Paediatric implications of the battered baby syndrome.

I very deeply appreciate the honour you have paid me by your invitation to deliver the Windermere Lecture. My sabbatical year of absence from the University of Colorado is just now coming to an end, and it is a splendid opportunity for me to thank all members of this Society who have helped me in my efforts during this year. I coined the term 'The Battered Child Syndrome', in 1962, despite its provocative and anger-producing nature. I had for the preceding 10 years talked about child abuse, non-accidental, or inflicted injury, but few paid attention. At a gathering very much like this in 1962, describing in some detail the physical findings, both subtle and severe, of the battered child and at the same time beginning to point out some of the dynamics involved in child abuse, there did result a degree of public attention and, I might add, physician attention, which had previously not been possible. In Denver we see about 40 new abuse cases each non-accidental injury and deprivation of children. Atoneendo ctrum isttheci whois frankly battered and may have repeated serious injuries. These injuries often occur in a crescendo of increasing severity from mild bruising to subperiosteal bleeding seen on x-ray, to fractures of the long bones and ribs, to subdural haematoma with or without skull fracture. Then there are the children who receive repeated minor trauma or unexplained repetition of falls and bruises (the 'accident prone baby'), and finally children who are not receiving either physical or emotional nourishment and are simply put aside in an ultimate form of passive rejection. The concept stressed by us that young parents can attack their small child without being necessarily 'bad' or 'mentally ill' cause a great deal of consternation.