The medical science supporting so called “shaken baby syndrome” (SBS) may be much weaker than most American physicians think. A recent article by writer Sue Luttner summarizes the findings of a 2016 Swedish report evaluating the strength of the science behind claims that violent shaking causes infant brain damage.
The report comes from the Swedish Agency for Health Technology Assessment and Assessment of Social Services. “Shaken baby syndrome” is the theory that posits that, absent an extremely forceful accident such as an auto collision, children presenting with subdural hematoma, retinal hemorrhages, and cerebral edema have necessarily been subjected to violent shaking. Many parents and others caring for children have gone to prison solely because a child in their care was found to have these three conditions.
Support for this theory, first posed in the 1960s, has been flagging recently in some medical circles. In its recent report, the Swedish health agency conducted a literature review of papers which discussed cases of pure shaking, that is, cases in which there was no indication the baby’s head had struck anything. While 3,773 scientific papers were initially identified, only thirty papers made it through the researchers’ screening standards for scientific reliability.
In its findings, the report identifies some recurring problems with the published research. One such problem is circular reasoning: studies often identify “shaken infants” by selecting for specific symptoms being studied, then use those very symptoms to diagnose SBS. Another problem with the existing literature is that other medical conditions can cause the three symptoms said to come only from shaking.
In 2014, the Swedish Supreme Court reversed a father’s conviction for Gross Assault based upon new studies indicating that the SBS theory had weak scientific support. Two medical experts convinced the high court in this case that “there is currently no clarity about the extent to which the components of [symptoms typically associated with SBS] are specific to violent shaking… Instead, it must be concluded that we do not know.” The court also questioned how an infant could have undergone such violent shaking without sustaining neck injuries.
The American Academy of Pediatrics (AAP) has not yet weighed in on the Swedish report’s findings, but it likely will do so soon. In a letter sent to the Swedish agency before publication of the report, the AAP asked the agency to “allow international peer review by AAP experts on child abuse, pediatric radiology, neurological surgery, and [consider] their feedback in the final report.” The Swedish agency declined to allow AAP to review its report before publication.
Shaken baby syndrome remains a subject of intense medical and legal debate in the United States. At the Marshall Defense Firm we have defended parents accused in Everett, Wenatchee, Vancouver, and elsewhere in Washington State.