{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T03:10:41Z","timestamp":1792120241946,"version":"4.4.0"},"reference-count":53,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,6,23]],"date-time":"2023-06-23T00:00:00Z","timestamp":1687478400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>The shaken baby syndrome was originally proposed in the 1970s without any formal scientific basis. Once data generated by scientific research was available, the hypothesis became controversial. There developed essentially two sides in the debate. One side claimed that the clinical triad of subdural haemorrhage, retinal haemorrhage, and encephalopathy, or its components, is evidence that an infant has been shaken. The other side stated this is not a scientifically valid proposal and that alternative causes, such as low falls and natural diseases, should be considered. The controversy continues, but the contours have shifted. During the last 15\u2009years, research has shown that the triad is not sufficient to infer shaking or abuse and the shaking hypothesis does not meet the standards of evidence\u2010based medicine. This raises the issue of whether it is fit for either clinical practice or for the courtroom; evidence presented to the courts must be unassailable.<\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>There is insufficient scientific evidence to assume that an infant with the triad of subdural haemorrhage (SDH), retinal haemorrhage, and encephalopathy must have been shaken.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Biomechanical and animal studies have failed to support the hypothesis that shaking can cause SDH and retinal haemorrhage.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Patterns of retinal haemorrhage cannot distinguish abuse.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Retinal haemorrhages are commonly associated with extracerebral fluid collections (including SDH) but not with shaking.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Infants can develop SDH, retinal haemorrhage, and encephalopathy from natural diseases and falls as low as 1 foot.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>The shaking hypothesis and the literature on which it depends do not meet the standards of evidence\u2010based medicine.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec>","DOI":"10.1111\/dmcn.15676","type":"journal-article","created":{"date-parts":[[2023,6,25]],"date-time":"2023-06-25T01:27:18Z","timestamp":1687656438000},"page":"290-297","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Retinodural haemorrhage of infancy, abusive head trauma, shaken baby syndrome: The continuing quest for evidence"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4183-3343","authenticated-orcid":false,"given":"Waney","family":"Squier","sequence":"first","affiliation":[{"name":"Department of Neuropathology John Radcliffe Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,23]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2007.02004.x"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.5759.430"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1987.66.3.0409"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-0408"},{"key":"e_1_2_12_6_1","first-page":"201","article-title":"Problems of infant retino\u2010dural hemorrhage with minimal external injury","author":"Guthkelch AN","year":"2012","journal-title":"Houst J Health Law Policy."},{"key":"e_1_2_12_7_1","unstructured":"Allegan Circuit Court 2018 State of Michigan v McFarlane"},{"key":"e_1_2_12_8_1","unstructured":"ElinderG ErikssonA HallbergB et al.Traumatic shaking. 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