Shaken baby syndrome: Fighting an epidemic mostly perpetrated by fathers and male caretakers (Springfield, Missouri)

Studies consistently show that most perpetrators of abusive head trauma are fathers followed by other male caretakers. Notice that this is totally the case here, but not stated explicitly. It's too politically incorrect to simply report all this accurately without a lot of flack.

http://www.news-leader.com/story/news/local/ozarks/2014/10/18/shaken-baby-syndrome-fighting-tragic-epidemic/17524271/

Shaken baby syndrome: Fighting a tragic epidemic

Stephen Herzog | 6:09 a.m. CDT October 19, 2014

Doctors said her baby wouldn't be able to walk. Wouldn't be able to talk. Might be "a vegetable."

Only 4 months old, Savannah Wilson's life was on hold after doctors diagnosed her with shaken baby syndrome.

"My world just collapsed around me," Ghesika Wilson said, imagining her daughter's life and all the things she wouldn't be able to do.

Savannah's injury was the result of Ghesika's boyfriend shaking the infant. He has since been sent to prison.

Officials say the syndrome is particularly prevalent in southwest Missouri, where the high number of child abuse reports is well documented. To try to stem the problem through education, a local hospital is trying out some new technology, through an interactive doll.

Savannah spent more than two weeks in the intensive care unit at then-St. John's in Springfield, before she was sent to the St. Louis area for rehab.

It was in St. Louis that Savannah suddenly started to improve. She sat up on her own, and eventually started crawling.

"She's such a competitive girl," Ghesika said. "I think she watched her sister and wanted to be able to do the same things."

Three years later, Savannah is doing great, Ghesika Wilson said. She still has some balance issues and doesn't run as fast as her friends, but she's otherwise a happy, healthy kid, still fighting to keep up with her 5-year-old sister, Addy Mae.

"She's so intelligent," Ghesika Wilson said. "She knows all her numbers, all the months of the year, the days of the week."

But as health care professionals in southwest Missouri know well, not all babies are so lucky.

Deaths, injuries

Nancy Hoeman, nurse coordinator for the Springfield-Greene County Health Department, said a state report shows less than a third of infants who suffer abusive head trauma recover. They're most likely to suffer "significant cognitive or neurological deficits."

"The severity can vary from learning disabilities to seizures, blindness, paralysis or severe neurological injury leading to vegetative state," she said.

The most recent report from the Missouri Child Fatality Review Board says that in 2012, 10 infants across the state died as a result of abusive head trauma. In the five years before that, 78 children died as a result of abusive head trauma, according to the board.

And, according to the board, those deaths only account for about 20 percent of cases.

"The number of fatalities is the tip of the iceberg, so to speak," Hoeman said.

She said infants, because of their proportionally large heads and undeveloped neck and shoulder muscles, are particularly vulnerable to abusive head trauma.

Jason Martin, injury prevention coordinator for CoxHealth, explained that infants have space between their brains and skulls, before their brains eventually grow to fit better. That space allows the brain to move back and forth and collide with the skull if the child is shaken.

Education

Martin said the hospital's staff is well aware of the special problem the region has with child abuse and with shaken baby syndrome specifically.

"Springfield, southwest Missouri, is tops in the state for child abuse and certainly shaken baby," he said.

He said the hospital is working hard to change the trend.

A few years ago, the hospital started to see a rise in cases of babies being shaken, he said.

It hit especially close to home when one of the hospital's employees, Monica Howard, discovered her daughter Lyla had been the victim of shaking when 3 months old. Her father pleaded guilty in the case in 2011.

Doctors were concerned Lyla wouldn't survive, and would at least be disabled. Martin said Lyla made a "miraculous recovery" and is now healthy and perfectly normal.

But that case, along with many others, led officials to question their prevention methods.

"So we said, 'What are we doing?'" he said. "'Can we do more?'"

After months of research and planning, the Trauma Services department started using an interactive simulation doll to simulate the effect of shaking a baby and the human brain.

The doll has a clear skull which lights up in places when it's shaken. Martin said nurses have seen a significant difference in how parents respond when the doll is used, compared to the traditional teaching methods.

One reason? He said the doll shows how what seems like a little shaking can have devastating results.

"It doesn't have to be violent," Martin said. "It can be a quick, brief, losing it for a second ... whip back and forth, and then the damage is done."

Now, every parent who brings an infant to the ICU sees the demonstration with the doll. Soon, the plan is for parents of every infant who comes through the hospital to see it.

Eventually Cox hopes to take dolls to Branson and Monett, with other hospital systems picking up the plan, if Cox can prove it works.

