title: Acceptance of Shaken Baby Syndrome and Abusive Head Trauma as Medical Diagnoses.
abstract: To assess the current general acceptance within the medical community of shaken baby syndrome (SBS), abusive head trauma (AHT), and several alternative explanations for findings commonly seen in abused children.
  
  
  
  This was a survey of physicians frequently involved in the evaluation of injured children at 10 leading children's hospitals. Physicians were asked to estimate the likelihood that subdural hematoma, severe retinal hemorrhages, and coma or death would result from several proposed mechanisms.
  
  
  
  Of the 1378 physicians surveyed, 682 (49.5%) responded, and 628 were included in the final sample. A large majority of respondents felt that shaking with or without impact would be likely or highly likely to result in subdural hematoma, severe retinal hemorrhages, and coma or death, and that none of the alternative theories except motor vehicle collision would result in these 3 findings. SBS and AHT were comsidered valid diagnoses by 88% and 93% of the respondents, respectively.
  
  
  
  Our empirical data confirm that SBS and AHT are still generally accepted by physicians who frequently encounter suspected child abuse cases, and are considered likely sources of subdural hematoma, severe retinal hemorrhages, and coma or death in young children. Other than a high-velocity motor vehicle collision, no alternative theories of causation for these findings are generally accepted.
authors.affiliation: Department of Pediatrics, Division of Child Abuse Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL. Electronic address: sanarang@luriechildrens.org.
authors.forename: Sandeep K
authors.initials: SK
authors.lastname: Narang
authors.affiliation: Department of Pediatrics, University of Texas Health Science Center at Houston, Houston, TX.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Estrada
authors.affiliation: Department of Pediatrics, University of Texas Health Science Center at Houston, Houston, TX.
authors.forename: Sarah
authors.initials: S
authors.lastname: Greenberg
authors.affiliation: Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Colorado School of Medicine, Aurora, CO.
authors.forename: Daniel
authors.initials: D
authors.lastname: Lindberg
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002423:Cause of Death; D002648:Child; D002649:Child Abuse / Q000175:diagnosis* / Q000401:mortality; D003128:Coma / Q000209:etiology; D006259:Craniocerebral Trauma / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D006408:Hematoma, Subdural / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D012166:Retinal Hemorrhage / Q000209:etiology; D038642:Shaken Baby Syndrome / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D055815:Young Adult
keywords: abusive head trauma; expert testimony; shaken baby syndrome