ATLANTIC CO.--- A new dermatology report contains some sobering facts for parents -- children under the age of 10 who get just one bad sunburn, more than double their chances of developing fatal skin cancer later in life.
"...I often say to people who are trying to use their kids for an excuse to be out there in midday sun...why do you want to kill your kids," said Dr. Anthony Campo, Jr., a dermatologist with a practice in Somers Point.
According to Campo, being exposed to the summer sun between 10 am to 4 pm, results in 10 times more skin damage per hour, than during other day light hours, "....we used to see, in this office, maybe one or two melanoma's a year, and now we're seeing 48 to 50 melanoma's a year."
Campo says that young children -- from birth to one year of age -- should never be exposed to midday sun under any circumstances. Children older than one, should have on physical sun barriers such as long sleeved shirts, and a broad brimmed hat, along with sunglasses. An umbrella or some other type of shade should also be provided.
Even though no sunscreen can protect against the suns X-ray radiation, UVC and infrared light -- which all cause skin damage -- a sunscreen that's effective against UVA and UVB rays is a must, "....we like to recommend a product that has stabilized avobenzone and some other UVA blockers."
Source
Wednesday, July 8, 2009
The pursuit of language for autism
Language is the operative word pertaining to autism and related disorders. Parents are perched waiting for expressive language, words that fail to flow from a toddler's lips, like sunlight that never shines. It is also the receptive language that baffles the scholars. Children appear deaf. They do not seem to understand simple commands or words of affection. Like a life in a fish bowl children with autism are being observed without knowing why.
William Safire, the consummate word smith speaks of thenotion of the Aha! moment in his NY Times On Language column. Mr.Safire's concentration is on "senior moments". He makes a reference to the perception: “We’ve all had our ‘aha’ moments,” reports the science writer Robert Lee Hotz in a recent article on “the payoff of daydreaming” in The Wall Street Journal. He cites the psychologist John Kounios for a definition: “An ‘aha’ moment is any sudden comprehension that allows you to see something in a different light. It could be a solution to a problem; it could be getting a joke or suddenly recognizing a face."
Perhaps "getting the joke" is far too auspicious a dream for parents of autism. However, "recognizing a face" or learning to listen conjures the Aha! from those who work meticulously and fervently with our children.
Safire reminds us that "In the current media world, Oprah Winfrey and Mutual of Omaha are involved in a legal dispute over the advertising use of the phrase “the aha moment.” It all seems rather trite. Mastering adversity just might hold the monopoly on the "Aha" exclamation. A simple response from a child is the quintessential Aha!
Ivar Lovaas, sometimes referred to as the "father of behavioral analysis" created The Me Book in 1981. Discreet trials, followed by data gave parents information about their child's progress. Holding a stimulus (even candy) to their eye, a therapist would command "Look at me!" The bonanza.....the Aha! moment arrived when the child looked into the therapist's eyes, "Good look at me!" responded the therapist with great enthusiasm and heightened sound.
Safire takes notice of the "senior moment", the one that produces the Aha! when we remember. He introduces us to Guy McKhann, "a leader in the new field of neuroeducation, which ties together cognitive science, arts training and learning in the schoolroom, hypothesizes that “the brain is bringing more resources to the problem without any conscious direction from you . . . perhaps the brain adapts by recruiting other pathways to help solve the problem."
Perhaps those pathways are circuits for autistic children as well. This could be the start of something BIG! Aha!!!!
Autistic kids learn things differently
A new piece of research suggests that when it comes to learning new behaviours,
autistic kids rely more on their own internal sense of body
position rather than external cues, typically used by developing children.
The study conducted by researchers from Kennedy Krieger Institute and Johns Hopkins University School of Medicine showed that greater the kids relied on their internal sense of body position (proprioception), the greater was their impairment in social skills, motor skills, and imitation.
For their study, the researchers recruited 14 children with autism and 13 typically developing children, and examined the patterns of generalization as they learnt to use a novel tool.
They further examined how much the autistic kids relied on visual information to guide learning, and how much they relied on proprioceptive information to guide learning.
“These findings can lead to important advances in methods for treating autism. Applying the knowledge gained in the current study, targeted interventions can be developed that enhance visuo-motor associations in children with autism as they learn new skills,” Nature magazine quoted Dr. Stewart H. Mostofsky, a pediatric neurologist in the Department of Developmental Cognitive Neurology at the Kennedy Krieger Institute, as saying.
“If done early enough, this could help to improve development of motor, social and communicative skills in children with autism. Further, it could also improve their ability to understand social cues because the brain systems critical to forming internal models of behaviour that guide our actions are also critical to developing an understanding of the meaning of those actions,” he added.
The study adds to the evidence suggesting that autism may be associated with abnormalities in the brain.
“These findings not only demonstrate why children with autism have difficulty learning motor skills, but also provide real insight into why these children have difficulty learning to interact with the world around them,” said Dr. Reza Shadmehr, senior study author and Professor of Biomedical Engineering and Neuroscience at the John Hopkins University School of Medicine.
“If the way their brain is wired is not allowing them to rely as much as typically developing children on external visual cues to guide behaviour, they may have difficulty learning how to interact with other people and interpret the nature of other people’s actions,” Shadmehr added.
The study appears in the journal Nature Neuroscience.
Source
autistic kids rely more on their own internal sense of body
  Autistic kids learn new behaviours differently than others (Getty Images) |
The study conducted by researchers from Kennedy Krieger Institute and Johns Hopkins University School of Medicine showed that greater the kids relied on their internal sense of body position (proprioception), the greater was their impairment in social skills, motor skills, and imitation.
For their study, the researchers recruited 14 children with autism and 13 typically developing children, and examined the patterns of generalization as they learnt to use a novel tool.
They further examined how much the autistic kids relied on visual information to guide learning, and how much they relied on proprioceptive information to guide learning.
“These findings can lead to important advances in methods for treating autism. Applying the knowledge gained in the current study, targeted interventions can be developed that enhance visuo-motor associations in children with autism as they learn new skills,” Nature magazine quoted Dr. Stewart H. Mostofsky, a pediatric neurologist in the Department of Developmental Cognitive Neurology at the Kennedy Krieger Institute, as saying.
“If done early enough, this could help to improve development of motor, social and communicative skills in children with autism. Further, it could also improve their ability to understand social cues because the brain systems critical to forming internal models of behaviour that guide our actions are also critical to developing an understanding of the meaning of those actions,” he added.
The study adds to the evidence suggesting that autism may be associated with abnormalities in the brain.
“These findings not only demonstrate why children with autism have difficulty learning motor skills, but also provide real insight into why these children have difficulty learning to interact with the world around them,” said Dr. Reza Shadmehr, senior study author and Professor of Biomedical Engineering and Neuroscience at the John Hopkins University School of Medicine.
“If the way their brain is wired is not allowing them to rely as much as typically developing children on external visual cues to guide behaviour, they may have difficulty learning how to interact with other people and interpret the nature of other people’s actions,” Shadmehr added.
The study appears in the journal Nature Neuroscience.
Source
Single Gene Mutation Responsible For 'Catastrophic Epilepsy'
ScienceDaily (July 8, 2009) — Catastrophic epilepsy – characterized by severe muscle spasms, persistent seizures, mental retardation and sometimes autism – results from a mutation in a single gene, said Baylor College of Medicine researchers in a report that appears in the current issue of the Journal of Neuroscience.
The BCM department of neurology team replicated the defect in mice, developing a mouse model of the disease that could help researchers figure out effective treatments for and new approaches to curing the disease, said Dr. Jeffrey Noebels, professor of neurology, neuroscience and molecular and human genetics at BCM and director of the Blue Bird Circle Developmental Neurogenetics Laboratory at BCM, where the research was performed.
"While many genes underlying various forms of childhood epilepsy have been identified in the past decade, most cause a disorder of 'pure' seizures," said Noebels. Why some children have a more complicated set of disorders beginning with major motor spasms in infancy followed by cognitive dysfunction and developmental disorders such as autism remained a mystery until the discovery by the BCM team that a mutation in only a single gene explains all four features of catastrophic epilepsy.
