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Bill could increase penalty for causing abusive head trauma to babies

Sunday, February 26, 2012 | 12:01 a.m. CST; updated 2:37 p.m. CST, Monday, February 27, 2012

*An earlier version of this story incorrectly reported this statistic.

COLUMBIA — The room was silent, save for a few sniffles, as Maryann Williamson shared the story about the death of her granddaughter, Karra, who died from abusive head trauma in 1999.

Williamson spoke to a group gathered at William Woods University on Thursday about her anger and struggles. But she also talked about her hope for a piece of legislation, House Bill 1317, that could change the punishment for those who inflict the harm that came to her granddaughter.

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Formerly known as "shaken baby syndrome," abusive head trauma occurs when a child has been shaken, or when a child receives an impact to the head in addition to shaking, according to the Missouri Child Fatality Review Program Annual Report for 2010.

One of the bill's co-sponsors, Rep. Noel Torpey, R-Independence, explained the terminology. "Shaken baby syndrome isn't defined well enough for the court system," he said. "You want to make sure the definition is clear. Abusive head trauma is clearly defined in the medical field, which will help prosecutors against these horrible acts against children."

The legislation was proposed because people are getting off too easily, Torpey said.

Right now, inflicting abusive head trauma is considered a class C felony. If House Bill 1317 passes, the felony charge would become more serious — a class B  felony — if there is enough evidence that serious damage was done to the child, Torpey said.

If the child dies, the felony is currently class A, and that part of the legislation will stay the same. The proposed effective date for the bill is Aug. 28.

Williamson has been working toward getting this bill passed for about six years. Like Torpey, she doesn't think the current punishment is severe enough. Williamson said the man who shook Karra and caused her death was sentenced to seven years in prison, but he only served four. 

"A mere slap on the wrist — a few years in prison — is not enough for those that harm our children or take the life of a child," Williamson said. "But, with the stricter legislation to back up longer sentencing, those that harm our innocent children will not be free after a couple of years of serving time."

Karra's story

Karra was 11 months old when she was shaken by her mother's boyfriend on Nov. 5, 1999.

Karra's last name is not included in this story for family safety reasons. 

"I will never forget the moment that the stretcher carrying her little body was lifted off the helicopter and we were able to see her," Williamson said. "Her innocent little body was just laying there, so still and quiet."

Karra suffered from irreversible brain damage, a fractured skull, bruises and detached retinas. She died from her injuries.

"I made a promise to Karra as she lay in that cold hospital room," Williamson said. "I promised her that I would not forget her, that I would do everything in my power to assure that she would not die in vain, that her short life would matter."

In 2005, Williamson started working toward a bill that would increase the punishment for harming a child. House Bill 1317 was filed Jan. 18, with Rep. Jeanie Riddle, R-Mokane, as the sponsor. 

What shaking does

According to the Missouri Children's Trust Fund, the state's foundation for child abuse prevention, babies are injured from shaking because their neck muscles are not strong enough to support their large heads. Shaking causes the brain to move within the skull.

"It's about the consistency of unset Jell-O," said Suzanne McCune, the administrator of St. Louis County's Medical Examiner's Office.

The immature brain of a child is more easily injured than the brain of an older child or adult, according to The National Center on Shaken Baby Syndrome. When the brain moves inside the skull, blood vessels can be torn, leading to bleeding around the brain. Brain tissue can be damaged or destroyed. Bleeding at the back of the eye can also occur.

Symptoms of abusive head trauma cannot be caused by normal child activities. According to The National Center on Shaken Baby Syndrome, it's fine for a person to gently toss a child in the air, bounce the child on his or her knee, use infant swings and jog with a child in a backpack.

How it starts

The most common trigger for a person to shake a baby is crying, said Amy Wicks, the information and research specialist of the National Center on Shaken Baby Syndrome. The caregiver of a child becomes frustrated with not being able to quiet the baby and might turn to shaking.

According to the Missouri Child Fatality Review Program Annual Report for 2010, research shows that crying starts to increase daily at about the first or second week of a newborn's life, and it continues increasing until about two or three months of age.

All infants go through a period of what is known as PURPLE crying:

  • The crying peaks.
  • The crying is unexpected.
  • The child resists soothing.
  • The child appears to be in pain.
  • The crying is long lasting — an average of 30 to 45 minutes and as long as two hours.
  • The crying tends to occur late in the afternoon or evening.

Wicks suggested feeding the baby, checking the diaper, changing the child's surroundings or trying to soothe him or her with white noise in the background. If all else fails, Wicks said to put the child in a safe place, such as an empty crib, and walk away for a moment.

Who shakes?

"Most people who do this have no prior history," Wicks said.

The Missouri Fatality Review Program Annual Report for 2010 stated that 60 percent to 70 percent of abusive head trauma perpetrators were male. Of the 14 Missouri children who died in 2010 of abusive head trauma, 10 were injured by their birth fathers, three by their birth mothers and one by a mother's boyfriend.

Missouri currently requires all obstetrical hospitals and health care facilities to offer new mothers a chance to view a video about preventing shaken baby syndrome.

Consequences

According to the National Center on Shaken Baby Syndrome, it is estimated that between 1,200 and 1,400* children are injured or killed by shaking every year in the U.S.

"Chances are, you know somebody who knows somebody who has been affected by shaken baby syndrome," Wicks said.

