{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:25:53Z","timestamp":1791228353146,"version":"4.1.0"},"reference-count":27,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2005,4,1]]},"abstract":"<jats:p>Objective. Abusive head injuries among infants (shaken infant or shaken impact syndrome) represent a devastating form of child abuse; an effective prevention program that reduces the incidence of abusive head injuries could save both lives and the costs of caring for victims. We wished to determine whether a comprehensive, regional, hospital-based, parent education program, administered at the time of the child's birth, could be successfully implemented and to examine its impact on the incidence of abusive head injuries among infants &amp;lt;36 months of age.<\/jats:p>\n                  <jats:p>Methods. All hospitals that provide maternity care in an 8-county region of western New York State participated in a comprehensive regional program of parent education about violent infant shaking. The program was administered to parents of all newborn infants before the infant's discharge from the hospital. The hospitals were asked to provide both parents (mothers and, whenever possible, fathers or father figures) with information describing the dangers of violent infant shaking and providing alternative responses to persistent infant crying and to have both parents sign voluntarily a commitment statement (CS) affirming their receipt and understanding of the materials. Program compliance was assessed by documenting the number of CSs signed by parents and returned by participating hospitals. Follow-up telephone interviews were conducted with a randomized 10% subset of parents, 7 months after the child's birth, to assess parents' recall of the information. Finally, the regional incidence of abusive head injuries among infants and children &amp;lt;36 months of age during the program (study group) was contrasted with the incidence during the 6 preceding years (historical control group) and with statewide incidence rates for the Commonwealth of Pennsylvania during the control and study periods, using Poisson regression analyses with a type I error rate of 0.05.<\/jats:p>\n                  <jats:p>Results. During the first 5.5 years of the program, 65 205 CSs were documented, representing 69% of the 94 409 live births in the region during that time; 96% of CSs were signed by mothers and 76% by fathers\/father figures. Follow-up telephone surveys 7 months later suggested that &amp;gt;95% of parents remembered having received the information. The incidence of abusive head injuries decreased by 47%, from 41.5 cases per 100 000 live births during the 6-year control period to 22.2 cases per 100000 live births during the 5.5-year study period. No comparable decrease was seen in the Commonwealth of Pennsylvania during the years 1996\u20132002, which bracketed the control and study periods in western New York State.<\/jats:p>\n                  <jats:p>Conclusions. A coordinated, hospital-based, parent education program, targeting parents of all newborn infants, can reduce significantly the incidence of abusive head injuries among infants and children &amp;lt;36 months of age.<\/jats:p>","DOI":"10.1542\/peds.2004-1896","type":"journal-article","created":{"date-parts":[[2005,4,1]],"date-time":"2005-04-01T13:03:40Z","timestamp":1112360620000},"page":"e470-e477","source":"Crossref","is-referenced-by-count":279,"title":["Preventing Abusive Head Trauma Among Infants and Young Children: A Hospital-Based, Parent Education Program"],"prefix":"10.1542","volume":"115","author":[{"given":"Mark S.","family":"Dias","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Smith","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"deGuehery","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Mazur","sequence":"additional","affiliation":[{"name":"Pediatrics, State University of New York, Kaleida Health Women's and Children's Hospital, Buffalo, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veetai","family":"Li","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele L.","family":"Shaffer","sequence":"additional","affiliation":[{"name":"Health Evaluation Sciences, Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2005,4,1]]},"reference":[{"key":"2021120819322068400_R1","doi-asserted-by":"crossref","unstructured":"Caffey J. On the theory and practice of shaking infants. Am J Dis Child.\u20081972;124:161\u2013169","DOI":"10.1001\/archpedi.1972.02110140011001"},{"key":"2021120819322068400_R2","doi-asserted-by":"crossref","unstructured":"Caffey J. The whiplash-shaken infant syndrome: manual shaking by the extremities with whiplash-induced intracranial and intraocular bleeding. Pediatrics.\u20081974;34:396\u2013403","DOI":"10.1542\/peds.54.4.396"},{"key":"2021120819322068400_R3","doi-asserted-by":"crossref","unstructured":"Duhaime AC, Gennarelli TA, Thibault LE, Bruce DA, Margulies SS, Wiser R. The shaken baby syndrome: a clinical, pathological, and biomechanical study. J Neurosurg.\u20081987;66:409\u2013415","DOI":"10.3171\/jns.1987.66.3.0409"},{"key":"2021120819322068400_R4","doi-asserted-by":"crossref","unstructured":"Dias MS, Backstrom J, Falk M, Li V. Serial radiography in the infant shaken impact syndrome. Pediatr Neurosurg.