A gene known as Aristaless-related homeobox or ARX has a specific mutation called a triplet repeat, which means that a particular genetic (in this case, GCG) is repeated many times in the gene. When the researchers duplicated this particular mutation in specially bred mice, the animals had motor spasm similar to those seen in human infants. Recordings of their brain waves showed that they had several kinds of seizes, included absence epilepsy and general convulsion. They also had learning disabilities and were four times more likely to avoid contact with other mice than their normal counterparts. This behavior is similar to that seen in children with autism or similar disorders in the same spectrum.
"The new model is an essential tool to find a cure for the disorder," said Noebels.
"Mutation of the ARX gene was previously known to affect interneurons, a class of cells that inhibit electrical activity in the brain," said Dr. Maureen Price, the report's lead author and an instructor in neurology at BCM.
When researchers evaluated the brains of the adult mice with the mutated gene, they found that a special class of interneurons had never developed in specific brain regions.
"Further study will allow use to pinpoint which brain region is liked to the autistic-like behavior," said Price.
Two members of the research team – Dr. James Frost, professor of neurology at BCM, who developed the concept of the special mouse, and Dr. Richard Hrachovy, also a professor of neurology at BCM – are pioneers in the study of human infantile spasms.
"At present there is no proven cure to offer children with this specific epilepsy", said Noebels. "We now have new clues into the mechanism and have already initiated studies with a new class of drugs not previously explored for this disorder." The new drug testing is supported by the private foundation People Against Childhood Epilepsy.
Others who took part in this work include Jong W. Yoo, Daniel L. Burgess and Fang Deng, all of BCM.
Funding for this work came from the Peter Kellaway Memorial Research Fund, the Blue Bird Circle Foundation, the National Institutes of Health Intellectual and Developmental Disabilities Research Center, and the PACE Foundation.
Autism and the new Celiac Disease Link
Kids of moms who have an autoimmune disease such as type 1 diabetes, rheumatoid arthritis and celiac disease have up to a three times greater risk for autism, according to a new study.
The first two have been linked in earlier research. But the surprise might be the last disorder, which is more commonly recognized as an intolerance to gluten. (Not “intolerance” as in: “I don’t want you in my club,” but as in “My body gets crampy and nasty and sick when I eat you.”)
Coincidentally, perhaps, there has been a four-fold increase in the incidence of celiac disease over the past 50 years.
Researcher William W. Eaton, chairman of the Department of Mental Health at the Bloomberg School of Public Health at Johns Hopkins University, said of the study,
This finding reinforces the suggestion that autoimmune processes are connected somehow with the cause of autism and autism spectrum disorder. This finding is on the pathway of finding the cause of autism.
There may be an overlap in the genetics of some of the autoimmune diseases and autism that would not be trivial. Autism is strongly inherited, but we don’t have the faintest idea where. But this may point a flashlight to areas of the genome that connect to autism.
He pointed out that these sensitivities might be factored in with environmental triggers.
- » See also: Mother Charged For Drunk Breastfeeding: Details Emerge, and the Case Makes Less Sense
- » Get Eco Child’s Play by RSS or sign up by email.
Indeed, recently we’ve brought you news on various environmental factors in ASD. Endocrine-disrupting chemicals in plastic may play a part. PVC has been linked to autism. And there has been a longstanding belief that thimerosol, a mercury-laden preservative in many vaccines, was a culprit. Mercury is a known neurotoxin.
And we also must notice the UC Davis M.I.N.D. study that discounted better detection as the rise in cases of ASD. The researchers there said that chemicals we are exposed to are strongly suspected and should be studied further.
Currently, genetics research is given much more funding than environmental research in the ASD field, approximately 10 to 20 times more.
In this case, data was collected on 3,325 Danish children diagnosed with ASD. Data on family members with autoimmune diseases came from the Danish National Hospital Register.
Eaton said that those diseases provided a link, but not a definitive cause.
The increased risk for type 1 diabetes is a little less than two times, for rheumatoid arthritis it’s about 1.5 times and for celiac disease it’s more than three times. That’s enough to impress an epidemiologist, but not enough to make anybody in the general population start changing their behavior.
Read more at Forbes.com.
Oh, Baby - Audrey Edmunds is rebuilding her life after her murder conviction was overturned
It was the fall of 1995, and Edmunds had the world at her feet. The striking blonde and her husband, Dave, were the proud parents of two little girls, Carrie and Allison, and were thrilled to be expecting their third in February. Edmunds felt fortunate she could stay home and care for her children in the family's new ranch home in Waunakee. During the week, the three went to the library for story hour, played in the park or frequented Waunakee's newest attraction, a McDonald's PlayPlace. Weekends often meant cookouts with the neighbors; Sunday mornings were reserved for services at Crossroads United Methodist Church.
Because she loved kids and wanted to help other neighborhood families, Edmunds started watching a few tots during the week. One of her new charges was six-month-old Natalie Beard, daughter of Waunakee residents Tom and Cindy Beard. From the start, Natalie was a difficult baby. "She fussed or cried all the time," recalls Edmunds' neighbor and friend, Patti Larson, who also babysat. "We'd go for walks together, and any time the stroller went over a sidewalk bump Natalie would cry. If there were any kind of noise, she'd startle. Audrey was constantly holding her and trying to soothe her and make her happy. But she never got frustrated with Natalie. In fact, it was the opposite. She'd say, 'Oh, this poor baby. I feel so bad for her.'"
Early in the morning of October 16, Edmunds and her girls got up and ate breakfast; they'd soon be walking Carrie to preschool with some of the neighbors. At 7:35 Cindy Beard dropped off Natalie, telling Edmunds the baby was irritable, that she'd been up twice the night before and had taken less than half her morning bottle. Natalie continued to fuss after Beard left, so Edmunds placed the baby in the master bedroom and propped the bottle of formula in her mouth, hoping the quiet room and bottle would calm her while she got the other kids ready.
During the next half hour Edmunds checked on Natalie once, and all was fine. But when she went to dress Natalie for the walk to preschool at 8:35, she quickly realized something was amiss. Natalie made some funny noises, says Edmunds, and was limp when she picked her up. Formula dribbled out of her nose and mouth, and then she became unresponsive. Fearing Natalie was choking, Edmunds sped out of the house and called to her neighbor for help. And that's when the nightmare began.
Coined in 1972, the term "Whiplash Shaken-Baby Syndrome" described children, typically under three years of age, who were violently shaken but often showed no visible signs of harm. Because their brains and neck muscles weren't fully developed, their internal injuries were severe--the typical "triad" included brain swelling and brain and retinal hemorrhaging, much like being in a serious car accident or falling several stories. The one positive, the theory went, was that a victim immediately becomes unresponsive, making it a snap to figure out who's guilty: the last person with the child. This was still the view held by most medical experts in October 1995, when Audrey Edmunds ran outside her house screaming, clutching an unresponsive infant.
After the ambulance and police arrived, Med Flight whisked away Natalie. Dave Edmunds, who had just arrived at his new job in the Twin Cities, turned around and drove back home. That afternoon the couple raced to UW Hospital to see how Natalie was doing. "I was so distraught, thinking about what had happened," recalls Edmunds, still assuming Natalie was a choking victim. "I kept thinking, 'Why did I leave her with a bottle?'" She had no idea of the storm clouds quietly gathering around her.
The physicians examining Natalie found a severe presentation of the classic Shaken Baby Syndrome symptoms. So when Natalie died that evening, Edmunds was immediately presumed guilty. The fact that Edmunds hadn't watched Natalie for the past four days and Natalie had only been in her care a mere hour before her tiny body shut down was irrelevant. Nor did it matter that Natalie had no outward signs of abuse, such as the rib fractures or bruised arms sometimes found on SBS victims. Or that much older hemorrhages were found inside her brain. Or that everyone who knew Edmunds loved her. Or that no one ever saw her abuse a child. All that mattered was Natalie had the classic SBS symptoms, and when she became unresponsive, Edmunds had her.
"There was no critical thinking about things that might have gone differently," says Stephen Hurley, her defense attorney and one of the most successful trial lawyers in Dane County. "It was complete tunnel vision."
During the investigation that followed, prosecutors would wave off information about Natalie's father, Tom, indicating he was a nervous dad who suffered from migraines and was often irritated by her incessant crying. Also dismissed was Natalie's health history, which included numerous ear infections--she was being treated for one the day she died--and dozens of calls and trips to the doctor. They even ignored the fact that Natalie's parents had taken her into the doctor for lethargy, irritability and vomiting, symptoms that can indicate brain injury, several days before her death.
