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Drabkin M, Fairbrother N, Crighton B, Miller E, Brant R, Riar S, Albert A, Barr RG. Prepartum and postpartum mothers' and fathers' feelings of frustration in response to infant crying. Infant Ment Health J 2024; 45:276-285. [PMID: 38343150 DOI: 10.1002/imhj.22107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 12/05/2023] [Accepted: 01/29/2024] [Indexed: 04/29/2024]
Abstract
In this cross-sectional study performed in Canada, we evaluated the frustration levels of prepartum and postpartum mother and father couple-pairs. Our goal was to determine if there were differences in frustration levels between mothers and fathers while listening to prolonged infant crying, and further, how frustration levels might differ between prepartum and postpartum samples. Using two discrete groups, prepartum (Sample 1; N = 48) and postpartum (Sample 2; N = 44) mother and father couple-pairs completed 600 s of listening to audio-recorded infant cry sounds. Participants continuously reported their subjective frustration using a computerized Continuous Visual Analog Scale (CVAS). There was no significant difference in frustration responses between mothers and fathers across both prepartum and postpartum samples. Postpartum mothers and fathers experienced greater frustration than their prepartum counterparts, and frustration increased faster in postpartum couples compared to prepartum couples. Informing first-time parents of the universal experiences of frustration to prolonged crying bouts that are characteristic of their infant's early weeks of life may lead to greater understanding towards their infant, and perhaps decreased instances of harmful responses.
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Affiliation(s)
- Meriah Drabkin
- Faculty of Medicine, Queen's University, Kingston, Canada
| | - Nichole Fairbrother
- Department of Psychiatry, Queen Alexandra Centre for Children's Health, University of British Columbia, Victoria, British Columbia, Canada
| | - Brianna Crighton
- Faculty of Medicine, Medical Science Building, University of British Columbia, Vancouver, British Columbia, Canada
| | - Erica Miller
- Faculty of Medicine, BC Women's Hospital & Health Centre, University of British Columbia, Vancouver, British Columbia, Canada
| | - Rollin Brant
- Department of Statistics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shivraj Riar
- Surrey Memorial Hospital Endocrinology Group, Surrey, British Columbia, Canada
| | - Arianne Albert
- Women's Health Research Institute, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Ronald G Barr
- Evidence to Innovation, BC Children's Hospital, Vancouver, British Columbia, Canada
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Massullo C, De Rossi E, Carbone GA, Imperatori C, Ardito RB, Adenzato M, Farina B. Child Maltreatment, Abuse, and Neglect: An Umbrella Review of Their Prevalence and Definitions. CLINICAL NEUROPSYCHIATRY 2023; 20:72-99. [PMID: 37250758 PMCID: PMC10211430 DOI: 10.36131/cnfioritieditore20230201] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Objective Child maltreatment (CM) is a recognized public health problem, and epidemiologic data suggest that it is a widespread phenomenon, albeit with widely varying estimates. Indeed, CM as well as child abuse (CA) and neglect (CN) are complex phenomena that are difficult to study for several reasons, including terminological and definitional problems that pose a hurdle to estimating epidemiological rates. Therefore, the main aim of this umbrella review is to revise recent review data on the epidemiology of CM, CA, and CN. A second aim was to revise the definitions used. Method A systematic search of three databases was performed in March 2022. Recent reviews (published in the last 5 years: 2017-March 2022) addressing the epidemiological rates of CM, CA, and/or CN were included. Results Of the 314 documents retrieved by the selected search strategy, the eligibility assessment yielded a total of 29 eligible documents. Because of the great heterogeneity among them, a qualitative rather than a quantitative synthesis was performed. Conclusions The data from this umbrella review show that the different age groups, methods, and instruments used in the literature to collect the data on the epidemiology of CM make it difficult to compare the results. Although definitions appear to be quite homogeneous, CM categorization varies widely across studies. Furthermore, this umbrella review shows that the CM reviews considered do not examine some particular forms of CM such as parental overprotection. The results are discussed in detail throughout the paper.
