Development of a Probability Model to Predict Head Injury Risk in Pediatric Falls

Each year there are ~2.8 million emergency department visits for fall-related injuries involving children. Although injuries from accidental falls in children are common, history of a fall is also the most commonly stated false scenario provided by caregivers to conceal physical abuse. Accurate differentiation between abuse and accident is critical for both abuse victims and accidentally injured children; abuse victims must be removed from unsafe environments and accident victims must remain with their innocent families. Often a central question in discriminating abuse is whether severe head injuries or fatalities can result from a caregiver provided fall history; this question challenges clinicians, social workers, law enforcement personnel, biomechanics experts and the judicial system daily. Numerous court proceedings have focused on whether children can be seriously or fatally injured in short distance falls. Determining biomechanical compatibility between injuries and caregiver fall history is a key aspect in discriminating abuse from accident in clinical and forensic investigations, and in obtaining accurate convictions. Biomechanical reconstruction of falls plays a critical role in forensic investigations, but is greatly limited by the lack of evidenced-based head injury thresholds suitable for use in predicting risk of pediatric head injury. Our research goal is to develop an evidenced-based statistical model capable of predicting probability of head injury risk in young children involved in falls to improve accuracy in forensic biomechanical investigations. Our high fidelity probability model will be based on falls data gathered through video monitoring of children with wearable head accelerometers in a childcare center (CCC; previously collected in on-going NIJ#2017-DN-BX-0158), combined with falls and injury data gathered on children presenting to a pediatric emergency department (PED) with fall history and head injury. Note: This project contains a research and/or development component, as defined in applicable law, and complies with Part 200 Uniform Requirements - 2 CFR 200.210(a)(14). CA/NCF