Shelly Rusch, Dane County assistant district attorney, says there was no reason to consider any of those factors because the case was one of simple timing. (Rusch was not involved with the case in 1995, but worked on it recently.) "We prosecutors were lucky," she says. "Natalie's injuries were so serious, any person suffering from them would have been immediately symptomatic. It is what it is."
John Plunkett is a Minnesota pathologist who has questioned SBS for years. Initially, he was considered part of the lunatic fringe; now he's treated with growing deference. Plunkett first became interested in the subject around 1985, when a defense attorney asked him to look into the death of an eighteen-month-old girl. The girl's mom said she'd been standing on the arm of a sofa and fell, hitting her head on the floor. She was brought to the hospital with retinal hemorrhages, brain swelling and subdural hemorrhages. The State alleged the mother shook her. "I said, 'Well, couldn't this fall have caused the death?'" says Plunkett. "They said, 'We never see it, so short-distance falls don't cause serious injuries in kids.' I said, 'But how do we know that?' And they said, 'Because we never see it.' That's just a circular argument, so I started looking at Shaken Baby Syndrome and realized something was very wrong."
But back then, few people agreed. Although Plunkett and other interested experts began studying everything from shaking's biomechanical effects on an infant's head and neck to whether a baby could have a lucid interval between the time shaking occurred and the baby became unresponsive, the medical and scientific communities were still largely united ten years later, when Natalie died. So rather than prosecutors having the burden of proving Edmunds' guilt, in reality Edmunds' defense team had to prove her innocence. In 1995, that was nearly impossible.
"When I took on the case, I couldn't find any experts who thought [Natalie] wasn't shaken," Hurley says. Further complicating matters, the death of a young child causes intense emotions. Prosecutors feel driven to give voice to the innocent lamb, while the public is hell-bent on finding who's to blame.
Hurley found just one medical expert who could help. Like the prosecution's experts, Mary Dominski, a pediatric neurologist with Dean Health System, believed Natalie had been shaken. But Dominski was the only physician to consider relevant her medical history and extreme fussiness the previous day, leading her to conclude Natalie was moderately shaken before she arrived at the Edmunds home. Then, Dominski theorized, Natalie suffered a major seizure at daycare from the prior shaking, culminating in her death.
Lacking additional experts, numerous friends testified to Edmunds' stellar character: She had boatloads of patience. She loved kids. They never heard her utter an angry word. They dropped in unannounced all the time and never saw anything amiss. "Audrey has that personality people automatically gravitate toward," says good friend and former neighbor Shelley Murphy. "She'd do anything for anyone." Might Edmunds have been overwrought and momentarily lost it, shaking the ever-fussy Natalie? "I never, ever even considered she might have done it," says Murphy. "I understand she was the last person with the child, but anyone who knew her knew there was just no way."
Unfortunately for Edmunds, nearly everyone judging her had never met her.
The prosecution easily amassed eight medical experts. And while they weren't in total agreement regarding Natalie's injuries and how they combined to cause her death, all believed she was an SBS victim and Edmunds was the one who killed her.
Lead prosecutor Gretchen Hayward, now retired, pulled out all the stops during Edmunds' trial, painting her as an outwardly nice person with a violent, hidden side. "Gretchen said very dramatic things, like I slammed Natalie's head into a blunt object," recalls Edmunds, interviewed recently near her home in Minnesota. "But Natalie had no head trauma, no skull fracture. I simply found a choking baby! They also tried to implicate me by saying everyone has a dark side, that my friends didn't know the real me, that I was stressed out because I was pregnant and moving, even though I was happy about both events. They tried to create a scenario that just didn't exist."
Despite the overwhelming opinions against her, Edmunds appeared headed for acquittal, Hurley says. And then she took the stand.
"She looked like the proverbial doe caught in the headlights on cross-examination," Hurley remembers. "She kept looking at me when the jury asked a question, like I was coaching her. She fell apart."
But what average American on trial for murder wouldn't be more than a little rattled when grilled by a seasoned prosecutor, questions Dean Strang, who later served as Edmunds' appellate lawyer. Nevertheless, Edmunds' fate was sealed. On November 26, 1996, she was pronounced guilty of first-degree reckless homicide. Her children were just five, two and nine months.
"I wanted to burst into tears and scream," says Edmunds. "I couldn't imagine being put into prison. I'm still shocked about it." When Edmunds arrived home that night, her conviction was already being blared across the ten o'clock news. She curled up beside her sleeping five-year-old, Carrie, and began to sob.
In the mid to late nineties, most people prosecuted for SBS were charged with second-degree reckless homicide, says Strang. If they professed innocence and were convicted, it typically meant seven or eight years behind bars. But Edmunds' conviction meant the jury felt she treated Natalie with "utter disregard for human life." Dane County Circuit Judge Daniel Moeser handed down a shocking eighteen-year sentence, barring Edmunds from raising her own girls.
"The prosecution really pushed the edges here," says Strang.
It was Dane County's most notable SBS case to date, and Judge Moeser apparently wanted to make a statement.
And so it was that in February 1997, sixteen months after the nightmare began, Edmunds found herself climbing into a van full of female convicts on its way to Taycheedah Correctional Institution, a maximum-security prison in Fond du Lac, seventy miles northeast of Madison. Sitting among seasoned criminals, dressed alike in their drab green prison garb and clanking metal shackles, Edmunds was still numb. Yet she was confident her attorneys would secure her release post haste because, well, she was innocent.
"I never dreamed I'd be in prison eleven years," she says. "I never even thought I'd be in prison one year."
Hurley turned the case over to Strang to start the appeals process, and Edmunds began her new life as a prisoner: Sleeping on an uncomfortable iron bed in a tiny cell. Urinating out in the open in a tin toilet. Signing up to use the shower or phone but not always given permission. Lacking freedom to do the tiniest things, like turn on a light or grab a snack from the fridge. Doesn't sound bad at all if you've committed a heinous crime, but if you're wrongly convicted, it suddenly appears downright inhumane.
It was right around this time the Louise Woodward case hit the news. Woodward was a nineteen-year-old British nanny working for a Massachusetts couple with two boys. After one of their sons was taken to the hospital with skull and brain injuries from which he later died, Woodward was charged with shaking him to death. Although she pled not guilty, she was convicted. The highly publicized trial caused America's medical and forensic experts to start taking a hard look at the science behind SBS.
They examined whether retinal hemorrhages can be caused by something other than shaking. They studied whether a child with SBS-type injuries can experience an extended "lucid interval," or a period of hours or days after injury where the child appears normal before becoming noticeably impaired or unconscious. They began to wonder if it was possible to violently shake a baby and cause SBS's famed triad of injuries without leaving some kind of visible neck injury. They explored similar brain injuries and death caused by lesser forces than vigorous shaking, such as short, accidental falls, or even conditions like vitamin deficiencies or immunizations. Little by little, compelling research began emerging that babies with brain swelling, retinal hemorrhages and brain hemorrhages aren't slam-dunk cases of SBS. And one by one, experts began changing their minds.
Patrick Barnes was one. A well-respected pediatric neuroradiologist at Stanford University, Barnes was the prosecution's star medical witness in the Woodward case. Today, he regrets that testimony, noting something as mundane as an ear infection can spread to the brain with dire consequences. Unless there's evidence of an impact on a baby such as a fractured skull, Barnes says SBS is more myth than science.
Minnesota's Plunkett, who has extensively studied the biomechanics of shaking, says SBS is a myth, plain and simple.
"There isn't any Shaken Baby Syndrome," he argues. "To cause subdural and retinal hemorrhages by shaking, you'd have to shake a baby twenty to twenty-five times per second to achieve the required force, or load. The most that's humanely achievable in a ten-pound model is three to four cycles per second. It's a simple mathematical equation."
Case closed.
Except it's not that simple. It never is.
At some point, Edmunds realized she was in trouble. Perhaps it was after her first appeal by Strang failed in 1999. Or when the next two petitions for her release were denied. Maybe it was after her first mandatory parole hearing in 2001. Despite being a model prisoner with no behavioral problems, plus immense community support, her parole request was summarily dismissed because she was deemed unrepentant. And in denial.