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Affiliation(s)
- Chiara Massullo
- Experimental Psychology Laboratory, Department of Education, Roma Tre University
| | - Elena De Rossi
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome
| | - Giuseppe Alessio Carbone
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome
- Department of Psychology, University of Turin
| | - Claudio Imperatori
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome
| | | | | | - Benedetto Farina
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome
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3
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Abusive head trauma: Canadian and global perspectives. Pediatr Radiol 2021; 51:876-882. [PMID: 33999233 DOI: 10.1007/s00247-020-04844-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 07/28/2020] [Accepted: 09/08/2020] [Indexed: 10/21/2022]
Abstract
Canada has come a long way since Dr. C. Henry Kempe first described battered-child syndrome in 1962. The year 1999 was crucial in Canada's battle against shaken baby syndrome/abusive head trauma (SBS/AHT), when the first national conference on the topic was held in Saskatoon. This was followed by the issuance of a national statement and multidisciplinary guidelines, recently updated in 2020. Incidence of AHT in Canada is similar to that found in population-based studies from Switzerland and New Zealand. The mainstay of prevention of AHT in Canada is education of parents and caregivers with respect to their response to infant crying. Population-based data for global incidence of AHT are lacking, largely because of social and cultural differences contributing to poor understanding of AHT as a medico-legal entity. India faces a distinct challenge in the battle against female feticide and infanticide.
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Gao Q, Tong L, Tang L, Zhong W, Zhu H. Parental knowledge on infant crying and abusive head trauma and relevant shaking behaviors in China. CHILD ABUSE & NEGLECT 2021; 115:105025. [PMID: 33714183 DOI: 10.1016/j.chiabu.2021.105025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 02/25/2021] [Accepted: 03/03/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND This study aims to characterize the knowledge about infant crying and abusive head trauma (AHT), and shaking behaviors in parents of children in China, which are lacking currently. METHODS A cross-sectional survey was conducted in 2020. We collected information about the knowledge of the typical patterns of infant crying and AHT, and asked about beliefs of the effects of violent shaking on children's health, and shaking behavior among parents. RESULTS A total of 568 parents completed the questionnaire, and only 1.6 % of them answered all nine knowledge questions related to infant crying correctly. Overall, 42.6 % of participants reported they had heard about AHT, but only 17.1 % of the parents reported they knew enough about the dangers of infant shaking. About 45 % of the parents acknowledged that they had shaken their infants at least once. Parents who were from western region of China (OR = 3.860; 95 % CI = 1.871, 7.966; p < 0.001) and have felt very frustrated because of the baby's crying over half of the time (OR = 3.401; 95 % CI = 1.862, 6.211; p < 0.001) had the highest risk of shaking. Majority of the parents reported that they needed further information about infant soothing techniques, knowledge of prevention and treatment about AHT. CONCLUSIONS Majority of Chinese parents do not have enough knowledge about normal infant crying, nevertheless, most of them expressing needs in learning more. Community-wide advocating efforts aiming to educate parents on awareness and knowledge about AHT should be a health priority in China.
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Affiliation(s)
- Qi Gao
- Capital Medical University School of Public Health, Department of Epidemiology and Health Statistics, Beijing, China.
| | - Linhang Tong
- Capital Medical University School of Public Health, Department of Epidemiology and Health Statistics, Beijing, China.
| | - Lixia Tang
- Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China.
| | - Weiqiang Zhong
- Capital Medical University School of Public Health, Department of Epidemiology and Health Statistics, Beijing, China.
| | - Huiping Zhu
- Capital Medical University School of Public Health, Department of Epidemiology and Health Statistics, Beijing, China.
