SKIPPER Initiative

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

2011-10-28T12:52:00.001-04:00

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

2011-10-26T17:43:00.000-04:00

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

2011-10-25T19:29:00.000-04:00

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

2011-10-18T12:49:00.001-04:00

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...

2011-10-16T15:17:00.000-04:00

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?

2011-10-06T17:30:00.000-04:00

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

2011-10-02T13:18:00.001-04:00

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

2011-09-19T17:29:00.001-04:00

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)

2011-09-16T17:42:00.000-04:00

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

2011-09-16T16:39:00.000-04:00

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?

2011-09-14T14:24:00.000-04:00

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

2011-09-08T09:14:00.000-04:00

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...

2011-08-31T17:34:00.000-04:00

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

2011-08-31T16:46:00.000-04:00

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

2011-08-24T01:46:00.002-04:00

~~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

2011-08-24T01:32:00.000-04:00

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

2011-08-22T12:46:00.001-04:00

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

2011-08-13T09:47:00.000-04:00

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?

2011-08-06T11:19:00.002-04:00

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

2011-07-21T12:44:00.000-04:00

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

2011-07-12T15:04:00.004-04:00

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

2011-07-08T17:47:00.000-04:00

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

2011-07-08T13:19:00.000-04:00

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

2011-07-06T12:29:00.003-04:00

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

2011-05-15T08:54:00.006-04:00

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.

SBS Prevention Education: in Iowa, all it takes is a sixth-grader...

2011-05-01T10:13:00.004-04:00

As the WCF Courier reports, there are some remarkable sixth-graders in Waterloo, Iowa: they educated a high school class at Columbus High School about the danger of shaking a young child. Link to article

Kudos to students Kaleb Boleyn, Luke Pranger and Jaime Mayerand their teacher, Nancy Hank, of St. Edward School!

St. Edward's class educates fellow students
By ANDREW WIND, andrew.wind@wcfcourier.com Saturday, April 30, 2011

St. Edwards School sixth-grader Kaleb Boleyn shows the proper way to hold and burp a baby with classmates Luke Pranger and Jaime Mayer looking on as they made a presentation to a class at Columbus High School in Waterloo, Iowa, on Thursday, April 28, 2011. (RICK CHASE / Courier Staff Photographer)
WATERLOO, Iowa --- Emily Gilstrap ignored her instincts when handed the crying baby doll.

Instead, the Columbus High School senior began shaking the doll, which fell silent within seconds. Designed to cry regularly to simulate an infant's behavior, the doll also features a transparent head that showcases its brain.

As the crying stopped, several red lights were activated in the front and back of the brain. Gilstrap's class had just learned those areas control emotions, problem solving and eyesight. If it had been a real baby, the amount of force from the shaking would have caused brain damage.

"It wasn't a very comfortable feeling," Gilstrap said, voicing surprise at how quickly the doll indicated brain damage.

Her child development class got a lesson Thursday on shaken baby syndrome from an unlikely source. Four sixth-graders in Karen Nank's St. Edward School class made a presentation on the topic as part of a service learning project.

April is Child Abuse Prevention Month. The St. Edward students narrowed down their project to shaken baby syndrome once they decided to focus on child abuse issues.

"After we got the facts, we thought it was the issue that needed the most attention," said sixth-grader Brian Knapp. Members of the class, making more presentations today at St. Edward, use the doll on loan from the Family & Children's Council of Black Hawk County to help emphasize their message.

The sixth-graders --- who also include Jaime Mayer, Kaleb Boleyn and Luke Pranger --- told the Columbus class that a child up to 5 years old could suffer brain damage after being shaken for as little as five to 20 seconds. Mayer said that babies typically are shaken by a care giver who is feeling stressed.

"Almost all cases are caused by a baby crying," she said. "A baby would have to fall from a two-story building to get the effect of a shaken baby."

A Black Hawk County prosecutor told the students that someone who causes brain damage by shaking a baby could be charged with child endangerment, which carries a sentence of up to 10 years in prison. A quarter of all shaken baby cases result in death, for which the perpetrator could be charged with first degree murder and receive life in prison if convicted in Iowa.
* * *
Members of the St. Edward's class created a brochure with tips on alternate ways to deal with a crying child that will be handed out by the Family & Children's Council.

Boise Idaho: Radio Block for SBS Awareness

2011-04-21T12:18:00.004-04:00

Hats off to Boise radio stations!

They'll be hosting a radio block to increase awareness of Shaken Baby Syndrome. Link

Kudos to Boise advocates who helped get it organized, and hat tips to others who've done one: 2009 post, Wisconsin, Milwaukee, Michigan

Want to hear how it works? Tune in today at 5:30 (Mountain Daylight Time) via Internet radio. Link to list of stations (the article mentions 107.1 KTHI).

Anyone else doing radio blocks out there? Leave a comment...

Treasure Valley Radio Stations form Radio Roadblock against Shaken Baby Syndrome

Disc jockey KJ Mac's been on the radio a long time.

"Longer than you've been alive," he said

But he's usually spinning the discs of the Rolling Stones, Stevie Nicks and Journey. Only once before has Mac passed on rock and roll to play a minute of baby-screaming.

That track's enough to make any DJ swear: "Never again."

But it's for a good cause: to raise awareness for Shaken Baby Syndrome. And so, once again, for only the second time in his career, Mac and more than 20 other local DJs will bump the shrieks and wails of a baby at 5:30 p.m. Thursday.

It's called a radio roadblock. And the last time it happened, phones at 107.1 K-Hits rang for hours.

"What's going on with the babies?" Mac mimicked. "Everywhere I go, every station I am listening to babies are crying."

And that says social worker and roadblock organizer Marcia Brothers is exactly the idea.

"If you're having a road-block," she said, "people will try to escape your message by changing the station."

But with 20 different Treasure Valley stations all playing the same thing, there's no way to escape the message.

"I don't think people realize that it just takes one little shake," Brothers said. One little shake, just one time could leave parents holding a dead kid.

Thankfully, Shaken Baby Syndrome's 100 percent preventable. To get that message out there, stations like K-Hits will break from the vocals of guys like Mick Jagger in favor of 50 seconds of very unhappy baby noise.

"It seems like three hours," Brothers said.

"It'll be interesting to see what kind of reaction we get," Mac said.

After those 50 seconds of wailing, listeners will hear a message: "No matter how much she cries. No matter how tired you are. No matter how frustrated you may become, never ever Shake a baby."

Perspective: Child Abuse Prevention Month 2011 - Who is Caring?

2011-04-03T15:06:00.008-04:00

As it has been since 1979, a presidential proclamation was issued designating April as "Child Abuse Prevention Month." Link to 2011, 2010, 2009

This is the Wordle view of the 2011 Proclamation :

And the Wordle view of the first Proclamation of Child Abuse Prevention Month in November, 1979 . Note that it seems to show a subtle shift in emphasis from children to abuse.

Google News found 437 articles today that mention "child abuse prevention" and 259 that mention "child abuse prevention month." In comparison, 12,497 mention Charlie Sheen, 2,923 mention Paris Hilton, and 10,333 mention "March Madness."

The Google Trends chart above shows how "child abuse" fares as a Google search term in comparison ("Child Abuse Prevention Month" doesn't even make the chart).

What's the lesson: push vs. pull. Most folks just don't have any interest in pulling information about CAP Month (or child abuse prevention, in general). Consequently, most media don't attend to it.

NB. The Journalistics blog has a good post on getting your message out via "pull" tools. Link

Try a Twitter search to see what's happening with CAP Month: I used
"child abuse prevention month" since:2011-01-01

Twitter hashtags #CAP2011, #Pinwheels

It's interesting to search Twitter: it seems that the hashtag #childabuse doesn't occur at all with #earlychildhood #ece (early childhood education), #homevisiting, #nfp (nurse family partnership).

This would be a good time to start breaking down the silo walls...

Prevention: NY Legislature Moves to Restore Home Visiting Funds

2011-03-23T13:30:00.004-04:00

Last month, we were dismayed to learn that the Governor's proposed budget stripped funding for home visiting programs. Link

This month, we are delighted to learn that the Legislature intends to keep that funding in their budget bills.

Now, the challenge is to educate the Governor about the salutary benefit of home visiting services on the bottom line, and the consequences when those services are lost.

Prevent Child Abuse NY reports, and provides this sample letter. You can help by using this convenient PCANY site - Link:

I have good news! Both the Senate and Assembly restored funding to Healthy Families New York (HFNY) and other home visiting programs. We applaud the Legislature's commitment to New York's most effective prevention programs. And we thank you. This victory couldn't have been possible without the hundreds of emails, letters and phone calls from child abuse prevention advocates around the state.

Our work is not over.

Our next task is to ensure the Governor supports the legislative budget proposal. We can't do this without you.

Please email this letter asking the Governor to restore funding for Healthy Families New York.

You can also mail a letter. Below is a sample that you can copy, paste and edit.

The Honorable Andrew Cuomo
Governor of New York State
NYS State Capitol Building
Albany, NY 12224

Dear Governor Cuomo:

I am writing to urge you to fully restore funding for Healthy Families New York and other home visiting programs. Home visiting prevents child abuse, increases school readiness, and saves the state millions of dollars in Medicaid because it prevents low-weight births that require costly medical services.

As you know, vulnerable families that go unserved in the earliest years often need costly remediation services later on. Home visiting helps provide better outcomes for children and families. Full funding for Healthy Families New York will also allow New York to draw down millions in federal home visiting dollars to expand and strengthen our system.

Please restore funding for these critical programs.

Thank you.
Sincerely,
[Your Name]

It is critically important that Governor Cuomo hear from all corners of the state that HFNY and other home visiting programs prevent child abuse, increase school readiness, and save the state millions in Medicaid costs.

Please contact the Governor today.

Thank you.

Christine Deyss
Executive Director

Simple Appearances

2011-03-23T12:03:00.004-04:00

We're trying a new Blogger template (Simple).

Let us know if you like it, particularly if you've visited before and notice a difference (for better or for worse)...

Resource: Educating Policy Makers Influences Policy

2011-03-23T10:37:00.007-04:00

While it should come as no surprise that educating policy makers about early childhood development results in more informed policy, it hasn't always been recognized by advocates that "telling ain't teaching."

Prevention Action (itself an interesting blog in the UK) reports on an important article in the February issue of Child Development by Jack Shonkoff and Susan Nall Bales: ‘Science does not speak for itself: Translating child development research for the public and its policy makers’ Link to PDF

It touches upon a couple of the paradoxes of sustainable advocacy: that every stage of parenthood is transient, and thus one important part of the constituency for early childhood programs (parents) are not only learning their new role as they go, but constantly going onwards to the challenges of the next stage of development, and that sustained advocacy therefore often devolves to institutional stakeholders, and those institutions require resources to sustain themselves.

Stated simply, the aim of this exercise is to communicate complex scientific principles simply but accurately, using techniques of investigation from the cognitive and social sciences in order to achieve that objective.

The lessons of this initiative so far are that child development researchers can influence the thinking and actions of the target group – comprising the professionals, policy makers, elected officials and interested parties mentioned earlier - if they focus on teaching about science and less on preaching about which policies and services should be supported. The authority of the ‘core story’ in terms of its scientific underpinning is essential for this. Second, the most effective dissemination occurs when scientists present their ideas directly to the target audiences but do so with advice and support from communication experts.

The benefit of this approach is that sound scientific knowledge is presented without being dumbed down and in a way that policy makers can understand, apply and pass on to colleagues.

The study offers some interesting lessons to those seeking to influence policy.

So what is special about this model? First, its intention is to convey a body of knowledge, in this case the theory of child brain development. Many disseminations exercise focus on one study and stop at summarising the findings and drawing out policy and practice implications. This exercise has a much wider educational brief affecting a whole way of thinking about the nature, cause and consequences of a social problem and the relevance of a whole area of child development to it.

Secondly, it seeks to present extremely complex theories and concepts in a new way without being selective or over-simplifying. The core story is a robust summary of current knowledge and not a list of findings presented as open to different interpretations.

Thirdly, the consultation and dissemination processes involve a lot of repetition as testing reveals failures, but it is ultimately cumulative as understanding grows.

Fourth, the need to link abstract ideas with policy and practice must always be in the mind of those seeking to explain.

The core story of brain development:

1. Child development is a foundation for community development and economic development, as capable children become the foundation of a prosperous and sustainable society.

2. Brain architecture is constructed through an ongoing process that begins before birth and continues into adulthood. As it emerges, the quality of that architecture establishes either a sturdy or a fragile foundation for all the capabilities and behaviour that follow.

3. Skill begets skill as brains are built in a hierarchical fashion, from the bottom up. Increasingly complex circuits and skills build on simpler circuits and skills over time.

4. The interaction of genes and experience shapes the circuitry of the developing brain. Young children serve up frequent invitations to engage with adults, who are either responsive or unresponsive to their needs. This ‘serve and return’ process (what developmental researchers call contingent reciprocity) is fundamental to the wiring of the brain, especially in the early years.

5. Cognitive, emotional and social capabilities are inextricably intertwined and learning, behaviour, and both physical and mental health are highly interrelated over the life course. You cannot address one domain without affecting the others.

6. Although manageable levels of stress are normative and growth promoting toxic stress in the early years (e.g. from severe poverty, serious parental mental health impairment, such as maternal depression, child maltreatment and/or family violence) can damage developing brain architecture and lead to problems in learning and behaviour, as well as increased susceptibility to physical and metal illness.

7. Brain plasticity and the ability to change behaviour decrease over time. Consequently, getting it right early leads to better outcomes and is less costly, to society and to individuals, than trying to fix it later. We can pay now or we will pay more later for society’s failure to promote healthy development in the earliest years of life.

8. Effectiveness factors make the difference between early childhood intervention programmes that work and those that do not work to support children’s healthy development. These factors can be measured and can inform wise investments in effective policies and programmes.

Link to Prevention Action postResource: Jack P Shonkoff and Susan Nall Bales, ‘Science does not speak for itself: Translating child development research for the public and its policy makers’, Child Development, 82:1, February 2011, pp. 17-32 Link

Resource: Shonkoff, Investment in Early Childhood Education Lays The Foundation of a Prosperous Society, Early Childhood Encyclopedia (2009) Link

Resource: Child Development Homepage Link

Resource: Society for Research in Child Development Link

The Society is a multidisciplinary, not-for-profit, professional association with a membership of approximately 5,500 researchers, practitioners, and human development professionals from over 50 countries.

The purposes of the Society are to promote multidisciplinary research in the field of human development, to foster the exchange of information among scientists and other professionals of various disciplines, and to encourage applications of research findings. Our goals are pursued through a variety of programs with the cooperation and service of our governing council, standing committees, and members.

Resources: Gender Differences in AHT/SBS - Pediatrics

2011-03-07T20:22:00.006-05:00

A study in the current issue of Pediatrics examines the outcomes of AHT/SBS cases involving males and female perpetrators. Link to Pediatrics.

Abusive Head Trauma in Children: A Comparison of Male and Female Perpetrators:

Several studies have examined the relationship between perpetrators of abusive head trauma and their victims. However, no study has evaluated the effect of perpetrator gender on victim presentation, victim clinical outcomes, and perpetrator egal outcomes.
This study reports significant gender differences in perpetrators of abusive head trauma in children. Male perpetrators were younger and more likely to confess and be convicted. Victims of male perpetrators had more serious acute presentations and neurosurgical intervention and suffered worse clinical outcomes.

