‘The Battered-Child Syndrome’ 50 Years Later - Much Accomplished, Much Left to Do



“A half century ago, Kempe and colleagues published in JAMA ‘The Battered-Child Syndrome,’ an article that would change the way physicians and others care for children with injuries. Although this article was not the first in the medical literature to address the problem of physical abuse of children, the authors did report the first epidemiologic study and highlighted important aspects of the evaluation of suspected abuse …,” writes John M. Leventhal, M.D., of the Yale School of Medicine, New Haven, Conn., and Richard D. Krugman, M.D., of the University of Colorado School of Medicine, Aurora.1

The authors write that the 50th anniversary of this article is an opportunity to reflect on 3 salient lessons learned over the past 5 decades about the care of maltreated children: (1) many children and families are affected; (2) the consequences can be lifelong and intergenerational; and (3) treatment and prevention can work but need to be expanded.

Susan C. Kim, J.D., M.P.H., of the Georgetown University Law Center, Washington, D.C., and colleagues examine the issue of what is the duty to report suspected cases of child abuse by individuals in positions of trust over young people, such as in the church or university sports.2

“Religious institutions, colleges, and schools have close ties to their communities, and the integrity of their employees is a matter of upmost public concern. These institutions should adopt stringent child protection policies because many sexual predators, often familiar with state law, seek out relationships with children in which they can assume positions of responsibility for the children. Institutions have a responsibility to be vigilant in preventing and detecting child abuse by members of their community.”

Daniel M. Albert, M.D., M.S., of the University of Wisconsin School of Medicine and Public Health, Madison (and Editor, Archives of Ophthalmology), and colleagues offer suggestions on how improve the quality of expert medical testimony given at trials of suspected pediatric abusive head trauma (AHT) (“shaken baby” syndrome).3

“… it is essential that a system is in place to provide some degree of certainty that physicians testifying for both the prosecution and defense as AHT medical experts are indeed expert, experienced, and unbiased,” they write. Additionally, they suggest “a certification program should be developed for medical professionals called on to provide opinions of diagnoses in cases of suspected AHT, thus providing them the prerequisite training, experience, and knowledge of the literature regarding AHT to be considered qualified to give expert testimony on this topic.”


1. (JAMA. 2012;308[1]:35-36.

2. (JAMA. 2012;308[1]:37-38.

3. (JAMA. 2012;308[1]:39-40.