1. ELAINE WHITFIELD SHARP, TLC ‘98
This is part of a book currently being written by Elaine Whitfield Sharp. Copyright by
Elaine Whitfield Sharp, July 2004. Permission to publish given to The Warrior.
Evil events are rarely committed to paper. The history of child abuse inherent-
ly involves pain inflicted in the dark and behind closed doors, providing us with
only the barest of facts. We know that royal children were poisoned and mur-
dered for convenience or for their crowns and that the ancient Greeks dis-
posed of handicapped children at birth. We hear words like “beaten,” “burned,”
“raped,” and “exploited,” but these do little to reveal the enormous tragedies
for which they are mere codes.
Today, there is a vast infrastructure of child protective services (CPS) in America.
It is funded by billions of federal and state tax dollars. History has been turned
on its head. Instead of children being ‘seen and not heard,’ or having no right
of survival at birth, children are now revered as precious, as our modern day
mocking birds. The entire ‘village’ is involved in their protection and welfare.
28 T H E W A R R I O R • F a l l 2 0 0 4

2. D
welling in the village are child protective services (CPS) THE PRISM OF THE PAST:
professionals, pediatricians and others committed to THE ALARMING HISTORY OF CHILD ABUSE
stomping out child abuse. The history of child abuse
plays a valuable role in helping to form the professional self- Read between the lines of the Florence phone book and you will
images of CPS and medical professionals. History helps them find the human face of child abuse: Hundreds of people with
identify the demons and mobilize for the mission. An apprecia- the last name, “Innocenti.” The name means “innocents” and it
tion of the present comes through the prism of the past and fos- was given to each child who was rescued in one of the early bat-
ters camaraderie between colleagues who share the vision. It is tles to fight the war against child abuse.
the grist of the CPS culture. In the 1500’s, liberal-minded, Florentine men helped them-
selves to the local slave women—mostly from Africa—and
But, there’s a dark side to this culture. The multi-billion dollar
fathered hundreds of unwanted children. The babies were rou-
annual budget keeping this community alive also encourages
tinely murdered at birth because the mothers could not care for
overzealous investigation and, with that, millions of false reports
them.
and accusations of child abuse every year. Powering the ‘indus-
try’ of false accusation are mandatory reporting laws requiring As a humanitarian alternative to this local wave of infanticide,
professionals who regularly come into contact with children to in 1491 the wealthy Florentine Medici family (of Vatican fame)
report suspected abuse. And the standard for ‘suspicion’ or even sponsored an orphanage for the newborns. A mother who could
‘reasonable cause’ is low. False accusations are particularly preva- not keep her baby now had a choice. Typically, a mother dis-
lent in cases of so-called shaken baby syndrome (SBS). The list guised her baby as a bundle of laundry and took it at dark
of professionals now legislatively mandated to report has through the narrow, winding streets of Florence to the House of
expanded. Failure to report suspected abuse may put a person in the Innocents. There she placed the child on a ‘wheel’ that was
the dock and subject them to civil liability. much like a lazy Susan—half inside the sanctuary behind a
small door and half outside the building. This wheel served as
Money, another familiar villain, also lurks on the landscape. the method of anonymous delivery. A mother signaled the
Some professionals may be encouraged to find ‘abuse’ because arrival of the baby with a knock on the door before fleeing into
they have government grants to look for it. The result is that the night. On hearing the knock, the sisters religious, who ran
alleged child abuse, especially of the SBS variety, may be not the the orphanage, turned the wheel around 180 degrees, took the
most probable diagnosis, but instead the most profitable. baby in, raised and educated the boy or girl, and arranged for
What follows are some snap shots from the world of child abuse each child to be trained in one of the many trades then bur-
recognition and prevention professionals. Understanding the geoning in Florence.
roots of this culture is one way to prepare for cross-examination Each child took as its surname “Innocenti.” Today, there are sev-
of child protection and medical witnesses who were part of a eral pages of “Innocenti’s” in the Florence phone book, all
medical emergency that has evolved into a criminal child descendants of that great humanistic experiment more than half
abuse case. a millennium ago. The babies had been saved by an act of social
Florence Phone Book: Hundreds of children were saved by a humanitarian experiment in Florence, Italy during
the Renaissance. Beginning in 1491, instead of being murdered at birth, newborns were taken to the House of the
Innocents where they were raised by the sisters religious and taught a trade. Today, hundreds of the orphans’ descendants
live in Florence where their names can be found in the city’s telephone book.