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Feld K, Feld D, Karger B, Helmus J, Schwimmer-Okike N, Pfeiffer H, Banaschak S, Wittschieber D. Abusive head trauma in court: a multi-center study on criminal proceedings in Germany. Int J Legal Med 2021; 135:235-244. [PMID: 33030617 PMCID: PMC7782463 DOI: 10.1007/s00414-020-02435-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 09/30/2020] [Indexed: 12/03/2022]
Abstract
The shaken baby syndrome (SBS) is a common variant of abusive head trauma (AHT) in infants and toddlers. Data on the legal outcome of such cases are still sparse. By means of a retrospective multi-center analysis, 72 cases of living children diagnosed with SBS/AHT from three German university institutes of legal medicine were identified. Forty-six of these cases with 68 accused individuals were available and could be evaluated with regard to basic data on the course of the criminal proceedings as well as the profile of the defendants (sub-divided into suspects, convicts, and confessed perpetrators). Criminal proceedings predominantly commenced with a complaint by the treating hospital (62%) and were found to be closed (without judgment) in 50% of the cases, mostly due to a "lack of sufficient suspicion." Of the 23 cases with judgment, the court decided on acquittal in 4 cases (17%). Imprisonment was the most frequent sentence (16 out of 19 cases with conviction, 84%), whereby the sentence has been suspended on probation in 63% of the cases. Suspects and perpetrators were mostly male and derived from the close family environment of the injured children. All confessed perpetrators stated an "excessive demand" as the reason for the violent shaking of the child. The results of the present study are in line with data from other studies with other legal systems. As many criminal proceedings were closed and the 4 acquittals occurred because the perpetration could not be ascribed to a specific perpetrator, improving the forensic methods for such an unequivocal assignment would be desirable.
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Affiliation(s)
- Katharina Feld
- Institute of Legal Medicine, University Hospital Cologne, Cologne, Germany
| | - Dustin Feld
- adiutaByte GmbH, Business Campus, Sankt Augustin, Germany
| | - Bernd Karger
- Institute of Legal Medicine, University Hospital Münster, Münster, Germany
| | - Janine Helmus
- Institute of Legal Medicine, University Hospital Essen, Essen, Germany
| | - Nneka Schwimmer-Okike
- Institute of Legal Medicine, Jena University Hospital, Friedrich Schiller University, Am Klinikum 1, 07747, Jena, Germany
| | - Heidi Pfeiffer
- Institute of Legal Medicine, University Hospital Münster, Münster, Germany
| | - Sibylle Banaschak
- Institute of Legal Medicine, University Hospital Cologne, Cologne, Germany
| | - Daniel Wittschieber
- Institute of Legal Medicine, Jena University Hospital, Friedrich Schiller University, Am Klinikum 1, 07747, Jena, Germany.
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Ornstein AE, Fitzpatrick E, Hatchette J, Woolcott CG, Dodds L. The impact of an educational intervention on knowledge about infant crying and abusive head trauma. Paediatr Child Health 2016; 21:74-8. [PMID: 27095881 DOI: 10.1093/pch/21.2.74] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Infants follow a predictable trajectory of increased early crying. Frustration with crying is reported to be a trigger for abusive head trauma (AHT). OBJECTIVE To evaluate the impact of postpartum delivery of the educational program, the Period of PURPLE Crying (PURPLE), in a group of first-time mothers. The primary objective was to determine whether there was a change in knowledge about infant crying and shaking after exposure to PURPLE. Factors associated with change in knowledge were also examined. METHOD A total of 93 participants were recruited over a four-month period at a tertiary care hospital in Nova Scotia. Pre- and postintervention data were collected. RESULTS Knowledge about infant crying increased significantly after program delivery (P=0.001). Low baseline crying knowledge was a significant predictor of increased knowledge about infant crying (P≤0.01). There was an insignificant decrease in shaking knowledge (P=0.5), which may have been the consequence of high baseline knowledge. CONCLUSION An educational program for new parents appears to be warranted, especially with respect to improving knowledge about infant crying. This may have a positive benefit in AHT prevention. Additional studies are required to evaluate the impact of the program on other caregivers and on rates of AHT.
