#11589. Recognising Limitations: Authors Response: An Invited Author Response to ‘Recognising Limitations: Pitfalls in Drawing Conclusions about Abusive Head Trauma’ by Edwards (20XX)

August 2026publication date
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Journal’s subject area:
Law;
Pediatrics, Perinatology and Child Health;
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More details about the manuscript: Science Citation Index Expanded or/and Social Sciences Citation Index
Abstract:
Although confessions related to abusive head trauma (AHT) are reported, no detailed analysis exists. Therefore, we systematically reviewed studies of AHT confessions and examined the details, including country of origin, mechanisms and perpetrators characteristics. All relevant studies underwent two independent reviews and data extraction. Of 6759 identified studies, 157 full texts were reviewed and 55 articles from 15 countries spanning four continents were included. Included articles contained 434 confessions. The mechanisms of abuse included shaking alone (64.1%), impact alone (17.1%), shaking plus impact (18.0%) and other (0.9%). There was no statistically significant difference in the percentage of confessions reporting shaking alone when comparing continents: North America (64.0%), Europe (64.2%) and Oceania (60.0%; p = 0.92), or when comparing circumstances in which the confession was obtained: medical evaluation (74.6%) vs police or judicial investigations (63.4%; p = 0.11). Of 119 cases with identified perpetrators, 67.2 per cent were cases with males alone. Confessions reveal striking similarities in the mechanism of AHT (predominantly shaking) that occur across the globe.
Keywords:
Abusive head trauma (AHT); mechanisms of abuse; shaking; impact

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