"Audrey Edmunds loved children. I believe that," says assistant D.A. Rusch. "I believe she properly cared for almost every child she took care of. But sometimes when people do something horrible, they don't want to believe they did it. And after a period of time, they convince themselves they didn't."
Meanwhile, the years ticked by. And neither side found peace. The Beards, who didn't want to comment for this story, divorced. So did Dave and Audrey. For nearly five years, Dave Edmunds fought to keep his family together, raising their daughters with help from Edmunds' parents and faithfully making the grueling five-hour drive from the Twin Cities to Taycheedah every other weekend so everyone could be together. But when Edmunds was denied parole in 2001, Dave apparently couldn't take the strain anymore, Edmunds says, and threw in the towel. Edmunds' friends and relatives began bringing the girls to visit, but now only monthly.
"There were years of tears during the girls' visits," Edmunds says. "It never, ever got easier, and I never got used to it. But hope became my religion. Without hope, you're crushed."
Then, in 2003, Edmunds finally got a break.
The University of Wisconsin Law School's Wisconsin Innocence Project was founded in 1998 to aid prisoners with plausible claims of innocence. Part of the Innocence Network, an umbrella organization of several dozen Innocence Projects worldwide, Wisconsin's has helped secure the release of twelve people. Of the five hundred requests for assistance that pour in annually from across the nation, says co-director and clinical law professor Keith Findley, the group investigates thirty to forty. Priority goes to the strongest Wisconsin-based pleas.
Although the Innocence Project hadn't handled an SBS case before, Findley was interested in Edmunds' almost immediately.
"Her trial and appellate lawyers were convinced of her innocence," he says. "But even more significantly, there was new research which had led one of the State's witnesses against Audrey at the trial to conclude his testimony was in error. Once I heard that, I knew this was something we had to look at."
That witness was Robert Huntington III, the pathologist who performed Natalie's autopsy. Finding the classic SBS triad of injuries, he had testified it was "highly probable" Natalie was injured shortly before she became comatose at Edmunds' home. But Huntington's conviction began to fade just three years later, after he performed an autopsy on another infant with injuries similar to Natalie's. When she was brought to UW Hospital, this girl was described as fussy and clingy, but interactive and responsive, much as Natalie had been in the week before her death. Yet it took trained hospital personnel more than fifteen hours to detect signs of brain injury. To Huntington, the elapsed timeframe between the girl's initial symptoms and eventual collapse now meant it was certainly possible Natalie was injured well before she reached Edmunds' home.
The Innocence Project prepared a motion for a new trial, based on new medical evidence and the current turmoil about SBS among experts. (Physicians generally favor the old science, while forensic pathologists typically side with the new.) But after an evidentiary hearing in 2007, including testimony on Edmunds' behalf by Huntington (as well as five other doctors), Judge Moeser denied the motion. The Innocence Project appealed the decision, and in January 2008 the District 4 Court of Appeals overturned her 1996 jury conviction, ruling Edmunds was eligible for a new trial. In the meantime, she was free.
Ten years and 352 days after Edmunds was led from the City-County Building in shackles (not that she was counting), she was released into the blustery grip of an early February snowstorm and her girlfriends' embrace. The State eventually declined to retry Edmunds and, at last, it was over.
At the time of her release, Edmunds' daughters were sixteen, thirteen and eleven. Natalie would have been twelve. The Beards had both remarried, but neither had other children. Edmunds moved to Minnesota to be near her children, taking a job at a Kwik-Trip and moving in with a friend.
She longs for a place of her own to share with her daughters. But that will have to wait until her finances improve. Although the State dismissed all charges against Edmunds, she isn't eligible for any compensation for wrongful imprisonment.
"I see the struggles she's having and it just upsets me so much," says Edmunds' friend Larson. "Things are certainly better than a year or two ago--she's out of prison. But I'm frustrated she still has all these other things to deal with."
Edmunds is determined not to be bitter. She knows there's no way to reclaim her girls' childhoods, so she's focusing on the present and the future. But she hopes her case draws attention to the new SBS medical findings and helps others in her predicament.
"This was never about me," she says. "There's some bigger purpose to all of this. I just hope it hasn't scarred my girls' lives."
Defense attorney Hurley isn't quite as forgiving. For starters, he's angry with physicians. "This case is all about the arrogance of doctors," he says. "Physicians are asked their opinion, and rather than surveying the data and saying there's uncertain science, they divide into camps that say these symptoms mean X or these symptoms mean Y. They think they're correct and there's no way they can be wrong."
Hurley's also frustrated with the prosecution's blind faith in the legal process. "Half of the medical profession doesn't believe what was said in court ten years ago, yet … the prosecution is unwilling to admit a person spent eleven years behind bars because they were wrong."
Rusch isn't the happiest camper, either. Still convinced Edmunds shook Natalie to death, she says the new science merely confirms the prosecution's initial theory. "Babies just don't die and have all of this bleeding in their head," she says, noting that while the new research now shows retinal hemorrhages, brain swelling and brain hemorrhages can each occur for reasons other than shaking, there have been no documented cases of the triad occurring together unless a baby was shaken.
Wrong, says Findley. "There are indeed numerous documented cases of retinal hemorrhages, brain swelling and subdural hematomas coinciding in cases where there was no shaking. In fact, there are no adequately documented cases in which shaking alone caused that triad of signs; it is only a theory, unproven. Unfortunately, this is another one of those cases in which prosecutors cling to discredited theories of guilt, despite the new evidence."
Tit, tat.
Despite Edmunds' release, the prosecution is satisfied she served most of her term (her mandatory release was just one year away). Still, Rusch says, "All the parents wanted was for Audrey to say she was sorry."
And all Team Edmunds wants is for the prosecution to apologize. "They just did not want to admit they were wrong, especially Judge Moeser," says Larson. "There's more information now, so just admit it. But there was no apology, no nothing. It's so frustrating. And it makes me wonder how many people are in prison who shouldn't be."
Which is precisely where the focus is shifting. Courts in the United Kingdom, Australia and Canada are re-opening old SBS cases; numerous have been reversed. While U.S. courts aren't at that point yet, Findley says American juries are starting to refuse to convict SBS defendants in light of the new medical research. Even more striking, the Kentucky Supreme Court is currently reviewing whether to conduct a discretionary hearing on an SBS case where a lower court judge granted a defense motion to prevent prosecutors from informing the jury the deceased infant had bleeding on the brain and retinal hemorrhaging because there were no outer signs of abuse. As of press time, the court had not ruled.
"Things are happening slowly, but I think this new understanding will filter into the U.S., and Audrey's case was one step in that direction," says Findley, who was inundated with requests for SBS assistance following Edmunds' release.
No matter what side of the issue experts are on, all agree on one thing: The term "Shaken Baby Syndrome" should no longer be used. Inflicted Traumatic Brain Injury or Abusive Head Trauma are now favored, says Rusch, because the term SBS suggests a manner of death. "But no two babies are killed the exact same way," she says. "ITBI or AHT move away from saying you know exactly what happened, because you don't unless you witnessed it."
Exactly Audrey Edmunds' point.
Melanie Radzicki McManus is a contributing writer for Madison Magazine.
Source
Because she loved kids and wanted to help other neighborhood families, Edmunds started watching a few tots during the week. One of her new charges was six-month-old Natalie Beard, daughter of Waunakee residents Tom and Cindy Beard. From the start, Natalie was a difficult baby. "She fussed or cried all the time," recalls Edmunds' neighbor and friend, Patti Larson, who also babysat. "We'd go for walks together, and any time the stroller went over a sidewalk bump Natalie would cry. If there were any kind of noise, she'd startle. Audrey was constantly holding her and trying to soothe her and make her happy. But she never got frustrated with Natalie. In fact, it was the opposite. She'd say, 'Oh, this poor baby. I feel so bad for her.'"
Early in the morning of October 16, Edmunds and her girls got up and ate breakfast; they'd soon be walking Carrie to preschool with some of the neighbors. At 7:35 Cindy Beard dropped off Natalie, telling Edmunds the baby was irritable, that she'd been up twice the night before and had taken less than half her morning bottle. Natalie continued to fuss after Beard left, so Edmunds placed the baby in the master bedroom and propped the bottle of formula in her mouth, hoping the quiet room and bottle would calm her while she got the other kids ready.
