Advertisement

Forensic Science, Medicine and Pathology

, Volume 15, Issue 4, pp 629–630 | Cite as

How reliable is parental/carer assessment of infant health status?

  • Roger W. ByardEmail author
  • Rebecca Shipstone
  • John M. D. Thompson
  • Jeanine Young
Commentary
  • 47 Downloads

Abstract

Problems often arise in cases of lethal inflicted injury in infants and children in determining the chronology of events. However, on occasion it may be assumed that a parent’s statement that the child appeared normal at a particular time is correct. It is then inferred that the lethal injury occurred after this time. In a study of infants from Queensland, Australia a significant number of cases occurred where a parent/carer did not actually recognise that an infant was deceased or in extremis despite handling of the infants, some of whom had established rigor mortis. Assessment of their infant’s health status was quite flawed, presumably due to inattention, fatigue, or confirmatory bias (seeing what is expected). This could also apply to infants with head injuries who may manifest quite non-specific signs such as lethargy, somnolence or alteration in conscious state, manifestations that could easily be confused with normal drowsiness or sleep. Thus, the evaluation of parent/carer statements must be tempered by the knowledge that their opinions may not always (for completely understandable reasons) be reliable, and should not be uncritically accepted as a basis for deciding the time course for a lethal process.

Keywords

head injury parental assessment death confirmatory bias SUDI 

Notes

References

  1. 1.
    Whybourne A, Zillman MA, Miliauskas J, Byard RW. Sudden and unexpected infant death due to occult lymphoblastic leukaemia. J Clin Forensic Med. 2001;8:160–2.CrossRefGoogle Scholar
  2. 2.
    Lambert V, Matthews A, MacDonell R, Fitzsimmons J. Paediatric early warning systems for detecting and responding to clinical deterioration in children: a systematic review. Brit Med J Open. 2017:7e014497.Google Scholar
  3. 3.
    Byard RW, Donald T, Hilton JN, Krous HF. Shaking-impact syndrome and lucidity. Lancet. 2000;355:758.CrossRefGoogle Scholar
  4. 4.
    Shipstone R, Thompson JMD, Young J, Byard RW. The use of post-mortem lividity to determine infant sleep position at time of death in cases of sudden unexpected death in infancy. Acta Paediatr. 2019.  https://doi.org/10.1111/apa.14834.
  5. 5.
    Byard RW, Gabriellian L, Helps SC, Thornton E, Vink R. Further investigations into the speed of cerebral swelling following blunt cranial trauma. J Forensic Sci. 2012;57:973–5.CrossRefGoogle Scholar
  6. 6.
    Mahoney MJ. Publication prejudices: an experimental study of confirmatory bias in the peer review system. Cog Ther Res. 1977;1:161–75.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Forensic Science South Australia (FSSA)The University of AdelaideAdelaideAustralia
  2. 2.School of MedicineThe University of AdelaideAdelaideAustralia
  3. 3.School of Nursing Midwifery and ParamedicineUniversity of the Sunshine CoastSippy DownsAustralia
  4. 4.Departments of Paediatrics, Child and Youth Health, and Obstetrics and Gynaecology, Faculty of Medical and Health ScienceUniversity of AucklandAucklandNew Zealand

Personalised recommendations