Almost all cases of abusive head trauma (AHT) in young children occur in private homes, with the usual child care arrangement in most cases by a single adult in charge of one or more children, according to a study published online Nov. 10 in Pediatrics.
Caroline Rey-Salmon, M.D., from the Assistance Publique Hôpitaux de Paris, and colleagues conducted a multicenter retrospective study covering an 18-year period, which included medical and court records for 323 children (aged 2.5 months to 3 years) with AHT. The usual child care arrangement and child’s location at the time of injury were recorded. Markers for abuse and forensic written reports were analyzed.
The researchers found that in 98.5 percent of AHT cases, the assault occurred in a private home (four occurred in other indoor settings and data were missing for one case). Shaking occurred in a day-care center in one case, when the nurse was left alone with the infant for a few minutes. For 98.5 percent of cases, the usual child care arrangement was by a single adult in charge of one or more children.
“Recent decisions to confine populations at home during pandemics set the framework for the importance and potential implications of this work,” the authors write.