During the next half hour Edmunds checked on Natalie once, and all was fine. But when she went to dress Natalie for the walk to preschool at 8:35, she quickly realized something was amiss. Natalie made some funny noises, says Edmunds, and was limp when she picked her up. Formula dribbled out of her nose and mouth, and then she became unresponsive. Fearing Natalie was choking, Edmunds sped out of the house and called to her neighbor for help. And that's when the nightmare began.
* * *
Coined in 1972, the term "Whiplash Shaken-Baby Syndrome" described children, typically under three years of age, who were violently shaken but often showed no visible signs of harm. Because their brains and neck muscles weren't fully developed, their internal injuries were severe--the typical "triad" included brain swelling and brain and retinal hemorrhaging, much like being in a serious car accident or falling several stories. The one positive, the theory went, was that a victim immediately becomes unresponsive, making it a snap to figure out who's guilty: the last person with the child. This was still the view held by most medical experts in October 1995, when Audrey Edmunds ran outside her house screaming, clutching an unresponsive infant.
* * *
After the ambulance and police arrived, Med Flight whisked away Natalie. Dave Edmunds, who had just arrived at his new job in the Twin Cities, turned around and drove back home. That afternoon the couple raced to UW Hospital to see how Natalie was doing. "I was so distraught, thinking about what had happened," recalls Edmunds, still assuming Natalie was a choking victim. "I kept thinking, 'Why did I leave her with a bottle?'" She had no idea of the storm clouds quietly gathering around her.
The physicians examining Natalie found a severe presentation of the classic Shaken Baby Syndrome symptoms. So when Natalie died that evening, Edmunds was immediately presumed guilty. The fact that Edmunds hadn't watched Natalie for the past four days and Natalie had only been in her care a mere hour before her tiny body shut down was irrelevant. Nor did it matter that Natalie had no outward signs of abuse, such as the rib fractures or bruised arms sometimes found on SBS victims. Or that much older hemorrhages were found inside her brain. Or that everyone who knew Edmunds loved her. Or that no one ever saw her abuse a child. All that mattered was Natalie had the classic SBS symptoms, and when she became unresponsive, Edmunds had her.
"There was no critical thinking about things that might have gone differently," says Stephen Hurley, her defense attorney and one of the most successful trial lawyers in Dane County. "It was complete tunnel vision."
During the investigation that followed, prosecutors would wave off information about Natalie's father, Tom, indicating he was a nervous dad who suffered from migraines and was often irritated by her incessant crying. Also dismissed was Natalie's health history, which included numerous ear infections--she was being treated for one the day she died--and dozens of calls and trips to the doctor. They even ignored the fact that Natalie's parents had taken her into the doctor for lethargy, irritability and vomiting, symptoms that can indicate brain injury, several days before her death.
Shelly Rusch, Dane County assistant district attorney, says there was no reason to consider any of those factors because the case was one of simple timing. (Rusch was not involved with the case in 1995, but worked on it recently.) "We prosecutors were lucky," she says. "Natalie's injuries were so serious, any person suffering from them would have been immediately symptomatic. It is what it is."
* * *
John Plunkett is a Minnesota pathologist who has questioned SBS for years. Initially, he was considered part of the lunatic fringe; now he's treated with growing deference. Plunkett first became interested in the subject around 1985, when a defense attorney asked him to look into the death of an eighteen-month-old girl. The girl's mom said she'd been standing on the arm of a sofa and fell, hitting her head on the floor. She was brought to the hospital with retinal hemorrhages, brain swelling and subdural hemorrhages. The State alleged the mother shook her. "I said, 'Well, couldn't this fall have caused the death?'" says Plunkett. "They said, 'We never see it, so short-distance falls don't cause serious injuries in kids.' I said, 'But how do we know that?' And they said, 'Because we never see it.' That's just a circular argument, so I started looking at Shaken Baby Syndrome and realized something was very wrong."
But back then, few people agreed. Although Plunkett and other interested experts began studying everything from shaking's biomechanical effects on an infant's head and neck to whether a baby could have a lucid interval between the time shaking occurred and the baby became unresponsive, the medical and scientific communities were still largely united ten years later, when Natalie died. So rather than prosecutors having the burden of proving Edmunds' guilt, in reality Edmunds' defense team had to prove her innocence. In 1995, that was nearly impossible.
"When I took on the case, I couldn't find any experts who thought [Natalie] wasn't shaken," Hurley says. Further complicating matters, the death of a young child causes intense emotions. Prosecutors feel driven to give voice to the innocent lamb, while the public is hell-bent on finding who's to blame.
Hurley found just one medical expert who could help. Like the prosecution's experts, Mary Dominski, a pediatric neurologist with Dean Health System, believed Natalie had been shaken. But Dominski was the only physician to consider relevant her medical history and extreme fussiness the previous day, leading her to conclude Natalie was moderately shaken before she arrived at the Edmunds home. Then, Dominski theorized, Natalie suffered a major seizure at daycare from the prior shaking, culminating in her death.
Lacking additional experts, numerous friends testified to Edmunds' stellar character: She had boatloads of patience. She loved kids. They never heard her utter an angry word. They dropped in unannounced all the time and never saw anything amiss. "Audrey has that personality people automatically gravitate toward," says good friend and former neighbor Shelley Murphy. "She'd do anything for anyone." Might Edmunds have been overwrought and momentarily lost it, shaking the ever-fussy Natalie? "I never, ever even considered she might have done it," says Murphy. "I understand she was the last person with the child, but anyone who knew her knew there was just no way."
Unfortunately for Edmunds, nearly everyone judging her had never met her.
* * *
The prosecution easily amassed eight medical experts. And while they weren't in total agreement regarding Natalie's injuries and how they combined to cause her death, all believed she was an SBS victim and Edmunds was the one who killed her.
Lead prosecutor Gretchen Hayward, now retired, pulled out all the stops during Edmunds' trial, painting her as an outwardly nice person with a violent, hidden side. "Gretchen said very dramatic things, like I slammed Natalie's head into a blunt object," recalls Edmunds, interviewed recently near her home in Minnesota. "But Natalie had no head trauma, no skull fracture. I simply found a choking baby! They also tried to implicate me by saying everyone has a dark side, that my friends didn't know the real me, that I was stressed out because I was pregnant and moving, even though I was happy about both events. They tried to create a scenario that just didn't exist."
Despite the overwhelming opinions against her, Edmunds appeared headed for acquittal, Hurley says. And then she took the stand.
"She looked like the proverbial doe caught in the headlights on cross-examination," Hurley remembers. "She kept looking at me when the jury asked a question, like I was coaching her. She fell apart."
But what average American on trial for murder wouldn't be more than a little rattled when grilled by a seasoned prosecutor, questions Dean Strang, who later served as Edmunds' appellate lawyer. Nevertheless, Edmunds' fate was sealed. On November 26, 1996, she was pronounced guilty of first-degree reckless homicide. Her children were just five, two and nine months.
"I wanted to burst into tears and scream," says Edmunds. "I couldn't imagine being put into prison. I'm still shocked about it." When Edmunds arrived home that night, her conviction was already being blared across the ten o'clock news. She curled up beside her sleeping five-year-old, Carrie, and began to sob.
* * *
In the mid to late nineties, most people prosecuted for SBS were charged with second-degree reckless homicide, says Strang. If they professed innocence and were convicted, it typically meant seven or eight years behind bars. But Edmunds' conviction meant the jury felt she treated Natalie with "utter disregard for human life." Dane County Circuit Judge Daniel Moeser handed down a shocking eighteen-year sentence, barring Edmunds from raising her own girls.
"The prosecution really pushed the edges here," says Strang.
It was Dane County's most notable SBS case to date, and Judge Moeser apparently wanted to make a statement.
And so it was that in February 1997, sixteen months after the nightmare began, Edmunds found herself climbing into a van full of female convicts on its way to Taycheedah Correctional Institution, a maximum-security prison in Fond du Lac, seventy miles northeast of Madison. Sitting among seasoned criminals, dressed alike in their drab green prison garb and clanking metal shackles, Edmunds was still numb. Yet she was confident her attorneys would secure her release post haste because, well, she was innocent.
"I never dreamed I'd be in prison eleven years," she says. "I never even thought I'd be in prison one year."
