth in foster care, including promoting a successful transition to adulthood for older youth; increase positive outcomes for children, youth and families in their homes and communities; and/or prevent child abuse and neglect as well as the re-entry of children into foster care.

A state must demonstrate readiness through a narrative description of the state’s capacity to effectively carry-out a demonstration projects.

A state must demonstrate that it has implemented, or plans to implement within three years of the date of application submission, at least two child welfare improvement policies, which are outlined in the bill. These improvement policies range from establishing a bill of rights for infants, children, and youth in foster care to increasing the number of sibling placements with the baseline year being 2008.

After three years, HHS can terminate the waiver demonstration project if the Secretary determines the state has not made “significant progress in implementing the child welfare improvement policies proposed by the state”. Finally, the demonstration projects are not subject to random assignment for the purposes of a control group and must be evaluated by an independent contractor.
Final Words

At this time, it is unclear how the Joint Committee on Deficit Reduction (the “Super Committee”), set up by the Budget Control Act (P.L. 112-25), will address Title IV-B funding, particularly the discretionary funds. There is an urgency to passing these bills because Title IV-B programs expire September 30. If these programs are not reauthorized, it would make them more vulnerable to Super Committee cuts. The deadlines set up by P.L.112-25 are fast approaching, with Senate and House Committees required to report to the Super Committee their recommendations for cuts by October 14, 2011. The House and Senate must vote on the legislation produced by the Super Committee on or before December 23, 2011.

Action

Please call your state delegation, particularly your Senators, to pass this bipartisan, bicameral legislation to pass these bills expeditiously.

To read a draft of either S. 1542 or H.R.2883, go here: http://thomas.loc.gov/home/thomas.php

For further information, please contact either Sheri Steisel sheri.steisel@ncsl.org or Emily Wengrovius at emily.wengrovius@ncsl.org or NCSL’s Washington DC office at 202-624-5400.

Reminder: 2011 NYC AHT/SBS Conference

Reminder that the Queen's District Attorney's Office is sponsoring a conference on Abusive Head Trauma/Shaken Baby Syndrome in New York City next week. 

It's hosted at the Medical Examiner's office in Manhattan on September 22 and 23.

ADAs Marjy Fisher and Leigh Bishop put together a very interesting program on Shaken Baby Syndrome.

The Thursday program is good, especially if you want a refresher on diagnosis and treatment, but it's the morning panel on Friday that should be really interesting...it includes Emily Bazelon, who wrote the NY Times magazine cover story on SBS earlier this year, and two defense doctors who appeared in that article.

Agenda

Sleeping Babies: Who Knew It Was So Complicated?

Very interesting article by Perri Klass in the New York Times.

It asks the question every first year parent wants to know:

What makes a child nap? Most parents cherish toddlers’ naps as moments of respite and recharging, for parent and child alike; we are all familiar with the increased crankiness that comes when a nap is unduly delayed or evaded. But napping behavior has been somewhat taken for granted, even by sleep scientists, and napping problems have often been treated by pediatricians as parents’ “limit-setting” problems.

Now, researchers are learning that it is not so simple: napping in children actually is a complex behavior, a mix of individual biology, including neurologic and hormonal development, cultural expectations and family dynamics.

Hence, the popularity of books in the vein of Go the F**k to Sleep."

Treat:  link to GTFTS narrated by Samuel L. Jackson

While uncontrollable crying is cited as the principal trigger for inflicted injury, the real trigger is the caregiver's response.

A nap allows everyone involved a bit of respite.

To a sleep deprived parent, getting an infant to sleep may be as frustrating as crying. As the article notes,

But for parents and scientists alike, there are many unanswered questions: When is it too early to give up a nap? Too late to hold on to a nap? How do domestic patterns and cultural norms affect the circadian and homeostatic processes?

“I think there’s a dire need for adults in general to be in tune with individual children’s physiology,” Dr. LeBourgeois said. “What are the capabilities, and what are the limits?

For an interesting look at SBS/AHT, and the PURPLE program, seek out this work by Rebecca Sullivan at Cook's Children...link

Resources: 2011 New York City (NYC) Shaken Baby (SBS/AHT) Conference

The Queens District Attorney's Office is sponsoring a conference on Shaken Baby Syndrome on September 23-24.

It's a two day program, with a great agenda of speakers including Bob Block, Mark Dias, Mary Case, Chris Greeley and Carole Jenny.

For dessert on Friday morning, a panel discussion among Emily Bazelon, Ronald Uscinski, Patrick Barnes, Chris Greeley and Mary Case.

Register on line and send payment ($25) by September 9

Link to agenda and registration: http://preview.tinyurl.com/4ye7n8z

Prevention: US ranks 40th in newborn mortality...

Today brings news of a study on neonatal mortality by researchers at the World Health Organization.

