www.aapnews.org Volume 36 • Number 5 • May 2015
Annual Leadership Forum
The needs of immigrant and refugee children topped the list
of resolutions brought forward for consideration at the Annual
Leadership Forum. Page 8
The pediatrics specialty remained highly desirable for medical
school graduates in the 2015 main residency match. Page 17
In this issue
See Abuse, page 4
Don’t miss signs, symptoms
AAP report helps pediatricians
identify, respond to child abuse
by Cindy W. Christian, M.D., FAAP
The emergence of research related to adverse child experiences,
toxic stress and the biological consequences of these problems for
adults and children highlights the importance of early recognition and intervention
for abused children.
All forms of child maltreatment are an important cause of toxic stress in children,
and physical abuse itself can result in high rates of later health problems, from permanent physical disability to a host of behavioral and mental health issues.
To assist pediatricians with identifying and responding to child physical abuse,
the AAP Committee on Child Abuse and Neglect has updated the clinical report Evaluation of Suspected Child Physical Abuse published in the May Pediatrics
(2015;135: e1337-e1354; bit.ly/1AwRKHw). The report can help primary care pediatricians learn clinical clues to the diagnosis of abuse and understand specific injuries
of concern, appropriate diagnostic tests and considerations, and legal requirements
related to mandated reporting of suspected abuse.
Overcoming barriers, challenges
Identifying abuse can be extremely challenging, especially in the youngest victims.
Of the 2 million reports of suspected child maltreatment in the United States
Academy offers guidance
on new lice treatments, opposes
school bans on infested children
by Cynthia D. Devore, M.D., FAAP,
and Gordon E. Schutze, M.D., FAAP
An updated AAP
clinical report contin-
ues to encourage pedia-
tricians to take a greater
role in ensuring appro-
priate use of effective
head lice treatments and
provides several new treatment options for their arsenal.
In addition, the report reiterates the Academy’s oppo-
sition to policies that ban children with lice or lice eggs
(“nits”) from school.
Head lice infestations, common among children
ages 2-12, are neither a health hazard nor a sign of poor
hygiene, according to the report titled Head Lice
See Commentary, page 4
Report questioning shaken baby
syndrome seriously unbalanced
by Howard Dubowitz, M.D., M.S., FAAP, and Errol R. Alden, M.D., FAAP
For a long time, child abuse stories made for important news. Now, suggesting
that parents have been falsely accused makes for a far more compelling story, as
is the case of a recently published article in the Washington Post, www.washing
But like the back-and-forth over childhood immunizations, this is a false debate. The
truth is that child abuse, including abusive head trauma, is a real problem that terribly
injures and sometimes kills children. The Post’s report on the “disputed diagnosis” of
shaken baby syndrome is disturbing. Indeed, the science has been shaken — but only
by the media and a small number of physicians.
The Washington Post, like other media outlets in recent days, focuses on wronged
parents, alleged to have been mistakenly accused and imprisoned for harming
or killing their children. Reporters interviewed physicians who once thought
that shaken baby syndrome was an accurate diagnosis but have since changed
their opinions, helping overturn criminal convictions. These physicians accuse
pediatricians of glibly rushing to judgment in diagnosing shaken baby syndrome.
Journalists can be commended for addressing child abuse. Unfortunately, the
Post’s report is seriously unbalanced, sowing doubt on scientific issues that actually
are well-established. It is very clear that shaking a baby is dangerous.
Spotlight on lifesaving achievements in pediatric research
See Lice, page 18