US News and World Report HealthDay summarizes the study's findings:

The tiny victims of shaken baby syndrome are equally likely to be injured by a man or a woman, although women are less likely to be convicted of the crime, according to a new study.

Perhaps because of men's sheer strength, the babies are also more likely to suffer graver harm if their abuser is male, and male perpetrators are more likely to confess to the crime and be convicted, the researchers found.

In data collected over 10 years on 34 cases of abusive head trauma (AHT) in infants, researchers found that abusers' gender was evenly split and that female abusers were typically significantly older than males.

And, as the MSNBC coverage notes:

... the researchers expressed concern that many cases of child abuse may go unreported. They cited research from the University of North Carolina showing that more than 2 percent of mothers admit to shaking children as a form of discipline on surveys -- likely a low estimate. [Link to UNC article]

Resource: Child Maltreatment Prevention as a Public Health Priority

2011-03-03T18:45:00.004-05:00

Via the Doris Duke Foundation, CDC's 2009 presentation on "Child Maltreatment Prevention as a Public Health Priority" featuring Jack Shonkoff and James Mercy.

Did you know some of the worst adult health problems in the nation can be linked to the toxic stress resulting from adverse experiences in childhood?

Population health priorities, including obesity, heart disease, and diabetes are associated with harmful childhood experiences such as abuse or neglect.

The goals of this webinar are to develop a shared understanding of how the prevention of child maltreatment not only promotes optimal development but also reduces disparities in health and explore the important role public health agencies play in improving the health of children and families by preventing childhood abuse and neglect.

Powerpoint presentations from the webinar are available here, although the webinar itself is not.
Instead, please listen to this excellent thought piece, sponsored by the Cambridge Trust Company: Early Childhood Development and Public Policy: Closing the gap between what we know and what we do. downloadable .MP3 file

Jack Shonkoff, the director of the Center on the Developing Child at Harvard University talks about the impact of early experience on brain development and the policy and practice implications of new research.

Doris Duke/Chapin Hall Fellowships: Child Abuse Prevention

2011-03-02T18:09:00.009-05:00

Good news from Chapin Hall at the University of Chicago...

Chapin Hall and the Doris Duke Foundation are collaborating to create 30 Child Abuse Prevention fellowships. Link to announcement

The fellowships sound encouraging: they're intended to identify and develop a new generation of leaders who will use diverse research methods and a "look over the fence" to improve child abuse prevention policy and practice.

Chapin Hall is seeking individuals with the skills, passion, and institutional support necessary for sustaining long-term professional involvement in child abuse prevention.

“We’re looking for applicants who demonstrate initiative to look over the fence and learn what is new in other domains,” said Daro. “We’re looking for those who actively engage in disseminating their findings and work to increase visibility of child abuse and neglect prevention within broader professional associations, and those who understand that research initiatives need to be developed with an eye toward influencing how program managers and policy makers do their work.”

“We hope that with its national reach and multidisciplinary approach, the Doris Duke Fellowships program will foster unique contributions that address the many opportunities and needs in child abuse prevention, a field that is gaining momentum across the country,” said Francie Zimmerman, program officer for the Doris Duke Charitable Foundation’s Child Abuse Prevention Program. “Fellows will benefit from Chapin Hall’s expertise as they participate in this robust learning experience.”

Link to Chapin Hall video of Research Fellow Deborah Daro, chair of the Doris Duke Fellowships for the Prevention of Child Abuse and Neglect, talking with Anne Cohn Donnelly, Senior Lecturer at Northwestern University, about opportunities provided by the fellowships.

The next application period will open August 2011 through December 2011.

Daro is the author of an interesting 2010 issue brief "Child Abuse Prevention: A Job Half Done." Link

And Chapin Hall researchers have developed and evaluated a diverse set of programs aimed at reducing risks for maltreatment and strengthening parental capacity.

One such example is Chapin Hall’s evaluation of the Community Partnerships for Protecting Children initiative as implemented in four urban communities. You can find this and more research—including a systems approach, an epidemiological perspective, and perspectives on early childhood home visitation—in the Home Visitation and Maltreatment Prevention tab. Link

Some other Chapin Hall resources:

Progress Toward a Prevention Perspective (2009)

Epidemiological Perspectives on Maltreatment Prevention (2009)

Evidence-Based Systems of Home Visitation: Opportunities for Replication and State Innovation (2009)

MIchigan: Educating Teen Parents

2011-02-27T10:33:00.005-05:00

WJRT in Flint, Michigan reports on a spike in SBS cases, and the efforts of a local pediatrician and hospital staff to reach out to teen fathers at local high schools and educate them not only about what not to do - but what to do - when caring for an infant. Link (video below)

FLINT (WJRT) -- (02/26/11) -- Doctors at Hurley Medical Center are reporting that Shaken Baby Syndrome is a rising problem in Flint.

After two shaken baby cases in Flint last month, a new awareness effort is underway in Mid-Michigan involving doctors reaching out to teens to put an end to the crime.

DeAngelo Henderson and Corey Yeager are the two young fathers who critically shook their month-old babies in January. Henderson's daughter died after the violent shaking. Yeager's daughter was last reported in critical condition. Both men could face more than 15 years in prison.

Preventing these cases is Dr. Faisal Mawri's passion. Mawri, a pediatrician, says he's seen one too many shaken baby cases at Hurley Medical Center. "Absolutely I care about it because shaken baby syndrome is 100 percent preventable," Mawri said.

Now, Mawri and his team are holding seminars at five Genesee County high schools to prevent the crime. The effort is part of a fellowship project funded by a $12,000 grant.
"We came in here today, handed them the baby and showed them what they shouldn't do with the baby," said Pediatric Emergency Physician Rachel Stanley. Following the seminar, the students were surveyed on the facts, tested two months later for retention, and then rewarded.

"I'm going to find all these kids again. I'm going to give them that survey and once they complete that survey, I'm going to give them a $10 gift card," said Hurley Medical Center pediatric researcher Beth Grundman. "Bringing in these babies brings a sense of reality to the whole educational department."

Arkansas: 2011 May Bring Hospital-Based Shaken Baby Education

2011-02-19T17:18:00.002-05:00

2011 could be a good year for children in Arkansas.

State Senator Percy Malone has introduced SB 328: it would provide new parents with the opportunity to learn how they can help keep their child safe from inflicted head injury. Link to bill.

Prevention: Changing Awareness Doesn't Mean Changing Behavior

2011-02-19T08:41:00.005-05:00

ScienceDaily brings word of an interesting study that examines the difference between awareness and action, and suggests more effective interventions.

Two things are pretty clear: people "know" exercise is important to maintain and improve health, and sedentary lifestyles and obesity rates are so high that they've become major national issues.

The parallel with child abuse is obvious. Increased awareness is necessary, but not sufficient, for prevention. This policy memo from Prevention Child Abuse America discusses the expanding gap between awareness and action, noting that the public's very high awareness of child abuse is not translating to action. So, PCAA solicited thought from Frameworks Institute on what to do. Link to Frameworks memo Link to Frameworks memo on child abuse and child development strategy

Back to the study.

The University of Missouri researchers found that healthy adults who received interventions focused on behavior-changing strategies significantly increased their physical activity levels. Conversely, interventions based on cognitive approaches, which try to change knowledge and attitudes, did not improve physical activity.

"The focus needs to shift from increasing knowledge about the benefits of exercise to discussing strategies to change behaviors and increase activity levels," said Vicki Conn, associate dean for research and Potter-Brinton professor in the MU Sinclair School of Nursing. "The common approach is to try and change people's attitudes or beliefs about exercise and why it's important, but that information isn't motivating. We can't 'think' ourselves into being more active."

Behavior strategies include feedback, goal setting, self-monitoring, exercise prescription and stimulus or cues. Self-monitoring, any method where participants record and track their activity over time, appears to significantly increase awareness and provide motivation for improvement, Conn said.

[Which reminds me of a story told in 2005...a researcher monitoring at risk parents gave them a cell phone, so she could call them and ask what their child was doing. As the study went on, she realized that the reports were changing because the parents were observing their child more closely, so they would have more interesting stories to tell. Link]

"Health care providers should ask patients about their exercise habits and help them set specific, manageable goals," Conn said. "Ask them to try different strategies, such as tracking their progress, scheduling exercise on their phones or calendars, or placing their pedometers by their clothes. Discuss rewards for accomplishing goals."

The study, featured in the American Journal of Public Health, incorporated data from 358 reports and 99,011 participants. Link to abstract

The study identified behavioral strategies that were most effective in increasing physical activity among healthy adults. Successful interventions were delivered face-to-face instead of mediated (i.e. via telephone, mail, etc.) and targeted individuals instead of communities.

[...which suggests that SBS prevention efforts that rely on brochures and community awareness initiatives may not be very effective. Conversely, what better place than face to face intervention by nurses in the hospital?]

Interventions were similarly effective regardless of gender, age, ethnicity and socioeconomic status.

[Another recent study shows awareness doesn't translate to action: calorie labels on food increased awareness of calories, but did not alter food choices by teens or adults. Link]

Silo Hopping: Doris Duke, Child Abuse Prevention, Pew Trust, Home Visiting

2011-02-13T09:47:00.003-05:00

Let's do a bit of silo hopping today...

The Doris Duke Charitable Foundation does quite a bit of child abuse prevention funding.

For example, they helped fund the special Future of Children issue on Preventing Child Maltreatment. They also helped the Urban Institute look at ways to improve services to new parents with depression.

And they help give policy perspectives. For example, Dr. Jack Shonkoff laid out the long term public health consequences of child abuse in his presentation at the CDC webinar on Child Maltreatment Prevention as a Public Health Priority.

In concert with the Pew Trust, DDCF has began to look at the advantages brought by home visiting programs, including reductions in child abuse. For example, the U.S. Triple P System Population Trial found lower rates of substantiated abuse cases, child out-of-home placements, and reductions in hospitalizations and emergency room visits [Medicaid cost cutting, anyone?] for child injuries in nine study counties in South Carolina where parenting interventions were implemented.

The need to identify and disseminate effective home visiting programs has gained speed now that significant federal funding is available. Link to webinar on Federal Home Visiting Funding.

Resources on home visiting:

Pew Trust issue brief that overviews the issues and makes the case for home visiting.

Pew Trust Campaign for Home Visiting

Pew Trust National Summit on Home Visiting

National Summit on Quality in Home Visiting Programs, an interactive forum for home visiting researchers, program leaders, and policy makers concerned about improving home visiting system quality and family outcomes.
Feb. 16-17, 2011
Omni Shoreham Hotel, Washington, D.C

Press release about the Summit.

Pew Trust National Overview on Home Visiting in the States

The Pew Center on the States surveyed state agency leaders in all 50 states and the District of Columbia and inventoried their state home visiting programs, models, funding and polices for fiscal year 2009-2010. The following findings emerged:

State home visiting programs: 46 states and the District of Columbia have some level of investment in home visiting;
Funding strategies: states made available $1.36 billion to home visiting programs via two primary funding strategies: categorical funds for home visiting only; and broad-based prevention funds that could be used for home visiting (although most states could not verify whether or how much funding was directed for this purpose);
Sources of state support: state general funds were the largest source of support for home visiting programs; and
Investment in national home visiting models: 34 states invested $277 million in national home visiting models.

Interview: how home visiting helps reduce child abuse...

Links to Home Visiting Programs

Nurse-Family Partnership
Nurse-Family Partnership® (NFP) helps change the lives of vulnerable first-time moms and their babies through ongoing home visits from registered nurses. This evidence-based community health program has proven results including long-term family improvements in health, education and economic self-sufficiency.

Triple P-Positive Parenting Program®
The Triple P-Positive Parenting Program® is a multi-level, parenting and family support strategy. Triple P aims to prevent behavioral, emotional and developmental problems in children by enhancing the knowledge, skills and confidence of parents (from the Triple-P website)

Good SBS Prevention Resources (2011)

2011-01-24T15:08:00.004-05:00

We'll be expanding this page to provide more links to websites that offer prevention resources, but for now:

National Center on Shaken Baby Syndrome

>http://www.dontshake.org/

Kempe Children's Hospital Center "Calm A Crying Baby" site

>http://www.calmacryingbaby.com/

The Upstate New York SBS Prevention Project

>http://www.wchob.org/shakenbaby/

Downloadable Infant Comforting Cards from the Ontario SBS Prevention Project (19 languages)

> Tiny URL link: http://tinyurl.com/4llr8p6

Downloadable resources from the Alberta SBS Prevention Project

> Tiny URL link: http://tinyurl.com/4ehv49y

If we're overlooking a good resource (and since this is only the beginning, I know we are), please use the comment feature below to let us know...

Economic Conditions Affect Incidence of SBS

2010-05-02T08:28:00.006-04:00

Articles in US News and World Report, USA Today and TIME cover a new study showing a significant correlation between abuse head injuries, such as Shaken Baby Syndrome, and the economy...

From the TIME article...

Presenting May 1 at the Pediatric Academic Societies annual meeting in Vancouver, a team of researchers led by child abuse expert Dr. Rachel Berger at Children's Hospital of Pittsburgh reported a significant increase in cases of shaken baby syndrome, in which youngsters are shaken violently by an adult, since the start of the current recession. Researchers analyzed data on 512 cases of head trauma in the children's centers of four hospitals in Pittsburgh, Cincinnati, Columbus and Seattle, and found that the number of cases had increased to 9.3 cases per month since Dec. 1, 2007, compared with 6 cases per month prior to that date — a rate that had held steady since 2004.

Survivors: Adam Carbajal, Part II

2010-04-26T00:12:00.006-04:00

Three First Five counties joined to bring the story of Adam Carbajal, and the remarkable campaign of his grandparents for legislation that creates serious consequences for those who inflict injuries on young children, to video - via YouTube...

More on Adam's story.

More on the effort to enact Adam's Law, sponsored by Assemblyman Mike Villines:

Adam's Law: Shake, Hit or Hurt a Child Severely = 15 Years-to-Life

In November of 2004, a young resident of our Fresno community, Adam Carbajal, became a victim of devastating child abuse by being subjected to shaken baby syndrome resulting in severe head trauma. Although Adam was initially given only a five percent chance of survival, he lives today with permanent brain damage and is paralyzed on the right side. Adam cannot walk, talk or do anything most little boys his age can do.

Adam's perpetrator was charged with two counts – corporal injury to a child and willful cruelty to a child under the age of five. After skipping bail and being on the run for months, then harassing Adam's family and insisting he fell on his own, only to later plead guilty, Adam's assailant will only serve seven and a half years in prison.This is because current California law does not take into consideration the consequences or the end result of an incident of child abuse when determining the sentence for the crime. Even if Adam's injuries only resulted in a broken arm or leg, the child abuser's punishment would remain the same.

When I heard about this family's story from Adam's concerned and loving grandparents, I knew action needed to be taken to correct this glaring deficiency in the law. To put an end to this, next year I will be authoring ''Adam's Law'', a measure that will result in longer prison sentences for perpetrators who cause severe and permanent damage to children.

If the child abuser shakes, hits or hurts a child severely, the punishment would be 15 years-to-life. I believe we should stop at nothing to protect our children from harmful and dangerous abusers like Adam's assailant.
I'm proud to stand by Adam's family and work with the Legislature to correct this loophole in our system, bringing justice to more families and most importantly, preventing this from happening to any more children.
To find out more information about Adam Carbajal and learn how you can help the efforts of his family, send an email to justiceforadam@yahoo.com.

SBS Awareness Week 2010 - Senate Resolution

2010-04-22T19:01:00.004-04:00

Another bit of good news from Congress: despite all that's going on (or not) with financial reform, Senator Dodd again sponsored a Senate resolution recognizing SBS Awareness Week 2010.

