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Iv House Of Innocents Law Review On Sbs


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Iv House Of Innocents Law Review On Sbs

  1. 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. 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 abuseplays a valuable role in helping to form the professional self- Read between the lines of the Florence phone book and you willimages of CPS and medical professionals. History helps them find the human face of child abuse: Hundreds of people withidentify the demons and mobilize for the mission. An apprecia- the last name, “Innocenti.” The name means “innocents” and ittion 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—andBut, 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 foroverzealous 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 darkof professionals now legislatively mandated to report has through the narrow, winding streets of Florence to the House ofexpanded. Failure to report suspected abuse may put a person in the Innocents. There she placed the child on a ‘wheel’ that wasthe 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 asMoney, another familiar villain, also lurks on the landscape. the method of anonymous delivery. A mother signaled theSome professionals may be encouraged to find ‘abuse’ because arrival of the baby with a knock on the door before fleeing intothey have government grants to look for it. The result is that the night. On hearing the knock, the sisters religious, who ranalleged child abuse, especially of the SBS variety, may be not the the orphanage, turned the wheel around 180 degrees, took themost probable diagnosis, but instead the most profitable. baby in, raised and educated the boy or girl, and arranged forWhat 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, allmedical emergency that has evolved into a criminal child descendants of that great humanistic experiment more than halfabuse 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. 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 AidA child symbolically seeks the charity of Florence’s rich in this with other boys where he Society (CAS). In what was to becomemedallion by Andrea della Robbia. From 1463-66, Robbia was forced to work. Meals the beginning of the modern-day fostermade 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 onBrunelleschi and funded by the Medici family as a refuge for “Orphan Trains,” initially to farmingnewborns 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 whoreform from the ultimate act of child states, Canada and Mexico. Even so, would ask for more at the next meal. Theabuse: murder. America’s homeless orphans and abused short straw fell to Oliver and so, the next children remained mostly voiceless andBut this type of Renaissance humanitari- day, he approached thean idealism was slow to spread. work-house master andInfanticide and other forms of physical, uttered what is perhaps thesexual and emotional abuse had been most famous of Dickens’going on since the advent of Man. No lines: “Please, sir, I wantlaws 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 thetheir newborns by making them hug the work-house to a localcorpse for 72 hours. In 1917, of 5,000 undertaker for five Englishillegitimate children born in Chicago, pounds. Beatings and star-1,000 disappeared without a trace. The vation continued thereVictorians stuffed their babies down sew- until, one night, Oliverers, clogging the city’s system. Today, the stole into the darkness—news of war and conflict is punctuated by only to fall into the handsstories 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 whatThe lessons of history are used in child becomes of Oliver.) Oliver Twist: "Please, sir, I want some more!" This is perhapsmaltreatment 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 protestof 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 us30 T H E W A R R I O R • F a l l 2 0 0 4
  4. 4. THE HOUSE OF THE INNOCENTSlargely ignored by mainstream, middle-class America for the next two decades.Fast-forward to 1874 when child abuseissues briefly took center stage in theAmerican media. The plight of MaryEllen Wilson, a crusade-inspiring casein New York City, sparked the creationof the early child protection movementin the United States.Mary Ellen, a nine-year-old orphan,was regularly beaten and berated by herfoster mother. A charity worker whowas boarding in the same house wantedto help Mary Ellen escape her misery,but there were no government agenciesto intervene. The charity worker turnedto the American Society for thePrevention of Cruelty to Animals(ASPCA) which, based on the premisethat a child was part of the animal king-dom, sought and obtained a writ ofhabeas corpus removing Mary Ellenfrom the abuser’s home. Mary Ellen’sfoster mother was convicted of assaultand battery and sentenced to one year of Orphan Trains: In 1850, there were some 30,000 orphaned, homeless and hungry children on thehard 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 ‘OrphanOutrage 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 toChildren in 1874. In 1875, the NewYork state legislature enacted a statute lected children in danger of becoming newly-developing X-ray technology. Thethat “authorized cruelty societies to file delinquent.” Stomping out physical distinction between visible and invisiblecomplaints