What is the evidence base for shaken baby syndrome or as it's preferred term is now called blunt force impact? Is the current diagnostic criteria accurate? For many years, the standard for determining whether or not a child was harmed intentionally centered around a theory. No other diagnosis, accusation or conviction is based on a theory so why does this continue?
Those gold standard symptoms ranged from subdural and retinal bleeding and or broken bones. A child could present himself with one or more of the hallmark symptoms and if the care giver's story was suspect by their training, it had to be abuse. Controversy swirled on whether or not a child could die from a small fall. The same controversy presents itself on the 'ah ha' moment when later it is learned a child had an underlying condition that the doctors either did not seek or discover or perhaps, a child suffered from an adverse reaction to a vaccination.
It recent past, many researchers and doctors have reported fallacies among the evidence base for shaken baby syndrome and the criteria physicians, lawyers and the judicial system utilize for proof of abuse. These criteria are presented as absolutes when in fact, there is proof showing otherwise. The past "evidence" of one criteria, retinal hemorrhages, was discussed and disputed by Patrick Lantz et al which it was concluded that it “cannot be supported by objective scientific evidence.” Just as another study where Mark Donahue reviewed the literature on shaken baby syndrome from 1966 to 1998 and found the scientific evidence to support a diagnosis of shaken baby syndrome to be much less reliable than generally thought.
This is just one example on how the evidence base is not there for one criteria associated with shaken baby syndrome.
To read the entire article from the BMJ with supplement and comments, click here.
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