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Affiliation(s)
- Amy E Ornstein
- Department of Pediatrics, Dalhousie University and IWK Health Centre, Dalhousie University, Halifax, Nova Scotia
| | - Eleanor Fitzpatrick
- Department of Emergency Medicine, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia
| | - Jill Hatchette
- IWK Health Centre Research Services and Adjunct Faculty Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia
| | - Christy G Woolcott
- Perinatal Epidemiology Research Unit, Departments of Obstetrics & Gynecology and Pediatrics, Dalhousie University, Halifax, Nova Scotia
| | - Linda Dodds
- Perinatal Epidemiology Research Unit, Departments of Obstetrics & Gynecology and Pediatrics, Dalhousie University, Halifax, Nova Scotia
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Education about crying in normal infants is associated with a reduction in pediatric emergency room visits for crying complaints. J Dev Behav Pediatr 2015; 36:252-7. [PMID: 25923528 DOI: 10.1097/dbp.0000000000000156] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The primary aim of this study was to determine whether there was any change in visits of 0- to 5-month old infants to the medical emergency room (MER) of a metropolitan pediatric hospital after province-wide implementation of a public health prevention program that teaches new parents about the properties of early crying in normal infants. METHODS Free-text descriptions of Presenting Complaint and Final Diagnosis on electronic MER clinic visit files were used to classify infants as cases of infant crying not due to disease. Annual crying case visits as a percent of MER visits were analyzed pre- and post-introduction of the prevention program. RESULTS Before the program, crying case visits represented 724 of 20,394 MER visits (3.5%). The age-specific pattern of MER visits for crying peaked at 6 weeks and was similar to the previously reported age-specific pattern of amounts of crying in the community. After program implementation, crying cases were reduced by 29.5% (p < .001). The most significant reductions were for crying visits in the first to third months of life. CONCLUSION The findings imply that improved parental knowledge of the characteristics of normal crying secondary to a public health program may reduce MER use for crying complaints in the early months of life.
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Barr RG. Crying as a trigger for abusive head trauma: a key to prevention. Pediatr Radiol 2014; 44 Suppl 4:S559-64. [PMID: 25501727 DOI: 10.1007/s00247-014-3100-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 06/18/2014] [Indexed: 10/24/2022]
Abstract
The devastating and for the most part irremediable consequences for an infant, his or her family, and society in cases of abusive head trauma have spurred research into ways of preventing it. In the last four or five decades, increasing interest in infant crying and its clinical manifestation of colic has led to a reconceptualization of crying in early infancy, such that most of the characteristics of colic can be understood as manifestations of the crying typical of normal infants. This includes an early increase and then decrease in the amount of crying, the unexpected and unpredictable appearance of prolonged crying bouts, and the presence of inconsolable crying that occurs in the early months of life. When these concepts are merged with anecdotal clinical experiences, perpetrator confessions and epidemiological evidence of abusive head trauma, it is clear that these crying characteristics--and caregiver responses--are the predominant, and potentially modifiable, risk factors for abusive head trauma. This unfortunate but understandable relationship between early crying, shaking and abuse has opened windows of opportunity for primary, universal prevention efforts that are appropriate for--and support--all parents and may be able to prevent at least some of these tragic cases.
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Affiliation(s)
- Ronald G Barr
- Child and Family Research Institute and BC Children's Hospital, Faculty of Medicine, University of British Columbia, 4480 Oak Street, F507, Vancouver, BC, V6H 3V4, Canada,
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Haig D. Troubled sleep: A response to commentaries. Evol Med Public Health 2014; 2014:57-62. [PMID: 24632049 PMCID: PMC3982903 DOI: 10.1093/emph/eou011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- David Haig
- *Corresponding author. Department of Organismic and Evolutionary Biology, Harvard University, 26 Oxford Street, Cambridge, MA 02138, USA. Tel: +1-617-496-5125; Fax: +1-617-495-5667; E-mail:
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Al Odhayani A, Watson WJ, Watson L. Behavioural consequences of child abuse. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2013; 59:831-6. [PMID: 23946022 PMCID: PMC3743691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To discuss the consequences of abuse on childhood behavioural development, to highlight some behavioural clues that might alert physicians to ongoing child abuse, and to explore the specific role of the family physician in this clinical situation. SOURCES OF INFORMATION A systematic search was used to review relevant research, clinical review articles, and child protection agency websites. MAIN MESSAGE A child's behaviour is an outward manifestation of inner stability and security. It is a lens through which the family physician can observe the development of the child throughout his or her life. All types of abuse are damaging to children-physically, emotionally, and psychologically-and can cause long-term difficulties with behaviour and mental health development. Family physicians need to be aware of and alert to the indicators of child abuse and neglect so that appropriate interventions can be provided to improve outcomes for those children. CONCLUSION Child abuse might cause disordered psychological development and behaviour problems. Family physicians have an important role in recognizing behaviour clues that suggest child abuse and in providing help to protect children.
