Vollmer-Sandholm, MJ et al. Characteristics of pediatric cases presenting for concerns of abusive head trauma in Norway. Child Protection and Practice, June 2026
https://doi.org/10.1016/j.chipro.2026.100296
Background
Abusive head trauma (AHT) is a frequent cause of severe and fatal head injury in young children. There are few published studies on AHT from Scandinavia.
Objective
To describe the characteristics of AHT in Norway and examine whether documented prior concerns could have enabled earlier identification and prevention.
Participants and Setting
Retrospective study of children aged <4 years admitted with head injury and reported to the police for suspected AHT between 2003–2019. Based on medicolegal investigation, cases were classified as deemed inflicted or indeterminate.
Methods
Mixed-methods retrospective chart review of medicolegal case files, including medical records and police investigation reports, focusing on demographics, medical and social history, and circumstances around the time of presentation to care.
Findings
Of 77 children (median age 4 months; 64% male), 55 were deemed inflicted and 22 indeterminate. Inflicted cases had typically more severe injuries and poorer outcomes, with low GCS on admission and 15% mortality. In 78% of all cases no history of trauma was initially offered and in 65% there was delay before seeking care. At least one prior concern related to illness, injuries or parental coping was documented before the head injury in 55% of cases, more often in inflicted (62%) than indeterminate AHT (36%; P = 0.04). In 32% of cases there appeared to have been opportunities to intervene prior to the injury.
Conclusion
Most AHT cases present without a reported trauma history and with delay in seeking care. Prior concerns about the child's well-being are common, indicating potential for prevention.
(06/2026)
(link)
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