\u20081998;29:77\u201385","DOI":"10.1159\/000028694"},{"key":"2021120819322068400_R5","doi-asserted-by":"crossref","unstructured":"Hadley MN, Sonntag VKH, Rekate HL, Murphy A. The infant whiplash-shake injury syndrome: a clinical and pathological study. Neurosurgery.\u20081989;24:536\u2013540","DOI":"10.1227\/00006123-198904000-00008"},{"key":"2021120819322068400_R6","doi-asserted-by":"crossref","unstructured":"Starling SP, Holden JR, Jenny C. Abusive head trauma: the relationship of perpetrators to their victims. Pediatrics.\u20081995;95:259\u2013262","DOI":"10.1542\/peds.95.2.259"},{"key":"2021120819322068400_R7","doi-asserted-by":"crossref","unstructured":"Zimmerman RA, Bilaniuk LT, Bruce D, Schut L, Uzzell B, Goldberg HI. Computed tomography of craniocerebral injury in the abused child. Radiology.\u20081979;130:687\u2013690","DOI":"10.1148\/130.3.687"},{"key":"2021120819322068400_R8","doi-asserted-by":"crossref","unstructured":"Sinal SH, Ball MR. Head trauma due to child abuse: serial computerized tomography in diagnosis and management. South Med J.\u20081987;80:1505\u20131512","DOI":"10.1097\/00007611-198712000-00006"},{"key":"2021120819322068400_R9","doi-asserted-by":"crossref","unstructured":"Ludwig S, Warman M. Shaken baby syndrome: a review of 20 cases. Ann Emerg Med.\u20081984;13:104\u2013107","DOI":"10.1016\/S0196-0644(84)80571-5"},{"key":"2021120819322068400_R10","unstructured":"New York State Department of Health. Shaken baby syndrome. 2001. Available at: www.health.state.ny.us\/nysdoh\/consumer\/sbs\/definition.htm. Accessed February 21, 2005"},{"key":"2021120819322068400_R11","unstructured":"Showers J. Executive summary. In: Showers J, ed. Proceedings from the Second National Conference on Shaken Baby Syndrome, 1998. Salt Lake City, UT: National Association of Children's Hospitals and Related Institutions; 1998:70"},{"key":"2021120819322068400_R12","unstructured":"Showers J. Don't Shake the Baby, Educational Manual. Groveport, OH: Ohio Research Institute on Child Abuse Prevention; 1991"},{"key":"2021120819322068400_R13","doi-asserted-by":"crossref","unstructured":"Showers J. Behaviour management cards as a method of anticipatory guidance for parents. Child Care Health Dev.\u20081989;15:401\u2013415","DOI":"10.1111\/j.1365-2214.1989.tb00631.x"},{"key":"2021120819322068400_R14","doi-asserted-by":"crossref","unstructured":"Showers J. Child behavior management cards: prevention tools for teens. Child Abuse Negl.\u20081990;15:313\u2013316","DOI":"10.1016\/0145-2134(91)90075-O"},{"key":"2021120819322068400_R15","doi-asserted-by":"crossref","unstructured":"Showers J, Johnson C. Students' knowledge of child health and development: effects on approaches to discipline. J Sch Health.\u20081984;54:122\u2013125","DOI":"10.1111\/j.1746-1561.1984.tb08785.x"},{"key":"2021120819322068400_R16","doi-asserted-by":"crossref","unstructured":"Showers J, Johnson C. Child development, child health and child rearing knowledge among urban adolescents: are they adequately prepared for the challenges of parenthood?Health Ed.\u20081985;16:37\u201341","DOI":"10.1080\/00970050.1985.10615875"},{"key":"2021120819322068400_R17","unstructured":"Showers J. Shaken baby syndrome: the problem and a model for prevention. Child Today.\u20081992;21:34\u201337"},{"key":"2021120819322068400_R18","doi-asserted-by":"crossref","unstructured":"American Academy of Pediatrics, Committee on Child Abuse and Neglect. Shaken baby syndrome: rotational cranial injuries: technical report. Pediatrics.\u20082001;108:206\u2013210","DOI":"10.1542\/peds.108.1.206"},{"key":"2021120819322068400_R19","doi-asserted-by":"crossref","unstructured":"McCullagh P, Nelder JA. Generalized Linear Models. 2nd ed. London, United Kingdom: Chapman and Hall; 1989","DOI":"10.1007\/978-1-4899-3242-6"},{"key":"2021120819322068400_R20","unstructured":"Rice JA. Mathematical Statistics and Data Analysis. 2nd ed. Belmont, CA: Duxbury Press; 1995"},{"key":"2021120819322068400_R21","doi-asserted-by":"crossref","unstructured":"Dubowitz H. Prevention of child maltreatment: what is known. Pediatrics.\u20081989;83:570\u2013577","DOI":"10.1542\/peds.83.4.570"},{"key":"2021120819322068400_R22","doi-asserted-by":"crossref","unstructured":"Olds D, Henderson, CR, Chamberlin R, Tatelbaum R. Preventing child abuse and neglect: a randomized trial of nurse home visitation. Pediatrics.\u20081986;78:65\u201378","DOI":"10.1542\/peds.78.1.65"},{"key":"2021120819322068400_R23","doi-asserted-by":"crossref","unstructured":"Olds D, Eckenrode J, Henderson CR, et al. Long-term effects of home visitation on maternal life course and child abuse and neglect: 15 year follow-up of a randomized trial. JAMA.\u20081997;278:637\u2013643","DOI":"10.1001\/jama.278.8.637"},{"key":"2021120819322068400_R24","unstructured":"Swenson J, Levitt C. Shaken baby syndrome: diagnosis and prevention. Minn Med.\u20081997;80:41\u201344"},{"key":"2021120819322068400_R25","unstructured":"Hicks RA. Prevention of Shaken Baby Syndrome: SCAN, Newsletter of the Section on Child Abuse and Neglect of the American Academy of Pediatrics. Elk Grove Village, IL: American Academy of Pediatrics; 2000:2"},{"key":"2021120819322068400_R26","doi-asserted-by":"crossref","unstructured":"Showers J. \u201cDon't shake the baby\u201d: the effectiveness of a prevention program. 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