HD10 - Shaken Baby Syndrome and Abusive Head Trauma

Executive Summary:

*This document was replaced in its entirety on June 5, 2015 by the Joint Commission on Health Care.

House Joint Resolution 632 (HJR632) introduced by Delegate Glenn Oder, was passed during the 2011 Session of the General Assembly. The resolution directed the Joint Commission on Health Care (JCHC) to “study the costs of Shaken Baby Syndrome and abusive head trauma in Virginia and identify best practices in reducing the incidence" of this type of intentional injury to children.

Shaken baby syndrome/abusive head trauma is defined by the National Center on Shaken Baby Syndrome as “a term to describe the constellation of signs and symptoms resulting from violent shaking or shaking and impacting of the head of an infant or small child." Shaken baby syndrome (SBS) usually occurs in children under the age of two, but has been seen in children up to the age of five. Shaking typically happens when an angry parent or caregiver shakes a child to punish or quiet him/her during a period of inconsolable crying. The perpetrators are most often males and often are not the victim’s father.

The majority of infants who survive severe shaking will have some form of neurological or intellectual disability; many will require lifelong medical care. Studies have shown that a number of victims of less severe shaking develop serious behavioral problems and may be placed in the foster care or juvenile justice systems.

JCHC staff worked primarily with the Virginia Department of Health, Virginia Department of Social Services, the Office of the Chief Medical Examiner and the Department of Medicaid Assistance Services in collecting statewide data on the incidence and costs of SBS to the Commonwealth. Mary Kay Goldschmidt, a graduate student at the University of Virginia, completed a complementary review that involved reviewing case studies and developing estimates of the costs associated with caring for specific SBS victims. Incidence calculations vary between agencies as well as individual institutions and there is no universally accepted method or terminology used in calculating incidence. As such, our study findings support the research of others that the incidence of SBS is under-reported. Additionally, the costs to the Commonwealth of caring for survivors of SBS are substantial and under-reported. As part of Ms. Goldschmidt’s research, she reviewed the costs involved in assisting one SBS survivor who lived for two and a half years and found the actual cost to the Commonwealth was almost $240,000.

There are a number of established prevention programs, most of which seek to teach new parents how to handle their frustration when their infant cries for long periods of time. These prevention programs typically have a hospital-based component which includes educational activities such as discussions with new parents, pamphlets, and videos describing the consequences of SBS and alternative ways to deal with frustration. While the hospital-based form of prevention is vital, additional prevention activities designed to reach men who are not the children’s fathers and informal caregivers are needed also.

As a result of the study findings, the JCHC approved two policy options:

• Request by letter of the chairman that the Departments of Health, Social Services, Behavioral Health and Developmental Services, Rehabilitative Services, and Education collaborate with other public and private sector stakeholders to identify current best practices, state-wide programs, surveillance and data, initiatives and interventions dedicated to addressing infant mortality in Virginia, including those efforts dedicated with specific attention to Shaken Baby Syndrome as a cause of infant mortality. The Virginia Department of Health, by July 1, 2013 and in collaboration with other agencies and stakeholders, shall submit a report to the Joint Commission on Health Care and the Virginia Disability Commission detailing these efforts with recommendations for improving public awareness and professional intervention and collaborative practices, and future program and policy development, supported by appropriate evaluation and outcome measures.

• Introduce a joint resolution to establish the third week of April as Shaken Baby Awareness Week in Virginia. The resolution would be in memory of Jared Nicolas Patton and the many other victims of Shaken Baby Syndrome in Virginia.

Kim Snead
Executive Director
January 2012