Shaken baby syndrome (SBS)/abusive head trauma (AHT) is one of the leading causes of death in child abuse cases in the United States. Therefore, it is crucial for criminal justice professionals entering their respective fields of practice to be well educated about the consequences associated with SBS/AHT cases. Concordia University, St. Paul’s forensic mental health programs, including our master’s degree and certificate program, provide accessible educational outlets to further your understanding of SBS/AHT and the criminal process behind such cases. Courses examine case studies and published literature to develop a broader knowledge of SBS/AHT and enhance training.
Familiarity with the signs and symptoms of SBS/AHT and how to effectively investigate cases are key components necessary to assist prosecution. The impact of proper training in SBS/AHT is well documented in the literature. “Unless the practitioner is aware of the possibility of abuse and knowledgeable about the signs of Shaken baby syndrome (SBS), the cause of these children’s symptoms can be missed” (Health Canada, 2001). Awareness of what constitutes SBS/AHT and how to prevent its reoccurrence should be included in the professional education of all involved disciplines. Awareness extends beyond the physical characteristics of SBS/AHT, to include livability conditions and relationship dynamics. It should be pointed out that a violently shaken child will typically exhibit symptoms immediately (Nashelsky & Dix, 1995).
Possible signs and symptoms of SBS/AHT include:
- Poor sucking or swallowing
- Decreased appetite
- Lack of smiling or vocalizing
- Difficulty breathing
- Altered consciousness
- Unequal pupil size
- An inability to lift the head
- An inability to focus the eyes or track movement
It is important to note that the above signs and symptoms are not intended to be used as medical advice, and that symptoms may vary from incident and/or child. The complexity of SBS/AHT illustrates the importance of continued education about the issue.
Although SBS/AHT can occur in families with no apparent risk factors, some risk factors commonly associated with child abuse and SBS/AHT are social isolation, family violence, substance abuse, psychiatric conditions, an adult having been abused as a child/youth, poor parental attachment to a child, and inadequate knowledge of child development. Understanding SBS/AHT requires a knowledge of the perpetrator’s mindset.
Institutions of higher learning can play a significant role in educating professionals by developing curricula that will provide students with a clear understanding of the signs and symptoms of SBS/AHT as well as risk factors associated with it. While there is extensive research for educators to assist them in development of this curricula, it is critical that experts in the field are brought into the classroom to provide a “real world” perspective.
Encouraging a multidisciplinary approach to learning about the complexities of SBS/AHT cases is highly recommended. There is a need for shared commitment among multiple disciplines such as medical, social services, law enforcement, and prosecutors, which often leads to a successful handling of cases. Simulating this multi-disciplinary practice within a classroom setting is essential.
Many criminal justice agencies stress the importance of undergraduate or graduate degrees to enhance the judgment, maturity and knowledge of employees and improve the delivery of services to their constituents. Professionals who are well educated about SBS/AHT will have the ability to think critically, employ complex problem-solving skills and exercise a high degree of discretion in potential cases.
About the Authors
Jerrod Brown, MA, MS, MS, MS, is the Treatment Director for Pathways Counseling Center, Inc. Pathways’ focus is to provide programs and services that benefit individuals impacted by mental illness and addictions. Mr. Brown is also the founder and CEO of the American Institute for the Advancement of Forensic Studies (AIAFS). His additional research interests include autism, fetal alcohol spectrum disorders, forensic aspects of sleep disorders, and serial killers.
Erv Winkauf, MA, is a retired 40-year law enforcement veteran who also has 19 years teaching experience. He currently serves as Criminal Justice Department Chair at Concordia University, St. Paul.
Natasha Lapcinski, BA, is Manager of the Minnesota Restorative Services Coalition, which is housed at Conflict Resolution Center. She has worked extensively with youth and adults in the criminal justice system that have experienced significant emotional and physical trauma. Natasha is currently completing her master’s degree.
Janina Wresh has 19 years’ experience in various law enforcement capacities including forensic crime, 4th Judicial Courts, corrections; domestic abuse response; crisis intervention; AIAFS COO. Wrash has served as deputy sheriff, crime scene technician, adjunct criminal justice professor, criminal justice evidence and property audit consultant; and is the founder and president of MN Association of Evidence and Property Specialists (MAPET) and board member of the Midwest Alliance on Shaken Baby Syndrome (MASBS).
Kim Kang is the parent of child that suffered abusive head trauma and co-founder of The Shaken Baby Alliance (Ft. Worth, Texas), a nonprofit dedicated to prevention, family support and justice. She lead this organization in its formative years from 1998–2001. She has presented on the topic of SBS/AHT at the state, national, and international levels and has been published nationally. She has worked for numerous Minnesota disability advocacy organizations covering special education public policy.
Health Canada. (2001) Joint Statement on Shaken Baby Syndrome. Ottawa: Minister of Public Works and Government Services. Retrieved from http://www.cpha.ca/uploads/policy/sbs_e.pdf
Nashelsky, M., & Dix, J.D. (1995). The time interval between lethal infant shaking and onset of symptoms: A review of the shaken baby syndrome literature. The American Journal of Forensic Medicine and Pathology, 16(2), 154–157.