Attachment and Risk of Future Harm: A Case of Non‐Accidental Brain Injury

Decision making in cases of non-accidental brain injury is complex. Courts often view 'alternate care' as a means of ensuring that children are protected from further physical abuse. It is important for treating and assessing clinicians to present the court with a broad systems perspective highlighting the multiple factors which combine to impact on the child's future safety, welfare and wellbeing. These include risk and protective factors in the family of origin, the family's openness to monitoring and treatment; the child's needs for long term attachment relationships, and the risks associated with alternate care. This article highlights the need to consider long term attachment needs as part of any risk-of-harm assessment for young children who have been maltreated. Attachment issues are considered in the case of Nellie, a 17 month old toddler with a serious and unexplained non-accidental brain injury. (author abstract)

[1]  K. Kozlowska,et al.  Factitious illness by proxy: understanding underlying psychological processes and motivations , 2006 .

[2]  Doug Shelton,et al.  Perpetrator accounts in infant abusive head trauma brought about by a shaking event. , 2005, Child abuse & neglect.

[3]  Michael J Meaney,et al.  Epigenetic programming by maternal behavior , 2004, Nature Neuroscience.

[4]  R. Sapolsky.  Mothering style and methylation , 2004, Nature Neuroscience.

[5]  A. Pérez-Albéniz,et al.  Gender differences in empathy in parents at high- and low-risk of child physical abuse. , 2004, Child abuse & neglect.

[6]  B. Fish,et al.  Mental Health Risks to Infants and Toddlers in Foster Care , 2004 .

[7]  A. Kemp,et al.  The role of health professionals in preventing non-accidental head injury , 2003 .

[8]  A. Kemp,et al.  Factors affecting clinical referral of young children with a subdural haemorrhage to child protection agencies , 2003 .

[9]  A. Pérez-Albéniz,et al.  Dispositional empathy in high- and low-risk parents for child physical abuse. , 2003, Child abuse & neglect.

[10]  A. Kemp,et al.  Apnoea and brain swelling in non-accidental head injury , 2003, Archives of disease in childhood.

[11]  S. Hodge,et al.  Abusive head trauma in Maine infants: medical, child protective, and law enforcement analysis. , 2003, Child abuse & neglect.

[12]  L. Hanney,et al.  The network perspective: an integration of attachment and family systems theories. , 2002, Family process.

[13]  P. Dale,et al.  Serious and fatal injuries to infants with discrepant parental explanations: some assessment and case management issues , 2002 .

[14]  B. Perry.  Childhood Experience and the Expression of Genetic Potential: What Childhood Neglect Tells Us About Nature and Nurture , 2002 .

[15]  R. Durant,et al.  Is race or ethnicity a predictive factor in Shaken Baby Syndrome? , 2000, Child abuse & neglect.

[16]  J. Wynne,et al.  Abuse of children in foster and residential care. , 1999, Child abuse & neglect.

[17]  K. Kozlowska,et al.  Family Assessment and Intervention Using an Interactive Art Exercise , 1999 .

[18]  K. Chisholm,et al.  A three year follow-up of attachment and indiscriminate friendliness in children adopted from Romanian orphanages. , 1998, Child development.

[19]  A. Duhaime,et al.  Long-term outcome in infants with the shaking-impact syndrome. , 1996, Pediatric neurosurgery.

[20]  J. Milner,et al.  Empathic responsiveness and affective reactivity to infant stimuli in high- and low-risk for physical child abuse mothers. , 1995, Child abuse & neglect.

[21]  M. Meaney,et al.  Maternal care, gene expression, and the transmission of individual differences in stress reactivity across generations. , 2001, Annual review of neuroscience.

[22]  P. Crittenden.  Atypical attachment in infancy and early childhood among children at developmental risk. VII. Danger and development: the organization of self-protective strategies. , 1999, Monographs of the Society for Research in Child Development.

[23]  J. Rosenthal,et al.  A descriptive study of abuse and neglect in out-of-home-placement. , 1991, Child abuse & neglect.