This article addresses Shaken Baby Syndrome, SBS (now officially renamed Abusive Head Trauma – AHT), and the so-called “triad” of symptoms that the bulk of the medical establishment and the justice system say are pathognomonic (exclusively indicative of) of SBS. The “triad” consists of retinal hemorrhage, subdural hematoma, and diffuse edema of the brain, and according to largely prevailing medical wisdom, violent shaking or abusive head trauma is the only thing that can cause these symptoms in an infant or child – not diseases or genetic conditions or short falls.
Documented, witnessed baby shakings are a rare event. Charges of SBS are almost universally brought against care givers in situations in which there are no witnesses, and the determination of SBS rests solely upon a medical opinion. Prof. Deborah Tuerkheimer of DePaul University has said that a “post mortem determination of SBS is essentially a medical diagnosis of murder.”
Sue Luttner is editor of a blog called OnSBS (www.onsbs.com), and has written a very interesting article about a medical team in Minnesota that was able to conduct in-depth medical evaluations of 12 infants that were witnessed to be violently shaken. In none of the 12 cases did they find any “triad” symptoms; although, in some cases, there were other signs of abuse (e.g. broken bones). This would tend to call into question the exclusive link between “shaking” and the “triad”. In fact, there is a cadre of bio-mechanical experts who state that it’s not possible to shake an infant hard enough to cause triad symptoms; at least not without also causing cervical spine injury.
You can read Sue Luttner’s post here.
Let me conclude with a Special Editorial Note to those of you blog readers who are still staunch advocates of the “SBS triad” and “no lucid interval” theories. Nobody ever said that there aren’t people who abuse their children or inflict abusive head trauma. And nobody ever said that abusive head trauma cannot produce “triad” symptoms in an infant. But anybody who has made an honest and objective study of the full spectrum of research done in these areas understands that to consider “triad” symptoms as exclusively indicative of abusive head trauma is both scientifically incorrect and ethically wrong. There are other things that can cause “triad” symptoms, and “lucid interval” does exist. And nobody ever said that those who abuse their children, and sometimes even kill them, should not bear the full weight of the consequences; but there are way too may truly loving caregivers who have not only lost a baby but have also been put in prison, because the infant presented with “triad” symptoms that were caused by something other than abusive head trauma. “Confirmation bias” is a terrible thing, because it can prevent us from seeing the truth in a situation. I just ask that you open up your minds, and consider information, evidence, and data that may not conform to your preconception of the way things are. Once again, the actually guilty should bear the consequences, but could we please stop putting innocent people in prison because of blind, dogged reliance on a diagnostic that is demonstrably not universally applicable?