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In the United States, one of the most educated and affluent countries in the world, over three-quarters of a million children were victims of child maltreatment in 2008 (USDHHS-ACF, 2010). Child fatalities are the most tragic consequence of maltreatment. In 2008, an estimated 1,740 children ages 0 to 17 died from abuse and neglect (rate of 2.3 per 100,000 children) (CDC, 2010b). Nearly 40 percent (39.7%) of fatalities suffered from multiple forms of maltreatments. Another 30 percent (31.9%) suffered from neglect only; 22.9% of fatalities were a result of physical abuse; medical neglect resulted in 1.5% of fatalities.
According to the National Center on Shaken Baby Syndrome (NCSBS, nd), approximately 1,300 U.S. children experience severe or fatal head trauma from child abuse every year. Abusive head injuries are the most common cause of death in child abuse (Case & NCSBS, nde).
Approximately 20% of cases of AHT are fatal in the first few days after injury and the majority of the survivors are left with handicaps ranging from mild - learning disorders, behavioral changes - to moderate and severe, such as profound mental and developmental retardation, paralysis, blindness, inability to eat or existence in a permanent vegetative state (NCSBS, nd). Dias, et al. (2005) reported that 13 to 30% of pediatric AHT cases result in mortality and significant neurologic impairments occur in at least one half of the survivors.
Medical costs associated with initial and long-term care for children who are victims of AHT can range from $300,000 to more than $1,000,000 (NCSBS, nd). Additional costs associated with loss of societal productivity and occupational revenue and with prosecution and incarceration of a perpetrator are unknown (Dias, et al., 2005).
Parents and their partners are responsible for nearly three fourths of cases, with fathers or stepfathers (37% of cases) and boyfriends (21% of cases) accounting for the majority of cases and mothers accounting for an additional 13%. The average age of the victims is 5 to 9 months, and almost all are less than 36 months of age (Dias, et al., 2005; CDC, ndb).
In the Commonwealth of Kentucky, during State Fiscal Year 2008, 21 cases of pediatric abusive head trauma resulted in a child fatality or near fatality. In State Fiscal Year 2009, 24 cases of pediatric abusive head trauma resulted in a child fatality or near fatality (Governor’s Press Release, May 27, 2010).
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