Speaking for Those Who Can't

By: Sandeep Narang, MD, JD
February 15, 2017

We need to change the way we approach child maltreatment, both medically and legally. Since taking over as head of the Division of Protective Services, my focus has been to make Lurie Children's Child Protection Team the nation's leader in child maltreatment research, education, training and clinical care.

As a former trial attorney in the U.S. Navy JAG Corps, I was impressed by the strength and courage an 11-year-old sexual abuse victim showed on the stand when I prosecuted her perpetrator. Although our legal system had helped her, I knew I had to do more.

I've always approached child abuse pediatrics with the understanding that the very nature of the child maltreatment system involves both medical and legal expertise. However, these two areas are often worlds apart. Making it easier for our legal colleagues to understand the nuances of child abuse ultimately helps protect its victims. To achieve this goal, we in the child welfare realm need to provide the empiric research evidence that harm has been inflicted.

For example, almost all physicians agree that shaking an infant or young child is dangerous and can cause bleeding in the brain and other injuries. However, the diagnosis of shaken baby syndrome has been called into question by recent judicial decisions, legal literature and prominent media sources. Consequently, courts have overturned prior shaken baby convictions. This trend has had a chilling effect on future prosecutions, and, more importantly, the safety of vulnerable infants in child protection hearings.

Our legal system relies upon generally accepted concepts in the medical community but is ill-equipped to assess them. Thus, courts are susceptible to the misinformation of a single or small cadre of experts. In efforts to assist our legal system, my colleagues and I conducted, and recently published in the Journal of Pediatrics, the first national study on the level of acceptance of shaken baby syndrome/abusive head trauma. Surveying specialists from multiple disciplines at the nation's leading children's hospitals, we found that physicians generally do accept that shaking a young child is a dangerous form of abuse. This data could finally help to turn legal disbelievers into believers.

My colleagues and I take our responsibility seriously to do all we can to prevent child abuse and advocate for its victims. By advancing the science through innovative research, increasing the awareness of child maltreatment studies and leveraging technology to enhance diagnostic accuracy, I believe we can chart a new course towards ending child abuse.

This article originally appeared in the Winter 2017 issue of Heroes magazine.