The stats don't look good for us: the United States dropped from No. 28 to  No. 41 in the rankings of newborn death risk, and is now tied with Qatar, Croatia and United Arab Emirates.

There are some confounding trends: for instance, preterms births make up a larger proportion of US births and the mortality rate among preterm infants is higher.

While you might think such news might spark national protests, the protest focus today is an oil pipeline.

You know, the one where Darryl Hannah got arrested...

Some days, I wonder when babies stopped being part of the environment.

Link to PLoS article on neonatal mortality

Prevention: Utah's "Perp Talk" on SBS

The Salt Lake City Tribune reports on an interesting initiative in Utah that will use perpetrator testimony for prevention targeted at Latino communities.


Not the first time I've heard of a "perp talk" on SBS, but given the cross-cultural context, and the birthrate that is moving Hispanics towards the majority minority, would be very interesting to couple this effort with a good program evaluation to see if there is real impact or not.

North Logan man sent to prison for killing son
By Arrin Newton Brunson
Special to The Salt Lake City Tribune
First published Aug 30 2011 05:50PM


Logan • A North Logan man who fatally injured his 4-month-old son two years ago was sentenced Tuesday to prison for up to 15 years.

First District Court Judge Kevin Allen concurred with the recommendation of the Cache County Attorney’s Office that Francisco Javier Martinez serve no more than five years and that he receive credit for 21 months and 10 days already served in the Cache County Jail.

Martinez, 37, of North Logan, was initially charged with first-degree felony child abuse homicide and two other counts of child abuse for the November 2009 murder of his son, Jesus Yandel Martinez. But he agreed to a plea deal that resulted in a single, reduced second-degree felony child abuse homicide charge.

As part of that agreement, Martinez described and demonstrated to law enforcement officials and medical personnel the series of assaults on the infant beginning in October 2009 when he broke the baby’s leg, continuing a few weeks later when he broke two of his ribs and ending on Nov. 18, when the child died as a result of injuries to the brain from being slammed twice into Martinez’s lap.

Prosecuting attorney Andrew McAdams told the court that Martinez’ "full disclosure" about the abuses will be a powerful tool in the nationwide fight against child abuse known commonly as "shaken baby syndrome."

Martinez has described the incidents and demonstrated his abuses for law enforcement officials and doctors from Primary Children’s Medical Center, who will use the videotaped interviews to educate others, McAdams said. As part of the plea agreement, Martinez has also been ordered to participate in a public service announcement aimed at preventing child abuse in Latino families, where resources are often limited Martinez has provided information that will save lives, McAdams told the court.

"You can’t hurt a baby by letting the baby stay in the crib and cry. If you need to get out so that you don’t snap, go to your garage and let it cry for a half-hour…" McAdams said. "This type of case can and does happen to anybody — whether you are a criminal offender, whether you are a drug user or whether you are the most devout religious person on the planet. It can happen."

Defense attorney James J. Lee said the "daily grind" became difficult for Martinez, who was the full-time caregiver for his four children after he came to the United States illegally. Aside from the abuse of the infant son, Lee said Martinez was a loving husband and an affectionate father with no prior crimes, who cleaned the house and prepared the family’s meals.


"He did not have a social system. Francisco bottled up most of his emotions because he didn’t think there was another option," Lee said. "Each incident where there was an injury came on a day when the children were particularly misbehaving. On the final day, a couple of the children were crying and one was sick and vomiting. Ever since that day, Mr. Martinez has lived in virtual torment, living in the knowledge, the guilt of killing his baby."


Using a translator, Martinez tearfully apologized and expressed his love for his children. He said he had a record of good behavior at the jail and accepts full responsibility for his crimes.

"I regret everything. I don’t know what was going through my head. I killed my son," he said. "My biggest punishment is that I won’t get to talk to my son again."


Allen said this case was tragic because a small child is no longer allowed to pursue his potential.

"We’ll never know would have been a great political leader, innovative scientist, compassionate medical care provider or perhaps even an insightful student of the law. Whenever a child is murdered we lose the potential for that child to change the world," Allen said. "I can understand the frustration of being a father of young children. When you lost control the first time, I don’t understand how you could keep going, knowing the potential danger that you have inside of you."

Allen told Martinez that his life isn’t over and he urged the immigrant not to return to the U.S. after his deportation.

"Wherever you reside, I hope you are able to salvage some sort of life for yourself, that you are able to make yourself a better person," Allen said. "Frankly I think that is the only way you will receive a small measure of peace for what you have done."

Tales of Three SBS Survivors: Jay-J in New York, Ryan Corrigan in Iowa, Alec Van Beveren in Ohio

Two Three stories that give some insight to the hard challenges that follow survivors of inflicted head injury....

In North Tonowanda, New York, WIVB.com tells the story of Jay-J, who's only 19 months old.

There's nothing "typical" about a typical day for the boy they call "Jay-J..."