April 22, 2010
SENATE PASSES DODD RESOLUTION DESIGNATING NATIONAL SHAKEN BABY SYNDROME AWARENESS WEEK
WASHINGTON, D.C. - This week, the Senate unanimously passed a resolution introduced by Senator Chris Dodd (D-CT) designating the third week of April 2010 as National Shaken Baby Syndrome Awareness Week. Senator Lamar Alexander (R-TN) joined Dodd in authoring and introducing the resolution.
Last year, nearly 95,000 children under the age of 1 were victims of abuse and neglect, said Dodd. One form of this abuse is Shaken Baby Syndrome, which often results in severe injury, lifelong disability, and even death. By proclaiming the third week of April to be National Shaken Baby Syndrome Awareness Week, the Senate is doing its part to raise public awareness about this preventable and devastating form of child maltreatment.
In recognition of the need to eliminate child abuse and to raise awareness about the issue, the month of April has been designated National Child Abuse Prevention Month, an annual tradition that was initiated in 1979 by former President Jimmy Carter.
In February, Dodd, along with Congresswoman Nita Lowey (D-NY) in the House of Representatives, introduced the Shaken Baby Syndrome Prevention Act, which would establish a national public health campaign to raise awareness about Shaken Baby Syndrome, encourage prevention programs, provide support to both families affected by abusive head trauma incidents as well as preventative support for parents and caregivers, and review data collection on Shaken Baby Syndrome.

The SBS Prevention Act of 2010

S.3003: A bill to enhance Federal efforts focused on public awareness and education about the risks and dangers associated with Shaken Baby Syndrome. [link to bill]

Sponsor: Sen Dodd, Christopher J. [CT] (introduced 2/4/2010)
Cosponsors: (4) Sen Bayh, Evan [IN], Sen Brown, Sherrod [OH], Sen Cochran, Thad [MS], Sen Johnson, Tim [SD]
Committees: Senate Health, Education, Labor, and Pensions
Latest Major Action: 2/4/2010 Referred to Senate committee.
Status: Read twice and referred to the Committee on Health, Education, Labor, and Pensions.

H.R.4642: Shaken Baby Syndrome Prevention Act of 2010 [link to bill]

Sponsor: Rep Lowey, Nita M. [NY-18] (introduced 2/22/2010)
Cosponsors: (None)
Latest Major Action: 2/22/2010 Referred to House committee.
Status: Referred to the House Committee on Energy and Commerce.

Pepsi Refresh Project: Fund Prevent Child Abuse Iowa

2010-04-21T23:26:00.003-04:00

Good News: Prevent Child Abuse Iowa is still in the running for Pespi funding of a statewide SBS prevention initiative.

Not So Good News: PCA Iowa is still ranked #45. What better way to celebrate SBS Awareness Week than voting - and you can vote once a day, until April 30.

Link to PCA Page - http://www.refresheverything.com/pcaiowa

Ohio Reflections: Jada Ruiz, Aiden Stein and Bill Spicer

2010-04-17T11:06:00.007-04:00

The Akron Beacon Journal reports on Jada Ruiz, a six month old girl in intensive care at Akron's Children's Hospital.

Her injuries are so severe that her mother wants to release her from life support, but her father, who is accused of inflicting the injuries, is battling to keep Jada on life support.

A sad story, and one that brought to mind the case of Aiden Stein, and the legal battle about whether he should be allowed to remain on life support. When the petition to remove life support is heard by Judge Bill Spicer, it will undoubtedly remind him of Aiden Stein: he was also the judge in that case.

Despite dire predictions, he survived. In 2009, a follow up story in the Cleveland Plain Dealer reported he was alive and responsive to stimuli. There are no good consequences when a child is shaken: cases such as these simply emphasize the importance of prevention.

Whatever happened to Aiden Stein, who was in a coma in Akron after being assaulted by his father?

The Mansfield boy will celebrate his sixth birthday Oct. 27.

Aiden was supposed to be deaf, blind and in a permanent vegetative state after his father severely shook and abused him in 2004 when he was 5 months old. Experts thought he would require life support -- including breathing tubes -- for the rest of his life. And they thought he wouldn't live long.

"This is the kid experts said was deaf, blind and would remain in a permanent vegetative state," said Dale Musilli, the child's court-appointed lawyer. "He responds to sound, he responds to light."
(AP file Aiden Stein)
"This kid has had some serious medical episodes. He's a tough little guy and has pulled back each time," Musilli said.

IL: Mentos, Guinness and SBS Awareness

2010-04-16T16:23:00.004-04:00

The Danville Commercial News reports on a school board meeting that involves Mentos, Guinness and SBS Awareness. Sounds like these middle school students in Danville and Reagan's Rescue are doing a great job of raising awareness!

So, how often do you get a chance to support a Guinness world's record AND increase awareness of SBS...

Board members also heard from a long line of student Problem Solvers from North Ridge Middle School. One by one, students told of their “I Will Prevent It” campaign for Shaken Baby Syndrome, which was awarded first place in state competition.

The students announced they would have another fundraiser for Reagan’s Rescue with a second attempt to break the Guinness World Record for Mentos geysers. An attempt at the 1,900 person record failed in January as 500 showed up in poor weather, but the students have taken their second try a step further by aiming for 2,500 geysers.

Students said in January they were disappointed they didn’t make the record but were buoyed by the fact they had raised awareness for their cause.

Geysers are created when a Mentos tab is dropped in a soda bottle with the ensuing fizz directed 10 feet into the air through a tube.

Organizers hope to employ area school districts to help with the record and the cost has been dropped from $10 to $2 in the second go-around due to leftover supplies from the first attempt.

The new world record attempt will take place at 1:30 May 13 at the WDAN radio station, 1500 N. Wabash St. Participants are asked to arrive at least an hour early and a rain date of May 17 has been set.

The Problem Solvers are also hoping the community supports a fundraiser to help the group attend an international competition in June.

To make a donation or participate in the geyser event contact sponsor Lori Woods at lwoods@danville.k12.il.us or 444-3456

http://commercial-news.com/local/x1687712297/D118-board-spotlights-students.

VT: Incidence of SBS rising (Vermont Public Radio)

2010-04-13T15:18:00.003-04:00

Vermont Public Radio interviewed the coordinator of the SBS Prevention Program sponsored by Prevent Child Abuse VT...

Link to listen to interview

Officials aren't quite sure why, but cases of Shaken Baby Syndrome are on the rise in Vermont. Prevent Child Abuse Vermont started keeping track of cases in the fall of 2007. Since then, there have been 19 cases. Six have resulted in the death of an infant.

Kay Shangraw is a registered nurse and she's also the program's Shaken Baby Syndrome Prevention Coordinator. Shangraw visited us in our VPR studios to speak with Mitch Wertlieb.
Shangraw described the injuries seen from abusive head trauma-the medical term for what can happen from less than ten seconds of shaking.

Iowa: Pepsi and Shaken Baby Prevention

2010-03-30T09:51:00.004-04:00

Google brought this announcement from the Denison Bulletin our way today.

There's no moment like the last moment...vote by ,~~March 31~~ April 30 (voting was extended) [link to voting page] to help Prevent Child Abuse Iowa meet an interesting Pepsi challenge:

Help the Iowa Child Abuse Prevention Program stop shaken baby syndrome

Published: Friday, March 26, 2010
The Iowa Child Abuse Prevention Program submitted an idea to the Pepsi Refresh program, which is awarding more than a million dollars in grants to deserving programs chosen by popular vote.

Amber Russell, ICAPP manager as part of Prevent Child Abuse Iowa, explained that the grant would be used to purchase and distribute 10,000 copies of the Period of PURPLE Crying DVD. The educational DVD was developed by The National Center on Shaken Baby Syndrome to help new parents understand the characteristics of their baby’s cries.

The ICAPP program is designed to help prevent shaken baby syndrome in Iowa. Only the top 10 vote getters in the $25,000 class will be awarded a grant and the ICAPP project is currently ranked 45th.

To vote for the project visit www.refresheverything.com/pcaiowa. Voting ends ~~March 31~~ April 30.

Under 5: Abusive Head Trauma

2010-03-29T12:47:00.004-04:00

Overall, the Fourth National Fourth National Incidence Study of Child Abuse and Neglect reports that the incidence of child abuse seems to be decreasing (an interesting take from Baltimore on those statistics - link)

Unfortunately, a recent report by CDC researchers estimates that 400 childen a year under age 5 still die from abusive head trauma - and half of the children who die as a result of child abuse are younger than 1. Link to abstract

Child maltreatment fatalities in children under 5: Findings from the National Violence Death Reporting System.
J Klevens and RT Leeb - Child Abuse Negl, March 19, 2010.

Centers for Disease Control and Prevention, 4770 Buford Highway,
Mailstop F-64, Atlanta, GA 30341, USA.

OBJECTIVE: To describe the distribution of child maltreatment fatalities of children under 5 by age, sex, race/ethnicity, type of maltreatment, and relationship to alleged perpetrator using data from the National Violent Death Reporting System (NVDRS).

STUDY DESIGN: Two independent coders reviewed information from death certificates, medical examiner and police reports corresponding to all deaths in children less than 5 years of age reported to NVDRS in 16 states.

RESULTS: Of the 1,374 deaths for children under 5 reported to NVDRS, 600 were considered attributable to child maltreatment. Over a half of the 600 victims of child maltreatment in this age group were under 1 year old, 59% were male, 42% non-Hispanic Whites, and 38% were non-Hispanic Blacks.
Two thirds of child maltreatment fatalities in children under 5 were classified as being due to abusive head trauma (AHT), 27.5% as other types of physical abuse, and 10% as neglect. Based on these data, fathers or their substitutes were significantly more likely than mothers to be identified as alleged perpetrators for AHT and other types of physical abuse, while mothers were more likely to be assigned responsibility for neglect.

CONCLUSIONS: Among children under 5 years, children under 1 are the main age group contributing to child maltreatment fatalities in the NVDRS. AHT is the main cause of death in these data. These findings are limited by underascertainment of cases and fair inter-rater reliability of coding.

PRACTICE IMPLICATIONS: The findings suggest the need to develop and evaluate interventions targeting AHT to reduce the overall number of child maltreatment deaths in young children. These interventions should make special efforts to include fathers and their substitutes.

Brain Injury Awareness Month: CDC Reports TBI is Rising

2010-03-21T15:24:00.008-04:00

It's Brain Injury Awareness Month... a new study released by the Centers for Disease Control and reported on MedPage underlines why awareness is important...(link to study)

A couple of facts leap out:

Boys aged 4 and younger have the highest rates of TBI-related emergency room visits, hospitalizations, and deaths combined (a statistic supported by a recent study that appears in the Journal of Child Abuse and Neglect: reseachers looked at deaths from child abuse in child under age 5, and found more than 50% of the victims were under age 1, and inflicted head injuries were most likely to be the cause of death...)

Assaults cause about 10% of traumatic brain injuries. They accounted for 2.9% of TBIs in children 14 and younger.

Resources:
CDC Brain Injury Awareness Month - link
Brain Injury Association - link
Brain Injury Awareness Month - activity calendar - Brainline.org - link
Brainline Brain Injury Awareness Month video - link
March 17, 2010 was Brain Injury Awareness Day on the Hill - link
Membership Congressional Brain Injury Task Force (2009)

CDC Study Examines Rising Incidence of TBI
By Cole Petrochko, Staff Writer, MedPage Today
Published: March 19, 2010

WASHINGTON -- Traumatic brain injuries (TBIs) account for 1.7 million hospital visits and 52,000 deaths each year -- almost a third of the nation's injury-related fatalities, the CDC reported.

The agency's study found that the incidence rate of TBI-related emergency department visits and hospitalization increased by 14.4% and 19.5%, respectively, during the 2002-2006 survey period. About 75% of those injuries were classified as concussions or other mild forms of TBI.

Its report, entitled "Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations, and Death," CDC found that TBIs tend to be concentrated among the young and old.

Children under 5, teens 15 to 19, and adults 65 and older are most likely to experience TBI.
* * *
Falls were the most likely known cause of TBI (35.2%), with the highest rates among children under 5 and seniors 75 and older. ... Among all age groups, the next leading cause of TBI was traffic accidents (17.3%), which accounted for the highest proportion (31.8%) of TBI deaths. Striking or being struck by objects accounted for 16.5% of TBIs, while assaults accounted for 10%. CDC could not determine the cause for 21% of the injuries.

The study is part of the CDC's "Heads Up" program to provide information to healthcare professionals and patients on preventing, recognizing, and managing TBI.

TBI may have short- and long-term consequences and can affect thought, perception, language, and emotions. Understanding the dangers of TBI are essential, the CDC said in a statement, because "consequences may not be readily apparent."

SBS Education: Central New York

2010-03-13T14:45:00.003-05:00

A short video from Central New York on educating parents about Shaken Baby Syndrome, including an interview with the mother of Fajo Edwards, who was shaken in 2006.

It shows how simple prevention education can be...

Shaken Baby Awareness Stroll - April 10 Birmingham - April 25 Boston

2010-03-10T09:37:00.010-05:00

Spring is coming (at least to the US Northeast - it may never have left Alabama).

What better time for a stroll with a few young children to raise awareness about Shaken Baby Syndrome?...in Boston (April 25) or Birmingham (April 10)

April 25 - Boston --Massachusetts Citizens for Children and WCVB-TV/Channel 5 announce Boston's 4th Annual Stroll for Shaken Baby Prevention on Sunday, April 25.

Babies and toddlers will be the stars of the event, as they are pushed in strollers or carried in baby carriers and slings along Boston’s historic streets by moms, dads, grandparents and other caregivers. Link to event page.

A brief pre-Stroll ceremony will include highlights of the organization's prevention efforts, remarks from families affected by SBS, and the releasing of blue and white balloons to remember infants who have died or been injured from shaking. Strollers will meet at Christopher Columbus Park in the North End, walk through portions of the Rose Kennedy Greenway and the Freedom Trail, and then wind their way through the North End back to Christopher Columbus Park.

Other sponsors joining with WCVB-TV include Boston Parents Paper, Isis Maternity and Kohl’s, the event's original sponsor whose Massachusetts stores will be contributing funds and volunteers to support the event. Uppababy Strollers, Baby Banz, BabyLegs, and Warm as a Lamb will also provide prizes and free products to strollers again this year.

April 10 - Birminghan - UAB to Host Inaugural Shaken Baby Prevention 4K Stroll and Education Fair

BIRMINGHAM, Ala. - The University of Alabama at Birmingham (UAB) Department of Pediatrics will host its inaugural Shaken Baby Prevention Program 4K Stroll and Education Fair Saturday, April 10 on the UAB Campus Green, University Boulevard, between 14th and 16th streets South. Link to brochure.

The fundraising walk will support the UAB Shaken Baby Prevention Program in its efforts to provide child-abuse prevention education in all birthing hospitals, licensed daycares and appropriate community settings across Alabama.

Early registration is $20 per person or $100 per team for up to six people and ends March 31. After that day, walk registration will be $25 per person or $125 per team for up to six people. Kids under 12 walk free. For more information or to register go to www.medicine.uab.edu/stroll or call 205-975-5659.

There will be a sidewalk stroll path along the UAB Campus Green for families with stroller-age children and a walk path around the perimeter of the Campus Green for fast-pace walkers. There also will be a kids zone with free games, crafts and activities for kids of all ages, an education fair featuring nonprofit agencies working to prevent child abuse and merchants and vendors with products and services to sample.

