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