Jay J's stepgrandmother, Tabitha Retzer said, "On a day-to-day basis, he has five different medications, three times a day, he has to take. He's a special diet, so that has to all be weighed out -- everything to tenths of a gram."  Jay-J has Lennox-Gastaut Sydrome, a neurological condition that causes severe seizures.

"His worst day was almost 200 seizures. And that was just painful to watch," added Retzer.


Doctors believe Jay-J developed L-G-S after being abused by his father as an infant.   Jay-J's maternal grandparents, who now have full custody of him, have struggled to put that behind them.


Retzer said, "It breaks your heart to think about it, so you kind of have to put that aside, in order to be active for him in the moment. He needs me now, not to be dwelling on what happened to him six, eight, ten, twelve months ago."

Now, at 19 months old, Jay-J receives physical and occupational therapy, as well as special education.

And Eastern Iowa Life tells the story of Jeff and Kirsten Corrigan, and their son...

...Ryan, 10, has endured a lifetime of profound cognitive and physical disabilities due to being shaken when he was 9 months old by a trusted caregiver, Mark Francke.

Mostly confined to a wheelchair, Ryan is non-verbal, cannot walk or stand on his own and has limited use of his arms.  He receives physical therapy once a week to work on stretching, range of motion and functional activities.

“A child’s body is a changing body,” says Sarah Bengtson, Ryan’s physical therapist at Witwer Children’s Therapy Center, 1079 N. Center Point Rd., Hiawatha. “It’s important to work with his spasticity (muscle tightness) and tone.” 

Although integrated with his fourth-grade peers at Indian Creek Elementary in the Linn-Mar School District, he is in the Level 3, severe and profound special education program.

And today, the Advertiser-Tribune brings the story of Amy Laird and Alec Beveren in Ohio

Alec Van Beveren is about to turn 14, but he suffered a brain injury as an infant that permanently limited his neurological development to that of a 4-month-old baby. The injury was the result of shaken baby syndrome.


Although the man who harmed Alec was tried in court and served time in prison, Alec's mother, Amy Laird of Tiffin, has borne the responsibility of caring for her disabled son. Now that he is older and bigger, caring for him at home has become more difficult for the petite woman.

Amy also cares for other children in her home to supplement the family income. That way, she can keep Alec home from school if he is ill and take him to appointments. She said he still has frequent epileptic seizures.


"Some things bring on a seizure, like loud noises, or something startling him," Amy said. "He takes two kinds of medications and he has a vagal nerve stimulator."  Recently, Alec had surgery to replace the vagal nerve stimulator that was implanted in is chest in 2004. Wires run up his neck and into his brain to deliver electrical impulses every two minutes.


As Alec adjusts to the new stimulator, the time is to be adjusted. Amy said the doctor programs the device with a wand. Although the stimulator does not stop the seizures, it does shorten their length.  Amy also has special magnets she can swipe across the stimulator to stop an intense seizure.


Amy takes Alec to Nationwide Children's Hospital in Columbus for doctors' visits and numerous hospital stays. Two years ago, Alec had a spinal fusion to correct scoliosis and make him more comfortable in his chair.  Because his muscles and bones have not developed normally, he is not able to support his body weight even in a sitting position.

Early on, Alec had a feeding tube put in and an additional surgery to insert a valve to prevent vomiting. Now he has a smaller tube called a mickey button, which must be replaced every three months.

School Based Prevention: From Oklahoma City, Proof of the Need...Crystian Rivera

On Sunday, I posted about a program in Missouri that gives middle-school students parenting education and coping skills, and commented that we need it because kids are taking care of siblings.

Today, this story from News9.com in Oklahoma City proves the point, but there's nothing good about a story that ends "he is too young to get the death penalty." 

(It's the sort of story that gets around: see this UK News article)

OKLAHOMA CITY -- Police say Crystian Rivera confessed to shaking his baby sister to death, now he's one of the youngest inmates at the Oklahoma County jail.


The 13-year-old is accused of first degree murder. He is being treated as an adult, but he's not allowed to stay in a jail cell with an adult.

8/23/2011 Related Story: OKC Teen Accused Of Killing Baby Sister Won't Get Death Penalty

One week ago, Crystian Rivera was your typical 13-year-old at home playing video games. But on that day, police say he was watching his 9-month-old sister, while their parents were at work.


Detectives say the baby distracted Rivera from his game, he told police he got angry and confessed to shaking his sister.  Three days later she died at the hospital from a severe brain injury, and Rivera was taken to the Oklahoma County jail.

We went behind the doors where Rivera is being held, with 26 other juveniles charged with serious offenses. He's locked up in cell number one with one other person. Jail officials say he is checked on every 30 minutes.

Rivera was arrested just days before school started. He would have been an eighth grader at Mayfield Middle School. But now, his schooling will happen behind bars.

"We have a contract with the Oklahoma City public schools," said Mark Myers, Oklahoma County Sheriff's Department spokesman. "And they provide teachers that come out and teach our juvenile inmates."

