The stressful effects of a faltering economy, skyrocketing unemployment and precarious personal finances can be dire. People take up smoking or use alcohol to cope, they become depressed or suicidal, and they develop stress-related illnesses like heart disease. Now researchers report that the harm may be spreading to children too, when parents' stress leads them to inadvertently injure their children.
Presenting May 1 at the Pediatric Academic Societies annual meeting in Vancouver, a team of researchers led by child-abuse expert Dr. Rachel Berger at Children's Hospital of Pittsburgh reported a significant increase in cases of shaken-baby syndrome, in which youngsters are shaken violently by an adult, since the start of the current recession. Researchers analyzed data on 512 cases of head trauma in the children's centers of four hospitals (in Pittsburgh, Pa.; Cincinnati, Ohio; Columbus, Ohio; and Seattle) and found that the number of cases had increased to 9.3 per month as of Dec. 1, 2007, compared with 6 per month prior to that date — a rate that had held steady since 2004.
The rise in shaken-baby cases correlates with the economic downturn associated with the recession. "This is a perfect storm in a bad way, where we have economic stressors that are causing the removal of social-service resources for preventing and addressing child abuse," says Berger. Although she says she was not surprised by the association observed in her study, she calls the sheer rise in recent cases of abusive head injuries in children "striking."
Berger cautions that her study highlights an association, not a cause-and-effect relationship, between the recession and incidence of shaken babies. But the findings are a stark reminder that any stressful circumstance — family tragedy, natural disaster or financial downturn — may push parents to the limits of their coping abilities. In 1999, following a devastating hurricane that hit regions of eastern North Carolina, researchers at the University of North Carolina at Chapel Hill found that in the six months post-hurricane, the rate of brain injuries caused by child abuse jumped fivefold from the rate before the disaster. In unaffected regions of the state, there was no such rise in cases.
Most cases of shaken-baby syndrome and head injuries to young children occur when frustrated parents shake their children in an effort to quiet their crying or stop tantrums. The force of the motion causes the child's brain to shift violently in the skull, crushing blood vessels and damaging still developing tissue. It is a desperate act, one that tends to surface as a knee-jerk response by a stressed parent.
Even a few seconds of violent shaking can have serious long-term consequences for a child's development. Shaking has been linked to learning disabilities, visual and hearing problems, seizures, behavior disorders and even death. In Berger's study, 63% of the children, ages nine months to six years, were hurt severely enough to require hospitalization, and 16% died.
There is no official central registry of shaken-baby statistics in the U.S., but the National Center on Shaken Baby Syndrome (NCSBS) estimates that each year about 1,200 to 1,400 babies die or suffer injury from being shaken, according to Amy Wicks, spokeswoman for the nonprofit advocacy group. The abuse leaves most children with serious damage: of the 75% who survive their episodes, 80% suffer from permanent disabilities ranging from mental retardation to undeveloped motor skills.
Since parental stress is the primary reported cause for shaken-baby syndrome, it is not surprising to see cases rise in tandem with a worsening economy. Researchers report that an increase in child abuse is being seen around the country in more and more hospitals. "In my own anecdotal experience at Children's Hospital in Oakland, Calif., there is no question that the incidence of physical-abuse rates have been going up over the last couple years, and it seems to be mirroring the economy," says Dr. James Crawford-Jakubiak, medical director of the Center for Child Protection at Children's Hospital and Research Center Oakland.
Since the recession began, the NCSBS has received more reports of shaken-baby syndrome from hospitals like Crawford-Jakubiak's as well as from prosecutors who are called by emergency-room physicians to investigate suspected abuse cases. "This report [by Berger] verifies what we've been hearing for some time now," says Wicks.
Berger says the findings also serve to highlight the risks of cutting back on social services provided by cities when economic times get tough; these services can help parents cope with their stress and prevent child abuse from occurring.
That the number of cases of shaken-baby syndrome is rising is particularly worrisome, Berger says, because it is among the most violent forms of child abuse and therefore one of the few types of abuse that is seen and tracked by hospitals. Much abuse of children goes unreported, and such cases may be increasing as joblessness and the recession drag on. Parents must be mindful that stress, whether personal or societal, can strain their ability to cope, especially with their families. "We as adults need to recognize how stress affects us," says Crawford-Jakubiak, "and make sure that the stresses in our lives don't get dumped onto our children."