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Stevenson M, Achille M, Lugasi T. Pediatric Palliative Care in Canada and the United States: A Qualitative Metasummary of the Needs of Patients and Families. J Palliat Med 2013; 16:566-77. [DOI: 10.1089/jpm.2011.0076] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Moire Stevenson
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
| | - Marie Achille
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
| | - Tziona Lugasi
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
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Ateah CA. Prenatal parent education for first-time expectant parents: "making it through labor is just the beginning…". J Pediatr Health Care 2013; 27:91-7. [PMID: 23414974 DOI: 10.1016/j.pedhc.2011.06.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Revised: 06/24/2011] [Accepted: 06/29/2011] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The purpose of this pilot project was to determine first-time expectant parents' perceptions of a parent education intervention, their education needs, and preferred sources and modes of such education. METHOD The intervention was carried out during the last class of a public health prenatal education series. A total of 31 first-time expectant parents participated and included both women (N = 16) and men (N = 15; mean, 29 years). The intervention was an in-person session on the topics of a safe sleeping environment, shaken baby syndrome, physical punishment risks and positive parenting, and expected development and safety. Participants completed the Infant Safety Education Project Questionnaire after the intervention. RESULTS Overall, most participants in this study found the content useful, planned to use it in caring for their infant, and indicated that this information should be shared with all expectant parents. DISCUSSION Findings support a larger scale study to determine parent education needs of expectant parents and the development, implementation, and evaluation of programming. Pediatric nurse practitioners and other primary care practitioners should be aware of the education needs of expectant parents and be prepared to provide anticipatory guidance and resources as appropriate.
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Affiliation(s)
- Christine A Ateah
- Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada.
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Barr RG. Preventing abusive head trauma resulting from a failure of normal interaction between infants and their caregivers. Proc Natl Acad Sci U S A 2012; 109 Suppl 2:17294-301. [PMID: 23045677 PMCID: PMC3477395 DOI: 10.1073/pnas.1121267109] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Head trauma from abuse, including shaken baby syndrome, is a devastating and potentially lethal form of infant physical abuse first recognized in the early 1970s. What has been less recognized is the role of the early increase in crying in otherwise normal infants in the first few months of life as a trigger for the abuse. In part, this is because infant crying, especially prolonged unsoothable crying, has been interpreted clinically as something wrong with the infant, the infant's caregiver, or the interactions between them. Here, we review an alternative developmental interpretation, namely, that the early increase in crying is a typical behavioral development in normal infants and usually does not reflect anything wrong or abnormal. We also review evidence indicating that this normal crying pattern is the most common trigger for abusive head trauma (AHT). Together, these findings point to a conceptualization of AHT as the consequence of a failure in an otherwise common, iterative, and developmentally normal infant-caregiver interaction. They also imply that there is a window of opportunity for prevention of AHT, and potentially other forms of infant abuse, through a public health primary universal prevention strategy aimed at changing knowledge and behaviors of caregivers and society in general concerning normal development of infants and the significance of early increased infant crying. If effective, there may be important implications for prevention of infant abuse nationally and internationally.
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Affiliation(s)
- Ronald G Barr
- Developmental Neurosciences and Child Health, Child and Family Research Institute, British Columbia Children's Hospital, University of British Columbia Faculty of Medicine, Vancouver, BC, Canada.
