Thursday, July 21, 2011

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
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.

Tuesday, July 12, 2011

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:

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) -

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

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

Michael Petit
President and Founder, Every Child Matters Education Fund

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

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

PCAKY PreventChildAbuseKY
Is home visitation an effective way of preventing child abuse and neglect? Learn the answer to this question and more

youngchildfacts Young Child Facts
7/12 Congressional Hearing on Child Maltreatment Read more on maltreatment under age 5

Friday, July 08, 2011

New Mexico: SBS Prevention Project

University of New Mexico Hospitals has a SBS prevention

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, 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, 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:

Wednesday, July 06, 2011

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; or the executive director of the MCC, Jetta Bernier, at (617) 742-8555, or by email at

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