The model of shaken baby syndrome that has been winning in court for the past 30 years says that only violence can create this distinctive cluster of symptoms in an infant:
- subdural hematoma
- retinal hemorrhages
I use the term “triad only” to mean a diagnosis of infant shaking based on the presence of the triad alone, with no scrapes, bruises, grasp marks, or fractures that might reveal an assault.
At the Eleventh International Conference on Shaken Baby Syndrome, in Atlanta, Georgia, in 2010, I heard a number of speakers say that they never prosecute “triad-only” cases, but my files tell a different story. See, for example, the rubber-band case.
Also beginning in 2010, child abuse experts started characterizing “the triad” as a defense concept that over-simplifies the condition for purposes of courtroom attack. In a keynote speech at the Atlanta conference, for example, Dr. Robert Block, then president-elect of the American Academy of Pediatrics, said, “Only people who are NOT active physicians working with children, naive journalists, and professors with a biased agenda would propose that only three signs and symptoms support a diagnosis.”
I have many, many printed examples, however, of statements from organizations like the National Center on Shaken Baby Syndrome articulating the triad as proof of infant shaking. Because it is an especially reputable example, I quote here from an editorial that ran in 2004 in the British Medical Journal, “Shaken Baby Syndrome: Pathological Diagnosis Rests On the Combined Triad, Not On Individual Injuries” (Harding B., Risdon R.A., Krous H.F., BMJ 2004 328; 720-721):
In shaken baby syndrome, it is the combined triad of subdural hematoma and retinal haemorrhage with brain damage, as well as the characteristics of each of these components that allow a reconstruction of the mechanism of injury, and assessment of the degree of force employed.
If you are not familiar with the debate surrounding shaken baby theory, please see the home page of this site.
copyright 2012 Sue Luttner