Rivera is being held without bond. The Oklahoma County District Attorney's office has not been presented with charges yet.

Under state law, Rivera will undergo a youthful offender study to determine if he can be rehabilitated. If that is the case, he would be released when he is 18 and half years old. If not, he could be sentenced to life in prison. He is too young to get the death penalty.

Prevention Resources: St. Louis MO - School Based Coping/Prevention Education

From St. Louis, news today of of a school based parenting program that hopes to help middle and high school students learn how to cope with the frustrating moments of raising children.  via dBusinessNews.com

I've been familiar with the Missouri Children's Trust Fund good work in the area of SBS prevention education for nearly a decade, and school is certainly a great place to learn positive parenting skills, as well as coping strategies.  Link: Missouri CTF campaign resources

Hopefully, COPE24 is engaged in the rigorous program evaluation practices that take a program from one that feels like it should work to one that has a solid evidence base showing it works efficiently and effectively.

We need effective school based parenting education as part of a comprehensive prevention strategy.

Kids don't just grow up to become parents, aunts or uncles someday: they babysit.  Now.

Presenting at a middle school in an affluent school district near our home, I was surprised to find that nearly 10% of the students babysat - quite literally,  helped care for a child under age one, often a sibling.  With 10 million children under age 5 in some form of child care for all or part of a day, finding good care for a baby is often daunting.  Sometimes, the search ends at home.

Whether they babysit this evening for a sibling or over the weekend to earn a bit of spending money, it's good that kids have the opportunity to get a structured exposure to positive parenting skills.

It's also good when parents don't just leave their cell phone number, but ask about coping skills, and let that babysitter know it's OK to call.

Unique School-based Parenting Program Targets Child Abuse Prevention in St. Louis Area

St.Louis - Launched in 2011, Changing Our Parenting Experience (COPE) is a riveting, reality-based parenting skills program aimed at middle and high school students to raise child abuse awareness and prevent teen pregnancy.

As middle and high school students across the region embark on another school year, thoughts of future parenting skills may not be top of mind. However, St. Louis-based non-profit organization COPE24 is trying to change that mentality in an effort to raise child abuse awareness and prevent teen pregnancy.

Launched in Missouri schools in early 2011, COPE24, which stands for Changing Our Parenting Experience, is a practical, effective two-week parenting skills program that is playing a key role in educating young people about the stresses of parenting and ways to notice and prevent child abuse. In March, the program was successfully piloted in six Missouri schools, and the organization has plans to reach even more children this school year.

Cope24 was founded by Rene Howitt after her experience as a foster parent led her to author the book, Whose Best Interest? A Fight to Save Two American Kids. After the book’s release in 2008, Howitt was appointed to the Missouri Children’s Justice Task Force, and she also acted as a child advocate, speaking to educators and students across Missouri and throughout the Midwest. The positive response she received from students prompted her to found the organization in 2010. Through her efforts and through the efforts of the COPE24 program, more than 13,000 high school students in St. Louis and throughout Missouri have been positively impacted.

"The COPE24 program helps kids in middle school and high school understand that parenting is very stressful, and it’s very easy to slip into neglectful abusive parenting," said Howitt. “By reaching out to adolescents, we hope to create awareness of child abuse and prevent teen pregnancy, which often translates in a higher rate of abuse and neglect among children by teen parents.”

The Cope24 program has already received positive feedback from the six schools it was piloted in earlier this year. Imagine College Prep High School, which is located in St. Louis City, is among the schools that have already received the program. An additional 12 school districts in Missouri; including Festus, Jennings and Wentzville/Timberland in the St. Louis area; and seven schools in Indiana, Oklahoma, South Dakota and Wisconsin, have plans to implement the program this year.

According to the Children’s Defense Fund, a child is abused every two hours in Missouri, and at the beginning of the year, 5,451 children were reported to be victims of abuse and neglect. The number of children in foster care in Missouri is approximately 9,912. The annual Child Maltreatment report issued by the US Department of Health and Human Sources Children's Bureau states that in 2009, almost 2,000 children died from abuse, neglect, or single impulsive incidents, such as shaking an infant or suffocation. Infants and toddlers are most vulnerable to maltreatment. One-third of the 2009 child victims reported were younger than four years old, and one-fifth of them were between the ages of 4 and 7.

The COPE24 program aims to break the cycle of abuse through a series of materials that consist of a professionally produced DVD with ten parenting scenarios, including shaken baby, co-sleeping, bedtime challenges, potty training, tantrums, homework, negative parenting, and sexual abuse. Each of the ten videos was created by actors with a reality-based theme to effectively connect with today’s youth. The instructor's manual, written and vetted by experts in their fields, includes detailed support materials and exercises to bring the messages home. The fee of the materials is the only cost of the program to educators and other organizations who wish to implement it.

