Sarpy County is used to appearing high on national rankings when it comes to development and growth. But the county has topped the charts in one area in which residents would probably rather not place.
The Medill Justice Project has identified Sarpy County as leading the nation in having the highest per-capita rate of shaken-baby syndrome, a form of child abuse when a child — typically an infant younger than age 2 — is shaken, inflicting head trauma and sometimes resulting in death.
The Medill group, founded at Northwestern University, cites Sarpy County’s rate as 7.45 cases per 100,000 people, which is 1.33 cases more than the next highest, and 2.6 cases more than neighboring Douglas County, which ranked fourth in the country.
Also included on the top five list are Richmond County in Georgia at No. 2, Weber County in Utah at No. 3 and Summit County in Ohio at No. 5.
“These unheralded counties throughout the nation share an unlikely distinction,” a Dec. 10 press release stated. “They have the highest rates of shaken-baby syndrome cases in the United States, adjusting for population, according to a new Medill Justice Project study on this criminal justice concern.”
Sarpy County Attorney Lee Polikov said shaken-baby syndrome was a growing trend in the early 2000s.
“I recall saying, ‘It’s an epidemic,’” he said.
However, Polikov said he’s wary of the report’s conclusion that Sarpy County has the highest rate in the nation.
“My belief is it’s universal,” he said.
Tricia Freeman, the chief deputy county attorney, said the Sarpy County Attorney’s Office identified that, in the past five years, there have been five cases of intentional child abuse where the mechanism of injury was shaking. No separate charge exists, so that number is based on the department’s research into the frequency of such cases.
“Four of those cases were prosecuted in criminal court,” she said in an email to the Papillion Times. “One of the cases was only filed in juvenile court because there was insufficient evidence to show who caused the injury.”
Lauryn Schroeder, a research fellow with the Medill Justice Project, said the study’s research involved a lengthy process, taking more than a year and a half to reach out to anyone who’s studied shaken-baby syndrome. They searched press accounts and cases, as well as verified each case by county, she said.
Alec Klein, director of the project, describes the organization as an “investigative journalism enterprise that examines potentially wrongful convictions, probes national systemic criminal-justice issues and conducts groundbreaking research,” according to its website, medilljusticeproject.org.
But Schroeder said Medill is different than just an innocence project.
“We’re not advocating for either side,” she said. “We’re out to find the truth.”
Whether it’s due to a difference in legal language or statistical reporting, Polikov said child abuse, including shaking young children, is a national issue. The county attorney struggles to believe Sarpy County truly has that many more cases, on average, than elsewhere.
Polikov serves as the vice president of the National District Attorneys Association. He said child abuse is a major issue in most jurisdictions around the country.
“I don’t care where you are, some (cases) may be backlogged, but I’ve never met a prosecutor who didn’t take child abuse as a high priority,” he said.
Polikov also raised concerns with the Medill Justice Project’s intentions.
“We’re worried the study might be tainted,” he said.
The project specifically focuses on shaken-baby syndrome, which it describes online as “a largely opaque criminal-justice issue.” There’s a reason for that, though, Polikov said.
Nationally, there are questions about the definition of shaken-baby syndrome because it lacks unique identifying symptoms indicating child abuse, Polikov said.
He said symptoms may be acquired through other injuries, and he is concerned this report may be a part of that trend to show wrongful convictions.
Schroeder defended the study’s aim as simply to raise awareness about the specific form of child abuse that often goes unnoticed.
“Not a lot of people are aware that this is an issue,” she said.
Dr. Amber Tyler of Bellevue Medical Center said it is difficult to distinguish this form of child abuse, but there are still signs and symptoms.
“There is no one thing we can look at and say, ‘Yes, this is shaken baby,’” Tyler said. “It’ll be a child who’s sleepy, crabby, not eating or vomiting. Also, there are other signs of abuse.”
Through tests like an MRI scan, signs of shaken-baby syndrome can be seen within an affected child’s skull. Developing veins that bridge across the brain can tear and bleed. As the child is still in a developmental stage, his or her brain is also likely to bounce against the skull and bruise.
“Once it’s been done, there’s very little that can undo it,” Tyler said. “Unfortunately, besides supportive care, we can’t heal the brain.”
The one unique part of shaken-baby syndrome is that it is not always a patterned form of child abuse but can result from a single poor choice.
“The abuse can be triggered by becoming overwhelmed by stresses,” Tyler said. “You just want the baby to stop crying. In one lost moment, you can’t go back and there are consequences that will always be there.”
As for these consequences, Dr. Brandi Reeve-Iverson of Alegent Creighton Health Midlands Hospital said the long-term effects can be varied depending on the extent of the injury and abuse.
“You never really know how bad the injury is until you follow them,” she said.
Reeve-Iverson said children who live after shaken-baby syndrome could develop a variety of health and other issues such as epilepsy or speech issues.
“For the most part, they do not have normal development,” she said. “And that’s for the ones who survive.”
According to the Journal of Forensic Nursing, mortality rates range from 15 percent to 38 percent.
To young and expecting parents, Tyler said crying has never hurt a baby. Should a stressful moment arise, it is best to set the baby in a safe and secure place and walk into another room to collect yourself, she said.
“They can cry the whole time, it is not going to hurt them,” she said.
As to Sarpy County leading the nation in frequency of abuse, both Tyler and Reeve-Iverson said they have not personally seen a large number of shaken-baby cases.
Tyler suggested it may be the result of a selection bias as Nebraska has a policy requiring a multidisciplinary team to investigate any potential child abuse case.
Polikov said this policy is a great benefit in investigating potential child abuse cases.
The process includes interviewers, doctors and psychologists, he said. Despite the effort to address such cases, Polikov said the Medill report should not make county residents feel their county is full of abuse — child abuse takes place and is aggressively investigated across the county.
While the multidisciplinary team may have an effect, Schroeder said it is difficult to pinpoint the exact reason Sarpy County took the No. 1 spot. But she said that team’s impact came up during her 30-some interviews with local officials in both Sarpy and Douglas counties.
“It narrows the investigation because they all go in one direction,” she said.
Other states also have similar teams in place, though, she said. Schroeder said the goal of the report is not to label one county more dangerous than another, but simply to highlight an issue that needs more awareness.
“I don’t think this report means in any way there are more cases going on in these areas than others,” she said.
Sarpy County, and Nebraska in general, might just be better at identifying cases when they come up, she said.
“Bottom line, we just want to create awareness,” Schroeder said.