for the violation of any laws abuse was to take second place behind the injuries had been created in the field ofaffecting 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, thatislature created the first statutory child FROM MISSION TO MONSTER Jaspers’ confession to shaking the babiesprotective services system in the United Historically, the signs of physical cruelty in her care was all that was needed toStates. to children were perceived as visible, “prove” that the intracranial bleedingBy 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 norto children (SPCC’s). The SPCC’s buckles and whip welts. But in 1956, Caffey excluded the possibility of impactassumed the primary role in handling radiologist John Caffey, M.D., believed or other possible causes of the bleeding inchild-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 ItThe 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 shakingventing physical abuse to providing food, SBS diagnosis slowly became more preva- some of the babies for whom she hadclothing 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 publicitybecame the hot issue under the Social Japsers’ story made Newsweek and other from C. Henry Kempe, M.D., who inSecurity Act of 1935. Through this national media. Jaspers’ victims had 1962 published an article, “The Batteredstatute, Congress attempted to create a intracranial bleeding, that is, bleeding Child Syndrome,” in the Journal of thesocial 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. 5. THE HOUSE OF THE INNOCENTSentire landscape of child protection. those who worked in the health care and Public awareness of intentionally inflictedHarnessing the increasing institutional child protection fields. Other categories child head injury continued to increase aspower of the American medical establish- of professionals who regularly came into Kempe, Caffey and others beat the drumsment, 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 theauthorities the parents of “battered chil- became mandated reporters. 1960’s and early 1970’s, SBS was still adren”—those with intracranial bleeding comparatively rare diagnosis. That was Shaking, alone, as a cause of child brainand retinal hemorrhages—in order to about to change. injury was not scientifically challengedprotect them from further injury. The sci- until 1987. It was shown to be a false AN EMPIRE IS BORNentifically-unreliable theory was that if hypothesis.5 But, in the climate of thebleeding could be seen on an X-ray, the In 1974, the federal government took a early 1970’s, many physicians eager tocause—violent shaking—could be identi- leadership position in child abuse when serve the legitimate cause of child abusefied. (This is like saying that a psychiatrist Congress enacted the Child Abuse prevention, diagnosed scores of so-calledwho views the skull on an X-ray, or the Prevention and Treatment Act (CAPTA).6 SBS cases.brain on CT, MRI or PET scans, candetermine the cause of mental illness even Under CAPTA, “the term ‘child abusein the absence of organic brain disease.) and neglect’ means, at a minimum, any recent act or failure to act on the part ofRecognition of so-called SBS was—and a parent or caretaker, which results instill is—part of the declared war against death, serious physical or emotionalchild abuse prevention. Kempe and harm, sexual abuse or exploitation, or anCaffey theorized that when a child had act or failure to act which presents anintracranial bleeding and bleeding behind imminent risk of serious harm.”7 Thatthe eyes in the layers of the retina (retinal broad definition pulls many withinhemorrhages), this meant only one thing: its net.they had been violently and intentionallyshaken. 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 ascores 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 haveRecognizing “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 childand preventing it was the major focus of Children (NYSPCC). Hearing of the plight of abuse is suspected and remove childrenthe child abuse protection community a child living in the Hells Kitchen area of on an emergency basis, but which furtherdeveloped 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 broaderseveral 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 thecare workers who see or suspect physical belief that children should be afforded the same In some states, mandated reporters whoabuse, such as so-called SBS, to report it protection as animals.” The NYSPCA fail to report their suspicions of abuseto 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 someIn 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 to32 T H E W A R R I O R • F a l l 2 0 0 4