"That's obviously the most important thing," Martin said. "Will this make a difference? Time will have to tell us that."

Prosecution

While health care professionals try to educate, prosecutors are working hard to incarcerate. They want offenders in prison.

It's not easy.

Greene County Prosecuting Attorney Dan Patterson said all child abuse cases, including abusive head trauma cases, come with challenges.

"Once you have a medical diagnosis of abusive injury, investigators have to work from that to narrow down the time frames to find out who inflicted the injuries," he said. "That's a challenge, frankly, in all physical child abuse cases. It depends on what the injuries are exactly with regard to how complicated that may be."

If the injuries are less severe, the time frame is harder to narrow down, he said.

"We rely on good police work to figure out those issues and find other corroborating evidence to identify the suspect," Patterson said.

"It is a priority in our office. We all know the statistics with regard to the reports of child abuse being higher in Greene County."

Even when officials can develop a case, it doesn't always result in a prosecution. Steven Kleber was charged with child abuse in connection with injuries his daughter suffered. Kleber maintained that he tripped and fell with the girl in his arms and a jury found him not guilty.

In the case of Savannah Wilson, her abuser was convicted and sent to prison.

Ryan Hudson, 28, was found guilty last year of felony child abuse and was sentenced to five years in prison.

Prosecutors say Hudson was taking care of Savannah while Ghesika Wilson was at work when the injuries occurred. Doctors testified that Savannah's injuries were consistent with shaken baby syndrome.

Ghesika Wilson said she will never feel like Hudson was punished harshly enough for what he did, but that she's glad the case was resolved for Savannah.

While Savannah has made nearly a full recovery, health care and law enforcement officials see too many babies who do not. They want to end the suffering, through awareness and education.

Martin said: "We really want parents to walk away understanding that babies cry and there are other ways to help the baby."

Justice for shaken babies

Here are a few examples of cases presented in Greene County court in which defendants were accused of hurting or killing babies by shaking them.

JEAN PHILLIPE JACQUET

Jacquet pleaded guilty to child abuse in 2011 and was sentenced to three years in prison. Prosecutors say Jacquet was a French citizen who was in the U.S. illegally.

Prosecutors say he shook his 3-month-old daughter until she had a seizure. Later he admitted the shaking is what led to her injuries.

At the time, the infant was taken to the intensive care unit and on a ventilator, according to court records.

The infant, Lyla, ended up having what Cox RN Jason Martin called a "miraculous recovery," and is now a healthy 4-year-old.

JOHN DILLEY

Dilley was found guilty of killing 2-year-old Dominic James by shaking him in 2002. Dilley was sentenced to 15 years in prison.

Dilley was the foster father of Dominic, who had been placed in the foster care after his parents were involved in a domestic dispute.

Dominic was hospitalized in 2002 and his parents insisted he be taken out of the foster home. Instead, he was sent back to the home and died a few days later.

MATTHEW HANDLANG

Handlang was sentenced to 20 years in prison last summer after he was found guilty of killing his 3-month-old daughter Aubrey by shaking her.

Documents say Handlang shook Aubrey, who was born prematurely, because she wouldn't stop crying and the family's dog wouldn't stop barking.

An autopsy found that Aubrey had brain swelling, severe brain bleeding, bleeding in the spinal cord and acute bleeding in the eyes.

STEVEN KLEBER

Kleber was found not guilty in 2012 of abusing his 7-week-old daughter, Mya.

But this case had a twist.

In 2010, Steven Kleber was confronted and shot by his then-wife Lindsey Kleber, who believed her husband injured their daughter. Two years later, Lindsey Kleber was convicted of kidnapping her husband and shooting him in the back.

On Oct. 7, 2010, Lindsey Kleber forced Steven Kleber to leave the Baptist Bible College campus at gunpoint.

Lindsey Kleber had met with Greene County prosecutors earlier that day, records say, and was afraid Steven Kleber might get probation for the alleged abuse of their daughter Mya. Lindsey Kleber was sentenced to three years in prison.

Family members say Maya suffered permanent brain damage and still suffers from seizures.

About shaken baby syndrome

According to the Centers for Disease Control, shaken baby syndrome occurs when a baby is shaken, resulting in a "whiplash" effect with the head.

The center says the shaking can lead to internal injuries, including bleeding in the brain or in the eyes.

Shaken baby syndrome is a form of a traumatic brain injury — which is simply a bump, blow or jolt to the head that disrupts the normal function of the brain.

Children from birth to 1 year old are most at risk.