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Barr RG, Rivara FP, Barr M, Cummings P, Taylor J, Lengua LJ, Meredith-Benitz E. Effectiveness of educational materials designed to change knowledge and behaviors regarding crying and shaken-baby syndrome in mothers of newborns: a randomized, controlled trial. Pediatrics 2009; 123:972-80. [PMID: 19255028 DOI: 10.1542/peds.2008-0908] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Infant crying is an important precipitant for shaken-infant syndrome. OBJECTIVE. To determine if parent education materials (The Period of PURPLE Crying [PURPLE]) change maternal knowledge and behavior relevant to infant shaking. METHODS This study was a randomized, controlled trial conducted in prenatal classes, maternity wards, and pediatric practices. There were 1374 mothers of newborns randomly assigned to the PURPLE intervention and 1364 mothers to the control group. Primary outcomes were measured by telephone 2 months after delivery. These included 2 knowledge scales about crying and the dangers of shaking; 3 scales about behavioral responses to crying generally and to unsoothable crying, and caregiver self-talk in response to unsoothable crying; and 3 questions concerning the behaviors of sharing of information with others about crying, walking away if frustrated, and the dangers of shaking. RESULTS The mean infant crying knowledge score was greater in the intervention group (69.5) compared with controls (63.3). Mean shaking knowledge was greater for intervention subjects (84.8) compared with controls (83.5). For reported maternal behavioral responses to crying generally, responses to unsoothable crying, and for self-talk responses, mean scores for intervention mothers were similar to those for controls. For the behaviors of information sharing, more intervention mothers reported sharing information about walking away if frustrated and the dangers of shaking, but there was little difference in sharing information about infant crying. Intervention mothers also reported increased infant distress. CONCLUSIONS Use of the PURPLE education materials seem to lead to higher scores in knowledge about early infant crying and the dangers of shaking, and in sharing of information behaviors considered to be important for the prevention of shaking.
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Affiliation(s)
- Ronald G Barr
- MDCM, FRCPC, Centre for Community Child Health Research, 4480 Oak St, L408, Vancouver, British Columbia, Canada.
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Bennett S. Suspected abusive head trauma: Guidelines for a multidisciplinary approach. Paediatr Child Health 2008; 13:97-98. [PMID: 19183711 PMCID: PMC2528735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2007] [Indexed: 05/27/2023] Open
Affiliation(s)
- Susan Bennett
- Correspondence: Dr Susan Bennett, Children’s Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario K1H 8L1. Telephone 971-50-500-7937 (United Arab Emirates), e-mail
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Lee C, Barr RG, Catherine N, Wicks A. Age-related incidence of publicly reported shaken baby syndrome cases: is crying a trigger for shaking? J Dev Behav Pediatr 2007; 28:288-93. [PMID: 17700080 DOI: 10.1097/dbp.0b013e3180327b55] [Citation(s) in RCA: 143] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE : This study aims to determine whether the age-specific incidences (1) of publicly reported cases of shaken baby syndrome (SBS) and (2) of publicly reported cases of SBS with crying as the stimulus have similar properties to the previously reported normal crying curve. METHODS : The study reports cases of SBS by age of the child at the time of the inflicted trauma from the data set of the National Center on Shaken Baby Syndrome using cases entered between January 1, 2003 and August 31, 2004. RESULTS : There were 591 cases of infants up to 1.5 years of age who had been reported to have been shaken or shaken and physically abused. Of these, crying was reported as the stimulus in 166 cases. In both samples, the curves of age-specific incidence started at 2-3 weeks, reached a clear peak at about 9-12 weeks of age, and declined to lower more stable levels by about 29-32 weeks of age, similar to the normal crying curve. These curves have similar onsets and shapes and a slightly later peak compared to the normal crying curve. CONCLUSIONS : The findings provide convergent indirect evidence that crying, especially in the first 4 months of age, is an important stimulus for SBS.
