NDAA responds to New York Times shaken baby syndrome editorial.

• Author: Burns, Scott
• Position: National District Attorneys Ass'n

On September 20, 2010, The New York Times published an Op-Ed by Professor Deborah Tuerkheimer, a former prosecutor, in which she criticized shaken baby syndrome and suggested that courts review criminal convictions based upon that diagnosis. NDAA Executive Director Scott Burns submitted this response that the New York Times did not publish.

IN THE RECENT New York Times Op-Ed Anatomy of a Misdiagnosis, Deborah Tuerkheimer presents as mainstream the fringe views of a very small minority of the scientific community. Unfortunately, she ignores the overwhelming consensus among medical professionals in support of an Abusive Head Trauma (AHT) diagnosis and underlying scientific research.

The term "Abusive Head Trauma," adopted by the American Academy of Pediatrics in place of "Shaken Baby Syndrome," was a semantic change intended to encompass a greater range of injuries suffered by a child that result from shaking, impact or blunt force. Contrary to Professor Tuerkheimer's assertion, the change in nomenclature does not indicate a lack of support for the diagnosis of shaken baby syndrome but seeks to more accurately describe the injuries suffered by these children. (1)

The presence of injuries referred to by Professor Tuerkheimer as the "Triad," merely forms a part of the bases for an AHT diagnosis. In addition to retinal hemorrhages, bleeding around the brain and brain

swelling, doctors consider the entire constellation of injuries suffered by the child. Doctors also take into consideration the child's medical history and the history the caretaker provides about the injury causation. When that history is inconsistent with the injuries the child suffered, a doctor will consider a diagnosis of intentional abuse.

The combinations of injuries children suffer in AHT cases are rarely the result of accidents and/or other pre-existing medical conditions. A recent study indicates that brain injuries almost never result from short falls. (2,3) Furthermore, infections or illnesses, such as sickle-cell anemia, do not cause the types of injuries seen in abusive head trauma cases such as skull, limb and rib fractures. Finally, birth-related subdural hematomas are different from those seen in AHT as they are small and isolated to the brain's posterior in contrast to the diffuse subdural hematomas that result from AHT. (4) Birth-related bleeding around the brain resolves shortly after delivery and does not lead to the serious symptoms which result from...