Useful Information on Child Abuse Backed by Solid Research. (Expert Rates the Literature)

Article excerpt

WASHINGTON -- Several biomarkers usually found only in intact brain tissue were detected in the peripheral blood for several days after abusive head trauma occurred, according to findings of one study.

"This is what we'll all be doing 5 years from now to diagnose shaken babies," Dr. Carole Jenny said at the annual meeting of the American Professional Society on the Abuse of Children. The article was her top choice among a selection of some of the best child abuse research literature published in 2000 and 2001.

In the study, the levels of the bio-markers correlated with injury severity and were predictive of neuropsychological deficits that persisted weeks after the injuries were incurred (J. Neurol. Neurosurg. Psychiatry 70[1]:95-100, 2001).

Dr. Jenny, professor of pediatrics and director of the child protection program at Brown University, Providence, selected two other papers that addressed markers that may aid in diagnosing child abuse.

Investigators in one study looked at cerebrospinal fluid samples from 18 infants and children with severe traumatic brain injury Those who had been injured during physical abuse showed extremely high levels of glutamate and glycine, compared with those who had sustained their injuries in accidents (J. Pediatr. 138[l]:18-25, 2001).

Cerebrospinal fluid levels of these neurotoxic amino acids also correlated with the extent of neurologic dysfunction following injury "These markers have the potential clinical use of differentiating localized trauma from massive abuse injury," said Dr. Jenny, past chair of the American Academy of Pediatrics section on child abuse and neglect.

Four papers dealt with physician assessment of suspected sexual abuse victims. One found that using a structured format for interviewing and examining these children doesn't necessarily induce more of them to disclose their abuse but does make courts more likely to accept the results as reliable evidence (Child Abuse Negl. …


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