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Affiliation(s)
- Cynthia Lee
- Centre for Community Child Health Research, Child and Family Research Institute, Vancouver, BC, Canada
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Barr RG, Trent RB, Cross J. Age-related incidence curve of hospitalized Shaken Baby Syndrome cases: convergent evidence for crying as a trigger to shaking. CHILD ABUSE & NEGLECT 2006; 30:7-16. [PMID: 16406023 DOI: 10.1016/j.chiabu.2005.06.009] [Citation(s) in RCA: 205] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2004] [Revised: 05/11/2005] [Accepted: 06/10/2005] [Indexed: 05/06/2023]
Abstract
OBJECTIVE To determine whether there is an age-specific incidence of hospitalized cases of Shaken Baby Syndrome (SBS) that has similar properties to the previously reported "normal crying curve," as a form of indirect evidence that crying is an important stimulus for SBS. DESIGN AND SETTING The study analyzed cases of Shaken Baby Syndrome by age at hospitalization from hospital discharge data for California hospitals from October 1996 through December 2000. PATIENTS All cases of children less than 18 months (78 weeks) of age for whom the diagnostic code for Shaken Baby Syndrome (995.55) in the International Classification of Disease, Ninth Edition, Clinical Modification was assigned. RESULTS There were 273 hospitalizations for SBS. Like the "normal crying curve," the curve of age-specific incidence starts at 2-3 weeks, has a clear peak, and declines to baseline by about 36 weeks of age. In contrast to the normal crying curve that peaks at 5-6 weeks, the peak of SBS hospitalizations occurs at 10-13 weeks. CONCLUSIONS The age-specific incidence curve of hospitalized SBS cases has a similar starting point and shape to the previously reported normal crying curve but the peak occurs about 4-6 weeks later. Of the likely predisposing causes, this pattern is only consistent with the properties of early crying. There are numerous explanations for the lag in the peaks between crying and SBS hospitalizations, including the possibility of repeat shakings prior to hospitalization. The importance of crying as a stimulus to SBS may provide an opportunity for preventive intervention.
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Affiliation(s)
- Ronald G Barr
- Department of Pediatrics, University of British Columbia, Faculty of Medicine, Vancouver, BC, Canada
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Ward MGK, Bennett S, King WJ. Prevention of shaken baby syndrome: Never shake a baby. Paediatr Child Health 2004; 9:319-21. [PMID: 19657516 PMCID: PMC2721176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Shaken baby syndrome (SBS) represents injuries to the head, skeleton and eyes of a young child and is the leading cause of fatal or life-threatening child abuse. SBS is preventable. The dangers and consequences of shaking a baby are not well appreciated by the general public. Simple educational programs and community nursing support programs have been shown to be helpful. Inadequate physician training and knowledge in child maltreatment have also been identified as problems. This article outlines the evidence for interventions in the prevention of SBS and recommendations for health care providers and educators.
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Affiliation(s)
- Michelle GK Ward
- Division of Pediatric Medicine, Department of Pediatrics, Children’s Hospital of Eastern Ontario, University of Ottawa
| | - Susan Bennett
- Child and Youth Protection Program, Department of Pediatrics, University of Ottawa, Ottawa, Ontario
| | - W James King
- Division of Pediatric Medicine, Department of Pediatrics, Children’s Hospital of Eastern Ontario, University of Ottawa
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Ateah CA, Secco ML, Woodgate RL. The risks and alternatives to physical punishment use with children. J Pediatr Health Care 2003; 17:126-32. [PMID: 12734459 DOI: 10.1067/mph.2003.18] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Despite strong evidence of negative developmental outcomes resulting from the use of physical (or corporal) punishment with children, its use by parents and other caregivers is common. Such negative outcomes include child aggression, mental health issues, and physical abuse. Health care providers have a responsibility to promote disciplinary strategies that facilitate positive parent-children relationships and keep children's self-esteem and bodies healthy and intact. The incidence, factors, and outcomes associated with parental use of physical punishment are reviewed and useful advice for parents and age-appropriate disciplinary strategies and resources are outlined for the various stages of child development from infancy to school age.
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Affiliation(s)
- Christine A Ateah
- Helen Glass Centre for Nursing, Faculty of Nursing, University of Manitoba, Winnipeg, Canada.
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