T H E W A R R I O R • F a l l 2 0 0 4 29

3. THE HOUSE OF THE INNOCENTS
to stand back from the treatment. A loyal champion of all boys,
everyday experience of his descriptions of maltreated children
confronting the battered stemmed from a desire to remedy evils
or neglected child and to that he had found in London and its sub-
reflect on the wider issues urbs. Dickens’ gave these victims of
of what has been present- tyranny and oppression a voice in his
ed to us as a single inci- novels. On hearing this voice, Londoners
dent in time.”1 were deeply affected and were stirred to a
storm of indignation and protest.
We rejoin history at the
Schools, work-houses, and other public
work-houses of Victorian
institutions were subjected to rigorous
England. These were a per-
examination, resulting in several closings
version of institutions like
and tremendous improvements.
the House of the Innocents.
Although Dickens’ goal was partly
Orphaned children were
accomplished, the war against child abuse
sent to these Hell holes.
had a long road ahead.
Moved by the stories of chil-
dren who were starved and Meanwhile, across the Atlantic, thou-
beaten in these places, sands of homeless children scraped out
Charles Dickens created a grim existences and often died on the
storm of indignation and streets of New York and other cities. By
outrage when, based on the 1850, in New York City, alone, there
lives of real boys, he wrote were an estimated 30,000 orphans on the
stories like “Oliver Twist.” streets. In response in 1853 Charles
Orphaned at birth, Twist Loring Brace, a young, Yale-educated the-
House of the Innocents terra cotta and glazed medallion: was put into a work-house ologian, formed the Children’s Aid
A child symbolically seeks the charity of Florence’s rich in this with other boys where he Society (CAS). In what was to become
medallion by Andrea della Robbia. From 1463-66, Robbia was forced to work. Meals the beginning of the modern-day foster
made 10 such medallions to decorate the arches of the House consisted of one small bowl movement in the U.S., the CAS shipped
of the Innocents, (Ospedale degli Innocenti), built by
of gruel, and no more. some 120,000 children out of the city on
Brunelleschi and funded by the Medici family as a refuge for
“Orphan Trains,” initially to farming
newborns who were abandoned there in lieu of being killed. The emaciated boys began
families in the Midwest and West and, as
to plot a rebellion of sorts
the Orphan Train Movement grew, to 45
and drew straws for who
reform from the ultimate act of child states, Canada and Mexico. Even so,
would ask for more at the next meal. The
abuse: murder. America’s homeless orphans and abused
short straw fell to Oliver and so, the next
children remained mostly voiceless and
But this type of Renaissance humanitari- day, he approached the
an idealism was slow to spread. work-house master and
Infanticide and other forms of physical, uttered what is perhaps the
sexual and emotional abuse had been most famous of Dickens’
going on since the advent of Man. No lines: “Please, sir, I want
laws or programs would or will ever put some more!”
an end to this. The ancient Egyptians Oliver was severely beaten,
used to punish mothers who murdered cast out and sold by the
their newborns by making them hug the work-house to a local
corpse for 72 hours. In 1917, of 5,000 undertaker for five English
illegitimate children born in Chicago, pounds. Beatings and star-
1,000 disappeared without a trace. The vation continued there
Victorians stuffed their babies down sew- until, one night, Oliver
ers, clogging the city’s system. Today, the stole into the darkness—
news of war and conflict is punctuated by only to fall into the hands
stories of dead babies left in public toilets, of the Artful Dodger.
garbage cans and dumpsters. (You’ll have to read the
book to find out what
The lessons of history are used in child becomes of Oliver.) Oliver Twist: "Please, sir, I want some more!" This is perhaps
maltreatment books as case studies of the most famous of Charles Dickens’ lines. The author’s descrip-
what to look for today. Wrote the editors Dickens’ stories were mile- tions of boy life in Victorian England caused a wave of protest
of one such text: stones in raising social con- against, and reform of the miserable conditions in which young
sciousness about child mal- children were forced to live.
“The historical perspective allows us
30 T H E W A R R I O R • F a l l 2 0 0 4

4. THE HOUSE OF THE INNOCENTS
largely ignored by mainstream, middle-
class America for the next two decades.
