Preventing

Shaken Baby Syndrome

The SKIPPER Initiative

Shaking Kills:
Instead Parents Please
Educate and Remember
1011 Dutchess Turnpike
Poughkeepsie, NY 12603
845-418-6960
 Mission

To increase general public awareness

about the danger of shaking babies
and young children
To educate parents and caregivers
about ways that they can help protect
children in their care from shaking
injuries
 Faces
Dutchess County, NY

George ‘Skipper’ Lithco III D.J. Anderson

Dec. 24, 1999 Sept. 10, 1999
Dec. 3, 2000 Feb. 9, 2001

Bridget Walker
SBS Survivor
 The SKIPPER Principles

Shaking injuries CAN be prevented.

EVERY caregiver will experience frustration and anger.

WE are all vulnerable to the impulses that result in shaking, so WE

all need to be prepared to cope with the inevitable moments of
frustration and anger.

Parents and caregivers should agree that it is not only OK to ask

for help, but that it is the hallmark of a responsible caregiver.
 Effective Education
Lessons learned from Stop & Shop:
Hear. Getting attention.
Listen. Getting the message.
Understand. Accepting the message.
Act. Getting results.
 Hearing the Message
Positive focus – injury prevention .
Enabling parents to keep their child safe .
Reframing the Message: you can help protect your
child from harm.
It’s not YOU: every caregiver needs to know this.
Avoid “you should never shake your baby” - “child
abuse” – cognitive bias.
Redirect focus: educate other caregivers.
 Hearing the Message
Birth is a “teachable moment.”
Challenge: overcome cognitive barriers –
for parents AND educators.
Cognitive biases – bad things happen to
bad people.
SBS is a bridge between worlds - and
words - of “child abuse” and “injury
prevention.”
 Understanding the
Message
It’s not about Good and Bad: all caregivers
are tired, and everyone gets frustrated and
angry
Becoming a parent means surrendering
much of your control over life
No one gets up in the morning….
56% of parents report THEY have at least
one “tantrum” a day.
 Understanding the
Message
It’s not about “those kind of people”: it’s
about “US”.
The value of video – fidelity of message,
and, in a video culture, seeing that SBS can
happen to people like US.
Education programs MUST be try to be
universal to be normal to be effective
 Getting Results
Emphasize the importance of
educating all other caregivers.
Emphasize how to educate others in a
positive, non-accusatory way.
Zero to Three: 47% of babies under 6
months of age have at least one other
caregiver
 Getting Results
We learn 5% of what we hear, 10% of
what we read and 90% of what we
teach.
 Getting Results: Who
Agencies Should Talk To
Foster and adoptive parents
Parents in aggression management
Parents in the criminal justice system
Teen parenting programs
Grandparents/Relatives as Parents
Middle School and High School
parenting/babysitting classes
 Getting Results: Why
Talk About SBS
Enable parents to take action that will
protect their child from injury
Upstate NY SBS Prevention Project reports
sustained 47% reduction in inflicted head
trauma- Pediatrics 4/2005
Coping skills to prevent shaking injuries will
also reduce other consequences of
frustration and anger directed at children
 Getting Results: Why
Support SBS Efforts?
Reduce the cost of the consequences to taxpayers:
$1.00 spent on prevention saves $1.73 spent on the
consequences of SBS.

Medical treatment.
Rehabilitation.
Criminal justice cost.
Learning disabilities.
Social costs.
 Medical costs
Non-survivors. $5—15,000
Survivors with critical care. $75,000 -
$125,000
Survivors without critical care: $2,500
 Rehabilitation costs.
$105,000 annual cost for child in
nursing home
Home care costs
 Dutchess County
2000-2003
8 months to 2-3/4 years old
7 women
2 grandmothers
3 child care providers
1 child of a foster parent
1 wife of a pediatrician

Lesson: there may be higher risk parents, but there

are no no risk parents
Normal?
 Not So
Normal

- For Better or For Worse, Lynn Johnston

 Normal
Percent of parents self-reporting
shaking of a child under age 2
Courtesy Dr. Desmond Runyan, UNC
 Coping

Develop a coping plan

Share the plan
Normalize the plan
Be proactive
Be organized and available
Be aware
How to talk to caregivers…

Make it NORMAL: part of your list of things to

go over with everyone.

