Shaken baby syndrome (SBS) is a form of inflicted traumatic brain injury most common in infants and toddlers up to two years of age. However, children up to five-years-old may also be victims. Shaken baby syndrome is a non-accidental head injury caused by the physical and intentional shaking of the child by an adult caregiver (such as a parent or a daycare worker).
Shaken baby syndrome is an extremely serious form of injury. In some instance bruising, bleeding or swelling might be noticeable, although in many cases there is no external evidence of trauma having occurred. Children who have suffered abusive brain trauma are likely to experience severe mental impairments as they grow up, the condition of which can vary from cases to case. A traumatic brain injury can severely impair a person’s cognitive, learning, physical, behavioral, and emotional abilities. It is extremely common for a child who has been violently shaken to suffer from severe brain damage which will cause permanent and life-long disabilities. Many children who are victims of abusive head trauma experience difficulties in the development of language, vision, balance and basic motor coordination.
Traumatic brain injuries occur as a result of shaking a young child for a number of reasons. Firstly, the rigorous action of shaking causes the child’s brain to move around within the skull, bouncing back and forth against the skull. Secondly, since young children do not yet have well-developed neck muscles, their heads are likely to rotate when forcefully shaken. This violent movement can cause additional damage to the child’s brain. Even greater injuries may occur when the child is dropped or strikes an object or surface at the shaking’s conclusion because the process of acceleration and deceleration is significantly greater.
Medical experts familiar with shaken baby syndrome generally agree that the presence of subdermal hematoma, retinal hemorrhage, cerebral oedema and/or acute encephalopathy are usually sufficient to determine that the injured child was the victim of shaken baby syndrome. It is often important to also consider the individual child’s clinical history as it has been argued in court that the mere existence of the triad of symptoms listed above does not necessarily guarantee an accurate diagnosis of shaken baby syndrome.
Shaken baby syndrome only results from the purposeful and violent shaking of the child. Throwing a child in the air and catching them, or bouncing a child on one’s knee will not result in shaken baby syndrome symptoms. Obviously falls and/or other accidents may result in a brain injury occurring, but these are usually minor in comparison. That said, certain incidents such as a child being injured in a traffic collision or being attacked by a vicious dog are likely to result in a severe traumatic brain injury.
Adults who abusively injure children through shaking are normally provoked by feelings of great frustration, and most incidents of shaking are triggered by the adult feeling out of control (for example, if the child is crying inconsolably). Experts have pointed out that in many cases the caregiver in question has unrealistic expectations of the child and expects them to conform to their needs (for example, for the child to be quiet), rather than understanding that it is their responsibility to fulfill the child’s needs.
Common symptoms of shaken baby syndrome include:
- Bruising around the head, neck, and chest
- Loss of consciousness
- Nervous disposition
- Bleeding behind the eye
- Retinal hemorrhage
- Skull fractures
- Soft tissue injuries
- Subdural hematoma
- Diffuse axonal injury
- Oxygen deprivation
- Difficulty breathing
- Swelling of the brain
- Damage to the neck, spine, and eyes
- Decreased alertness
- Extreme irritability
- Not smiling
- Loss of vision
- Loss of hearing
- Pale or bluish skin
- Behavioral changes
- Lack of appetite
- Developmental delays
- Impaired intellect
- Speech and learning difficulties
- Problems with memory and attention
- Severe mental retardation
- Cerebral palsy
- Poor sucking or swallowing
- Lack of vocalization
- Altered consciousness
- Unequal pupil size
- An inability to lift the head
- An inability to focus their eyes or track movement
- Rib and leg bone fractures
Approximately 20 to 25 percent of all shaken baby syndrome victims suffer fatal injuries as a result of their abuse.
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