  6. 6. THE HOUSE OF THE INNOCENTSsix months in jail for those who fail to any other physical evidence of shaking, Alabama spent more than $65 m ($12 mreport. Failure to report may also subject most of the 5,000 to 6,000 people in federal dollars). California spent $1.3a 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). MassachusettsPredictably, 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 mdefinition of child abuse, large amounts THE VILLAGE federal).of funding at stake, coupled in somestates with the fear of criminal prosecu- The oldest federal agency dedicated to The Children’s Bureau also awards grantstion and/or civil liability, reports of child fighting child abuse is the Children’s on behalf of the Department of Justiceabuse have more than quadrupled since Bureau. It is part of the Department of (DOJ) that administers the Children’s1974. 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 districtAlmost three million reports of suspected Year (FY) 2004 was $6.7 billion. Of that, attorneys in how to effectively prosecutechild abuse were made in 1999. Of those, a whopping $2.5 billion was funneled to accused child abusers, including cases of1.8 million were investigated and of those the states in grants for various child abuse alleged SBS. Funding is also awarded toless than half were substantiated.8 While programs for protection and prevention, hire expert witnesses to testify against thethe protection of those unfortunate chil- which includes recognition. Many, many accused, including SBS experts.dren who had been abused or neglectedwas necessary, the flip side of those num- millions of that go directly to a vast The National Clearing House on Childbers tell another sorry story. A good por- bureaucracy of programs focused on one Abuse and Neglect which along with thetion 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 andlect were falsely or mistakenly accused. $81 million was awarded to states for Families, provides guides on how to getWith 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 ofOrwellian life that mandatory reporting nize child abuse heavily emphasize find- Regularly announcements are made inof ‘invisible’ abuse still occurs even ing cases of so-called SBS.12 the Federal Register that the Children’sthough that form of alleged abuse—SBS Every year, each state matches multi-mil- Bureau is seeking grant proposals fromwithout spinal cord injury—has been sci- lion-dollar federal funding in partnership public or private agencies to study how toentifically 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 CPSIt is another fact of Orwellian life that theright hand of the government does notknow what the left hand is doing.9 Forexample, the National Institutes ofHealth (NIH), under HHS, defines“shaken baby syndrome” as resultingspecifically in “TBI [Traumatic braininjury] and spinal cord injury.”10 Eventhough a scientific experiment has provedSDH’s cannot be caused by shaking,alone, and even though NIH’s officialposition is that real cases of SBS includespinal cord injuries, those who are trainedand paid by the government to find SBScases, and those who are under the gun toreport it, are not taking any chances. Themajority of SBS cases reported in themedical literature or currently being pros-ecuted do not involve spinal cord injury. Children During Great Depression: Feeding, clothing and sheltering children were at the topIn 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. 7. THE HOUSE OF THE INNOCENTSagencies, to private child advocacy organ- Next Issue: Every year the federal, ENDNOTESizations, or to individuals studying for state and local governments pump 1 Hobbs, CJ, Hanks, HGI, Wynne,their doctorates. The types of grantsavailable and the organizations to which billions of dollars into programs JM, Child Abuse and Neglect , Athey are awarded are limited only by the designed to help an army of social Clinician’s Handbook, Churchill- Livingstone, Harcourt Brace, 1991imagination—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 ofIn any given case of so-called SBS, it’s money may encourage some children who had intracranialimportant to get as much information as physicians and some who work in bleeding and broken bones in 1947.possible about the background of theState’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 theices 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 traumaticservices 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, putstomping out child abuse. But, if these an accelerometer on its neck, and hadwitnesses have been involved in training the federal and/or state freedom of some burly Penn State footballand/or research that manifests a clear bias information acts (FOIA) and the players shake the model as hard asin favor of the existence of SBS (without Internet to get a fuller picture of they could. The result was that thespinal cord injury) as a real diagnosis, and witnesses’ backgrounds and likely ‘shakers’ were unable to create theif they also failed to seek to study or forces needed to cause intracranialunderstand any of the known mecha- orientations. Knowing where to send FOIA requests and what to bleeding. The experiment alsonisms of head injury, then it’s important showed that to cause intracranialto get that information for cross-exami- ask for requires an understanding bleeding, or what is medicallynation 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 beInternet and requests under state and fed- grants and awards that are avail- impact. Impact forces were found toeral freedom of information acts can help able. The sequel to this article will be 50 times greater than those ayou find facts that you can use for cross- cover that topic. human being could generate byexamination. 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. 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 of5 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 amendments7 42 USC § 5106g(B)(2). DCFS had received several com- reflect sensitivity to the colossal8 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 claimed9 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