Fast-forward to 1874 when child abuse
issues briefly took center stage in the
American media. The plight of Mary
Ellen Wilson, a crusade-inspiring case
in New York City, sparked the creation
of the early child protection movement
in the United States.
Mary Ellen, a nine-year-old orphan,
was regularly beaten and berated by her
foster mother. A charity worker who
was boarding in the same house wanted
to help Mary Ellen escape her misery,
but there were no government agencies
to intervene. The charity worker turned
to the American Society for the
Prevention of Cruelty to Animals
(ASPCA) which, based on the premise
that a child was part of the animal king-
dom, sought and obtained a writ of
habeas corpus removing Mary Ellen
from the abuser’s home. Mary Ellen’s
foster mother was convicted of assault
and battery and sentenced to one year of Orphan Trains: In 1850, there were some 30,000 orphaned, homeless and hungry children on the
hard labor. streets of New York City. This emergency sparked the creation of the Children’s Aid Society (CAS) in
1853. Over the next few years, the CAS shipped some 120,000 of these children on ‘Orphan
Outrage over Mary Ellen’s case resulted Trains’ to farming families in the Midwest, the West and to places as far away as Canada. Today,
in the organization of the New York descendants of the Orphan Train movement keep in touch by e-mail and the Internet.
Society for the Prevention of Cruelty to
Children in 1874. In 1875, the New
York state legislature enacted a statute lected children in danger of becoming newly-developing X-ray technology. The
that “authorized cruelty societies to file delinquent.” Stomping out physical distinction between visible and invisible
complaints for the violation of any laws abuse was to take second place behind the injuries had been created in the field of
affecting children and required law need to fill bellies. As it did so, the role of child abuse.
enforcement and court officials to aid the SPCC’s gradually diminished.
It is part of the alarming history of med-
agents of the societies in the enforcement icine that Caffey assumed, without reli-
of these laws.” In doing so, that state leg-
THE SPECTER OF INVISIBLE ABUSE:
able-scientific proof of causation, that
islature created the first statutory child FROM MISSION TO MONSTER Jaspers’ confession to shaking the babies
protective services system in the United Historically, the signs of physical cruelty in her care was all that was needed to
States. to children were perceived as visible, “prove” that the intracranial bleeding
By 1905, there were more than 400 pri- only: bruises, burns, obviously broken they had was, in fact, caused by shaking,
vate charitable societies to prevent cruelty bones, or ‘pattern injuries,’ such as, belt alone. Neither the medical examiners nor
to children (SPCC’s). The SPCC’s buckles and whip welts. But in 1956, Caffey excluded the possibility of impact
assumed the primary role in handling radiologist John Caffey, M.D., believed or other possible causes of the bleeding in
child-abuse complaints that, if founded, he had discovered a new form of ‘invisi- the Jaspers’ baby cases.
they referred to the courts for action. ble abuse’: whiplash shaking, later to be
Although it was to be shown in 1987,
called “shaken baby syndrome” (SBS).2 It
The Great Depression brought with it a and again in 2003, that shaking, alone,
was in that year that a nursemaid,
shift in child-welfare priorities from pre- could not cause intracranial injuries, the
Virginia Jaspers, confessed to shaking
venting physical abuse to providing food, SBS diagnosis slowly became more preva-
some of the babies for whom she had
clothing and shelter for poor and father- lent over the next three decades.3
cared.
less children. Supplying these necessities The diagnosis received a lot of publicity
became the hot issue under the Social Japsers’ story made Newsweek and other
from C. Henry Kempe, M.D., who in
Security Act of 1935. Through this national media. Jaspers’ victims had
1962 published an article, “The Battered
statute, Congress attempted to create a intracranial bleeding, that is, bleeding
Child Syndrome,” in the Journal of the
social welfare system for “the protection between the skull and the brain. This
American Medical Association (JAMA).
