Editor's note: The 2017 AAP National Conference & Exhibition will take place from Sept. 16-19 in Chicago.
In 2015, the Washington Post published a lengthy article detailing its investigation with the Medill Justice Project at Northwestern University that called into question the diagnosis of shaken baby syndrome. Similar stories have run in other major media outlets, including The New York Times, ABC News and NPR.
Despite what the media have been reporting about the veracity of shaken baby syndrome, there are no data to support a significant controversy, said Sandeep Narang, MD, JD, FAAP, division head, child abuse pediatrics, Lurie Children’s Hospital of Chicago, and associate professor of pediatrics, Northwestern Feinberg School of Medicine.
“The misperception that’s made is that there is a wave or shift in the medical community about the certainty of the diagnosis. That’s not really the case based on a study I did in 2016,” said Dr. Narang, a member of the AAP Committee on Medical Liability and Risk Management and Section on Child Abuse and Neglect.
Dr. Narang and his colleagues surveyed physicians who evaluate injured children at 10 leading children's hospitals to assess their acceptance of shaken baby syndrome and abusive head trauma as medical diagnoses. Eighty-eight percent of the 628 physicians who responded considered shaken baby syndrome to be a valid diagnosis, and 93% said abusive head trauma was a valid diagnosis (Narang SK, et al. J Pediatr. 2016;177:273-278).
In addition, a large majority of physicians said that shaking a baby, with or without impact, was likely or highly likely to result in subdural hematoma, severe retinal hemorrhages and coma or death.
Dr. Narang will discuss the purported controversy over the diagnosis and how pediatricians can respond during a plenary session titled “Shaken Baby Syndrome: Science vs. Myth (P4051)” from 11:10-11:30 am Tuesday in McCormick Place West, Skyline Ballroom.
During his presentation, he plans to focus on three areas:
- how the controversy has gained traction and how it has the potential to impact child protection;
- the importance of general pediatricians being aware of this potential controversy because it can impact their patients involved in child protection hearings; and
- what pediatricians can do to educate the courts, attorneys and child welfare services in their communities about the science underpinning the diagnosis.
Dr. Narang began his career as a prosecutor in the military. One of his last cases prior to starting medical school was a very difficult child sexual abuse case, which sparked his interest in the field. When he embarked on a fellowship in child abuse pediatrics, he was shocked to learn that the legal community embraced the concept of a “controversy” over the diagnosis of shaken baby syndrome.
“I had been a general pediatrician for two years prior to that and didn’t realize that kind of resistance, that kind of momentum against the diagnosis was starting to develop in the legal community,” he said. “Having a legal background, I took it to heart.”
He decided to survey physicians regarding their views of shaken baby syndrome so that the legal community could make decisions based on solid data. As his study showed, most doctors do not dispute the diagnosis. Rather, questions are being raised by a small cottage industry of physicians, groups such as the Innocence Project and the media, which are drawn to stories of possibly wrongfully convicted or wrongfully accused individuals based on a mistaken medical diagnosis, he said.
Disagreements over the shaken baby syndrome diagnosis bear a large resemblance to the debates over vaccines and autism, and climate change, Dr. Narang said.
“You simply have people who are unwilling to accept the large body of data or evidence,” he said.
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