* * *
Hurley turned the case over to Strang to start the appeals process, and Edmunds began her new life as a prisoner: Sleeping on an uncomfortable iron bed in a tiny cell. Urinating out in the open in a tin toilet. Signing up to use the shower or phone but not always given permission. Lacking freedom to do the tiniest things, like turn on a light or grab a snack from the fridge. Doesn't sound bad at all if you've committed a heinous crime, but if you're wrongly convicted, it suddenly appears downright inhumane.
* * *
It was right around this time the Louise Woodward case hit the news. Woodward was a nineteen-year-old British nanny working for a Massachusetts couple with two boys. After one of their sons was taken to the hospital with skull and brain injuries from which he later died, Woodward was charged with shaking him to death. Although she pled not guilty, she was convicted. The highly publicized trial caused America's medical and forensic experts to start taking a hard look at the science behind SBS.
They examined whether retinal hemorrhages can be caused by something other than shaking. They studied whether a child with SBS-type injuries can experience an extended "lucid interval," or a period of hours or days after injury where the child appears normal before becoming noticeably impaired or unconscious. They began to wonder if it was possible to violently shake a baby and cause SBS's famed triad of injuries without leaving some kind of visible neck injury. They explored similar brain injuries and death caused by lesser forces than vigorous shaking, such as short, accidental falls, or even conditions like vitamin deficiencies or immunizations. Little by little, compelling research began emerging that babies with brain swelling, retinal hemorrhages and brain hemorrhages aren't slam-dunk cases of SBS. And one by one, experts began changing their minds.
Patrick Barnes was one. A well-respected pediatric neuroradiologist at Stanford University, Barnes was the prosecution's star medical witness in the Woodward case. Today, he regrets that testimony, noting something as mundane as an ear infection can spread to the brain with dire consequences. Unless there's evidence of an impact on a baby such as a fractured skull, Barnes says SBS is more myth than science.
Minnesota's Plunkett, who has extensively studied the biomechanics of shaking, says SBS is a myth, plain and simple.
"There isn't any Shaken Baby Syndrome," he argues. "To cause subdural and retinal hemorrhages by shaking, you'd have to shake a baby twenty to twenty-five times per second to achieve the required force, or load. The most that's humanely achievable in a ten-pound model is three to four cycles per second. It's a simple mathematical equation."
Case closed.
Except it's not that simple. It never is.
* * *
At some point, Edmunds realized she was in trouble. Perhaps it was after her first appeal by Strang failed in 1999. Or when the next two petitions for her release were denied. Maybe it was after her first mandatory parole hearing in 2001. Despite being a model prisoner with no behavioral problems, plus immense community support, her parole request was summarily dismissed because she was deemed unrepentant. And in denial.
"Audrey Edmunds loved children. I believe that," says assistant D.A. Rusch. "I believe she properly cared for almost every child she took care of. But sometimes when people do something horrible, they don't want to believe they did it. And after a period of time, they convince themselves they didn't."
Meanwhile, the years ticked by. And neither side found peace. The Beards, who didn't want to comment for this story, divorced. So did Dave and Audrey. For nearly five years, Dave Edmunds fought to keep his family together, raising their daughters with help from Edmunds' parents and faithfully making the grueling five-hour drive from the Twin Cities to Taycheedah every other weekend so everyone could be together. But when Edmunds was denied parole in 2001, Dave apparently couldn't take the strain anymore, Edmunds says, and threw in the towel. Edmunds' friends and relatives began bringing the girls to visit, but now only monthly.
"There were years of tears during the girls' visits," Edmunds says. "It never, ever got easier, and I never got used to it. But hope became my religion. Without hope, you're crushed."
Then, in 2003, Edmunds finally got a break.
The University of Wisconsin Law School's Wisconsin Innocence Project was founded in 1998 to aid prisoners with plausible claims of innocence. Part of the Innocence Network, an umbrella organization of several dozen Innocence Projects worldwide, Wisconsin's has helped secure the release of twelve people. Of the five hundred requests for assistance that pour in annually from across the nation, says co-director and clinical law professor Keith Findley, the group investigates thirty to forty. Priority goes to the strongest Wisconsin-based pleas.
Although the Innocence Project hadn't handled an SBS case before, Findley was interested in Edmunds' almost immediately.
"Her trial and appellate lawyers were convinced of her innocence," he says. "But even more significantly, there was new research which had led one of the State's witnesses against Audrey at the trial to conclude his testimony was in error. Once I heard that, I knew this was something we had to look at."
That witness was Robert Huntington III, the pathologist who performed Natalie's autopsy. Finding the classic SBS triad of injuries, he had testified it was "highly probable" Natalie was injured shortly before she became comatose at Edmunds' home. But Huntington's conviction began to fade just three years later, after he performed an autopsy on another infant with injuries similar to Natalie's. When she was brought to UW Hospital, this girl was described as fussy and clingy, but interactive and responsive, much as Natalie had been in the week before her death. Yet it took trained hospital personnel more than fifteen hours to detect signs of brain injury. To Huntington, the elapsed timeframe between the girl's initial symptoms and eventual collapse now meant it was certainly possible Natalie was injured well before she reached Edmunds' home.
The Innocence Project prepared a motion for a new trial, based on new medical evidence and the current turmoil about SBS among experts. (Physicians generally favor the old science, while forensic pathologists typically side with the new.) But after an evidentiary hearing in 2007, including testimony on Edmunds' behalf by Huntington (as well as five other doctors), Judge Moeser denied the motion. The Innocence Project appealed the decision, and in January 2008 the District 4 Court of Appeals overturned her 1996 jury conviction, ruling Edmunds was eligible for a new trial. In the meantime, she was free.
Ten years and 352 days after Edmunds was led from the City-County Building in shackles (not that she was counting), she was released into the blustery grip of an early February snowstorm and her girlfriends' embrace. The State eventually declined to retry Edmunds and, at last, it was over.
* * *
At the time of her release, Edmunds' daughters were sixteen, thirteen and eleven. Natalie would have been twelve. The Beards had both remarried, but neither had other children. Edmunds moved to Minnesota to be near her children, taking a job at a Kwik-Trip and moving in with a friend.
She longs for a place of her own to share with her daughters. But that will have to wait until her finances improve. Although the State dismissed all charges against Edmunds, she isn't eligible for any compensation for wrongful imprisonment.
"I see the struggles she's having and it just upsets me so much," says Edmunds' friend Larson. "Things are certainly better than a year or two ago--she's out of prison. But I'm frustrated she still has all these other things to deal with."
Edmunds is determined not to be bitter. She knows there's no way to reclaim her girls' childhoods, so she's focusing on the present and the future. But she hopes her case draws attention to the new SBS medical findings and helps others in her predicament.
"This was never about me," she says. "There's some bigger purpose to all of this. I just hope it hasn't scarred my girls' lives."
Defense attorney Hurley isn't quite as forgiving. For starters, he's angry with physicians. "This case is all about the arrogance of doctors," he says. "Physicians are asked their opinion, and rather than surveying the data and saying there's uncertain science, they divide into camps that say these symptoms mean X or these symptoms mean Y. They think they're correct and there's no way they can be wrong."
Hurley's also frustrated with the prosecution's blind faith in the legal process. "Half of the medical profession doesn't believe what was said in court ten years ago, yet … the prosecution is unwilling to admit a person spent eleven years behind bars because they were wrong."
Rusch isn't the happiest camper, either. Still convinced Edmunds shook Natalie to death, she says the new science merely confirms the prosecution's initial theory. "Babies just don't die and have all of this bleeding in their head," she says, noting that while the new research now shows retinal hemorrhages, brain swelling and brain hemorrhages can each occur for reasons other than shaking, there have been no documented cases of the triad occurring together unless a baby was shaken.
Wrong, says Findley. "There are indeed numerous documented cases of retinal hemorrhages, brain swelling and subdural hematomas coinciding in cases where there was no shaking. In fact, there are no adequately documented cases in which shaking alone caused that triad of signs; it is only a theory, unproven. Unfortunately, this is another one of those cases in which prosecutors cling to discredited theories of guilt, despite the new evidence."
Tit, tat.
* * *
Despite Edmunds' release, the prosecution is satisfied she served most of her term (her mandatory release was just one year away). Still, Rusch says, "All the parents wanted was for Audrey to say she was sorry."
