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D4 • WEDNESDAY, MARCH 25, 2015
IDAHO STATESMAN • IDAHOSTATESMAN.COM
THE DISPUTED SCIENCE OF SHAKEN BABY SYNDROME
For more than a decade, a growing movement of doctors and engineers has questioned the science behind Shaken Baby Syndrome, long considered a serious public health threat.
Testing has been unable to conclusively show if violent shaking can produce the conditions often linked to the diagnosis — bleeding and swelling in the head and bleeding in the back
of the eyes — and doctors have found that accidents and a series of diseases can in some cases produce identical conditions in infants. Doctors who support the diagnosis, however, say
that it has been validated by years of clinical work, research and confessions from parents and caregivers. Here is how those doctors describe the impact of violent shaking:
Brain swelling
Retinal hemorrhaging
Acceleration and deceleration changes cause swelling
of the brain. This damage changes the shape of the
brain and triggers the loss of neurons, very similar to
conditions that have been observed in boxers.
During violent shaking,
blood vessels in a child’s
brain may break, causing
widespread bleeding in
the back of the eyes.
Pediatricians say they
have found retinal
hemorrhages in 85
percent of babies who
were shaken.
Subdural
hematoma
Gyri
Flattened
gyri
Ventricles
Pupil
Young children have proportionally bigger and
heavier heads than adults and weaker neck
muscles. Their brains are also immature and
more susceptible to injuries.
Retina
Bleeding
Compressed
ventricles
Subdural hematoma
Skin
When a child is shaken or
thrown, the head twists
and whips back and
forth, creating shearing
forces in the brain. This
can cause tears to the
bridging veins and nerve
cells and trigger
bleeding and swelling.
1
Cornea
Skull
Subdural
space
Cerebral
cortex
2
3
1. Blood vessels run between the surface of the brain and the cerebral cortex.
2. When the head is vigorously shaken, the bridging veins are stretched
beyond their elasticity and break. 3. Blood fills the subdural space.
Severe shaking causes
the child’s head to move
violently back and forth.
Sources: Pediatrician Robert W. Block, past president of the American Academy of Pediatrics,
American Association of Neurological Surgeons, National Center on Shaken Baby Syndrome
SHAKEN BABY
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It has also led to more
than a decade of fierce debate: Testing has been unable to show whether
violent shaking can produce
the bleeding and swelling
long attributed to the diagnosis, and doctors have
found that accidents and diseases can trigger identical
conditions in babies.
Challenges to the diagnosis have spilled into courts
on two continents. In 2005,
Britain’s Court of Appeal
found that the head and eye
injuries alone were not absolute proof of abuse, and, in
Sweden last year, the
Supreme Court ruled that
the scientific support for the
diagnosis had “turned out to
be uncertain.”
In the United States, 16
convictions have been overturned since 2001, including
three last year. In Illinois, a
federal judge who recently
freed a mother of two after
nearly a decade in prison
called Shaken Baby Syndrome “more an article of
faith than a proposition of
science.”
Despite the uncertainty,
prosecutors are still using
the diagnosis to help prove
criminal cases beyond a
“reasonable doubt” against
hundreds of parents and
ALBERTO CUADRATHE
/ WASHINGTON POST
caregivers.
“You can’t necessarily
prove Shaken Baby Syndrome one way or another
— sort of like politics or religion,” said forensic pathologist Gregory Davis, the chief
medical examiner in Birmingham, Ala., and the board
chairman of the National
Association of Medical Examiners. “Neither side can
point to compelling evidence and say, ‘We’re right
and the other side is wrong.’
So instead, it goes to trial.”
The Washington Post, in
partnership with journalists
at Northwestern University’s Medill Justice Project,
carried out the first systematic examination of disposi-
tions in Shaken Baby cases
since doctors started disputing the science behind the
syndrome.
Reporters used court records and newspaper reports
to track down murder or
abuse cases involving shaking
that have been filed or dismissed since 2001. The yearlong study unearthed about
1,800 resolved cases nationwide, finding some of the
heaviest concentrations in
counties in Ohio, Pennsylvania, Wisconsin and Nebraska.
About 1,600 cases resulted in a conviction, a rate that
is higher than that for other
violent crimes. In hundreds
of cases, there were reports
of shaking along with more
obvious forms of violence
that left extensive bruises
and broken bones, with
prosecutors alleging that babies also had been slammed,
thrown or beaten.
The study for the first
time identified about 200
cases in 47 states that ended
when charges were dropped
or dismissed, defendants
were found not guilty or convictions were overturned.
Among them: a 39-yearold software entrepreneur in
California who mourned his
infant son while locked in an
isolation cell; a 13-year-old
baby sitter in Washington
who was charged with second-degree murder; and a
46-year-old grandmother in
Arizona who spent nearly
2› years facing capital murder charges.
Kelly Kline, acquitted in
2012 of shaking a baby to
death in her home day care
in rural Ohio, met her 6year-old daughter for a parents’ lunch at school the day
her mug shot flashed on the
local news.
“If I wasn’t married and
didn’t have kids, I would
have committed suicide because of the hell, the embarrassment,” said Kline, a
mother of three.
In four of the cases, doctors who had diagnosed
shaking later revised their
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