Abusive Head Trauma Nearly Always Occurred in Private Home, Not Childcare Centers: French Study

A French study that reviewed abusive head trauma cases involving young children over an 18-year-period found that nearly all assaults occurred in a private home rather than a childcare center – a finding that may have relevance during stay-at-home orders amid the COVID-19 pandemic. The study, “Abusive Head Trauma in Daycare Centers,” published in the December 2020 Pediatrics (published online Nov. 10) analyzed medical and court records of 323 children between ages 2.5 months – 3 years old who suffered from abusive head trauma between 2002 and 2020. Abusive head trauma is diagnosed based on a constellation of findings: the overall clinical picture, the pattern of brain lesions, and the presence of so-called “sentinel” lesions such as bruising or fractures. In 317 cases (98.5%), the assault occurred in a private home (4 in other indoor settings, 1 missing data). In only one case, shaking occurred in a childcare center when the nurse was alone with the baby for a few minutes. In 317 cases (98.5%), the usual childcare arrangement was by a single adult in charge of one or more children. The authors conclude that the findings could help social service agencies make decisions in terms of prevention, given the fact that abusive head trauma is an unusual occurrence in childcare centers.

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.