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.
Similar content being viewed by others
References
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.
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.
Byard RW, Donald T, Hilton JN, Krous HF. Shaking-impact syndrome and lucidity. Lancet. 2000;355:758.
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.
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.
Mahoney MJ. Publication prejudices: an experimental study of confirmatory bias in the peer review system. Cog Ther Res. 1977;1:161–75.
Author information
Authors and Affiliations
Corresponding author
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Byard, R.W., Shipstone, R., Thompson, J.M.D. et al. How reliable is parental/carer assessment of infant health status?. Forensic Sci Med Pathol 15, 629–630 (2019). https://doi.org/10.1007/s12024-019-00157-8
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12024-019-00157-8