The UAB Shaken Baby Prevention Program is a hospital-based maternity education program within UAB Hospital, Cooper Green Mercy Hospital and UAB Medical West designed to decrease the number of child-abuse and shaken baby syndrome victims in Alabama. Through a partnership with the Children's Trust Fund of Alabama and the Alabama Child Death Review System, parents are educated on the dangers of shaking small children and taught healthy ways to respond to infant crying before they leave the hospital with their new baby.
* * *
Along with the hospital-based work, the Shaken Baby Prevention Program is active in the community. The program administers community and school education events plus training sessions for nurses, social workers and child-care providers to increase awareness of the dangers of shaking an infant and to teach safe and effective methods to calm a crying infant.

AMCHP Conference: The Zen of a SBS Presentation without a Presenter

2010-03-08T18:09:00.005-05:00

Unfortunately, I couldn't make it to the 2010 AMCHP Conference, but I did do this presentation that's available via the magic of Scribd.

If you're lucky to be there, check out the presentation by Dr. Richard Volpe of the Ontario Neurotrauma Foundation's SBS Prevention Project (and check out "Preventing Inflicted Infant Head Trauma: Best Practices") , and Sally Fogerty and Sally Kerschner of the Children's Safety Network, on "Going to Scale" with injury prevention programs (and sample some of the CSN webinars on violence and injury prevention)

Great opportunity to learn about two regional collaborations to prevent SBS and ATV injuries while discussing the challenges in expanding successful initiatives.

11:00 AM Tuesday.

Session ID: H5 - Workshop
Taking Injury Prevention to Scale: New Approaches at the State and Community Levels

To reduce injury deaths in rural areas, the Children’s Safety Network formed a community of practice (COP) consisting of six states that met monthly to learn about rural injury issues, share resources, and develop prevention strategies. The COP offers a model of multistate, cross-agency collaboration to address the disparity in rural and urban injury rates, focusing on four key injury issues: teen motor vehicle crashes, teen suicides, ATV injuries, and farm injuries. This workshop describes the COP and explains how each participating state developed and implemented an action plan to adapt evidence-based interventions for use in rural communities.

Since it was implemented at Children's Hospital of Buffalo, the Upstate New York Shaken Baby Syndrome (SBS) Prevention Project has reduced the incidence of SBS and other inflicted head injuries by more than 50%. It has been adopted and extended to culturally diverse settings such as the Ontario SBS Prevention Project, which is part of Ontario's provincial injury prevention initiative, and the Centers for Disease Control, which have funded statewide prevention projects in North Carolina and Pennsylvania. During this workshop, participants will learn to 1) develop effective strategies and coalitions to reframe and support prevention initiatives; 2) develop, implement, and support hospital-based prevention education for new parents in MCH settings; 3) respond to common challenges and obstacles to adoption of prevention initiatives; and 4) use advocacy tools and techniques in the legislative process to support adoption of prevention legislation.

AMCHPSKIPPER03082010

Free - "Are You Tough Enough" SBS Awareness Poster

2010-03-05T18:41:00.002-05:00

Just in case you’re not on the email list from the Center, thought you might be interested in this offer… I’ve highlighted the operative term…FREE (well, S&H).Kudos to the National Center for making this Gentle reminder for parents available in time for April.Please pass it along to anyone else who might be interested.

April is Prevent Child Abuse Month

Free “Are You Tough Enough” Posters

From the National Center on Shaken Baby Syndrome

Shipping and Handling Not Included

Sizes Available: 18 x 25

Place your order online at https://secure.dontshake.org/buymaterials/ or

by phone at 801-627-3399

COUPON CODE: FreePoster

ITEM NUMBERS: POST-TUF-25

Hurry -Offer Expires 4/30/2010

Mind Hacks - Baby Brains

2010-03-04T11:55:00.003-05:00

In the blog roll, you'll notice Mind Hacks.

It's an always engaging blog that looks at a fascinating variety of things psychological.

For example, a recent post covers two articles related to baby (and mommy) brains.

All aboard the baby brain:

The March edition of The Psychologist has just appeared online and has two freely available articles: one article investigates whether women really suffer a reduction in mental sharpness during pregnancy, and another interviews baby psychologist Alison Gopnik about her work.

Prevention: North Carolina

2010-02-09T18:58:00.003-05:00

The McDowell News has a great story on efforts to increase awareness in North Carolina. Link

The Carolina Hurricanes recognized the work of Carrie Price, a nurse at Rutherford Hospital, to educate new parents. And even better, the Hurricane's team captain, Eric Staal and his infant son appeared in a PSA to increase awareness. Link

By Britt Combs The McDowell News
Published: February 9, 2010

What with the recent snowy weather, many in McDowell have seen more than ever of the inside of their homes.
But not Carrie Price.
When nearly a foot of snow blasted North Carolina, she and her husband, Patrick, drove to Raleigh to take in a Carolina Hurricanes hockey game.
The team invited Price, a registered nurse from Rutherford Hospital's Birth Place, to take part in an event designed to prevent child abuse and raise awareness of some of the frustrations faced by parents of young babies.
"We had to drive there in the falling snow," she said. "What's normally a 3 hour trip took seven hours. We had a great time and it was very exciting to see the Hurricanes play."
Adding to the fun was the excitement of seeing the Hurricanes defeat the Chicago Blackhawks 4-2. The trip was a blast and the Prices were glad to have an excuse to spend the night and make a
romantic weekend of it.
She said she would have made the trip without the hockey game if it helped prepare parents for that difficult stage of their new babies' lives. She has seen more than enough to make her aware just how confused and powerless parents can feel when their babies are inconsolable.
"They used to call it 'colic,'" said Price, but, she explained, that gives the impression the tendency of some babies to cry for extended periods is a disease. In fact, she said, many babies go through a stage of crying for no discernable reason.
"That's why we call it 'The Period of Purple Crying'; because it's just a normal stage."
Price works to prepare new parents for this frustrating process. Hopefully, with information and tools ready, the parents will be better prepared to deal with the situation that has been cited as a aggravating factor in "shaken baby syndrome."
The mission to spread that awareness has become a favorite cause of Hurricanes Captain Eric Staal. He, his wife, Tanya and their infant son, Parker filmed a PSA to encourage parents to be cool when the screaming starts.
"We all know it's normal for babies to cry, but it can be really frustrating when they cry for hours and nothing we can do makes the crying stop," Staal explained in the message.
"The most important thing is what we do with that frustration. You just have to stay cool and know that this normal crying period will end."
Price, a mother of three, has been working in the maternity department at Rutherford since 2003. She said the Purple Crying campaign has enabled her to get a lot of information across to new parents very quickly -- at a time when they are exhausted and want to go home. And that, she said, has been key to having a lasting impact.
"None of my babies went through that stage," she said, "and not all babies do. But it is very normal." She said babies can cry for hours on end and the parents feel completely powerless to
comfort their babies.
In the noise and chaos, combined with the frustration and helplessness, she said, a parent may be tempted to shake the baby -- a hasty decision that can leave the child with devastating, disabling injuries, and the parent with a lifetime of regret.
The best coping mechanism, she said, is to "simply put the child down in a safe place and get away until you can calm down." The injuries the child can sustain, often called shaken baby syndrome,
include blindness, seizures, learning disabilities and death.
Lyn Jackson, of the group Keeping Babies Safe in North Carolina, said the Hurricanes' involvement has been very effective in changing what is considered "normal behavior" in infants.
She said the Price and the Purple Crying campaign have been successful in reducing child abuse because they take a positive approach, helping parents feel more capable, better prepared and better about their babies.

Update - 4 Cosponsors for Shaken Baby Prevention Act 2010 (S.3003)

2010-02-05T17:59:00.003-05:00

A bit of good news from Congress.

Despite all that's been going on (or not) with financial reform and health care, Senator Dodd reintroduced the Shaken Baby Prevention Act of 2010. So far, it's picked up four sponsors in the Senate.

S.3003 A bill to enhance Federal efforts focused on public awareness
and education about the risks and dangers associated with Shaken Baby Syndrome.
Sponsor: Sen Dodd, Christopher J. [CT] (introduced 2/4/2010

Cosponsors
Sen Brown, Sherrod [OH] - 2/22/2010
Sen Johnson, Tim [SD] - 3/8/2010
Sen Cochran, Thad [MS] - 3/8/2010
Sen Bayh, Evan [IN] - 3/16/2010
(As of 3.29.2010)

Latest Major Action: 2/4/2010 Referred to Senate committee.
Status: Read twice and referred to the Committee on Health, Education, Labor, and Pensions.

Congresswoman Lowey introduced a counterpart bill in the House (HR.4642). To date, the House bill awaits its first cosponsor...

SBS Prevention Act 2010

2010-02-05T16:49:00.005-05:00

Senator Dodd and Congresswoman Lowey have reintroduced the SBS Prevention Act.

In the Senate, it's S.3003. Note that cosponsors are needed...

S.3003 A bill to enhance Federal efforts focused on public awareness and education about the risks and dangers associated with Shake Baby Syndrome.
Sponsor: Sen Dodd, Christopher J.[CT] (introduced 2/4/2010) Cosponsors (None)
Latest Major Action: 2/4/2010 Referred to Senate committee.
Status: Read twice and referred to the Committee on Health, Education, Labor, and Pensions.

In view of Senator Dodd's decision not to seek reelection, let's hope the second time will be the charm...

Below, Senator Dodd's introductory remarks in the Senate...with far too many names.

STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS -- (Senate - February 04, 2010)

[Page: S495] GPO's PDF
By Mr. DODD: 
   S. 3003. A bill to enhance Federal efforts focused on public awareness and education about the risks and dangers associated with Shaken Baby Syndrome; to the Committee on Health, Education, Labor, and Pensions.
   Mr. DODD. Mr. President, today I rise to introduce the Shaken Baby Syndrome Prevention Act of 2010, important legislation that promotes awareness and prevention of Shaken Baby Syndrome/Abusive Head Trauma, a devastating form of child abuse that results in the severe injury, disability or death of hundreds of children each year.
   Child abuse and neglect is a well-documented tragedy for some of our youngest and most vulnerable citizens. According to the National Child Abuse and Neglect Data System, NCANDS, 794,000 children were victims of abuse and neglect in 2007. Babies are particularly vulnerable; in 2007, children aged 12 months or younger accounted for nearly 40 percent of all child abuse and neglect fatalities and children aged 4 years and younger accounted for almost 77 percent. Yet even these disturbing statistics may not paint an accurate picture; most experts agree that child abuse is widely under reported.
   Abusive head trauma, including Shaken Baby Syndrome, is the leading cause of death of physically abused children, in particular for infants younger than one. When a frustrated caregiver loses control and violently shakes a baby or impacts the baby's head, the trauma can kill the child or cause severe injuries, including loss of vision, loss of hearing, brain damage, paralysis, and/or seizures, resulting in lifelong disabilities and creating profound grief for many families.
   Far too many children have experienced the horrible devastation of Shaken Baby Syndrome. A 2003 report in the Journal of the American Medical Association estimates that as a result of Shaken Baby Syndrome, an average of 300 U.S. children will die each year, and 600 to 1,200 more will be injured, of whom 2/3 will be infants younger than one. Medical professionals believe that thousands of Shaken Baby Syndrome cases are misdiagnosed or undetected, as many children do not immediately exhibit obvious symptoms after the abuse.
   Prevention programs can significantly reduce the number of cases of Shaken Baby Syndrome. For example, the upstate New York SBS Prevention Project at Children's Hospital of Buffalo has used a simple video to educate new parents before they leave the hospital, reducing the number of shaken baby incidents in the area by nearly 50 percent.
   In Connecticut, a multifaceted prevention approach involving hospitals, schools, childcare providers, and community-based organizations in awareness and training activities, including home visits and targeted outreach, has raised awareness and encouraged prevention across the state. Hospitals in many states educate new parents about the dangers of shaking a baby, yet it is estimated that less than 60 percent of parents of newborns receive information about the dangers of shaking a baby. Without more outreach, education, and training, the risk of Shaken Baby Syndrome will persist.
   With the introduction of the Shaken Baby Syndrome Prevention Act of 2010, I hope to reduce the number of children injured or killed by abusive head trauma, and ultimately to eliminate Shaken Baby Syndrome. Our initiative provides for the creation of a public health campaign, including development of a National Action Plan to identify effective, evidence-based strategies for prevention and awareness of SBS, and establishment of a cross-disciplinary advisory council to help coordinate national efforts.
   The campaign will educate the general public, parents, child care providers, health care professionals and others about the dangers of shaking, as well as healthy preventative approaches for frustrated parents and caregivers coping with a crying or fussy infant. The legislation ensures support for families who have been affected by SBS, and for families and caregivers struggling with infant crying, through a 24-hour hotline and an informational website. All of these activities are to be implemented through the coordination of existing programs and/or the establishment of new efforts, to bring together the best in current prevention, awareness and education practices to be expanded into areas in need. Awareness is absolutely critical to prevention. Families, professionals and caregivers responsible for infants and young children and must learn about the dangers of violent shaking and abusive impacts to the head.
   Additionally, this bill will include a study to identify the current data collected on Shaken Baby Syndrome and examine the feasibility of collecting uniform, accurate data from all states regarding the incidence rates of Shaken Baby Syndrome, the characteristics of perpetrators, and the characteristics of victims. It is my hope that having this information will enable us to better reach those who may be at risk for Shaken Baby Syndrome and, thus, prevent Shaken Baby Syndrome.
   On behalf of the victims of Shaken Baby Syndrome, including Cynthia Gibbs from New York, Hannah Juceum from California, Sarah Donohue from New York, Kierra Harrison from Nevada, Miranda Raymond from Pennsylvania, Taylor Rogers from Illinois, Cassandra Castens from Arizona, Gabriela Poole from Florida, Amber Stone from New York, Bennett Sandwell from Missouri, Jamison Carmichael from Florida, Margaret Dittman from Texas, Dalton Fish from Indiana, Stephen Siegfried from Texas, Kaden Isings from Washington, Joseph Wells from Texas, Dawson Rath from Pennsylvania, Macie McCarty from Minnesota, Jake Belisle from Maine, Benjamin Zentz from Michigan, Chloe Salazar from New Mexico, Madison Musser of Oklahoma, Daniel Carbajal from Texas, Nykkole Becker from Minnesota, Gianna D'Alessio from Rhode Island, Brynn Ackley from Washington, Rachael Kang from Texas, John Sprague from Maryland, Ryan Sanders from Virginia, David Sedlet from California, Reagan Johnson from Virginia, Skipper Lithco from New York, Brittney Sheets from New York, Madilyne Wentz from Missouri, Nicolette Klinker from Colorado, Brianna Moore from West Virginia, Shania Maria from Massachusetts, Dayton Jones from Pennsylvania, Breanna Sherer from California, Evelyn Biondo from New York, Kenneth Hardy from Pennsylvania, Alexis Vazquez from Florida, Joshua True from Washington, Stephen David from California, Michael Blair from Arkansas, Olivia Thomas from Ohio, Kaleb Schwade from Florida, Aiden Jenkins from Pennsylvania, Isabella Clark from Pennsylvania, Aaron Cherry from Texas, Dominic Morelock from Ohio, Emmy Cole from Maine, Chelsea Forant from Massachusetts, Joshua Cross from Ohio, Gavin Calloway from Maryland, Christopher Daughtrey from North Carolina, McKynzee Goin from Oregon, Bryce McCormick from Florida, and many other innocent lives lost or damaged, I look forward to working with my colleagues to see that this legislation becomes law so that we can expand efforts to eradicate Shaken Baby Syndrome.