"My students had lots of questions after going through this two-week program, one scenario a day. The compelling dialogue and videos really help kids 'get it'," according to Kristi Hodson, one Missouri high school teacher who participated in the pilot program.

Howitt feels that the more preparation young people receive about parenting, the less likely they will be to start their own families at a young age. "We also want to help kids and adults understand that drugs and alcohol play a significant role in child abuse, and that learning good parenting skills can really help down the line," she said.

The COPE24 Parenting Skills program is discounted through Aug. 31, 2011, to encourage schools nationwide to sign up, bring the program to their students this year and help lessen the strain on school budgets (purchase orders accepted). COPE24’s ultimate goal is to provide the program free of charge to schools nationwide.

As a result, the organization is hosting its first fundraising event at Over/Under Bar at 911 Washington Ave. in downtown St. Louis. From 6:30 – 10:00 p.m. on Monday, September 26, Over/Under will donate 15 percent of its drink proceeds to benefit the COPE24 mission. Complimentary food will be served from 6:30 – 8:00 p.m., and the event will also feature a 50/50 raffle.

For more information about the fundraising event, or for order details for both the COPE24 program and Whose Best Interest? The Fight to Save Two American Kids, please visit http://www.cope24.com/.

COPE24, a 501(c)(3) non-profit educational and charitable organization based in St. Louis, Mo, is also exploring grants and funding to provide communities, hospitals, child advocacy groups, and churches with the program. Howitt is also available to speak to organizations concerned about the health and welfare of our youth.

Prevention: Legislative Champions

The summer brings news that two legislators who have been champions for prevention legislation are moving on...

In New York, Assemblyman Sam Hoyt, who sponsored a bill calling for education for new parents in 2000 and who played an important role in securing funding for the expansion of the program developed by Mark Dias at Children's Hospital of Buffalo into the Upstate New York SBS Prevention Program, left the Assembly in July, after 19 years of service, to become Senior Vice President for Regional Economic Development at the Empire State Development Corporation.

In Virginia, Representative Glenn Oder is leaving Virginia's House of Delegates to become the new executive director of the Fort Monroe Authority. HCR 632, a legislative bill introduced by Rep. Oder in 2010 at the request of Steve Stowe and Shaken Baby Syndrome of Virginia, Inc., directed Virginia's Joint Commission on Health Care to study the costs of Shaken Baby Syndrome (SBS) and identify best practices in reducing the incidence of SBS in Virginia.

Thanks to both for their efforts on behalf of preventing SBS.

We'll be needing some replacements...nominations, anyone?

Prevention: Enlisting Celebrity Parents in Prevention - What Would Angelina Jolie Do?

There's a great fascination with celebrities.

That fascination is amplified when the celebrities have offspring.  What better evidence that the payment offered for the first photo of the child of an A-List celeb?  Head of the list: Forbes reports People magazine paid $4.1 million for the Shiloh Nouvel Jolie-Pitt baby photos. 

And it goes on: simple actions of celeb parents can have significant impact on the actions of other parents. Link Significant effort goes into placing baby products with celeb parents. Link .  For example, when the Beckhams named their most recent child Harper Seven, sale of Harper Lee's "To Kill A Mockingbird" jumped 123% when his mother said it was her favorite book.

Celebrities are making use of the opportunity not only to reap the benefits themselves, as Forbes reports, but to support favored causes.

The latest twist? A QR tag on celeb clothes donated to a high-end used clothes sale allows browsers to scan the code and view a video interview with the celeb, explaining what the article of clothing means to them or where the money will go.. Link (he article includes a video of Annie Lennox talking about the dress she donated...)

In the case of Oxfam, it may mean higher prices and a better understanding of how Oxfam uses donations to support its activities.

Wouldn't it be interesting to do the same for baby clothing, gently used by the child of a celeb parent, but offer a video explaining how that parent coped with challenges of raising a young child, including moments of frustration and anger.

Wouldn't you be curious to know how Pierce Brosnan coped with a colicky baby (reportedly, the former 007 did have that experience...of course, teen parents might be interested in someone closer in time)?

PS. The fascination is cross-cultural too Bollywood babies

Point of reference: Alexandra.com measures website traffic - it ranks celebritybabies.people.com/ #429, while the National SBS Center ranks #19 million or so, despite excellent resources.

Prevention: Illinois and Early Childhood Development

Unfortunately, Illinois has a great idea: incorporate current knowledge about early child development into programs that deal with children.

I say "unfortunately", because it's common sense, yet so uncommon as to seem novel.

Given the demonstrated long term benefits of starting early with children, it's unfortunate that actually doing that is still so novel.