And all Team Edmunds wants is for the prosecution to apologize. "They just did not want to admit they were wrong, especially Judge Moeser," says Larson. "There's more information now, so just admit it. But there was no apology, no nothing. It's so frustrating. And it makes me wonder how many people are in prison who shouldn't be."
Which is precisely where the focus is shifting. Courts in the United Kingdom, Australia and Canada are re-opening old SBS cases; numerous have been reversed. While U.S. courts aren't at that point yet, Findley says American juries are starting to refuse to convict SBS defendants in light of the new medical research. Even more striking, the Kentucky Supreme Court is currently reviewing whether to conduct a discretionary hearing on an SBS case where a lower court judge granted a defense motion to prevent prosecutors from informing the jury the deceased infant had bleeding on the brain and retinal hemorrhaging because there were no outer signs of abuse. As of press time, the court had not ruled.
"Things are happening slowly, but I think this new understanding will filter into the U.S., and Audrey's case was one step in that direction," says Findley, who was inundated with requests for SBS assistance following Edmunds' release.
* * *
No matter what side of the issue experts are on, all agree on one thing: The term "Shaken Baby Syndrome" should no longer be used. Inflicted Traumatic Brain Injury or Abusive Head Trauma are now favored, says Rusch, because the term SBS suggests a manner of death. "But no two babies are killed the exact same way," she says. "ITBI or AHT move away from saying you know exactly what happened, because you don't unless you witnessed it."
Exactly Audrey Edmunds' point.
Melanie Radzicki McManus is a contributing writer for Madison Magazine.
Source
Health-care reform should include child abuse prevention
Even the most seasoned prosecutors are haunted by cases involving abused and neglected children. By the time those cases make it to court, the damage to innocent children is done and their lives are irrevocably changed.
While the majority of children who are abused go on to live normal lives and don’t abuse their own kids, the survivors of abuse and neglect will face significant hurdles for the rest of their lives. They are more likely to struggle in school, more likely to be unemployed, and more likely to abuse drugs and alcohol. Victims of abuse are also more likely to grow up to be adults who act violently, become abusers, and commit crimes.
In 2008, there were 41,125 officially confirmed cases of child abuse and neglect in Massachusetts-more than enough to fill Fenway Park. Nationally, more than 1,700 children die from abuse and neglect each year. Child abuse is one of the leading causes of death for children age four and under.
There are, however, solutions available that not only reduce abuse and neglect, but also have substantial health improvement outcomes and cut future crime.
As Congress tackles the issue of health-care reform, Senator John Kerry and his Senate Finance Committee colleagues can take tremendous steps to reduce child abuse and neglect by including President Obama’s proposal for new federal funding for evidence-based home visiting programs in any reform package.
Voluntary home-visiting programs provide trained professionals to work with at-risk, first-time expectant mothers and new parents to help them learn about children’s health and nutrition and avoid abusive behavior.
Long-term analysis of one program that provides intensive home visiting for at-risk new moms was shown to cut abuse and neglect in half, to cut the future arrests of kids by 60 percent, and to save more than $18,000 for every high-risk family they serve. It’s the very definition of a high-yield investment.
Right here in Massachusetts, home visiting is making a significant difference. The Healthy Families program, funded by Children’s Trust Fund, has been shown to reduce reports of child abuse among young mothers by 66 percent while increasing the rate of young mothers who complete high school, compared to similar populations in other states. Moreover, Healthy Families infants are on track developmentally despite research that shows children of young mothers to lag behind.
In the coming days, Senator John Kerry and members of the Senate Finance Committee will be deciding on which initiatives should be part of the larger health-reform bill. It’s my hope, and the hope of law enforcement leaders across our Commonwealth, that Congress will make home-visiting a part of any health care legislation.
By doing so, it will be a preemptive strike against child abuse and neglect, safeguarding our communities and protecting those children who cannot protect themselves.
Daniel F. Conley is the District Attorney for Suffolk County.
Source
While the majority of children who are abused go on to live normal lives and don’t abuse their own kids, the survivors of abuse and neglect will face significant hurdles for the rest of their lives. They are more likely to struggle in school, more likely to be unemployed, and more likely to abuse drugs and alcohol. Victims of abuse are also more likely to grow up to be adults who act violently, become abusers, and commit crimes.
In 2008, there were 41,125 officially confirmed cases of child abuse and neglect in Massachusetts-more than enough to fill Fenway Park. Nationally, more than 1,700 children die from abuse and neglect each year. Child abuse is one of the leading causes of death for children age four and under.
There are, however, solutions available that not only reduce abuse and neglect, but also have substantial health improvement outcomes and cut future crime.
As Congress tackles the issue of health-care reform, Senator John Kerry and his Senate Finance Committee colleagues can take tremendous steps to reduce child abuse and neglect by including President Obama’s proposal for new federal funding for evidence-based home visiting programs in any reform package.
Voluntary home-visiting programs provide trained professionals to work with at-risk, first-time expectant mothers and new parents to help them learn about children’s health and nutrition and avoid abusive behavior.
Long-term analysis of one program that provides intensive home visiting for at-risk new moms was shown to cut abuse and neglect in half, to cut the future arrests of kids by 60 percent, and to save more than $18,000 for every high-risk family they serve. It’s the very definition of a high-yield investment.
Right here in Massachusetts, home visiting is making a significant difference. The Healthy Families program, funded by Children’s Trust Fund, has been shown to reduce reports of child abuse among young mothers by 66 percent while increasing the rate of young mothers who complete high school, compared to similar populations in other states. Moreover, Healthy Families infants are on track developmentally despite research that shows children of young mothers to lag behind.
In the coming days, Senator John Kerry and members of the Senate Finance Committee will be deciding on which initiatives should be part of the larger health-reform bill. It’s my hope, and the hope of law enforcement leaders across our Commonwealth, that Congress will make home-visiting a part of any health care legislation.
By doing so, it will be a preemptive strike against child abuse and neglect, safeguarding our communities and protecting those children who cannot protect themselves.
Daniel F. Conley is the District Attorney for Suffolk County.
Source
Citizen Review Panels forming for PA Child Welfare Systems
Pennsylvania is preparing to implement the first phase of Citizen Review Panels. Citizen Review Panels provide opportunities for members of the community to take an active role in protecting children from abuse and neglect.
Children who have been abused or neglected will often live out the remainder of their lives with physical, cognitive and/or emotional disabilities. If they do not enter the child welfare system, they will likely at some time require government subsidized health care, special education services, personal care assistance and vocational rehabilitation services. Parents of children with special needs and all concerned citizens are being invited to have a voice in reviewing the Child Welfare Systems across the Commonwealth.
On November 9, 2006, House Bill 2670 was signed into law as Act 146 by Governor Edward G. Rendell. Act 146 of 2006 provided Pennsylvania with the necessary statutory requirements for full compliance with the Federal Child Abuse Prevention and Treatment Act (CAPTA). The Department of Public Welfare (the Department) has embraced the requirement to establish citizen review panels by reconvening the CAPTA Workgroup to assist with implementing the Citizen Review Panels. Consisting of volunteers from a variety of backgrounds and specialties, the CAPTA Workgroup assisted with drafting statutory language that became Act 146.
The mission of the workgroup is to facilitate citizen participation and provide opportunities for citizens to evaluate state and local child welfare systems to ensure that these systems:
Ø Provide the best possible services ;
Ø Prevent and protect children from abuse and neglect; and
Ø Meet the permanency needs of children.
The vision is that, as a result, Pennsylvania children will have the opportunity to develop to their full potential living in nurturing, safe, healthy, permanent families.
Eight Citizen Review Panels will be established across the Commonwealth. The first phase will consist of a total of three panels in the north west, south central and north east regions of Pennsylvania. The panels are required to meet at least quarterly and provide annual recommendations to the Department regarding the continuous improvement of child welfare services in Pennsylvania.
Citizen Review Panels are composed of volunteer members, including individuals with expertise and interest in the prevention and treatment of child abuse and neglect. Citizen Review Panels evaluate practices as well as policies and procedures, develop a means for public outreach, and prepare an annual report highlighting panel activities and recommendations to improve child welfare services.
For more information on Citizen Review Panels or to apply to be a panel member please visit the Pennsylvania Child Welfare Training Program’s website at www.pacwcbt.pitt.edu/CAPTA.htm or contact Christine Reese at 717-795-9048. You can also send any questions via email to pacrp@pitt.edu.