and care of homeless, dependent and neg- type of bleeding could only be seen with
That article contributed to changing the
T H E W A R R I O R • F a l l 2 0 0 4 31

5. THE HOUSE OF THE INNOCENTS
entire landscape of child protection. those who worked in the health care and Public awareness of intentionally inflicted
Harnessing the increasing institutional child protection fields. Other categories child head injury continued to increase as
power of the American medical establish- of professionals who regularly came into Kempe, Caffey and others beat the drums
ment, Kempe called for physicians to contact with children—clergy, teachers, of this newly-discovered form of ‘invisi-
look for and to report to child protection school nurses, dentists and more— ble’ child abuse. Even so, between the
authorities the parents of “battered chil- became mandated reporters. 1960’s and early 1970’s, SBS was still a
dren”—those with intracranial bleeding comparatively rare diagnosis. That was
Shaking, alone, as a cause of child brain
and retinal hemorrhages—in order to about to change.
injury was not scientifically challenged
protect them from further injury. The sci-
until 1987. It was shown to be a false AN EMPIRE IS BORN
entifically-unreliable theory was that if
hypothesis.5 But, in the climate of the
bleeding could be seen on an X-ray, the In 1974, the federal government took a
early 1970’s, many physicians eager to
cause—violent shaking—could be identi- leadership position in child abuse when
serve the legitimate cause of child abuse
fied. (This is like saying that a psychiatrist Congress enacted the Child Abuse
prevention, diagnosed scores of so-called
who views the skull on an X-ray, or the Prevention and Treatment Act (CAPTA).6
SBS cases.
brain on CT, MRI or PET scans, can
determine the cause of mental illness even Under CAPTA, “the term ‘child abuse
in the absence of organic brain disease.) and neglect’ means, at a minimum, any
recent act or failure to act on the part of
Recognition of so-called SBS was—and a parent or caretaker, which results in
still is—part of the declared war against death, serious physical or emotional
child abuse prevention. Kempe and harm, sexual abuse or exploitation, or an
Caffey theorized that when a child had act or failure to act which presents an
intracranial bleeding and bleeding behind imminent risk of serious harm.”7 That
the eyes in the layers of the retina (retinal broad definition pulls many within
hemorrhages), this meant only one thing: its net.
they had been violently and intentionally
shaken. Their legacy persists. Fast forward The statute was designed to raise aware-
to a July 2004 TV news story, typical of ness about child abuse and to create a
scores like it. The TV news reporter led: nationwide child protective services sys-
tem on a state-by-state basis. In the past
Physical child abuse is hard to look 30 years, Congress has used CAPTA as
at. But what if a baby has no marks? the main funding vehicle to pump bil-
What if they look perfectly healthy, lions of dollars annually into state coffers
but come into the doctor’s office, to build a child-protection-services infra-
clinic or emergency room vomiting? structure. It is now a mighty force with
Dr. Rachel Berger, Children’s which to be reckoned.
Hospital of Pittsburgh….
It could be that they have reflux, it THE MONSTER UNDER THE BED:
could be that they have the flu, but it MANDATORY REPORTING
could be that they have a brain In order to drink at CAPTA’s trough,
injury . . . . If you return a child to states had a number of obligations,
an environment where he or she was including a requirement that they enact
injured, there’s a high likelihood that Mary Ellen Wilson (before and after). As tougher mandatory reporting statutes.
the child will come back and be re- related by the New York City Museum, “The With all that money at the end of the car-
injured or be killed.4 startling child abuse case of Mary Ellen Wilson rot, they did. All 50 states now have
Recognizing “shaken baby syndrome” spawned the formation of the New York statutes that not only increase the states’
Society for the Prevention of Cruelty to power to intervene in cases where child
and preventing it was the major focus of
Children (NYSPCC). Hearing of the plight of abuse is suspected and remove children
the child abuse protection community
a child living in the Hell's Kitchen area of on an emergency basis, but which further
developed in response to the writings of
Manhattan, social worker Etta Angell Wheeler broaden the net of those who are man-
Caffey and Kempe. Beginning in 1962,
enlisted the assistance of Henry Bergh (of the dated to report and provide a broader
several groups drafted model child-abuse-
American Society for the Prevention of Cruelty definition of child abuse.
reporting statutes that mandated health
to Animals -- NYSPCA), who acted in the
care workers who see or suspect physical belief that children should be afforded the same In some states, mandated reporters who
abuse, such as so-called SBS, to report it protection as animals.” The NYSPCA fail to report their suspicions of abuse
to the authorities. By 1967, every state obtained a writ of habeas corpus to rescue may be criminally prosecuted.