Quinn Administration Spotlights Importance of Early Childhood Development Child welfare leaders review early brain science research; goal is to ensure policies that promote healthy development of children

OAK LAWN – Governor Pat Quinn’s Office of Early Childhood Development today convened a high-level conference of researchers and policy makers to review state-of-the-art developments in the field of early childhood development.  The goal of the conference, which is co-sponsored by the Department of Children and Family Services (DCFS) and made possible through the collaboration of Casey Family Programs, is to ensure that child welfare and other social service agencies in the state are taking into account groundbreaking research in the field and using all resources at their disposal to promote healthy development in children from birth onwards. “In step with Governor Quinn’s emphasis on early childhood development as a major priority on his education agenda, this conference is a tremendous opportunity to bring all our child welfare policy makers and advocates in Illinois together and learn about the cutting edge research in the field of early brain development,” said DCFS Director Erwin McEwen. “There are so many well-meaning and extremely hard-working stakeholders and organizations in our state. We want to make sure that our efforts are in line with the latest research in the field that is coming from scientists like Dr. Shonkoff.” The keynote speaker at the daylong conference is a pediatrician and a leader in the application of research in early brain development, Jack P. Shonkoff, M.D., Director of the Center on the Developing Child at Harvard University. Shonkoff describes research showing that exposure to “toxic stress” at the earliest stages of life can affect the developing brain circuits and hormonal systems of the child and lead to lifelong problems responding to stress and health problems, including heart disease. Toxic stress occurs when a child experiences prolonged exposure to stressful events without the support of caring adults. “Experts who are studying how the brain develops in very young children are telling us that what happens to a child very early on in life has consequences that can last a lifetime. Those consequences affect the individual and society as a whole,” Director McEwen said. “That is why it is so important that we base our policies on the latest science that teaches us how to promote the healthy development of the brain in our youngest children.”       Other speakers include Bryan Samuels, the former director of DCFS and currently the Commissioner of the federal Administration on Children, Youth and Families, as well as researchers, child welfare advocates, state agency leaders and a Cook County judge. The conference in Illinois is one of a series around the nation made possible through the collaboration of Casey Family Programs, a private operating foundation committed to improving the lives of children and families in Illinois and across the nation. For more information about Casey Family Programs, go to:www.casey.org. Early childhood education is a major part of the Governor’s education agenda. The Governor’s Office of Early Childhood Development was established in 2009 at the recommendation of the Governor’s Early Learning Council, an advisory group representing early childhood stakeholders from around the state. Its mission is to strengthen Illinois’ efforts to establish a comprehensive, statewide system of early childhood care and education.

Tracking Child Abuse Fatalties: Congress Hears GAO Recommendations on Improving the Body Count

Once, I was aligned with the guy who wrote that if it was important, I had learned about it in kindergarten.


Now, not so much: if it's really important, I'll probably learn about it on Twitter.


Twitter brought news that the House Ways and Means Committee Subcommittee on Human Resources is holding a hearing today on child abuse fatalities. Link: http://1.usa.gov/r0ZkWB


No real surprise: the statistics are not accurate.  The AP news report is here; 

The GAO report was just released.  Judging from the GAO testimony at the hearing, GAO did keep the focus on getting the numbers right. GAO summary (note that not one "related term" on that page mentions prevention); link to GAO Child Fatalities Report. 

Reading through the testimony quickly, while there is much discussion of resources needed, there is only one brief mention so far of the cost of abuse (at p. 9 of Every Child Matters) - and that's only the dollars spent, not the dollars and human potential lost. In these time, cost and benefits are critical parts of policy.

The background of the hearing:

Focus. The hearing will review data on child deaths due to maltreatment, determine how to improve the accuracy of this data, and review how improving the accuracy of this data may help prevent future fatalities.

Background. According to State reports, over 1,700 children died nationally in FY 2009 due to maltreatment. However, research has shown that these reports may substantially understate the number of child victims each year. To gain a clearer understanding of this issue, the Government Accountability Office (GAO) has reviewed what is known about the circumstances of child deaths and near deaths due to maltreatment, State approaches to gathering and reporting this information, and what the Department of Health and Human Services (HHS) is doing to support the collection and accurate reporting of this information. GAO will testify about the findings of their review at the hearing,

Not much on prevention - one witness mentions state initiatives, including SBS public awareness campaigns (should have said new parent education) - but seems to recognize the need for incident analysis to inform prevention (just imagine if we spent the same amount of money to investigate the deaths of 50 children and recommend prevention action as NTSB spends to investigate the cause of a plane crash that caused the deaths of 50 people).

Perhaps not surprisingly, Caylee Anthony is mentioned in testimony. [Update: hearing schedule just coincidence]

While I didn't see any Tweet about the hearing before yesterday (thanks, @youngchildfacts), I was pleased to see PCAKy Tweet about prevention and home visiting (Link; Link).


For what it's worth, I plan on bringing that focus on prevention to the Committee's attention...

