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Transient decline in abusive head trauma in children during the COVID-19 pandemic provides lessons for prevention
  1. Biswadev Mitra1,2,
  2. Dianne Crellin3,4,5
  1. 1Emergency & Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia
  2. 2School of Public Health & Preventive Medicine, Monash Univerity, Melbourne, Victoria, Australia
  3. 3The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia
  4. 4Department of Nursing, The University of Melbourne, Melbourne, Victoria, Australia
  5. 5Murdoch Children's Research Institute, Melbourne, Victoria, Australia
  1. Correspondence to Dr Biswadev Mitra, Emergency & Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia; b.mitra{at}

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Commentary on: Maassel NL, Graetz E, Schneider EB, et al. Hospital Admissions for abusive head trauma before and during the COVID-19 pandemic. JAMA Pediatr 2023;177(12):1342-47

Implications for practice and research

  • The COVID-19 pandemic was associated with reductions in abusive head trauma (AHT) among children.

  • Improved assessment of parental roles and earlier detection of family violence and coercive control present opportunities to prevent AHT.

  • Strengthening social supports by mitigating effects of financial strain on families may also reduce AHT.


Child abuse or neglect is estimated to occur in 10–30 per 100 000 infants in developed countries but is likely under-reported.1 Abusive head trauma, which includes all inflicted head trauma regardless of specific mechanisms such as shaken baby syndrome, is a severe form of physical abuse and linked to high rates of morbidity and mortality.2 Babies less than 1 year of age are at the highest risk of …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer-reviewed.