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Considering suffocatory abuse and Munchausen by proxy in the evaluation of children experiencing apparent life-threatening events and sudden infant death syndrome
- Authors:
- TRUMAN Thomas L., AYOUB Catherine C.
- Journal article citation:
- Child Maltreatment, 7(2), May 2002, pp.138-148.
- Publisher:
- Sage
Describes 138 young children admitted to hospital over 23 years for recurrent apparent life threatening events (ALTEs), unexplained deaths, or with diagnoses related to sudden infant death syndrome (SIDS). In examining the potential for suffocatory abuse in living children, the authors used characteristics in the literature distinguishing SIDS or ALTEs due to natural disease states from abuse. Findings demonstrate a co-occurrence of risk factors that raise suspicions of suffocatory abuse or Munchausen by proxy. Of the 35 children who died, SIDS was the presumed clinical diagnosis at time of death in 71%. Comprehensive chart review and autopsy findings revealed a non-SIDS diagnosis in 54% and confirmed or suspicious child abuse in 37% of deaths. Reports to child protective services were made in 6% of cases. Offers recommendations for assessment of children including attention to risk indicators, involvement of child protection teams, mandatory autopsies, and death scene investigations. Part of the focus section 'Munchausen by proxy'.