FYI - The Subcommittee will take testimony for the record up to two weeks (7.26.2011) after the hearing: instructions for submission are here on this page - click here to make a submission

The witness list (click on links for testimony):

Kay E. Brown
Director Education, Workforce, and Income Security, U.S. Government Accountability Office
(Testimony) - http://waysandmeans.house.gov/UploadedFiles/Kay_E_Brown_Testimony.pdf


Tamara Tunie
Actor, Law and Order: SVU and Spokesperson, National Coalition to End Child Abuse Deaths
(Testimony)

Theresa Covington
M.P.H., Director, The National Center for Child Death Review
(Testimony)

Michael Petit
President and Founder, Every Child Matters Education Fund
(Testimony)

Carole Jenny, M.D.
Director, Child Protection Program, Hasbro Children’s Hospital
(Testimony)


Jane McClure Burstain, Ph.D.
Senior Policy Analyst, Center for Public Policy Priorities
(Testimony)

Twitters

PCAKY PreventChildAbuseKY
Is home visitation an effective way of preventing child abuse and neglect? Learn the answer to this question and more http://ow.ly/5rSVs

youngchildfacts Young Child Facts
7/12 Congressional Hearing on Child Maltreatment http://1.usa.gov/r0ZkWB Read more on maltreatment under age 5 http://bit.ly/pQfQvX

New Mexico: SBS Prevention Project

University of New Mexico Hospitals has a SBS prevention program...link

It's alway interesting to see the range of languages at different site - here, Navjaho and Vietnamese.

Link to program description...

UNMH is helping new parents identify and prevent shaking injuries and understand how to respond when infants cry. Our program is a duplication of an educational study conduced by Dr. Mark Dias. From 1998 to 2004, Mark Dias, MD, FAAP and colleagues implemented a hospital-based, parent educational program in upstate New York to teach new parents about the dangers of infant shaking.

The goals of the program are (1) to provide educational materials about SBS to the parents of newborn infants, (2) to assess parents' comprehension of the dangers of violent infant shaking, (3) to track penetration of the program through the collection of returned commitment statements (CS), and (4) to evaluate the program's affect on the regional incidence of SBS.

This UNMH SBS prevention program will be administered to all parents of newborn infants prior to discharge from the hospital. Nurses will provide parents with the following materials: 1) a one-page English, Spanish, Vietnamese, or Navajo leaflet about preventing SBS, and 2) to view a 11-minute video called Portrait of Promise: Preventing Shaken Baby Syndrome. The 11-minute video, Portrait of Promise: Preventing Shaken Baby Syndrome featured 3 families whose lives were affected by SBS and a message from Carolyn Levitt, a nationally recognized child abuse specialist, who addressed the effects of violent shaking and the potentials of prevention.

Posters were placed in the maternity wards and both parents were asked to voluntarily sign a commitment statement (CS) confirming their receipt and understanding of the materials. Program compliance will be assessed by the number of signed CSs and comprehension of the materials as assessed by a 7 month follow-up telephone survey.

Data collection began June 2010 and will continue indefinitely. This pilot should replicate the results of the original New York study. We have begun the process of collecting SBS ICD-9 codes within the hospital to determine the baseline incidence of SBS for children born in the hospital. Our eventual goal will be to collect the data statewide.

SBS Prevention Tales of Two States: Michigan, Kentucky

In Michigan, HealthCanal.com reports a pediatrician at Mott Children's Hospital is working with Flint High schools to increase awareness about the vulnerability of young children to inflicted head injuries.  The project is supported by a CATCH grant from the AAP, funded by Pfzier ..

U-M pediatrician strives to improve children’s health through community-based initiative

08/07/2011 - There are approximately 1,300-1,600 reported cases of Shaken Baby Syndrome (SBS) each year in the U.S. One out of four babies with Shaken Baby Syndrome die. The other three babies will need ongoing medical attention for the rest of their short life spans.

Faisal Mawri, M.D., FAAP, a pediatrician at U-M C.S. Mott Children’s Hospital, has developed a community-based initiative to combat this health challenge. With support from the Community Access To Child Health (CATCH) Program, a national program of the American Academy of Pediatrics (AAP), Mawri endeavors to reduce the incidence of SBS in the Flint area.

“Shaken Baby Syndrome or Abusive Head Trauma is a form of inflicted head trauma on infants and young children. SBS represents one of the most severe forms of child abuse with up to 30% mortality among infants. Despite the severity of the injuries and enormous societal cost, SBS continue to occur frequently in our society.” Mawri said. “I believe the Flint area has a higher per capita Shaken Baby Syndrome rate than the national average.”

Through a CATCH implementation grant, Mawri was able to create the Keep Infants Safe and Secure (KISS) program for local schools. Mawri’s research shows that young first-time parents, particularly young fathers, benefit from education about SBS. The KISS program is working with three Flint high schools to educate the students about the effects and dangers of SBS.