Prevention: Baby Texting

2010-02-03T22:46:00.002-05:00

The AP, via the Washington Post, reports on a texting tool for new parents that will deliver infant health information to mobile phones.

Being optimistic that the more parents know about what they should do, the less likely they are to do things they shouldn't do to their child, kudos to the sponsors and the cellular providers who've partnered on this initiative

Hope one of the next steps is to include a variant for infant crying...

By MATTHEW PERRONE The Associated Press
Wednesday, February 3, 2010

WASHINGTON -- Expectant mothers are getting a new tool to help keep themselves and their babies healthy: pregnancy tips sent directly to their cell phones.

The so-called text4baby campaign is the first free, health education program in the U.S. to harness the reach of mobile phones, according to its sponsors, which include Johnson & Johnson, Pfizer, WellPoint and CareFirst BlueCross and Blue Shield. Wireless carriers including AT&T, Verizon and Sprint have agreed to waive all fees for receiving the texts.

Organizers say texting is an effective means of delivering wellness tips because 90 percent of people in the U.S. have cell phones.

"Especially if you start talking about low-income people, cell phones are the indispensable tool for reaching them and engaging them about their health," said Paul Meyer, president of Voxiva, a company which operates health texting programs in Africa, Latin America and India.

Studies in those countries have shown that periodic texts can reduce smoking and other unhealthy behaviors in pregnant mothers. Meyer said the U.S. program, run by Voxiva, will be the largest health-related texting program ever undertaken.

Under the new service, mothers-to-be who text "BABY" to 511411 will receive weekly text messages, timed to their due date or their baby's birth date. The messages, which have been vetted by government and nonprofit health experts, deal with nutrition, immunization and birth defect prevention, among other topics. The messages will continue through the baby's first birthday.

Text4baby is expected to be announced Thursday morning by officials from the White House's Office of Science and Technology Policy. Government officials will be publicizing the campaign in speeches and promotional materials.

Organizers hope the effort can curb premature births, which can be caused by poor nutrition, excessive stress, smoking and drinking alcohol. About 500,000 babies are born prematurely in the U.S. each year, and 28,000 infants die before their first birthday, according to the Healthy Mothers, Healthy Babies Coalition. The nonprofit is among the sponsors of the campaign.

* * *

Researchers at the George Washington University have agreed to evaluate the effectiveness of text4baby by measuring health trends for mothers and newborns.

SBS Prevention Legislation: KY, NJ, OK

2010-01-30T00:51:00.003-05:00

Prevention legislation has been introduced in the current sessions of the Kentucky (HB 285), New Jersey and Oklahoma (HB 411) state legislatures.

This article from WAVE TV in Frankfort reports on prevention efforts at Norton Hospital, with the assistance of the Child Advocacy Office at Kosair Children's Hospital. The last paragraph, as well as this blog post, succinctly sum up the reasons why legislation introduced by Rep. Addia Wuchner is necessary...

Legislators work to lower child abuse cases high in Kentucky
Posted: Jan 29, 2010 - By Elizabeth Donatelli - bio | email
FRANKFORT, KY (WAVE) – With several recent baby abuse cases in Kentuckiana, lawmakers are looking at ways to prevent them before they happen. In 2009, Kentucky had the most child deaths related to abuse in the country.

With 39 years under her belt as a critical care nurse, Justi O'Flynn, who works at Kosair Children's Hospital, has seen lots of kids play with dolls, but there is one that could save a life.

"This doll is the size of a 4-month-old baby and it shows the different areas of the brain," said O'Flynn. O'Flynn uses the toy most children cling to as a model of what can happen if a parents loses control.

"What happens when someone gets frustrated with a baby and they shake them and it causes the little vessels inside the brain to cause some bleeding," said O'Flynn shaking the doll.

When the doll shakes, its brain hits the side of the scull, lighting up the parts that can have lasting damage. The damage can happen by just shaking a child for as few as five seconds.

"Blindness; they can be ventilator-dependant," said O'Flynn describing what can happen to the baby. "They can have learning difficulties they can have learning disorders. They can die."

To teach this valuable lesson to parents, Norton Hospital is piloting a program.

"New mommies, new daddies, new caregivers, to watch this video to become educated one-on-one on comprehensive treatment to help prevent child abuse, specifically shaken baby syndrome," said Therese Sirles, director of child advocacy.

Lawmakers in Frankfort are proposing a bill that will spread the video message across the state, not just for parents, but teach front-line workers the signs of abuse and how to prevent it.

"We've been on defense with this," said Rep. Addia Wuchner (R-Burlington). "We're seeing them as first responders, law-enforcement is seeing them, the doctors are seeing them when they come in. Now we're taking in a sense an offensive."

The plan is to make the doll can once again be a comfort to children instead of a reminder of abuse.

The video teaches parents that all children cry and it is normal. If you're feeling overly frustrated, take a few steps back, count to ten, or call someone to come over and be with the baby for a little while.
Copyright 2010 WAVE-TV. All rights reserved.

Prevention: Exchange Club Family Skills, Birmingham, AL

2009-09-27T14:48:00.003-04:00

CBS42.com in Birmingham, Alabama reports that the Exchange Club Family Skills Center partnered with several agencies for a Child Safety Fair at the Marks Village Community Center. One of the focal points was a display which offered a detailed demonstration of what happens to a baby's brain when it is shaken.

Resources:

Exchange Club Family Skills Center, Birmingham - Link
Exchange Club SBS Education Program - Link
Exchange Club Resources - Link
Realityworks SBS Simulator Doll - Link

Legislative Alert: Home Visiting Services

2009-09-27T13:05:00.012-04:00

In August, the Child Welfare League of America sent an email reminder about home visiting services.

It's still timely: action you can take to ensure your legislators are aware of the importance of providing new parents with home visiting services (Congress should be returning home at the end of October). Link to CWLA resources on home visiting...

Home visiting provides opportunity - not an obligation - for parents to learn more about raising children and keeping them safe...(and here's a link to take CWLA's survey about prevention initiatives: so far, "prevention of child abuse and neglect was ranked by 16% of respondents as the number one priority...ahead of other critical areas such as strengthening child protective services (14%) and youth transitioning out of foster care (11%)...CWLA is going to use these survey findings to gather more information on each of the critical issues.")

Home visiting provisions have been included in health reform legislation. While your U.S. Senators and Representative are back in your state and district...tell them to keep home visiting in the final health reform package!

Before making your call, review CWLA's one pager explaining why home visiting is important! See http://www.cwla.org/advocacy/HomeVisitingisImportant.pdf

ACTION REQUIRED

Call your U.S. Senators and Representative and tell them to support home visiting in health reform legislation. The toll-free number to be connected to your lawmakers' offices is 1-800-828-0498

Support comprehensive health reform legislation!

Support the home visiting amendments that will reduce child maltreatment and save on unnecessary healthcare costs down the road.

BACKGROUND

The U.S. House and Senate are debating comprehensive health reform legislation. This legislation is too important to be trampled by partisan politics. The home visiting elements that are in the current health reform legislation refer to evidence based models that deliver parent education and family support to parents with young children.

Home visitation is an effective, research-based and cost-efficient way to bridge the gap between vulnerable families and the resources that will ensure that children grow up healthy and ready to learn.

There are many families who are in need of the prenatal and maternal health services that these home visits can provide.

Children who experience maltreatment are at a greater risk of adverse health effects and home visiting not only educates parents, but also provides access to mental health, educational, and social services that might be available in the community.

For more information on current home visiting legislation, check out http://www.cwla.org/advocacy/homevisitation.htm

Preventing Injury: Tampa, Florida

2009-09-19T07:40:00.002-04:00

The St. Petersberg Times reports on an interesting campaign in the Tampa area intended to keep infants safe. I do hope the "safe caregivers" portion includes education about SBS prevention...

Child advocates launch Hillsborough County campaign to save lives
By Stephanie Bolling, Times Staff Writer
In Print: Saturday, September 19, 2009
TAMPA — Susan Martin- Warren looks at her 4-year-old son. A brace on his right ankle. A splint on his limp right hand. He talks and walks, but she worries about his development.
When Graham was just months old, his father caused permanent trauma to the left side of his brain. Doctors called it shaken baby syndrome. Authorities sent the father to prison.
Graham will live with the impairment for the rest of his life.
"We don't know what he will face as an adolescent and young adult. I worry about him everyday," said Martin-Warren.
It's the sort of incident that has led child advocates to launch a major campaign to reduce preventable deaths and traumatic injuries of young children.
"I got sick of hearing about kids dying from being wedged in a couch cushion or drowning in 6 inches of bath water. They had loving parents that didn't know any better. Their deaths were completely preventable," said Nick Cox, the Suncoast regional director for the Department of Children and Families.
So he and other child advocates have teamed up and launched an ambitious new effort. The campaign has gained sweeping momentum county-wide with partnerships between the Children's Board of Hillsborough County, the Department of Children and Families, Healthy Start Coalition of Hillsborough and public and private organizations.
"Most parents have good intentions and want the best for their child and most communities are equipped with the resources to aid parents, but the challenge is connecting the two together," said Carolyn Eastman, director of communications for the Children's Board of Hillsborough County.
She says the campaign focuses on three initiatives: safe sleeping, safe caregivers and water safety. To promote these messages, CBS Outdoor will post 16 billboards of rotating child safety messages, and HARTline buses will display 30 full-length ads on buses traveling all routes of Hillsborough County.
Hospitals will also play a big role, according to Jane Murphy, executive director for the Healthy Start Coalition. Beginning this fall, updated informational packages will be distributed to new mothers. The package will include a 95-page pamphlet outlining infant developmental processes and safety guidelines with a listing of community resources and phone numbers; a parenting DVD focusing on child safety that features mother Martin-Warren and her son Graham; a onesie reading "Put me on my back to sleep"; and a letter that parents will be asked to sign promising the child good care.
Some hospitals will offer one-on-one training and screening, including risk assessments, where they can provide parents with helpful advice, like where to get the best child care or how to obtain free car seats and baby beds.
Throughout the county, five Family Support and Resource Centers see about 60,000 families a year.
They too have committed to supporting the campaign and will tailor information and resources specific to their surrounding communities, Eastman said.
"The best result is when the entire community sees it as their responsibility to protect a child," she said. "If they don't know how to do it, then they will know how to find a resource and come together as community to help the impact of the needless amount of children that die every year."
The campaign will run at least through the end of next year, Cox said.
"If it saves one child, then it is worth it," he said.
Stephanie Bolling can be reached at (813) 226-3408 or sbolling@sptimes.com.

Awareness Vigil: Middletown, CT - 9/15

2009-09-14T12:24:00.002-04:00

If you're near Middletown CT on September 15th, the Hartford Courant reports that the Connnecticut Children's Trust Fund is joining with a local group to sponsor a candlelight vigil.

Unfortunately, increasing awareness is not only a good thing, but apparently a necessary one...

Three Middletown babies have been injured recently after being shaken severely by an adult.
The Connecticut Children's Trust Fund and the local group, Shaken Baby Syndrome Committee, are sponsoring a candlelight vigil at 6 p.m. Tuesday at Middletown South Green to talk about shaken baby syndrome.

SBS Survivors: Trae Caster, Texas

2009-09-08T07:30:00.003-04:00

Trae Caster is a member of the Trinity High School marching band. You might not think that unusual, unless you know he survived injuries inflicted by a (licensed) child care provider when he was an infant. Now, he's playing with the band.

The Fort Worth Star-Telegram reports on his accomplishments (with video). It sounds like band director Mario Casanova deserves some kudos too!)...Link

Trae’s vision, his mother said, "comes and goes." He struggles to form words and walks with an uneven gait. But the slender youth clutching a pair of drumsticks is no less a part of the Trinity band than any of its other members — a fact that underscores the school’s mission statement.

"We . . . strive to educate, respect and recognize all students," it reads in part.

Band director Mario Casanova said he had no qualms about inviting Trae to make music with other students. Last year, a senior who played the trumpet marched with the Trojan band despite being legally blind. After his graduation the student embraced the band leader and thanked him for treating him like everyone else.

"We don’t know what Trae can or can’t do," Casanova said. "He doesn’t even know. But whatever he can do, more power to him. He loves music. And he’s having a great time.

SBS Awareness: Arizona

2009-09-07T08:20:00.004-04:00

School Notes in the Arizona Star reports on an award-winning awareness project by Mountain View High School junior Londyn Whittier presented at the Family, Career and Community Leaders of America's National Leadership Conference.

Kudos to Ms. Whittier and her teachers at Mountain View HS...

Mountain View High School junior Londyn Whittier received a gold medal in Applied Technology at the 2009 Family, Career and Community Leaders of America, or FCCLA, National Leadership Conference held in July in Nashville, Tenn.

Whittier earned a score of 91.3 out of 100 for her project on shaken baby syndrome in the Applied Technology category.

She used a computer, video camera and a shaken baby syndrome simulator, which is a doll with a transparent head that lights up areas of the brain to indicate damaged areas when it is shaken, as part of her project.

Whittier also received a 10 out of 10 score for her oral presentation.

CDC Webinar: Child Maltreatment Prevention - 9/10/09

2009-09-04T00:04:00.002-04:00

Ooo! Ooo! - "Tootie", Car 54

Couldn't help it - I channeled Tootie when I saw the speakers scheduled for this webinar. Should be interesting to hear their take on prevention, especially Jack Shonkoff....

Webinar Invitation

A Better Start:

Child Maltreatment Prevention as a Public Health Priority

Did you know some of the worst adult health problems in the nation can be linked to the toxic stress resulting from adverse experiences in childhood? Population health priorities, including obesity, heart disease, and diabetes are associated with harmful childhood experiences such as abuse or neglect.

The Centers for Disease Control and Prevention’s Division of Violence Prevention invites you to learn how your public health agency can make a difference in the lives and health of both children and adults at an upcoming webinar. James Mercy, PhD, and Jack Shonkoff, MD, experts in child maltreatment prevention and early childhood development, respectively, will discuss several topics including:

The important role public health agencies can and do play in preventing child maltreatment
The body of research linking harmful childhood experiences with long-term quality of life
How public health agencies can prevent child maltreatment by using the concept of safe, stable, nurturing relationships

The goals of this webinar are to develop a shared understanding of how the prevention of child maltreatment not only promotes optimal development but also reduces disparities in health and explore the important role public health agencies play in improving the health of children and families by preventing childhood abuse and neglect.

Speakers:

Ms. Francie Zimmerman - Doris Duke Charitable Foundation – Child Abuse Prevention Program

Dr. Jack Shonkoff - Harvard University – Center on the Developing Child

Dr. James Mercy - CDC – Division of Violence Prevention

Date: Thursday, September 10, 2009

Time: 1:00 pm – 2:00 pm EST

Webinar Registration:

Click here to register for A Better Start: Child Maltreatment Prevention as a Priority.

Click here to learn more about CDC’s child maltreatment prevention efforts.

Reading List: SBS Articles

2009-09-03T23:33:00.002-04:00

From my alert...