had a statute. Mary Ellen from her cruel stepmother who was Mandatory reporting statutes in some
In the following years, mandatory report- later sentenced to one year of jail and hard states, such as Alabama and California,
ing statutes cast their net far beyond labor. (Photo from NYSPCC.) authorize fines of up to $1,000 and up to
32 T H E W A R R I O R • F a l l 2 0 0 4

6. THE HOUSE OF THE INNOCENTS
six months in jail for those who fail to any other physical evidence of shaking, Alabama spent more than $65 m ($12 m
report. Failure to report may also subject most of the 5,000 to 6,000 people in federal dollars). California spent $1.3
a mandated reporter to civil liability. charged with causing SBS every year billion ($42 m federal). Florida spent
must surely be in the group of those who $329 m ($19 m federal). Massachusetts
Predictably, with a larger number of peo-
are falsely accused.11 spent more than $101 m ($11 m federal).
ple now mandated to report, a broader
Wyoming spent almost $4 m ($1.3 m
definition of child abuse, large amounts THE VILLAGE federal).
of funding at stake, coupled in some
states with the fear of criminal prosecu- The oldest federal agency dedicated to The Children’s Bureau also awards grants
tion and/or civil liability, reports of child fighting child abuse is the Children’s on behalf of the Department of Justice
abuse have more than quadrupled since Bureau. It is part of the Department of (DOJ) that administers the Children’s
1974. Health and Human Services (HHS), Justice Act. The awards are made, for
under the Administration for Children example, not only for research to recog-
MANDATORY REPORTING and Families, Administration on nize child abuse, but also to state and
MEETS JUNK SCIENCE Children, Youth and Families. county prosecutors for the training of
The Children’s Bureau budget for Fiscal assistant attorneys general and district
Almost three million reports of suspected
Year (FY) 2004 was $6.7 billion. Of that, attorneys in how to effectively prosecute
child abuse were made in 1999. Of those,
a whopping $2.5 billion was funneled to accused child abusers, including cases of
1.8 million were investigated and of those
the states in grants for various child abuse alleged SBS. Funding is also awarded to
less than half were substantiated.8 While
programs for protection and prevention, hire expert witnesses to testify against the
the protection of those unfortunate chil-
which includes recognition. Many, many accused, including SBS experts.
dren who had been abused or neglected
was necessary, the flip side of those num- millions of that go directly to a vast The National Clearing House on Child
bers tell another sorry story. A good por- bureaucracy of programs focused on one Abuse and Neglect which along with the
tion of more than half of the people target: finding child abuse. In 2002, for Children’s Bureau is under the HHS’
investigated for child abuse and/or neg- example, in just one genre of grants, some Administration for Children and
lect were falsely or mistakenly accused. $81 million was awarded to states for Families, provides guides on how to get
With a population of about 280 million, child abuse “recognition.” And, we grant money to CPS and medical profes-
this means that in 1999, alone, as many haven’t even begun to talk about the sionals, “community-based organiza-
as one in 300 people in America may mandated state matching requirements. tions” “public and non-profit agencies,”
have been the victim of false accusations As has been the pattern over the last 30 “universities,” “service providers,” “train-
of child abuse and/or neglect. years, many of the federally funded state ers” and “researchers helping to protect
and local programs organized to recog- children.”
It is one of those modern facts of
Orwellian life that mandatory reporting nize child abuse heavily emphasize find- Regularly announcements are made in
of ‘invisible’ abuse still occurs even ing cases of so-called SBS.12 the Federal Register that the Children’s
though that form of alleged abuse—SBS Every year, each state matches multi-mil- Bureau is seeking grant proposals from
without spinal cord injury—has been sci- lion-dollar federal funding in partnership public or private agencies to study how to
entifically refuted. budgets for preventive and primary care recognize child abuse. Grants are avail-
of children. For example, in FY 2002, able to departments within state CPS
It is another fact of Orwellian life that the
right hand of the government does not
know what the left hand is doing.9 For
example, the National Institutes of
Health (NIH), under HHS, defines
“shaken baby syndrome” as resulting
specifically in “TBI [Traumatic brain
injury] and spinal cord injury.”10 Even
though a scientific experiment has proved
SDH’s cannot be caused by shaking,
alone, and even though NIH’s official
position is that real cases of SBS include
spinal cord injuries, those who are trained
and paid by the government to find SBS
cases, and those who are under the gun to
report it, are not taking any chances. The
majority of SBS cases reported in the
medical literature or currently being pros-
ecuted do not involve spinal cord injury. Children During Great Depression: Feeding, clothing and sheltering children were at the top
In the absence of spinal cord injury or of the child abuse agenda during the Great Depression. Child abuse issues were mostly put
on the back burner until the 1960’s.