Administration for Children & Families
http://www.acf.hhs.gov/programs/cb/laws_policies/policy/pi/pi9909.htm
Department of Public Welfare
http://www.dpw.state.pa.us
National Citizen Review Panel Virtual Community
http://www.uky.edu/SocialWork/crp/resources.htm
National Citizen Review Panel Directory
http://www.uky.edu/SocialWork/crp/files/NationalDirectory.pdf
National Resource Center for Child Protective Services
http://www.nrccps.org/citizen_review_panels/citizen_review_panels.php
Prosecution rests case in Oregon City faith healing trial
Prosecutors in the Raylene and Carl Brent Worthington trial rested their case this afternoon after calling the last of three pediatricians who offered opinions about the medical conditions that caused the death of the couple's daughter.
The doctors, and the deputy medical examiner who conducted 15-month-old Ava Worthington's autopsy, generally agreed that the girl suffered from malnutrition, breathing difficulties and a weakened immune system.
She had a cyst that blocked her trachea and esophagus and she failed to grow or gain weight.
Although she started out a large newborn, her height and weight did not progress normally. When she died on March 2, 2008, her development was consistent with a four-month-old.
The Worthingtons, who believe in faith healing rather than secular medicine, are charged in Clackamas County Circuit Court with second-degree manslaughter and criminal mistreatment for failing to seek medical care for their daughter.
Their attorneys will rely on an Oregon City pediatrician and on an expert witness, Dr. Janice Ophoven, to counter the medical testimony. Ophoven, a pediatric forensic pathologist from Minnesota, regularly testifies in cases involving a child's abuse or death.
Last week she testified in the case of a South Dakota day-care center owner who was accused of causing severe head trauma to six-month-old boy. Ophoven was the only defense witness and the defendant was acquitted.
The Worthington's attorneys also will have to deal statements the Worthingtons made to investigators less than 48 hours after Ava died in March 2008.
The Worthingtons said they did not use doctors and would not have sought medical care for the girl. Instead, they relied on spiritual treatment including prayer, the laying on of hands and anointing with oil.
Several members of the Worthington's Oregon City church, the Followers of Christ, are expected testify. The witnesses include family members and possibly the Worthingtons.
Defense attorneys said that those who saw Ava during the last few days of her life believe she was getting better and that in the hours before she died, she was active, playful and happy. The defense also claimed that prosecution's medical witnesses were not provided police interviews with the parents and other eyewitness accounts that would have reflected the girl's condition.
Dr. Dan Leonhardt testified this morning that Ava Worthington was the victim of "long-standing medical neglect,"
Leonhardt, a pediatrician and child abuse expert at Legacy Emanuel Hospital & Health Center, said Ava started life as a large and sturdy baby but when she died 15 months later her weight and height was so far off the growth chart that "there isn't even a line for it."
Risk of child abuse rises in potty training
Chavira Brown isn't the only child to have died because of a dirty diaper.
Potty training — one of the most frustrating events in the lives of parents and children — has been linked to many serious cases of child abuse, including the death of the 18-month-old Wichita girl whose caretaker was found guilty of first-degree murder Monday.
According to the American Academy of Pediatrics, more child abuse occurs during potty training than any other developmental milestone.
"Those frustrating times in a child's development can be triggers, and we need to really... be aware of that as a community," said Vicky Roper, director of Prevent Child Abuse Kansas at the Kansas Children's Service League.
Some recent cases:
* Last summer in Memphis, Tenn., police say a 2-year-old girl was beaten to death by her father over a potty training issue.
* Last month in Sacramento, Calif., a 27-year-old man was arraigned on murder charges for allegedly throwing his girlfriend's 4-year-old son against a wall after the boy urinated in his diaper in the night.
* A husband and wife in Phoenix were accused last month of severely beating their 4-year-old daughter because she had not gone to the bathroom.
* And in Columbia, S.C., a father is in jail after being accused of kicking his 3-year-old daughter in the head and stomach, critically injuring her, over potty training issues.
Prompted by a recent spate of child-abuse-related deaths in Wichita, local officials and the National Center on Shaken Baby Syndrome recently launched a campaign aimed at teaching parents how best to cope with a crying infant.
Unfortunately, Roper said, parental frustration doesn't end when babies become toddlers and preschoolers — and neither does potential abuse.
"We're really trying to look at all of these cases and what could have been done to prevent the abuse from happening in the first place," Roper said.
"Our goal is to strengthen the protective factors, which might be (increasing parents') knowledge of parenting and child development."
Roper said such initiatives are especially important now, because incidents of child abuse and domestic violence usually increase during times of economic stress.
Wichita recorded eight homicides linked to child abuse or neglect in 2008.
During the trial of Jonell Lloyd, who was convicted Monday of murdering 18-month-old Chavira, a witness testified that Lloyd beat the girl with a belt after she woke up from a nap with wet pants.
Lloyd admitted during testimony that he had "whupped" Chavira hard enough to draw blood on her buttocks, but denied killing the child.
Most parenting experts discourage spanking and other forms of negative punishment during potty training, saying it can actually delay the training process. Nevertheless, soiled clothes, beds or furniture sometimes cause stressed parents to explode in rage.
"Patience, patience, patience — that's what it takes," said Linda Crockett, a Wichita grandmother and longtime child-care provider who has potty-trained many children.
Crockett, who is in the process of helping potty-train a particularly challenging 3-year-old granddaughter, said the Chavira Brown case saddened her.
"I just thought, 'That poor, poor child,' " said Crockett, 60. "I've potty-trained dozens of kids, maybe hundreds, and they all are different.
"There were times I thought, 'Is this kid ever going to get it?' But with a little love and patience, they get it. They always do. All it takes is love and patience and consistency and, yes, a lot of detergent."
Roper, the Prevent Child Abuse director, said her group hopes to ramp up efforts to educate parents and caregivers about potty training and other issues. Starting this month, for instance, Connecting Point will launch a free series of classes designed for parents with children ages 2 to 10.
"Parents who have realistic developmental expectations of their children... are more likely to refrain from child abuse and neglect," she said.
Guild Donation to Prevent Child Abuse
Fresno, CA (KFSN) -- Children's Hospital Central California received a $4-million pledge Tuesday to help combat child abuse. The goal is to reduce this staggering statistic. 2,240 children in Fresno County were abused between October 2007 and September 2008.
Child abuse is a crisis in the Valley with thousands of innocent victims each year.
"We need to decline those numbers and not allow them to increase," said Tracy Lifer with the Central Valley guilds.
Lifer hopes to reduce abuse statistics by pledging $4-million of the guild's fundraising dollars to the Children's Hospital of the Central Valley over the next 6 years.
Lifer: "It is going to be enough to get the job started. It's going to continue to take the work of the guild to the hospital to the community to continue that job in the long term."
The hospital's child abuse prevention clinic has faced its share of cutbacks to service with the downturn in the economy.
"It's going to continue supporting services that have either gone away because of the economy due to state budgets and funding of independent based community organizations," said Leanne Kozub with child advocacy.
Kozub said this donation will position the children's hospital as the 'go-to' center for child abuse and could prevent children like 10-year old Seth Ireland from dying.
Investigators said Ireland was beaten to death by his mother's boyfriend in late December. Child protective services had been investigating Ireland's family in the months leading up to his death.
"It's the one chance you've got to intervene and make sure this doesn't happen again," said Dr. John Kinnison.
Kinnison examines every child that comes through the clinic with broken bones and injuries. Kinnison said there is not a direct correlation between the bad economy and increase in child abuse.
"Child abuse has always been around and it's always going to be around until we start preventing," said the doctor.
With the money pledged hospital officials said they are on the right track to preventing child abuse in the Central ValleySource
Man charged with child abuse now charged with first degree murder
Kansas City, Kan. —
A Kansas City, Kan. man is now facing first-degree murder charges for the death of a 10-month-old child.The Wyandotte County District Attorney's office announced Tuesday that Anderson Cheffen, who had previously been charged with child abuse, has seen his charges upgraded to first degree murder after the child died about a week after the June 17 incident in Edwardsville.
Cheffen is in custody at the Wyandotte County Jail in lieu of a $1,000,000 bond. His next court appearance is scheduled for July 21.
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