MG Ward, S Bennett, and WJ King
Prevention of shaken baby syndrome: Never shake a baby.
Paediatr Child Health 1 May 2004 9(5): p. 319.
http://highwire.stanford.edu/cgi/medline/pmid;19657516

L Meskauskas, K Beaton, and M Meservey
Preventing shaken baby syndrome: a multidisciplinary response to six tragedies.
Nurs Womens Health 1 Aug 2009 13(4): p. 325.
http://highwire.stanford.edu/cgi/medline/pmid;19686555

Ana Isabel Curcoy, Victoria Trenchs, Marta Morales, Alicia Serra, Merce Pineda, and Jordi Pou
Do retinal hemorrhages occur in infants with convulsions?
Arch Dis Child 6 Aug 2009.
http://highwire.stanford.edu/cgi/medline/pmid;19666457

Legacy: Positive Parenting

2009-09-01T14:44:00.003-04:00

Science Daily reports on a new parenting study, with an important insight: effective parenting education can become a legacy for generations to come....

A new study that looks at data on three generations of Oregon families shows that "positive parenting" – including factors such as warmth, monitoring children's activities, involvement, and consistency of discipline – not only has positive impacts on adolescents, but on the way they parent their own children.

The study will be published in the September issue of the journal Developmental Psychology in a special issue devoted to findings of some of the few long-term studies of intergenerational family processes.

Kerr said there is often an assumption that people learn parenting methods from their own parents. In fact, he said most research shows that a direct link between what a person experiences as a child and what she or he does as a parent is fairly weak.

"Instead, what we find is that 'negative' parenting such as hostility and lack of follow-through leads to 'negative' parenting in the next generation not through observation, but by allowing problem behavior to take hold in adolescence," Kerr said. "For instance, if you try to control your child with anger and threats, he learns to deal in this way with peers, teachers, and eventually his own children.

If you do not track where your child is, others will take over your job of teaching him about the world.

"We knew that these negative pathways can be very strong," Kerr said. "What surprised us is how strong positive parenting pathways are as well. Positive parenting is not just the absence of negative influences, but involves taking an active role in a child's life."
* * *
The researchers found that children who had parents who monitored their behavior, were consistent with rules and were warm and affectionate were more likely to have close relationships with their peers, be more engaged in school, and have better self-esteem.

"So part of what good parenting does is not only protect you against negative behaviors but instill positive connections with others during adolescence that then impact how you relate with your partner and your own child as an adult," Kerr said

"This research shows that when we think about the value of prevention, we should consider an even wider lens than is typical," he added. "We see now that changes in parenting can have an effect not just on children but even on grandchildren."

Link

Texas: You Can't Have Too Much Awareness...

2009-09-01T12:31:00.005-04:00

The Killeen Daily Herald reports that the Bell County Commissioners Court voted Monday to designate September as Shaken Baby Syndrome and Child Safety Awareness Month in Bell County.

A statistic cited by County Judge Jon Burrows suggests there is a need for education.

The court also agreed to declare September as Shaken Baby Syndrome and Child Safety Awareness Month. About one in three Texans polled doesn't know it is dangerous to shake babies, Burrows said.

Although the Texas legislature did pass hospital prevention legislation (SB 316) in 2005, it only requires hospitals to provide a brochure. Unfortunately, effective education requires more, but fortunately some hospitals in Texas are going beyond the minimum requirements of the law.

Resources:

2009 SBS Awareness Week Resolution, US Senate - Link
2009 SBS Awareness Week Resolution, Texas Senate, SR 429 - Link
Hospital education requirement, Texas - Link to Senator Lucio's bill memo
Story of one family's effort in Texas to increase awareness link

Prevention: Another DVD

2009-08-24T21:23:00.003-04:00

24Dash.com reports that parenting educators in Staffordshire, with support from the Queen's Nursing Institute and the West Midlands Innovation Fund, will be creating a DVD to educate new parents and students about the causes, consequences and prevention of SBS.

The DVD will be piloted in 5 local high schools.

Hopefully, they will look around to see what's been done already...

Future parents in south Staffordshire are to be given new life skills educational support and advice about the dangers of rough handling and shaking babies to help prevent Shaken Baby Syndrome.

Stop That Shake – Babies Break! – is a innovative project set up between South Staffordshire Primary Care Trust’s (PCT) and Torc Vocational Centre, Tamworth. Project leads Janine McKnight, Specialist Community Public Health Practitioner for South Staffordshire PCT and Alison Mennell, Health Tech Project Co-ordinator, of Torc, will also be working with safeguarding teams, police, paediatricians and students from Torc Vocational Centre.

The project has been given a £7,500 cash boost from the Queen’s Nursing Institute (QNI) and NHS West Midlands Innovation Fund to develop a DVD covering the cause, consequences, risks and prevention factors around Shaken Baby Syndrome.
* * *
In addition to funding Janine and Alison, who is also a nurse and midwife, will be given professional leadership support and enjoy project management training from QNI and West Midlands Innovation Fund team to develop their unique project.

It sounds like a great project, and the project staff surely have good intentions, but it doesn't seem that creating a DVD about SBS prevention is a "unique" project.

Now, if the DVD is useful and informative, and helps parents talk to other caregivers about the need for a coping plan, AND they put it on YouTube for parents and students around the world to use, that might do qualify it as "unique"...

New Zealand: Increased Child Abuse Drives SBS Prevention Program

2009-08-16T05:46:00.004-04:00

The New Zealand Sunday Herald reports on research by doctors Patrick Kelly, Judith MacCormick and health board social worker Rebecca Strange that looks at increasing rates of child abuse in NZ and the failure of child protection services to cope with that increase. Link to PubMed abstract (not surprisingly, it has a somewhat different emphasis).

One encouraging sign: the adoption of a shaken baby prevention program.

Dr Patrick Kelly, a paediatrician at Starship children's hospital, said there were great hopes the programme would save lives. In it parents will be spoken to "in the first few days after [the birth] to talk about the dangers of shaking a baby". They would then have to sign a sheet of paper acknowledging the discussion and the ways to avoid abuse. If successful, the pilot scheme may be rolled out across the country. In the United States it has resulted in a 40 per cent reduction in abuse. Health professionals at Starship hope to have it running by the end of this year. The Shaken Baby Prevention Programme is being funded by the Ministry of Social Development, and is based on a programme developed by US professor Mark Dias. Kelly said the programme was suited to New Zealand's independent midwife network. The trial was awaiting the appointment of key staff and development of material such as a video.

Surviving SBS: Jack Koller, Boulder, CO

2009-08-11T11:59:00.003-04:00

From 9News. com in Boulder, Colorrado, another remarkable story of survival.

About half-way through the story, the reporters added the word "preventing" to a quote by the maternal grandmother. She had apparently said she was going to become "a huge advocate for abuse and shaken baby syndrome".

A small thing, but in a way it's telling: those who suddenly find themselves volunteers in the effort to prevent inflicted injury often lack the words to move the focus from consequences to the prevention.

Family determined to bring good out of baby's survival story
by: Jeffrey Wolf and: Cheryl Preheim

BOULDER - A 2-month-old who doctors did not think would survive was released from the
hospital on Monday evening.

His father, 27-year-old Ben Koller, is in jail accused of shaking, hitting, biting and suffocating his infant son. Social Services has given custody of Baby Jack to his grandmother, Claudia Riggs, his mom's mother. "I am just glad he's home," Riggs said. "The first few days they told us that he wasn't going to survive.

But everyday he's been amazing us. He just keeps getting better and better." The 2-month-old has survived what seemed like the impossible. "Three weeks ago, if you would have seen him, you would have thought it was time to plan a funeral," said Mark Schmidt, the baby's grandfather, also on his mother's side.

Jack Koller had a fractured skull and couldn't breathe or eat on his own. He was also blind, but has regained his sight. "The MRI showed significant brain damage," Schmidt said. "It's horrendous. The one person who was supposed to be protecting was the person he knew to have the most fear about."

Police say Koller shook the baby when he wouldn't stop crying. Koller is being held at the Boulder County Jail on a $1 million bond. He faces charges of child abuse resulting in serious bodily injury.

Now, after 20 days at The Children's Hospital in Aurora, Riggs and Jack got to leave together. Riggs says they leave with a greater purpose. "He was happy to walk outside," she said. "It would be my hope that this would never happen again to another child. Somehow we are going to make really good things come out of this."

At home in Boulder, gifts were waiting from friends to help Riggs, who has just left her job as a ibrarian to be a full-time grandma to care for Jack. "I know I am going to become a huge advocate for [preventing] abuse and shaken baby syndrome. I may have a new career," she said.

Jack's mother is 20 years old and says she did not know about the abuse. She will be allowed to have supervised visits and she is getting parenting classes and counseling.

As for Jack's long term prognosis, doctors say they'll know more with time but he could have challenges with walking, talking and could have learning disabilities. But he's already shown he's a fighter so his family expects great things.

While Baby Jack still has a long recovery ahead, at least he gets to continue it at home. "This is a wonderful day. He is a miracle," Riggs said. As she held him in her arms, she told him, "We are all here to protect you and take care of you."

Riggs wants to make sure every day is a day they can look forward too. "Grandma is going to give you a bath tomorrow. We have a big day planned," she said. "I just want Jack to know he's very loved. I want to one day take him for a walk in the park. It will be a special day when that day comes," Schmidt said.

Nevada: Bad News, Good News

2009-07-28T11:47:00.002-04:00

KVVU (Fox5Vegas) reports that child abuse is increasing in the Las Vegas metro area.

The good news is that they also report the Metro Police Department is working with local hospitals to educate new parents.

Child Abuse In Vegas Rises 17 Percent
Police: Clark County Has Surge Of Child Abuse Cases

POSTED: 3:24 pm PDT July 27, 2009

LAS VEGAS -- After months in which accidental child shootings and parental arrests have dominated news headlines, Las Vegas Metro police confirmed what many already suspected.
Clark County is seeing a surge in child abuse cases. The numbers have risen 17 percent, according to authorities.
“More broken bones, more shaken baby syndrome,” said Metro Lt. Ray Steiber, who believes the weakened economy and stress on families is partly to blame for the increase.
“Being out of work, wondering how you're going to pay for that next meal or how to pay the light bill. We do see that and sometimes it transitions into the way people tend and care for their children,” Steiber said.
Through July of this year, Metro Police have dealt with seven cases of shaken baby syndrome. Police responded to nine total cases in 2008. There have also been four cases of murder by child abuse, police said, tying the same number of cases from last year.
Related Link: Clark County Department of Family Services
In April, the police department launched its “Just Step Back” prevention program, a partnership with area hospitals that’s intended to educate new parents before they go home with their children.
“[Parents] will be seeing a video that gives information as well as signing off on a checklist from the hospital,” Steiber said.

News: Education Begins At Home Hearing

2009-06-15T12:17:00.002-04:00

The Children's Monitor Online, an e-newsletter from CWLA (and a great source of info on action at the federal level - subscribe here) reports that the House held a hearing on the Education Begins At Home Act...

Key Committee Hearing on Home Visiting

On Tuesday, June 9, the House Ways and Means Subcommittee on Income Security and Family Support held a hearing on proposals to provide federal funding for early childhood home visitation programs. The focus was largely placed on how to produce the best practical, cost-effective home visiting programs. Chairman Jim McDermott (D-WA) began the hearing by bringing attention to the startling fact that less than 15% of families in need of home visitation actually receive services. He also indicated the possibility of the legislation, the Early Support for Families Act, HR 2667, moving as part of health care reform.

The hearing included many expert witnesses. The first witness, Joan Sharp, Executive Director of the Council for Children and Families of Washington in Seattle, echoed the appropriateness of thinking about home visiting in the context of health care reform, as there are many negative health outcomes for children who are victims of child abuse and neglect. Dr. Jeanne Brooks-Gunn, a developmental psychologist, centered her testimony on the outcomes that should be associated with any form of intervention, strategies for enhancing the lives of children and their families, the factors that determine the effectiveness of a given program, and how to best invest in home visiting. Cheryl D'Aprix, a Family Support Worker with the Starting Together Program in Canastota, New York, described her experience with home visiting as both a participant and a home visitor, and expressed the life changing possibilities of home visiting. Finally, Sharon Sprinkle, a Nurse Consultant with the Nurse Family Partnership (NFP) shared her success with the NFP model and asked that Congress look closely at this program as a way to improve the lives of low-income, vulnerable families. For a complete copy of the testimonies from the hearing, visit the Ways and Means Committee website.

A number of themes dominated the hearing, including the cost for this new initiative and how to meet it, as well as determining how to reach the most vulnerable families, finding approaches for including fathers, and understanding that no one program will reach all families because different families have different needs. CWLA has endorsed HR 2667 and will continue to work with Congress to refine and to pass this initiative.

Brain Injuries: Diagnosis and Management

2009-06-08T07:55:00.002-04:00

The New York Times reports on a controversy about the identification and management of concussions in high school sports...Link

It points out the importance of social context in framing the issue for high school students.

New Guidelines on Young Athletes’ Concussions Stir Controversy
By ALAN SCHWARZ
Published: June 7, 2009

New guidelines for the care of youth athletes who sustain concussions are causing controversy among brain-injury experts, reigniting the debate over whether strict rules regarding concussions can actually leave athletes at greater risk for injury.

An international panel of neurologists, updating their recommendations on concussion care in the May issue of The British Journal of Sports Medicine, said that any athlete 18 or younger who was believed to have sustained a concussion during a game or practice should never be allowed to return to the playing field the same day. The group had previously said that such athletes could return if cleared by a doctor or certified athletic trainer, but now contend that such determinations are too difficult and dangerous for same-day return to be considered safe.

Other doctors, many of whom work the sidelines of high school athletic events, said they feared the effects of such strictness. They predicted that athletes would respond by hiding their injuries from coaches and trainers even more than they are already known to do, leaving them at risk for a second and more dangerous concussion.

The panel’s recommendation to remove all players suspected of concussion has no direct influence on rules governing United States youth sports, which are generally made at the state and local levels. But it does spotlight how some attempts to improve concussion-related safety can instead compromise it, a paradox encountered at levels as high as the N.F.L.

“So many bad decisions are made when trying to assess whether a player is symptomatic or not,” said Dr. Robert Cantu, an author of the guidelines who is also a director of the Neurological Sports Injury Center at Brigham & Women’s Hospital in Boston. “We know that an unacceptable number of kids are being sent back while symptomatic, and sometimes with devastating effects. The majority believe that the bullet should be bitten, and not let a kid go back into the same contest.”

But Dr. Bob Sallis, a past president of the American College of Sports Medicine and a longtime sideline doctor in Southern California, said he saw the recommendation as a step backward.

“More kids will be hurt seriously because of this, either by players not admitting they might have gotten a concussion or coaches encouraging them not to be up front about their symptoms, whether subtly or overtly,” Sallis said.

Asked how the guidelines could have any influence on league rules throughout the country — in Iowa, for example — Sallis said: “It does put the people in Iowa in scrutiny. When a kid gets hurt, they’ll get sued and be told, why didn’t you follow those guidelines?”

High school athletes in nine primary sports sustained an estimated 137,000 concussions in the 2007-8 school year, according to a study conducted by the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio. Football had the most, with more than 70,000, followed by girls soccer (24,000), boys soccer (17,000) and girls basketball (7,000). These were only reported concussions; more were almost certainly sustained but went unrecognized or ignored.

“Sometimes, postconcussion symptoms can be delayed for hours or even days, like difficulty sleeping or concentrating,” Cantu said. “It’s a clinical decision that’s difficult or sometimes damn near impossible to be made on the sideline, and we aren’t doing a very good job at it. Athletes, even when assessed by qualified people, seem to be returning to contests prematurely or when symptomatic — an unacceptable number of cases.”

The panel also emphasized the importance of not just physical rest for players found to have a concussion, but cognitive rest as well. It said that teenagers should be kept from activities ranging from schoolwork to video games and text messaging while recovering from a concussion.