T H E W A R R I O R • F a l l 2 0 0 4 33

7. THE HOUSE OF THE INNOCENTS
agencies, to private child advocacy organ- Next Issue: Every year the federal, ENDNOTES
izations, or to individuals studying for state and local governments pump 1 Hobbs, CJ, Hanks, HGI, Wynne,
their doctorates. The types of grants
available and the organizations to which billions of dollars into programs JM, Child Abuse and Neglect , A
they are awarded are limited only by the designed to help an army of social Clinician’s Handbook, Churchill-
Livingstone, Harcourt Brace, 1991
imagination—and the Children’s workers and doctors find child (2nd ed).
Bureau’s stated “research agenda.” abuse. Inasmuch as the prospect of
2 Caffey first wrote about some cases of
In any given case of so-called SBS, it’s money may encourage some children who had intracranial
important to get as much information as physicians and some who work in bleeding and broken bones in 1947.
possible about the background of the
State’s medical and child protective serv-
the child-abuse-prevention com- He continued to study and write
munity to find what they are look- about the topic throughout the
ices witnesses, especially those who 1950’s and 1970’s.
played a role in the evolution of the med- ing for to justify continued fund-
ical case into a criminal case. ing or to study the area to obtain 3 In 1987, that assumption was proved
false when a biomechanician experi-
Naturally, physicians and child protective initial funding, it is useful to sup- enced in the science of traumatic
services professionals testifying in crimi- plement criminal or civil discovery brain injury (TBI) together with neu-
nal child abuse cases are dedicated to with information obtained under rosurgeons created a model baby, put
stomping out child abuse. But, if these an accelerometer on its neck, and had
witnesses have been involved in training the federal and/or state freedom of
some burly Penn State football
and/or research that manifests a clear bias information acts (FOIA) and the players shake the model as hard as
in favor of the existence of SBS (without Internet to get a fuller picture of they could. The result was that the
spinal cord injury) as a real diagnosis, and witnesses’ backgrounds and likely ‘shakers’ were unable to create the
if they also failed to seek to study or forces needed to cause intracranial
understand any of the known mecha-
orientations. Knowing where to
send FOIA requests and what to bleeding. The experiment also
nisms of head injury, then it’s important showed that to cause intracranial
to get that information for cross-exami- ask for requires an understanding bleeding, or what is medically
nation to demonstrate the bias that may of the basic federal, state and local termed, “subdural hematomas”
be the only reason your client is in the funding trees and the types of (SDH’s) and “subarachnoid hemor-
dock. This is where research on the rhages” (SAH’s), there had to be
Internet and requests under state and fed- grants and awards that are avail-
impact. Impact forces were found to
eral freedom of information acts can help able. The sequel to this article will be 50 times greater than those a
you find facts that you can use for cross- cover that topic. human being could generate by
examination. q shaking the model. For a fuller dis-
cussion of this study, see “The
Elephant on the Moon,” Part I of the
three-part series published in The
Warrior. Virtually the same experi-
ment was repeated and validated
again in 2003, and in the March
2004 issue of the Journal of
Neurosurgery, the lead neurosurgery
experimenter from the 1987 model-
baby-shaking experiment, agreed that
because the evidence for shaking is
not complete, that the term should
not be used to describe the cause of
intracranial injuries in babies. J
Neurosurg. 100:574-75, March 2004,
“Neurosurgical Forum,” “Letters to
the Editor,” regarding, “Rotational
Injury,” Prange, MT, Coats, B,
Duhaime AC, et al,
Penetrating X-rays Were Used to Find ‘Invisible Abuse’: The scientifically-unreliable “Anthropomorphic simulations of
claim made by Caffey, Kempe and others was that if intracranial bleeding was seen with an falls, shakes and inflicted impacts in
X-ray, the cause of this bleeding – violent shaking – could be identified. This is like saying infants,” J Neurosurg., 99:143-150,
that if a psychiatrist views a patient’s skull on an X-ray, or the brain on CT, MRI or PET July 2003.
scans, they can determine the cause of mental illness or insanity.