Physical results of shaking can vary in severity, Wicks said. Babies can become limp, lethargic and less alert and active. They might vomit, not be able to track objects with their eyes, have seizures and stop breathing. It is estimated that more than 300 abusive head trauma cases a year result in death.  

But not all victims of shaken baby syndrome show symptoms right away. Wicks said the frontal lobe of the brain can be damaged, which can result in behavioral problems later in life. Children might have trouble paying attention or dealing with impulse control.

Shaking also has monetary consequences. The cost of care is expensive and can last a lifetime, Wicks said. Medical bills can reach more than a million dollars in the first few years.

And then there's the emotional toll. For Williamson, recovering from her granddaughter's death has been a long process.

"It would be very easy to get lost in bitterness and anger that such a tiny little girl should have died so tragically," Williamson said. "And, for a long time, I had to fight my way out of the anger that I felt toward not only the person who killed Karra but also our society that seems to forget how precious human life is."

Still, the pain lingers.

"You never get over losing a child, and it is even more difficult when the loss is 100 percent preventable."


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Comments

Connie Sullivan February 27, 2012 | 4:29 p.m.

"Right now, inflicting abusive head trauma is considered a class C felony." This is not correct. Prosecutors have almost unfettered discretion to make charging decisions, and a charge of child abuse is not the only option when a child is injured. Ideally, in cases where injury to anyone has occurred, the prosecutor is guided by the severity of the injury and the intent of the person who may have caused the injury. This Bill does not even attempt to mandate that causing abusive head trauma is a class B felony. The only thing that will change is that a definition of abusive head trauma will be added to the statute and "serious physical injury on a child less than two years of age" will be inserted into the penalty clause. That "serious physical injury" is not limited to "abusive head trauma." This will not resolve the real conflict which is whether these symptoms - whether called shaken baby syndrome or abusive head trauma - are always the result of actual abuse or whether they can result from other causes.

(Report Comment)
Jeremy Praay February 27, 2012 | 5:20 p.m.

Child abuse is despicable, and I have little sympathy for those who inflict it, especially in cases resulting in the death of the infant. However, the diagnosis of Shaken Baby Syndrome (aka Abusive Head Trauma) has been increasingly under fire of the past several years, with many, many doctors now coming forward to state their concerns about how the diagnosis is being misused to convict the innocent. I'm not sure which is more despicable: sending an innocent, grieving parent to prison when their infant dies of natural causes, or the child abuse itself.

In fact, even the man who created the diagnosis, A. Norman Guthkelch, is now "horrified" by the way his diagnosis has been perverted and over-diagnosed to the point that perhaps hundreds of innocent people are sent to prison every year.
http://www.npr.org/2011/06/29/137471992/...

Furthermore, Dr. Waney Squier, one of the top infant neuropathologists in the world has stated that she feels that perhaps HALF OR MORE of Shaken Baby Convictions that go to trial ARE WRONGFUL CONVICTIONS. http://www.dailymail.co.uk/femail/articl...

The UK and Canada have both begun to recognize the horrible mistakes that this faulty diagnosis have caused, but the United States is lagging far behind. And now we want to increase the penalty for crimes that may not even be real? This is madness.

Professor Deborah Tuerkheimer recently wrote a paper on the problems regarding the prosecution of Shaken Baby Syndrome from a legal standpoint. In her opinion as well, some day we are going to have to come to terms with an injustice that we have never before faced in our legal system, and it will be monumental, as this diagnosis is eventually proven to be junk science. http://lawreview.wustl.edu/inprint/87/1/...

The only "good news" is perhaps that half of those sent to prison for this "crime" may indeed be guilty.

(Report Comment)
Mark Foecking February 27, 2012 | 6:04 p.m.

Here's another theory on it, and it's something I've wondered about also. I'd expect a shaken baby to have neck injuries, not brain injuries.

http://www.npr.org/blogs/health/2011/07/...

DK

(Report Comment)
Erin Jones February 28, 2012 | 8:54 a.m.

Erin Jones, REPORTER for the Columbia Missourian.
To Connie Sullivan: Thank you for your comment, I am trying to get into contact with the sponsor or one of the co-sponsors for house bill 1317 to clarify any misunderstandings or inaccuracies regarding what the current punishment for abusive head trauma is, and if the bill will increase the class of felony. When I have more information, I will post another comment.

(Report Comment)
Erin Jones February 28, 2012 | 9:59 a.m.

Erin Jones, REPORTER for the Columbia Missourian.
To Connie Sullivan: I spoke with Jeanie Riddle, the sponsor of House Bill 1317 this morning. I clarified your comments with her. She said that causing abusive head trauma is currently a Class C felony, and if the bill passes, abusive head trauma will becomes a class B felony if it causes serious physical injury to a child less than two years of age. It states in the bill that abusive head trauma will be considered child abuse. And child abuse is a Class C felony, unless serious physical injury has been inflicted on a child less than two years of age, in which it will become a Class B felony. As for whether abusive head trauma comes only from abuse or if it can come from other causes, there is currently a lot of debate on that topic. However, that is a separate issue from what my article discusses, so I cannot give any definitive answers on the subject. Thank you for bringing the misunderstanding to my attention, and if you have any other questions please let me know.

(Report Comment)

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