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Abusive head trauma in children: a literature review
Nahara R L Lopes1, Evelyn Eisenstein, Lúcia C A Williams
1Master's Degree in Psychology, Departamento de Psicologia, Laboratório de Análise e Prevenção da Violência, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil.
Insights
Pediatric abusive head trauma, or shaken baby syndrome, is severe physical abuse in young children. Early identification and parental education are crucial for prevention and reducing devastating consequences.
Area of Science:
- Pediatrics
- Child Abuse
- Neurology
Background:
- Pediatric abusive head trauma (AHT) is a severe form of physical abuse against infants and young children.
- It is characterized by injury to the skull or intracranial contents due to intentional impact or violent shaking.
Purpose of the Study:
- To review the scientific literature on AHT.
- To highlight its prevalence, signs, symptoms, consequences, risk factors, and prevention strategies.
Main Methods:
- A systematic review of the MEDLINE, SciELO, LILACS, and Web of Science databases was conducted.
- The review covered literature published from 2001 to 2012.
- Search terms included "shaken baby syndrome" and "abusive head trauma" in English, Spanish, and Portuguese.
Main Results:
- AHT primarily affects infants under 1 year old and can lead to severe physical or mental disabilities, or death.
- Clinical signs of AHT can be mistaken for common childhood illnesses or accidental injuries, necessitating professional training for accurate diagnosis.
- Prevention strategies should focus on early case identification and educating parents about child development, particularly infant crying patterns.
Conclusions:
- Implementing and evaluating AHT prevention strategies is critical in the Brazilian context due to the severity of the condition.
- It is recommended to assess national-level incidence indicators for AHT.
Objective:
To review the scientific literature on pediatric abusive head trauma as a form of physical abuse against infants and young children, highlighting the prevalence, signs and symptoms, consequences, risk factors for its occurrence, and prevention strategies.
Data Source:
The MEDLINE, SciELO, LILACS, and Web of Science databases from 2001 to 2012 were reviewed, using the terms "shaken baby syndrome" and "abusive head trauma" in English, Spanish, and Portuguese.
Data Synthesis:
Pediatric abusive head trauma is defined as injury to the skull or intracranial contents of a infant or child younger than 5 years due to intentional abrupt impact and/or violent shaking. It occurs mainly in infants and children under 1 year of age, and may result in severe consequences, from physical or mental disabilities to death. Although there are specific signs for this form of abuse, they can be mistaken for common illnesses in children or accidental head injury; thus, clinical training of professionals involved in the assessment of cases to attain the correct diagnosis is crucial. Prevention strategies should include early identification of cases, as well as parental education on child development, especially on the infant's crying pattern.
Conclusions:
Considering the severity of abusive head trauma in children, it is critical that prevention strategies be implemented and evaluated in the Brazilian context. It is suggested that its incidence indicators be assessed at the national level.
