SHAKEN BABY SYNDROME--Virginia's 'Minimum Standards' reaches for a new, lower minimum

REPORT TO FRIENDS--July 27, 2000

SHAKEN BABY SYNDROME
Virginia's 'Minimum Standards' reaches for a new, lower minimum

Letter from Parents and Teachers Against Violence in Education (PTAVE) to the Child Welfare Licensing Unit, Division of Licensing Programs, Virginia Department of Social Service
July 27, 2000
Doris Jenkins, Manager, Child Welfare Licensing Unit Division of Licensing Programs
Virginia Department of Social Services
P.O. Box 1475
Richmond, VA 23218

Dear Ms. Jenkins,
We are in receipt of a copy of "The Minimum Standards for Licensed Child-Placing Agencies," sent to us by Mr. Claude A. Allen, Secretary of Health and Human Services, in his correspondence of July 20, 2000.
While this proposed change in policy contains several points which are of grave concern to us, the purpose of this letter is to seek clarification on one point only--harsh shaking--which the revised standard would forbid.
Because only "harsh" shaking, as opposed to any other kind of shaking, would be proscribed, we assume that the drafters had in mind certain criteria that differentiate harsh from not harsh. Would you please share those criteria with us, so that we can share them with others by means of our Web site, Project NoSpank. Many caretakers, and others in child-related fields, come to the site for precisely for that kind of information. Moreover, the information will be invaluable to foster parents and prospective foster parents in Virginia. Since you propose to allow a certain level of shaking, we believe you are duty bound to inform them about the risks of shaken baby syndrome. It would be grossly unfair to foster parents (as well as potentially disastrous for infants and children) if you advise them that they may shake their charges, but fail to give them precise guidelines for the correct way of doing it.
Additionally, your proposed policy change has serious legal ramifications. It will in effect be creating a ready-made legal defense for anyone who shakes a child even to the point of causing blindness, spinal cord injury, brain damage or death. A mere lay person could not reasonably be expected to know what constitutes acceptable shaking if the Division of Licensing Programs, Virginia Department of Social Services doesn't know, or if it knows but doesn't disseminate the information. In these circumstances, prosecutors would be reluctant to prosecute any but the most blatant violators, and most child injuries as a result of shaking would be dismissed as unfortunate accidents. In fact, the children themselves could be implicated for having been accident prone, soft-boned, easy bruisers or having had some other mysterious defect or weakness. Thus, adult perpetrators would be largly, if not wholly, exonerated. That's how violence against children was handled traditionally, and continues to be handled in culturally backward places. We trust it is not the intention of the Department of Social Services to reestablish that tradition in Virginia.
In addition to posting this correspondence on Project NoSpank (nospank.net/jenkins.htm), we will circulate it to the physicians listed below, all of whom specialize in the diagnosis and treatment of victims of child abuse, and will be keenly interested in developments in Virginia.
Thank you for your kind attention.
Sincerely,
Jordan Riak,
Executive Director
cc: Claude A. Allen
cc: (physicians)

Mia Amaya, M.D., M.P.H.
University of Alabama
Birmingham, Alabama
Kirsten Bechtel, M.D.
St. Christopher's Hospital
Philadelphia, PA
Steven D. Blatt, M.D.
SUNY, Syracuse Health Science Center
Syracuse, NY
Ann S. Botash, M.D.
Syracuse University Health Care Center
Syracuse, NY
David L. Chadwick, M.D.
Children's Hospital and Health Center
San Diego, CA
Cindy Christian, M.D.
Children's Hospital of Philadelphia
Philadelphia, PA
Daniel L. Coury, M.D.
Children's Hospital
Columbus, OH
Michael D. DeBellis, M.D
University of Pittsburgh Medical Center
Pittsburgh, PA
John de Triquet, M.D.
Children's Hospital
Norfolk, VA
Howard Dubowitz, M.D.
University of Maryland
Baltimore, MD
Kenneth W. Feldman, M.D.
University of Washington
Seattle, WA
Emalee G. Flaherty, M.D.
Children's Memorial Hospital
Chicago, IL
Martin A. Finkel, D.O.
Univ. Medicine & Dentistry of New Jersey
Camden, NJ
Gilles Fortin M.D
Chief of Clinique de Pediatrie Socio-Juridique
Hopital Sainte-Justine
Montreal, Qubec, Canada
Lori Frasier, M.D.
University of Missouri Hospitals & Clinics
Columbia, M.O.
Lorraine Gari, M.D.
Wolfson Children's Hospital
Jacksonville, FL
Jill Glick, M.D.
University of Chicago Children's Hospital
Chicago, IL
Penny Grant, M.D.
Broward County Child Protection team
Fort Lauderdale Florida
Lorraine Gari M.D.
Wolfson Childrens Hospital
Jacksonville, FL
Scott Halpert, M.D.
Lane County Child Advocacy Center
Eugene, OR
Ralph A. Hicks, M.D.
The Children's Medical Center
Dayton, Ohio
Dirk Huyer, M.D.
Hospital for Sick Children,
University of Toronto
Toronto, Ontario
Carol Jenny, M.D.
Hasbro Children's Hospital
Providence, RI
Mark Joffe, M.D.
Children's Hospital of Philadelphia
Philadelphia, PA
Steven W. Kairys, M.D, M.P.H.
Dartmouth Medical School
Lebanon, NH

