Abusive Head Trauma

Last Reviewed Date
December 15, 2022
Head Trauma

Abusive head trauma (AHT) is the leading cause of fatal head injuries in children younger than 2 years.1  “Abusive head trauma, which includes shaken baby syndrome, is a preventable and severe form of physical child abuse that results in an injury to the brain of a child. Abusive head trauma often happens when a parent or caregiver becomes angry or frustrated because of a child’s crying. It is caused by violent shaking and/or with blunt impact".2      

Child care providers have an important role that they can play in adopting prevention strategies to support themselves, other caregivers, parents, and families. These strategies include: 

  • learning about abusive head trauma
  • sharing information on typical child development and self-care 
  • helping infants and caregivers build relationships 
  • connecting with community resources (such as home visiting and family support groups) 
  • identifying sources of household family stress and connecting families to resources in partnership with health and other systems  

Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education Programs, outlines best practices regarding abusive head trauma.  According to Caring for Our Children Standard, Preventing and Identifying Shaken Baby Syndrome/Abusive Head Trauma, the goal of this standard is that:

  1. All child care facilities should have a policy and procedure to identify and prevent shaken baby syndrome/abusive head trauma.
  2. All caregivers/teachers who are in direct contact with children, including substitute caregivers/teachers and volunteers, should receive training on preventing shaken baby syndrome/abusive head trauma; recognizing potential signs and symptoms of shaken baby syndrome/abusive head trauma; creating strategies for coping with a crying, fussing, or distraught child; and understanding the development and vulnerabilities of the brain in infancy and early childhood.

Children with special needs or health problems are often at increased risk for abusive head trauma. One reason that a child with a disability may be at increased risk is that they are not meeting the developmental milestones that their caregiver is expecting. 2 Children experiencing colic cry for longer periods of time which increases caregiver frustration and the risk of being shaken.  

Programs that are exempt from licensing need to meet health and safety requirements for abusive head trauma, as outlined by their state, if they care for a child for whom they receive federal child care financial assistance. 

The following pages have information and resources on best practices for states, providers, and families on abusive head trauma and shaken baby syndrome.

Download the PDF with information for all audiences.

General Resource

  • National Center on Shaken Baby Syndrome
    The National Center on Shaken Baby Syndrome is committed to prevent shaken baby syndrome and promote the well-being of infants generally through the development and implementation of programs, policy, and research; and to support and educate families, caregivers, and professionals.
  • The Period for Purple Crying Website
    The Period of PURPLE Crying is a way to help parents understand the first months in their baby's life when crying is their main form of communication, which is a normal part of every infant's development.  This program is part of the work of the National Center on Shaken Baby Syndrome.
  • Resources on Preventing Abusive Head Trauma from the Child Welfare Gateway
    These resources address different strategies and programs to prevent AHT/SBS, including state and local examples.
[2]Choudhary, A. K., Servaes, S., Slovis, T. L., Palusci, V. J., Hedlund, G. L., Narang, S. K., Moreno, J. A., Dias, M. S., Christian, C. W., Nelson, M. D. Jr., Silvera, V. M., Palasis, S., Raissaki, M., Rossi, A., Offiah, A. C. (2018). Consensus statement on abusive head trauma in infants and young children. Pediatric Radiology, 48(8), 1048–1065. doi: 10.1007/s00247-018-4149-1.

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