Copyright by Sidney Harris, 2004. Reprinted with Permission.
4 Medical Reporter Marilyn Brooks,
34 T H E W A R R I O R • F a l l 2 0 0 4

8. THE HOUSE OF THE INNOCENTS
Money Matters: Expert witnesses testify in 2003 before a Congressional subcommittee to sustain and increase the huge federal budg-
et for child abuse protection and prevention. The Children’s Bureau is the main federal agency that signs the checks to the states and
to a long list of private child protective services organizations under the amended 1974 Child Abuse Prevention and Protection Act
(CAPTA). The annual budget of the agency was $6.7 billion in 2004.
Over the past 30 years, and to date, a significant portion of that has gone and still goes to programs to train and encourage child
protective services and medical professionals to recognize child abuse, including so-called “shaken baby syndrome” (SBS). This cre-
ates the risk that SBS may sometimes be diagnosed not because it is probable, but because it is profitable. Some people believe that
this financial incentive compounds the problems already caused by mandatory reporting of suspected child abuse by contributing to
the more than one million unsubstantiated child abuse reports and the large number of false child abuse accusations every year.
The Pittsburgh Channel, Action Avenue to investigate a tip that the a procedure for speedy expungement
News, “Healthcast,” WTAE-TV, people there were dealing drugs. of records of those who were accused
Channel 4, July 22, 2004, 5 PM. The They did not find any drugs, but but found to be without fault. But,
news story also discusses the develop- they did find nineteen children, most once accused of SBS, because physi-
ment of a blood test to detect brain under five years old, all huddled on cians and CPS workers believe it is a
injury. bare mattresses. The children were real diagnosis, there is no hope of
5 Fn 4, Id. wearing little but soiled diapers and expungement for that segment of the
dirty underwear, and two of them population of the falsely accused.
6 42 USC § 5102, et seq., as amended. shared meat off a bone with a dog. Although CAPTA’s amendments
7 42 USC § 5106g(B)(2). DCFS had received several com-
reflect sensitivity to the colossal
8 Opening Statement of Rep. Peter plaints about the plight of the
problem of false accusations of child
Hoekstra (D-Mich), Chairman of the Keystone Kids and had failed to
investigate. One might say the abuse, there are no corresponding
Subcommittee on Select Education, grants for criminal defendants
before the U.S. House of Keystone Kids were "lucky" After all,
some children die as a result of CPS accused of SBS (or any other form of
Representatives, Committee on child abuse). So much for one of
Education and the Workforce, failures to investigate. Doctors and
CPS professionals are all too aware of CAPTA’s stated purposes—to keep
Subcommittee on Select Education,
“CAPTA: Successes and Failures at these kinds of cases. Cases like these families together.
Preventing Child Abuse and create a systemic and, often, an indi- 12 Also high on the list are cases of
Neglect,” August 2, 2001. vidual tension. Physicians and CPS sexual abuse and Munchausen
workers are concerned not to falsely Syndrome by Proxy. In this claimed
9 Over reporting and over-zealous accuse anyone and, in doing that, risk
investigations are only half of the “factitious” disorder, parents are said
tearing apart families they would
story. The flip side is that some cases to make their children sick to get
rather help to preserve.
of alleged reported child abuse are attention for themselves.
not properly investigated or followed 10 NIH Consensus Statements for the
up. Children who are in danger slip Rehabilitation of Persons with Thanks is due to Susan Kelly, author of “The
through the cracks and suffer terribly Traumatic Brain Injuries, 1998, Oct. Boston Stranglers,” for her incredibly aggressive
as a result. The Keystone Kids in 26-28; 16(1): 1-41, NIH Consensus and thorough research which helped me get
Chicago were victims of the failure of Development Panel. started on the funding trail, to Jan E. Leestma,
M.D., for his balanced view of child abuse pre-
the Illinois Department of Children 11 Given the magnitude of the problem vention culture and its problems of under-
and Family Services (DCFS). In that of false accusations of child abuse, reporting and over-reporting, and most of all to
case, Chicago police officers entered CAPTA amendments in the past Ayub K. Ommaya, M.D., for first inspiring me
an apartment at 219 North Keystone decade require states to have in place to write about the topic of SBS.
T H E W A R R I O R • F a l l 2 0 0 4 35