Karen M. Kaplan, M.D.
Penn State Geisenger Health System
Hershey, PA
Robert H. Kirschner, M.D.
University of Chicago
Chicago, IL
Kathi J. Kemper, M.D., M.P.H.
Swedish Family Medicine
Seattle, WA
Henry Krous, M.D.
Children's Hospital-San Diego
San Diego, CA
Alex V. Levin, M.D
Hospital for Sick Children,
University of Toronto
Toronto, Ontario
John McCann, M.D.
University of California,
Davis Medical Center
Sacramento, CA
Marcellina Mian, M.D.
Hospital for Sick Children,
University of Toronto
Toronto, Ontario
Kieran Moran, M.D.
Sydney Children's Hospital
Sydney, Australia
Lucy M. Osborn, M.D., M.S.P.H.
University of Utah Health Sciences Center
Salt Lake City, UT
Vincent Palucci, M.D.
DeVos Children's Hospital
Grand Rapids, MI
Robert M. Reece, M.D.
Institute for Professional Education, MSPCC
Boston, MA
Lawrence R. Ricci, M.D.
The Spurwink Child Abuse Program
Portland, ME
Des Runyan, M.D., Dr.P.H.
University of North Carolina
Chapel Hill, NC
Michael Ryan, M.D.
The New Children's Hospital
Sydney, Australia
Matthew D. Sadof, M.D.
General Pediatrician
Temple University Health System
Philadelphia, PA
Matthew D. Sadof, M.D.
Temple University Health System
Philadelphia, PA
Robert Sege, M.D., Ph.D.
The Floating Hospital
Boston, MA
Benjamin Siegel, M.D.
Boston Medical Center
Boston, MA
Robert A. Shapiro, M.D.
Children's Hospital Medical Center
Cincinnati, OH
Suzanne P. Starling, M.D.
Vanderbilt University Medical Center
Nashville, TN
Carol Stashwick, M.D. ,Ph.D.
Children's Hospital at Dartmouth
Lebanon, NH
John Stirling, M.D.
Clark County Child Abuse Intervention Center
Vancouver, WA
David Turkewitz, M.D.
York Hospital
York, PA
J.M. Whitworth, M.D.
Children's Crisis Center
Jacksonville, FL

Document sent to PTAVE by Claud A. Allen, Secretary of Health and Human Services, Virginia, July 20, 2000

The Minimum Standards for Licensed Child-Placing Agencies

The Minimum Standards for Licensed Child-Placing Agencies regulation was published in The Virginia Register on July 17, 2000. Public comments may be received from that date through September 16, 2000. Please send your comments to me via e-mail or through interoffice or regular mail to the DSS, 730 East Broad Street, Richmond, Virginia 23219. You may request a hard copy of the regulation from me or find it on the Internet at http://legis. state.va.us/codecomm/register (The Virginia Register) or http://www.townhall.state.va.us.The Virginia Register is also available at public libraries.
The proposed changes regarding corporal punishment and discipline are:

Abusive corporal punishment is prohibited. Abusive is defined as physical abuse using the same definition as found in the Child Protective Services' regulation. Corporal punishment is defined as the use of physical force that is abusive which causes a child to experience pain, but not necessarily injury, for the purpose of correction or control of the child's behavior. Prohibited punishment includes all actions, when abusive, such as hitting with any part of the body or with an implement, pinching; jerking; harsh shaking, binding a child; forcing him to assume a bodily painful position; or locking him in a room or closet.

Private agencies must develop policies on discipline, which may include non-abusive corporal punishment, and acceptable methods of control of children based on research of scientific literature on discipline.

Agencies must make these policies known to the foster and adoptive parent applicants prior to or during the home study.

Agencies must develop an individual plan of discipline for each child placed in a foster or adoptive home based on the needs of the child.

Agencies must have policies to ensure that children are not subjected to physical abuse, mental abuse or sexual abuse; verbal abuse or remarks that belittle or ridicule the child or his family; physical neglect or denied essential program or treatment services, meals, water, clothing, bedding, sleep, or personal care products; or subjected to any humiliating, degrading or abusive actions.
I hope this information is helpful to you. Please let me know your questions or comments.
Thank you,
Doris Jenkins, Manager, Child Welfare Licensing Unit
Division of Licensing Programs
Va. Department of Social Services
804-692-1773
See Backsliding Virginia, Report to Friends, July 1, 2000.
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