History of the definition process

Dr. John Caffey started defining Shaken Baby Syndrome (SBS) and Abusive Head trauma (AHT) in 1946 when he described the association of subdural hemorrhages with long bone fractures. In 1972 and 1974, he published the seminal article describing the clinical features with the radiologic findings associated with shaking injuries. The term ‘ Shaken Baby Syndrome’ was first used by Ludwig and Warman in 1984 when they reviewed 20 infants and toddlers injured from being shaken. It was Duhaime et al in 1998 who provided evidence that the shaken babies could also have injuries related to blunt force trauma. Some researchers today believe the models and theories are incomplete in their ability to completely understand the components of Abusive Head Trauma and Shaken Baby Syndrome.

Current definitions

The American Academy of Pediatrics believes AHT in infants and young children is a settled scientific fact. According to the AAP

The scientific support for the diagnosis of AHT comes from over 40 years of research in a broad array of clinical and basic science disciplines, including pediatrics, neurosciences, ophthalmology, orthopedics, radiology, pathology, epidemiology, and biomechanics.

Components of Abusive Head Trauma

Severely shaking an infant can cause neurologic injury. Blunt force trauma to the head can cause additional injuries including superficial injury, cranial fracture, etc. Abusive head trauma (AHT) is considered to include both components: forcible shaking of an infant or toddler (Shaken Baby Syndrome) and blunt force trauma from hitting or slamming an infant or child’s head against something hard.

The CDC and others consider Shaken Baby Syndrome as a subsidiary of AHT.

Iowa definition of Shaken Baby Syndrome

Shaken Baby Syndrome is a highly preventable form of child abuse which occurs when an infant or young child is violently shaken or slammed. It is usually triggered by inconsolable infant crying. ... From 1995 to 2007, fifty-one Iowa infants died from Shaken Baby Syndrome (SBS).

Department of Public Health, #135.119

f. Shaken baby syndrome means the collection of signs and symptoms resulting from the vigorous shaking of a child who is three years of age or younger. Shaken baby syndrome may result in bleeding inside the child’s head and may cause one or more of the following conditions: irreversible brain damage; blindness, retinal hemorrhage, or eye damage; cerebral palsy; hearing loss; spinal cord injury, including paralysis; seizures; leaning disability; central nervous system injury; closed head injury; rib fracture; subdural hematoma; or death. Shake baby syndrome also includes the symptoms included in the diagnosis code for shaken infant syndrome utilized by Iowa hospitals.

Kentucky definition of abusive head trauma and Shaken Baby Syndrome

Pediatric abusive head trauma" means the various injuries or conditions that may result following the vigorous shaking, slamming, or impacting the head of an infant or young child. These injuries or conditions, also known as pediatric acquired abusive head trauma, have in the past been called "Shaken Baby Syndrome" or "Shaken Infant Syndrome." Pediatric abusive head trauma injuries or conditions have included but are not limited to the following:

(a) Irreversible brain damage;

(b) Eye damage;

(c) Retinal hemorrhage;

(d) Blindness;

(e) Hearing loss;

(f) Spinal cord injury;

(g) Paralysis;

(h) Central nervous system injury,

(i) Learning disability;

(j) Closed head injury;

(k) Seizures;

(l) Subdural hematoma

(m) Cerebral palsy;

(n) Rib fracture;

(o) Hemorrhage;

(p) Death;

Shaken Baby Syndrome New York

New York proclaimed April 16-22 as Abusive Head Trauma/Shaken Baby syndrome Awareness Week in the State of New York. They state 66,676 children in NY were victims of abuse and neglect in 2015 with 6,605 under the age of one year. The leading cause of death of abused children under age five is Abusive Head Trauma, including trauma known caused by shaking an infant severally known as Shaken Baby Syndrome. Shaken Baby Syndrome and other inflicted head trauma occur when a caregiver loses control and shakes a baby or young child, resulting in loss of vision, brain damage, paralysis, seizures, or death.

Shaken Baby Syndrome legislation in Pennsylvania

In Pennsylvania, the name, Shaken Baby Syndrome (SBS), is used to describe a collection of signs and symptoms that occur when a child is shaken.

Act No. 2002 - 176, Shaken Baby Syndrome Education and Prevention Program was signed in December 2002.
The Act requires hospitals to: 

• provide parents educational materials on SBS free of charge
• present parents with a voluntarily commitment statement indicating that they have received the educational materials (This information compiled from:  PA Act 176 of 2002, The Pennsylvania Shaken Baby Syndrome Education Program, the Brain Injury Association of America, the New York Department of Health, and The Arc.)   

For more information on the Pennsylvania Shaken Baby Syndrome Prevention and Awareness Program go to

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Abuse is the result of the acts or omissions.