“That is the No. 1 management issue in our clinic — how do we manage the cognitive activity that stresses that brain’s abnormal metabolism?” said Gerry Gioia, the chief of pediatric neuropsychology at Children’s National Medical Center in Washington. “Studying for an algebra exam, reading a lengthy text, sitting in a classroom for an hour and a half trying to keep notes and keep up — it extends recovery, it feels miserable to the kid, and it’s misunderstood by the school and public.”

SBS Survivors: Evan Coleman, West Allis Wisconsin

2009-05-15T21:33:00.004-04:00

WISN.com in Milwaukee has a compelling video news report on the consequences of SBS.

It's the story of Evan Coleman, who's eight years old, and the story of how his parents are working to increase awareness - even though his father is responsible for those injuries...Link

Evan's father spent seven years in prison.

His son's sentence will last much longer."He now has epilepsy. He's been hospitalized four or five times for seizures. His behavior, his social skills -- he's 8 years old and his social skills are about a 4-year-old level," Coleman said.

Coleman said a portion of Evan's brain -- the part that regulates reasoning and emotion -- is permanently damaged, so Evan goes into rages and tantrums.

The news video includes an interview with his father, who admitted that he lost was responsible for those injuries.

Evan's father, who 12 News is not identifying, was caring for him one day in 2001 when he said Evan's constant crying pushed him over the edge.

"I lost it, and I picked him up, and I shook him. I think two or three times, and I kind of tossed him into his crib, and that's when I think he hit his head on the railing of the crib," Evan's father said. "As soon as I did it, I couldn't believe what had happened, what I had done.

"He drove his son to Children's Hospital. Evan's mother -- who had been at work -- rushed to be with them.

"I remember walking into the room, and Evan was laying there in a little bed, and his eyes were black and blue, and he had cuts all over his face. He had tubes in his head. He looked like the life was pretty much sucked out of him," Jenny Coleman said. "I said, 'I will find who did this to you and they will pay.'"

She didn't have to look far.

"I was so ashamed of myself. I couldn't bring myself to say it," Evan's father said.

Within hours, Evan's father confessed.

Action: Wisconsin Awareness PSA, Radio Blocks

2009-05-15T14:32:00.005-04:00

TMJ4 reports the folks in Milwaukee have done a radio block - an amazing awareness event that enlists all radio stations in the listening area to broadcast the sound of a crying baby - followed by a short SBS awareness message - for one minute. Link to video news report

Kudos to Gary Mueller, the prevention advocates in Milwaukee, and participating radio stations.

Resource: Story of the first Milwaukee radio block Link (from Free Range Thinking: also a good resource - published by A Goodman - Good Ideas for Good Causes)

Unfortunately, increased awareness does seem to be a very necessary thing in Milwaukee these days...

Shaken Baby Announcement you Can't Escape
Diane Pathieu

MILWAUKEE - A crying, screaming baby, on your radio, for 60 seconds.
60 long, ear-popping seconds. It's on every radio station you turn to. And that is the point.

Gary Mueller is behind creating this public service announcement designed to teach people not to shake a baby, and end the climbing number of baby deaths in our area. "It was a message of crying that you cannot escape and I think it's an unforgettable one."

Gary is right. He's tried that before, and the numbers have dropped.
"The shaking's stopped," Mueller says.

In order to target men, Gary even created stickers placed on products that men often buy, like WD-40, spray paint, and even garden products in 3 local ACE Hardware stores.

"75% of the perpetrators of shaken baby cases are men, and they are very difficult to reach so we thought let's catch them by surprise," says Mueller.

With four kids of his own, Gary says this campaign is very close to his heart, and hopes it works for good.

8 Year Old Boy - SBS Alleged

2009-05-14T00:34:00.003-04:00

From WSMV.Com in Nashville comes a report of an eight year old boy in Cookeville, Tennessee with symptoms of SBS....Link

Perspective: More Unmarried Mothers

2009-05-14T00:21:00.005-04:00

Underscoring the need for techniques that help mothers educate males in their household about SBS prevention, the Washington Post reports on a dramatic increase in the number of unmarried mothers...Link

The mothers are part of a far-reaching social trend unfolding across the United States: the number of children being born out of wedlock has risen sharply in recent years, driven primarily by women in their 20s and 30s opting to have children without getting married. Nearly four out of every 10 births are now to unmarried women.

"It's been a huge increase - a dramatic increase," said Stephanie J. Ventura of the National Center for Health Statistics, which documented the shift . . . based on an analysis of birth certificates nationwide. "It's quite striking."

Of course, "unmarried" doesn't necessarily mean "single"...

About 1.7 million babies were born to unmarried women in 2007, a 26 percent rise from 1.4 million in 2002 and more than double the number in 1980, according to the new report. Unmarried women accounted for 39.7 percent of all U.S. births in 2007 -- up from 34 percent in 2002 and more than double the percentage in 1980.

"If you see 10 babies in the room, four them were born to women who were not married," Ventura said.

Although experts have been concerned about a recent uptick in births to older teenagers after years of decline, that is not the driving force in the overall trend but more likely a reflection of it, Ventura said. Instead, much of the rise is due to significant increases in births among unmarried women in their 20s and 30s. Between 2002 and 2006, the rate at which unmarried women in that age group were having babies increased between 13 percent and 34 percent, the report found.

The rates increased for all races, but they remained highest and rose fastest for Hispanics and blacks. There were 106 births to every 1,000 unmarried Hispanic women in 2006, 72 per 1,000 blacks, 32 per 1,000 whites and 26 per 1,000 Asians, the report showed.

...Previous research indicates that about 40 percent of births to unmarried women occur in households where couples are cohabitating.

Wisconsin SBS Awareness Video News: Men, SBS Awareness, and a Hardware Store

2009-05-13T13:04:00.004-04:00

WITI-TV in Milwaukee, Wisconsin, the local Fox affiliate, reports on an innovative and inexpensive SBS awareness initiative. It's a story involving a hardware store, an awareness message and, needless to say, guys. Link to story, news video

It's a couple of minutes long, and well worth watching...

The folks in Wisconsin who put this campaign together deserve compliments.

Two things I noticed:

- one of the student volunteers mentioned he learned about SBS in seventh grade, showing school-based SBS education does make a difference;

- the reporter mentioned a dramatic rise in SBS cases being treated this year at the Children's Hospital, emphasizing the impact of economic stresses on families and communities.

To help prevention efforts, the Milwaukee Journal Sentinel reports that the Shaken Baby Association is planning another radio PSA campaign. Link to article, PSA

By the way, Benjamin Moore might be a good sponsor if you want to replicate this locally...

Resource: Radio PSAs, Radio Block - Link

Rear View Mirror: Child Abuse Prevention Month Proclamation

2009-05-12T13:14:00.009-04:00

April 1, 2009
NATIONAL CHILD ABUSE PREVENTION MONTH, 2009- - - - - - -
BY THE PRESIDENT OF THE UNITED STATES OF AMERICA
A PROCLAMATION When the child next door is maltreated, we all suffer. Every American has a stake in the well-being of our Nation's children. They are members of our communities, and they are our future.
National Child Abuse Prevention Month provides the opportunity to underscore our commitment to preventing and responding appropriately to child abuse. This month, we emphasize the importance of understanding child abuse and the need for all Americans to help families overcome this devastating problem.
The tragedy of child abuse may afflict American children in different ways. Abuse may occur physically, sexually, and emotionally. Child neglect, another form of child maltreatment, may occur physically and emotionally.
Understanding the forms of child abuse is critical to preventing and responding to maltreatment.A well-informed and strong family is the surest defense against child abuse.
To help educate and strengthen families, community members can offer their time and counsel to parents and children who may need assistance.
For example, parent support groups provide an organized forum for assistance. More informally, community members may simply offer a helping hand to families under stress.
More information about what families and communities can do is available at www.childwelfare.gov/preventing.
Civic organizations and government also have an important role to play. Civic groups offer essential support through education, assistance to those at risk, and treatment for victims.
Government at the local, State, and Federal level must provide funding for services, conduct public education projects, and enforce child abuse laws.
As we recognize that we all suffer when our children are abused, that we all benefit from mutual concern and care, and that we all have a responsibility to help, more American children will grow up healthy, happy, and with unlimited potential for success.
NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America, by virtue of the authority vested in me by the Constitution and laws of the United States, do more hereby proclaim April 2009, as National Child Abuse Prevention Month.
I encourage all citizens to help prevent and respond to child abuse by strengthening families and contributing to all children's physical, emotional, and developmental needs.

This is the Proclamation, transliterated by the cool tool at Wordle.net

And this is the Proclamation, circa 2001
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Persistent Effects of Pediatric TBI

2009-05-12T12:11:00.004-04:00

Science Daily reports on two studies that describe the persistent effects of traumatic brain injuries in children....

Traumatic Brain Injury Haunts Children For Years With Variety Of Functional Problems
ScienceDaily (May 12, 2009) — Children who suffer traumatic brain injuries can experience lasting or late-appearing neuropsychological problems, highlighting the need for careful watching over time, according to two studies published by the American Psychological Association.

In one study, a team of psychologists used a longitudinal approach to gain a better idea of what to expect after traumatic brain injury (TBI). The researchers found that severe TBI can cause many lasting problems with day-to-day functioning. Some children may recover academically but then start acting up; other children do surprisingly well for unknown reasons.

In the second study, the first systematic meta-analysis summarizing the collective results of many single studies, the researchers found that problems lasted over time and, in some cases, worsened with more serious injury. Some children with severe TBI started to fall even further behind their peers than one would normally expect, in a snowball effect that requires further study.

The Centers for Disease Control in 2000 cited traumatic brain injury as the single most common cause of death and disability in children and adolescents...
Journal references:
Fay et al. Predicting longitudinal patterns of functional deficits in children with traumatic brain injury.. Neuropsychology, 2009; 23 (3): 271 DOI: 10.1037/a0014936
Babikian et al. Neurocognitive outcomes and recovery after pediatric TBI: Meta-analytic review of the literature.. Neuropsychology, 2009; 23 (3): 283 DOI: 10.1037/a0015268

Read more...Link

As Science Daily notes, the authors of the second study draw attention to a very important consequence of TBI in very young children:

That makes severe brain injuries at younger ages a "double hazard," the authors noted. Because younger children have more development ahead of them, the same injury can affect a 4-year-old and a 12-year-old very differently. This finding highlights the importance of targeted treatment developed specifically for children with severe TBI.

Perspective: Child Abuse Detection

2009-05-12T07:36:00.005-04:00

Perri Klass writes in today's New York Times about her experience with child abuse detection and the evolution of expertise in the pediatric profession...

The conclusion is especially important:

The child abuse experts don’t want the rest of us in the profession to stop thinking about the subject. “I think the average pediatrician can diagnose this, even though it’s becoming a specialty,” Dr. Legano said.

But it’s an emotionally difficult diagnosis for a pediatrician to contemplate, especially when it concerns a family you feel you know well. And all too often, it is a diagnosis we fail to consider in families that don’t match our mental profiles of abusers. That’s why pediatricians and parents alike need all the clinical experience and all the science we can get, deployed on the side of the children.

While "average" may be statistically accurate, this excellent article by Dr. Cindy Christian describes the minimal levels of training that medical students receive, and the resulting perception among a significant number of practicing physicians that they lack skills needed to evaluate cases.

Resource: Professional Education in Child Abuse and Neglect, Cindy W. Christian, http://www.pediatrics.org/cgi/content/full/122/Supplement_1/S13

Abstract: Physicians have reported feeling that they were not adequately trained to identify and report child abuse. This article reviews the current state of medical education and residency training and the needs of physicians in practice and proposes changes and additions that can be made to improve the ability and confidence of physicians who are faced with the responsibility of keeping children safe. Pediatrics 2008;122:S13–S17

Two thoughts. First, "child abuse detection", not prevention, seems an apt term to describe this important process. Second, I wonder how medical students and practicing physicians would describe their training and skills in prevention education? There's one skill set required to know how to diagnose the consequences: the skill set to do something about preventing the consequences is likely to be much different...

News; PURPLE Prevention Program Planned for Kansas

2009-05-11T06:57:00.002-04:00

The Topeka Capitol Journal reports on plans by the Wichita Child Abuse Fatality Community Response Team to implement the PURPLE prevention program in Wichita, KS...

WICHITA -- Amid a recent spate of child-abuse deaths, a community group has announced a campaign to teach parents how to cope with a crying baby.

The program is the first initiative of the Wichita Child Abuse Fatality Community Response Team, which formed in the fall in response to eight homicides in the city that were linked to child abuse or neglect in 2008.

Their so-called “Period of Purple Crying” initiative starts June 1.

Parents giving birth at Wichita hospitals or birthing centers will watch a brief DVD before leaving with their newborn. Parents also will get a copy of the DVD and a booklet titled “Did you know your infant would cry like this?” The materials were developed by the National Center on Shaken Baby Syndrome.

The idea is to prevent child abuse, particularly shaken-baby syndrome, by emphasizing that it is normal for babies to cry, sometimes for hours and for no apparent reason. It also assures parents it is OK to put a crying baby down and walk away for a few minutes.

The simple reminders are especially important now because incidents of child abuse and domestic violence usually increase during times of economic stress, said Vicky Roper, director of Prevent Child Abuse Kansas at the Kansas Children’s Service League.

Her group hopes parents will share the video with anyone who might care for their baby.

“To have a baby that cries and cries and cries despite all your best efforts — that’s probably the time when you feel the absolute worst as a parent,” said James Haan, a Wichita doctor with four children, including two sets of twins under the age of 3.

Haan, medical director of trauma services at Via Christi Medical Center, said he already is seeing more cases of possible abuse. Shaken-baby syndrome can cause permanent paralysis, brain damage and death.

“Things are tough and money is tight, and a baby can stress things out even more,” he said.

The Kansas Department of Social and Rehabilitation Services is funding the $35,000 campaign through a grant from the federal Child Abuse Prevention and Treatment Act.

“We want to make sure that all children in our community are safe,” said Jean Hogan, regional director for Social and Rehabilitation Services.

Apple iPhone App: Continued...

2009-05-10T08:29:00.002-04:00

The San Franscico Chronicle has a letter to the editor today

Commendable coverage
As pediatricians and members of the San Francisco Child Abuse Prevention Center's board of directors, we commend The Chronicle's coverage of the iPhone "Baby Shaker" application and the focus on this deeply disturbing issue.
Each year in the United States, more than 1,500 children die after being shaken by their caretakers. These situations are often due to the caretaker's inability to cope with the child's persistent crying.
The action of rapidly shaking an infant may cause severe brain injury. If the infant does not die, shaking can cause lifelong injury, including cerebral palsy, mental retardation and blindness.
The five delivery hospitals in San Francisco have partnered with the Department of Public Health and the center to create the San Francisco Shaken Baby Project. This project educates nurses who then educate every new parent about the danger of shaking. The project provides community resources, including a 24-hour talk line - (415) 441-KIDS - to help caretakers cope with the stress of parenting.
We urge Apple to join the effort to educate the public on the dangers of shaking a baby. Perhaps they could create "an app for that," too.
CHRIS STEWART, M.D., SHANNON THYNE, M.D., San Francisco

Making Amends: making the iPhone educational

2009-05-06T11:48:00.009-04:00

This editorial from the Times-Call in Longmont, Colorado includes an inspired suggestion for an iPhone app that will allow Apple to atone for the atrocious "Baby Shaker."

We presume Jenn Ooton, the Editorial Page Editor, deserves kudos for the suggestion.

