Head injury secondary to suspected child maltreatment: results of a prospective Canadian national surveillance program

Objective

We sought to determine the incidence, clinical features, and demographic profile of head injury secondary to suspected child maltreatment (abuse or neglect) in Canada to help inform the development and evaluation of prevention programs for abusive head injuries.

Methods

From March 1, 2005 to February 28, 2008, an average of 2,545 paediatricians and paediatric subspecialists were surveyed monthly through the established network of the Canadian Paediatric Surveillance Program. We calculated incidence rates using the number of confirmed cases over the product of the duration of the study (3 years) and population estimates by age group.

Results

There were 220 confirmed cases of head injury from suspected child maltreatment. The annual incidence rate was 14.1 per 100,000 for children less than 1 year of age and 1.4 per 100,000 for those less than 15 years. Seventy three percent (141) of cases involved infants less than 12 months of age and 52% (100) of cases involved infants less than 6 months of age. Seventy-five percent (165) of cases presented to the emergency room. With regard to outcome, 12% (27) of cases resulted in death and 45% (75) of survivors had neurological sequelae at discharge. Thirty percent (67) of all cases, as well as 30% (8) of deaths were previously known to child welfare authorities.

Conclusion

This study provides an estimate of the rate of head injury secondary to suspected child maltreatment in Canada. The young age and poor medical outcomes of those involved highlights the need for prevention efforts that are implemented early in life. Given that a significant percentage of injured infants and children were already known to child welfare authorities, the study also highlights the need to establish and evaluate additional preventive efforts for parents and caregivers already in the child welfare system.     

Blocking between landmarks during 2-D (touchscreen) and 3-D (ARENA) search tasks with pigeons

Many studies investigating cue competition have focused on the blocking effect. We investigated the blocking effect with pigeons using a landmark-based spatial search task in both a touchscreen preparation (Exp. 1a) and an automated remote environmental navigation apparatus (Exp. 1b). In Phase 1, two landmarks (LMs: A and Z) appeared on separate trials as colored circles among a row of eight (touchscreen) or six (ARENA) identical response units. Subjects were rewarded for pecking at a target response unit to the right of LM A and to the left of an extraneous LM, Z. During the blocking trials in Phase 2, LM X was presented in compound with a second LM (A) that had been previously trained. On control trials, LM Y was presented in compound with LM B and a target in the same manner as in the trials of AX, except that neither landmark had previously been trained with the target. All subjects were then tested with separate trials of A, X, B, and Y. Testing revealed poor spatial control by X relative to A and Y. We report the first evidence for a spatial-blocking effect in pigeons and additional support for associative effects (e.g., blocking) occurring under similar conditions (e.g., training sessions, spatial relationships, etc.) in 3-D and 2-D search tasks.     

Diversity in deafness: Assessing students who are deaf or hard of hearing

The purpose of this article is to support members of a student's multidisciplinary team to identify complex factors involved in providing valid classroom-based assessment data, including issues surrounding technology-based assessment for students who are deaf or hard of hearing (DHH). The diversity of this population creates unique challenges in creating guidelines for assessment. An overview of the diversity of DHH students is used to provide a framework for examining current assessment practices, including both effective and ineffective practices. Cognitive and linguistic learning differences and diverse language learning experiences in the population are discussed as they relate to assessment protocols. Paralleling technology-based learning experiences with comparable technology-based assessment experiences is also presented. Recommendations for planning for accessible and meaningful assessment include the use of innovative technologies to align instruction and assessment.