Fatalities and the Organization of Child Care in the United States , 1985 – 2003

old Dylan Salmon dropped him off at the house of Maryann Constantino. Dylan’s mother had located the provider, a 36-year-old mother, after an extensive search for child care. Her older daughter, Rachel, had been in Constantino’s care for 2 years before starting school. “This isn’t someone I just found in the phone book,” Salmon said. “I was careful to find someone I trusted and came recommended” (Estes 2001:1). The mother got a call at work during lunch. “I don’t like the way Dylan is breathing,” Constantino told her. By the time she got to Constantino’s home, the paramedics were working on her unconscious son. Dylan was rushed to the hospital, where he was diagnosed with brain damage from being shaken. He suffered seizures, bleeding behind his eyes, and massive cell death in his brain. Three months later, Dylan was released from the hospital but still had to be fed through a tube. Dylan’s mother said, “Our whole life changed in a day.” “In a moment,” her husband added (Estes 2001:1). Constantino first said that another child fell on Dylan, then that her own 3-year-old daughter dropped him on the carpeted basement floor. Finally, she admitted to police that she had shaken the baby at least three times (Richardson 2001:2). No complaints had been lodged against Constantino in the 9 years that she had provided licensed care in Rockland, Massachusetts. Other parents with children in Constantino’s care were disbelieving. One mother told reporters, “In my heart I know Maryann would never hurt a child—her own or anyone else’s. It’s very sad. Her reputation is now ruined” (Estes 2001:1). Fatalities and the Organization of Child Care in the United States, 1985–2003