PS. If you agree, why not let Dean G. Lehman, the Editor and President, and John Vahlenkamp, the Managing Editor, know: jvahlenkamp@times-call.com, dlehman@times-call.com opinion@times-call.com

Times-Call Editorial
Publish Date: 5/6/2009
Create application to make amends for 'Baby Shaker'

Apple did the right thing when it pulled an application for the iPhone off the market after people complained that it was insensitive and inappropriate.
The “Baby Shaker” application caused the phone to cry like a baby until the user shook it.
As they vie for the attention of iPhone users, software developers have raced to create new and unusual applications for the “smart phones.” Developers have come up with virtual sheets of bubble wrap, fishing rods and applications to monitor the stock market, the weather, blood pressure, blood sugar and even the H1N1 flu virus.
The applications are downloaded for an average of 99 cents each. At up to 10,000 downloads a day, the money can add up for popular applications.
Though some of the applications might sound a bit inane, they’re typically harmless fun.
Not so in the case of the Baby Shaker.
Shaken baby syndrome is a serious problem and shouldn’t have been made a joke to profit this huge company and the small software developer that created the application.
Shaking can cause a baby or small child’s brain to bounce back and forth within the skull, causing brain damage, according to the National Institute of Neurological Disorders and Stroke. An estimated 1,200 to 1,600 babies suffer from shaking abuse each year, with one in four dying at the hands of their abusers. The others suffer long-term medical problems that can range from serious brain injuries and mental retardation, to paralysis, blindness, broken bones, seizures, learning difficulties and delayed development.
Shaking babies is no joke.
If Apple really wants to atone for releasing the Baby Shaker, perhaps it should develop a new application that would cry like a baby until the phone user figured out what the phone-baby needs — a diaper change, a feeding, a burping or other comfort. And if the user shook the phone, the phone might die, never to come back to life, or it might be so damaged that it could never again function as it should.
That could teach the people who played this mean-spirited game a little something about the real world.

I left a comment in response:

As the father of a shaken baby who has spent much of the last nine years advocating for education and awareness, I'd like to extend my compliments to the Times-Call and the author for an excellent editorial.
It not only makes the simple and straightforward case for what was wrong with Apple and its app, but has a wonderful suggestion for how Apple can atone.

As with parenting education, it's necessary to educate Apple on what not to do (the "don'ts", but it's not sufficient. They need to know about positive and constructive actions they can take to help parents and caregivers keep children safe ("the do's").

Survivors: Matthew Washburn, Colorado

2009-05-06T11:35:00.004-04:00

KKTV.com in southern Colorado reports on the story of Matthew Washburn. The article includes a video report. Link to story and video.

Every parent has had to comfort a crying baby. But inconsolable crying can lead to danger. According to CASA, Court Appointed Special Advocates, this is the #1 cause of shaken baby syndrome. What you do in that moment literally can mean life or death for the child.

But even if the baby is shaken… and lives... what will his life be like?

"Matthew is deaf and blind and in a wheelchair and in diapers and nonverbal” said Jackie Washburn. “What kind of life is that?"

She’s talking about her adopted son Matthew. He was shaken when he was just 31 days old. Jackie adopted Matthew when he was two. Back then, she was hopeful. But today...

“Matthew is 13 years old and functions like a 2-month-old,” said Jackie.

Dr. Paul Grabb is a pediatric neurosurgeon in Colorado Springs. He says it doesn't take much shaking to cause injuries like Matthew's. “It's only a moment necessary to cause irreversible and at times fatal brain injuries,” said Dr. Grabb.

What's even more disturbing is that it's happening more and more in our community.

“We have seen … a dramatic increase in shaken baby especially from January to March of this year,” said Trudy Strewler with CASA. In that time, at Memorial Hospital alone, there were 12 suspicious cases. That's almost half of the number of cases seen there all of last year.

These may just be numbers. But they could represent kids just like Matthew. He'll never ride a bike, or smile for his school picture. And because of his feeding tube, he'll never even have birthday cake. It's a difficult existence for his mother to watch.

"Sometimes I just think if he got pneumonia and would just pass and go to heaven and he would have wings and he'd run and he'd jump and splash and run with kids and feel the wind in his hair, said Jackie. “Then think I must be a terrible person to think that. But your heart breaks to see the life that he has. I wouldn't want to live like that."

Despite her agony over the hardships Matthew faces, Jackie knows his life is not in vain. "His purpose was to make life better for people. And if it’s to suffer the way he does to give a lesson to someone, Matthew's life has purpose."

Resources: Abstracts on SBS cases in NYC, AAP and AHT

2009-05-05T08:21:00.003-04:00

Just got an email with links to three article abstracts that sound interesting...

JR Gill, LB Goldfeder, V Armbrustmacher, A Coleman, H Mena, and CS Hirsch; Fatal head injury in children younger than 2 years in New York City and an overview of the shaken baby syndrome; Arch Pathol Lab Med 1 Apr 2009 133(4): p. 619.
http://highwire.stanford.edu/cgi/medline/pmid;19391663

CW Christian, R Block, and and the Committee on Child Abuse and Neglect; Abusive head trauma in infants and children; Pediatrics 1 May 2009 123(5): p. 1409.
http://highwire.stanford.edu/cgi/medline/pmid;19403508

Section on Radiology; Diagnostic imaging of child abuse; Pediatrics 1 May 2009 123(5): p. 1430.
http://highwire.stanford.edu/cgi/medline/pmid;19403511

Perspective: SBS Education in Prenatal Classes

2009-05-03T17:06:00.005-04:00

If you've been wondering why pre-natal classes aren't a better place for SBS education than hospitals, this reflective post by CatandMuse deserves your attention (caution - well-placed, functional expletives were used in the making of this post...). Link to blog post (Thanks, Pam!)

During our birthing class, my husband and I learned and saw a lot of things we didn’t already know about the birthing process and newborn care. What neither of us expected was to continually hear the sentence, “NEVER, ever shake a baby” . It was almost annoying to hear that sentence repeated so casually and so frequently, I mean isn’t that OBVIOUS?

It was such an annoyance that Cybr and I spoke of it one night on our way home, agreeing that it was ridiculous that it need be repeated so much. Everyone knows that and surely it is few and far between that need be reminded.

This was our thinking before our baby was born.

After we had been home with Kira for a few weeks, that is when it became clear as to exactly why it is repeated so frequently. Bringing home a newborn is stressful, exhausting and frightening. It pushes you to limits mentally, physically and emotionally that you have never before been. This happens while mothers are simultaneously having EXTREME hormone fluxuation, sleep deprivation and more than likely self-doubt. I can also add burning a high fever and being in severe pain to that list, which I am certain others have experienced as well....

Baby Blues: The Night Shift

2009-05-03T09:50:00.006-04:00

Looking at the website for the Baby Blues comic, I noticed this cover on their comic "scrapbook" called "The Night Shift": it encapsulates an important part of daddy parenting in the first year...

Ohio: Evaluating the Effectiveness of Hospital Based SBS Education

2009-05-03T00:22:00.006-04:00

I read again the abstract of an evaluation of "Love Me, Never Shake Me", an Ohio SBS education progam sponsored by Prevent Child Abuse Ohio. Link to program; Link to abstract

On second blush, some interesting points to keep in mind:

- even though awareness of SBS is high, parents still say the education is important;
- hospital-based education is still likely to be the only opportunity to educate a new parent;
- a significant percentage of mothers don't appear to live with the father, emphasizing the importance of helping single mothers discuss SBS with unrelated males in the household.

Secondary Analysis of the "Love Me...Never Shake Me" SBS Education Program, Deyo, Grace; Skybo, Theresa; Carroll, Alisa, Child Abuse & Neglect: The International Journal, v32 n11
p1017-1025 Nov 2008

Objective: Shaken baby syndrome (SBS) is preventable; however, an estimated 21-74 per 100,000 children worldwide are victims annually. This study examined the effectiveness of an SBS prevention program in the US.

Methods: A descriptive, secondary analysis of the Prevent Child Abuse Ohio (PCAO) "Love Me...Never Shake Me" SBS education program database included 7,051 women who completed a commitment statement, pre- and post-test, and follow-up survey.

Results: Participants were mostly White (76%), had at least some college education (62%), were privately insured (62%), and lived with the father and infant (63%). Mothers knew of the dangers of shaking (96%) and recommended SBS education for all parents (98%) because they found it
helpful (97%). Scores on the pre- and post-tests were significantly different, but there was no difference based on education site or demographics. There was a significant increase in a pre/post-test item pertaining to infant crying.

At follow-up, participants remembered postpartum SBS education (98%), but post-discharge did not receive SBS education from their primary care provider (62%). Most mothers practiced infant soothing techniques (79%) provided in the education; however, few women practiced self-coping techniques (36%) and accessed community support services (9%).

Conclusions: Postpartum SBS prevention education should continue. Development of SBS programs should result from these study findings focusing on education content and program evaluation.

Practice implications: Mothers report that shaken baby syndrome education is important for all parents and memorable at follow-up.

Postpartum SBS education should continue because the hospital is the primary place they receive education. Mothers' report they less frequently receive education from healthcare sources post-discharge. Diligence of primary care providers to incorporate SBS prevention education in well child visits will increase parental exposure to this information.

Education may need to place greater emphasis on infant crying and soothing, as well as parent support and self-coping techniques versus the dangers of shaking.

Other resources:

Quebec hospital education program - Goulet et al. (2009) - Link to abstract

Vancouver PURPLE evaluation - Barr et al. (2009) - Link to abstract

PURPLE evaluation - Barr et al. (2009) - Link to abstract

Evaluation of SBS education techniques - Russell et al. (2008) - Link to abstract

Upstate New York SBS Prevention Project - Dias et al. (2005) - Link to abstract

Perspective: On Creating a Foundation for Seeing What Works

2009-05-02T23:55:00.003-04:00

In 2007, students at the University of Maryland School of Social Work engaged in an interesting project:

Students in the School’s Child Welfare Research class have each conducted reviews of evidence about interventions that may increase child safety for children.
These reports range in focus from primary prevention programs (like education to prevent incidents of shaken baby to interventions that might address the consequences of child maltreatment and prevent the recurrence of child maltreatment, to interventions that focus on helping adolescents in foster care prevent future maltreatment of their children).
They post[ed] a brief version of their reports by replying to this post. I hope you join in the discussion about what “might” work to decrease the risk of child abuse and neglect and increase safety for children. [Link to the blog post]

The blog provides an interesting overview of prevention programs. While it appears to remain one of the more popular posts on the UMB, it doesn't seem that the online community took up the challenge to discuss prevention programs that work.

It's also unfortunate that this work remains a snapshot taken at one point in time. I visited the Acropolis in 1972: the perspective of viewing the world from a place that has been part of human experience for thousands of years and at least a hundred generations was profound.

So, this is the comment I left:

It would be a real service if this overview could be provided each year: so many survey articles capture a moment in time, without providing any sense of development over time.

For example, the SBS prevention program mentioned above has expanded to several other states. Ohio and Hawaii are conducting evaluations of its effectiveness in preventing SBS incidents, and the Ontario Neurotrauma Foundation has just published a guide to implementing the program at new sites.
http://skippervigil.blogspot.com/2009/04/resources-ontarios-cookbook-for.html

It would be really helpful if an academic program would look at the results of those evaluations (which are likely to vary themselves in effectiveness) and elict lessons learned in implementing the program in different contexts.

It would also give the students a unique perspective on prevention, based on a common foundation, and a sense of the challenges in implementing evidence based practices.

The literature is full of palliative interventions that are responsive to the consequences of the child welfare system. They are resource intense and focused on prevention of recurrences.

Let’s encourage prevention efforts that work to build strengths and to actually prevent those consequences.

The Paris Index Climbs to Record High

2009-05-01T23:41:00.003-04:00

At the close of Child Abuse Prevention Month, the Paris Index (the ratio of news stories mentioning "Child Abuse Prevention" (1085 hits) to stories mentioning Paris Hilton (2028 hits)) reached a record high in 2009: 53%...

All is not lost: Paris has launched a line of children's clothing and visited a children's hospital.

Resources: Ontario's Cookbook for Implementing SBS Prevention

2009-04-28T17:47:00.003-04:00

The Ontario Neurotrauma Foundation has posted an excellent "cookbook" for implementing hospital-based SBS (oops, AHT for those who will be in court) prevention activities.

Great resources!

Link to ONF SBS Prevention Program Implementation Guide (Outline, 2009)

Link to ONF "Preventing Inflicted Infant Head Trauma: A Best Practice Implementation" (2009)

Link to ONF SBS Prevention Program home page

Link to ONF SBS Prevention Resources: crying cards in 21 languages and more!

Hearsay: Baby Brain Development

2009-04-26T18:54:00.003-04:00

In the law, it's called hearsay evidence and discounted....

However, Vaughan at Mind Hacks speaks well of an article in today's Boston Globe by Jonah Lehrer, who has done some excellent science writing. Link to Boston Globe article.

It reminds us we have much to learn about the way a baby's brain functions. In the Mind Hacks review, this caught my eye:

Newborns start with fewer synapses than adults but this number rockets, so by six months of age we have approximately twice as many connections. This tails off as the brain prunes connections on a 'use it or lose it' basis.

I'm always slightly awestruck whenever I view that graph as it is a vivid illustration of the incredibly rapid changes changes that take place as we grow and learn to make sense of the world.

And reading the BG article, I thought this was interesting...

By using new research techniques and tools, they've revealed that the baby brain is abuzz with activity, capable of learning astonishing amounts of information in a relatively short time. Unlike the adult mind, which restricts itself to a narrow slice of reality, babies can take in a much wider spectrum of sensation - they are, in an important sense, more aware of the world than we are.

This hyperawareness comes with several benefits. For starters, it allows young children to figure out the world at an incredibly fast pace. Although babies are born utterly helpless, within a few years they've mastered everything from language - a toddler learns 10 new words every day - to complex motor skills such as walking. According to this new view of the baby brain, many of the mental traits that used to seem like developmental shortcomings, such as infants' inability to focus their attention, are actually crucial assets in the learning process.

Finally, how many times do parents almost get their infant to sleep, only to have the slightest noise or motion startle them into wide-eyed awareness?

They might be better prepared if they knew this:

While adults automatically block out irrelevant information, such as the hum of an air conditioner or the conversation of nearby strangers, babies take everything in: their reality arrives without a filter. As a result, it typically takes significantly higher concentrations of anesthesia to render babies unconscious, since there's more cellular activity to silence.

Stroll for SBS Prevention MA

2009-04-26T18:23:00.004-04:00

Today, MassKids sponsored its third Annual Stroll for Shaken Baby Prevention.

Link to MassKids page on the Stroll.
Link to article about the Stroll.

As part of the lead up to the Stroll, WBZ interviewed Shannon Byron, the mother of a shaken baby, and ex-husband Sean Forant, the man who shook his child. It's worth a listen...

Link to WBZ interview

SBS Survivors: Lily Smth, Idaho

2009-04-24T17:47:00.003-04:00

NNCN.com News in Boise, Idaho reports on Lily Smith. Link to article and video.

Her story is testimony to the ability of life to endure against all odds, and an apt story to consider at the end of SBS Awareness Week 2009.

A month ago, Lily was allegedly shaken by her mother's 18 year old boyfriend, and was not expected to survive.

However, she's returned home, blind and partially paralyzed, just a week before her first birthday.

It will likely be a bittersweet celebration.

According to the news article, her mother and grandmother will be working to increase awareness of Shaken Baby Syndrome. Let's hope Lily will be able to join them and tell her story for years to come.