"With a relatively small grant, pediatricians with a vision can make a big difference to help make communities healthier for the children who live there," says O. Marion Burton, M.D., FAAP, president of the AAP. AAP has recently awarded twenty-five CATCH implementation grants nationwide, totaling $280,655. Mawri’s project is supported in full by Pfizer.

And in Kentucky, following Kentucky's 2010 adoption of SBS prevention legislation sponsored by Rep. Adda Wuchner, WLKY.com reports that child abuse deaths are showing an encouraging trend...

Child Abuse Deaths Down In Kentucky
Number Still Above National Average

LOUISVILLE, Ky. -July 7, 2011 - The latest report on child abuse deaths shows Kentucky has lost its No. 1 ranking, but is still above the national average.   The only forensic pediatrician in the state said the improvement in ranking is due in part to increased awareness and training.

Kosair Children's Hospital said it sees about 75 cases of abusive head trauma each year, one-third of those cases resulting in death.   Experts said in these cases, the explanation of the child's injuries usually does not match the trauma suffered, and medical professionals need to know the difference.

"When it's a case of abusive head trauma, almost always either the child comes in with no history of trauma. Yet the child clearly has suffered trauma to the head, or there's a history that is just not consistent with what we're finding," said Dr. Melissa Currie.

Currie said the most common trigger for abusive head trauma is crying.  Offering help to new moms, and teaching caregivers it's OK to lay a baby in a safe place and take a break, goes a long way in preventing these deaths and injuries.

Read more: http://www.wlky.com/news/28471002/detail.html#ixzz1RXB0ZFK6

Masschusetts: 2011 SBS Awareness Quilt, PS Ontario: Baby Caps

Via Worcester's Telegraph and Gazette, news of a SBS awareness quilt in the making.  

Sadly to say, despite MCC's excellent education efforts, there are probably enough families in Massachusetts with history to make a sizable quilt, but let's hope the quilt is getting smaller every year...

Wednesday, July 6, 2011

Group seeks families with shaken baby history

A statewide children’s advocacy group is seeking families affected by shaken baby syndrome for their stories, which will be commemorated on a quilt.

Volunteers with Massachusetts Citizens for Children will stitch a quilt to commemorate children who have died or been injured because of shaking. The quilt will be unveiled at the group’s fifth annual Stroll for Shaken Baby Prevention scheduled this fall.

For more information, contact: Bob Logan, chairman of the SBS Quilt Committee, at logans_27@yahoo.com; or the executive director of the MCC, Jetta Bernier, at (617) 742-8555, or by email at jetta@masskids.org.

PS. If you'd like to knit for awareness, Metronews brings word that London (Ontario) is calling on knitters to knit purple new baby caps...

The trauma program at London Health Sciences Centre’s Children’s Hospital is recruiting knitters to help raise awareness about shaken baby syndrome.


Interested knitters are asked to knit or crochet purple baby caps in any pattern or shade of purple, and to not include strings, pom-poms or wool on the baby caps.


The caps will be provided to parents and caregivers in support of the Period of Purple Crying program, which provides information to parents about shaken baby syndrome.


Completed caps can be mailed or dropped off by Oct. 20 to:
Denise Polgar, Trauma Program, Room E1-129, Children’s Hospital, London Health Sciences Centre, 800 Commissioners Rd. E., London, Ont., N6A 5W9

Resources: Child Voices, Zero to Three Reports on Child Maltreatment and Policy

The Child Welfare League of America provides some very useful advocacy resources online, including the Children's Monitor, a very informative e-newletter.

Sign up to receive the Children's Monitor - CWLA's weekly e-newsletter containing the latest information on federal legislation and policy affecting children, youth, and families is now available only online-and it's absolutely free. Link to sign up page

For example, the May 9 edition reports on two assessments of child maltreatment statistics and policies by Child Trends and Zero to Three, looking at how maltreatment relates to very young children:

Maltreatment of Young Children: Risk and Response

Attention to the maltreatment of the youngest children was amplified over Child Abuse Prevention Month in April. In particular, two reports were released that together reveal infants and toddlers' elevated risk of maltreatment and resulting harm, as well as policies, programs, and practices to counter both.

Child Trends released Young and Vulnerable: Children Five and Under Experience High Maltreatment Rates, which makes use of data from the National Child Abuse and Neglect Data System, National Data Archive on Child Abuse and Neglect, and the National Incidence Study to demonstrate youngest children's disproportionate maltreatment through an array of statistical analysis. The paper concludes with an overview of relevant federal policies.

Additionally, Zero To Three and policy partners, including CWLA's Linda Spears, Vice President of Policy and Public Affairs, published A Call to Action on Behalf of Maltreated Infants and Toddlers. This report represents a collective vision of important policy, program, and practice steps to better address the developmental needs of infants and toddlers who come to the attention of the child welfare system. It is intended to provide a starting point for federal, state, and local policymakers and administrators to assess and identify where and how they can revise or institute policies and practices that protect the development and safety of infants and toddlers.