Assessment of Shaken Infant Syndrome

0070-525.10 | Revision Date: 07/01/14


This policy guide provides information on assessing for and observing, gathering and assessing evidence of Shaken Infant Syndrome.



Assessing Shaken Infant Syndrome

Physical Symptoms

Risk Factors for Infants

Risk Factors for Parents/Caregivers

Diagnosing Shaken Infant Syndrome

Alternative Explanations for Symptoms of Shaken Infant Syndrome


Assessing for Shaken Infant Syndrome

ER/Case-Carrying CSW Responsibilities

Investigating Shaken Baby Syndrome

ER/Case-Carrying CSW Responsibilities


Helpful Links

Referenced Policy Guides

Version Summary

This policy guide was updated from the 09/22/10 version, as part of the Policy Redesign, in accordance with the DCFS Strategic Plan.


Assessing Shaken Infant Syndrome

Shaken Infant Syndrome, also known as Shaken Baby Syndrome or Whiplash Shaken Infant Syndrome, is the most common cause of child fatality due to abuse by violent shaking. Although most common in infants, it can occur in children up to age four.

Physical Symptoms

Generally speaking, in cases of Shaken Infant Syndrome, there is no visible evidence of trauma other than occasional bruising, especially along the chest however the child may exhibit other symptoms which may include:



Decreased feeding

Poor sucking/swallowing


Failure to thrive

Lethargy or rigidity



Convulsions/rapid heart beat


Difficulty breathing


Poor muscle tone

Inability to follow movements

No smiling or vocalizations

Risk Factors for Infants

As part of a comprehensive assessment, the presence of the following risk factors in infants may help in determining whether Shaken Infant Syndrome is present.


The child has:


The child is:

Risk Factors for Parents/Caregivers

The presence of the following risk factors in parents/caregivers may help in determining whether an infant has Shaken Infant Syndrome:

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Diagnosing Shaken Infant Syndrome

Only medical personnel may provide the diagnosis of Shaken Infant Syndrome. Shaken Infant Syndrome is diagnosed through medical finding of intra-cranial, intra-ocular and/or skeletal injuries. A consultation must occur between the CSW, Public Health Nurse and medical provider to obtain a complete medical history and medical examination to assist in formulating an accurate assessment. 

Alternative Explanations for Symptoms of Shaken Infant Syndrome

There are some situations which can result in a similar cluster of symptoms, but are not a cause of Shaken Infant Syndrome, such as:

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Assessing for Shaken Infant Syndrome

ER/Case-Carrying CSW Responsibilities

  1. Identify risk factors for infants being assessed for Shaken Infant Syndrome.


  1. Identify risk factors for the parents/caregivers of infants being assessed for Shaken Infant Syndrome.


  1. Document findings in the Contact Notebook.

Investigating Shaken Infant Syndrome

ER/Case-Carrying CSW Responsibilities

  1. Conduct a detailed and thorough interview of the parent and/or caregiver.


  1. Differentiate between accidental versus abusive causes, reasonable versus unreasonable explanations.


  1. Obtain an accurate history of when the infant last appeared unharmed.


  1. If the child is brought to the hospital immediately following the severe damage, the injury probably occurred just after the child was last observed to be well.  In cases where there is a delay in bringing the child for treatment (usually with less severe injuries), it often becomes impossible to prove who did the shaking.


  1. Consult with the Public Health Nurse according to established procedures.
  1. Provide any identified risk factors
  1. Provide all known medical information
  1. Request assistance with a face-to-face home visit
  1. Request informational resources on Shaken Infant Syndrome for distribution to caregivers (if appropriate)
  1. Seek help in identifying any special medical needs of the infant to assist in discharge planning/placement (including consultation of the Medical Case Management Section)
  1. Request assistance with resources/referrals for follow-up of special medical needs of the child including any special training needs for the caregiver
  1. Ask for input on the development of the Health/Medical component of the Case Plan (if appropriate)


  1. If applicable, take the child to the HUB for a forensic examination.


  1. Follow procedures regarding disposition of allegations and detention of children.


  1. Document all information accumulated during the assessment in all appropriate Case Notebooks (Contact Notebook, Health Notebook, etc.)

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Referenced Policy Guides

0070-548.10, Disposition of Allegations and Closure of Emergency Response Referrals


0070-548.20, Taking Children into Temporary Custody

0070-548.24, Structured Decision Making (SDM)

0070-548.25, Completing the Structured Decision Making (SDM) Safety Plan

0070-560.05, Joint Response Referral: Consulting with PHN

0400-503.10, Contact Requirements and Exceptions

0600-500.00, Medical Hubs

1000-504.10, Case Transfer Criteria and Procedures

Criteria and Transfer Procedures

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