Talk about a narrative: an article you read.

Share a brochure, or let your baby do it…

Onesie way to break the
ice with caregivers…
 Legislative Action
Hospital Education Legislation
Video: NY, MO, IL, MN, PA, WI MA, OH, SC,
NE, IA (2010: KY)
Brochure: WA, TX, VA,TN, IN, CA (2010: NJ)
Campaign: WA, NJ
Child Care Education
TX, NY, AL, NJ, FL, WI, MN, MA, OH, NE, SC
School Education
NY, WI (2010: KY)
 Legislative Action
In 2010, nearly 2/3 of US births will take
place in a state with some form of education
requirement.
A law requiring education for ALL new
parents makes it easier for educators.
Reframing education as safety and injury
protection makes it easier for educators and
institutions.
JACHO: compliance for accreditation
Governor Pataki, at signing of hospital
education legislation, 2004
 Legislative Action
Shaken Baby Prevention Act 2010
S. 3003, HE 4642
Fund national prevention education for new parents,
caregivers, support services for providers
Education Begins at Home Act
Home visiting programs ($440 m. stimulus)
- Parents As Teachers, Nurse-Family Partnership, etc.
- RAND study: effective
 Awareness Campaign
National Awareness Week 2010
- US Senate Resolution, States, Counties
Posters and Brochures: Pediatric Offices, Hospitals,
Child Care Centers
Partners
Child Care Community
Schools (babysitter safety)
Children’s Trust Funds
Medicaid and Health Insurers
Parenting Organizations
 Statistical Sampler
1400-1600 cases brought to medical
attention
300 deaths, 600-900 disabilities
NY: 41% Medicaid births
2.6% mothers self report shaking (NC)
-
 More Statistics

100% think PoP is worthwhile

86% report talking to others
15-20% colic
 More Statistics
Parent is a transitional position. It has the
highest turnover rate in the world: every day,
there are 10,000 more babies whose
parents need education.
Parenting education is optional.
Nearly 60% of new parents don’t feel ready.
Back to Sleep – After 10 years of the Back
to Sleep campaign, CA reports 65% of new
parents know about it at birth (2004) – which
means 35% don’t!
 Opportunities
Awareness campaign
Support hospital education programs
Develop ped office protocols
ask parents to identify a support person
teething, colic, vax
Support reframing education
Support early childhood Partnerships
- child care, schools
Normalize frustration
 Going To Scale
Identify existing resources – collaborate and share
Look for ladders to climb – use existing organizations to
develop partnerships – hospital associations, child care and
social service agencies, children’s trust funds
Focus on Reframing - enable parents and educators
Change the info dynamic, so parents pull information
Use social media judiciously – quicker, easier, cheaper
Use Internet tools to repurpose information, act at a distance
AND multiply effort: YouTube, Twitter, Blogs
Use Internet tools to adapt models, maintain fidelity
Identify and develop staff who can act as agent/coach:
positive, supportive, knowledgeable and persistent.
Going To Scale - Caution
Understand the nuances of turf: whose program is
it?
Collaboration peril: the narcissism of small
differences - it’s easiest to argue when you almost
agree (the devil is in the details)
Reframing - enable parents and educators
 Going To Scale -
Opportunities
Understand the non-monetary reward for a legislator – public
recognition of their efforts
Work with state and local legislators to implement an action
plan for legislative awareness of costs and opportunities,
recognition of prevention efforts
Understand the role of legislative staff and build relationships
– often (turnover).
Understand the importance of awareness actions that don’t
require funding, bridge partisan chasms, and build
collaborations.