1. Simulator Demonstration
Shaken Baby Syndrome:
Simulator Demonstration

2. What Happens During a Shaking?
1. At the first level of forceful shaking severe enough to cause injury, the back of the simulator’s brain lights up. A baby would become visually impaired or blind.
2. At the second level of forceful shaking, the front of the simulator’s brain lights up, and the baby would have additional injuries that would cause loss of memory and emotion. The loss of these functions can cause learning disabilities and behavioral disorders.
3. At the third level of forceful shaking, injury to the brain is extensive. The sides of the simulator’s brain light up in addition to the back and front. The baby would lose the ability to speak and hear, and would be paralyzed on one or both sides. This level of force can result in death.

3. Meet our SBS baby Look at Baby’s head
a baby’s head is 25 percent of the baby’s body weight—
Much heavier in proportion to the body than an adult’s
which is only 10 percent of body weight

4. SBS baby
Watch as I move the simulator’s head back and forth on the neck
A baby’s neck muscles are weak and unable to stop the head from moving
When the baby is shaken

5. SBS baby
A baby’s skull is roomier than an adult’s to accommodate growth of the brain
For this reason, when a baby is shaken, its brain moves farther and gains speed before it hits the skull

6. SBS baby
Many blood vessels attach the brain to the surrounding membranes
and deliver oxygen to the brain.
As a baby’s brain moves around inside the skull when shaken,
the baby’s blood vessels stretch
and are torn,
causing bleeding over the surface of the brain

7. SBS baby
Swelling results from the impact of the brain against the skull
The pressure from swelling stops blood circulation to parts of the brain,
and those parts can die.

8. Icons on Baby’s head
In the back of the brain is the occipital lobe, which controls vision.
In the front of the brain is the frontal lobe, which controls memory and emotion.
The sides of the brain control speech and hearing and the movement of the arms and legs.

9. What Happens During a Shaking?
1. At the first level of forceful shaking severe enough to cause injury, the back of the simulator’s brain lights up. A baby would become visually impaired or blind.
2. At the second level of forceful shaking, the front of the simulator’s brain lights up, and the baby would have additional injuries that would cause loss of memory and emotion. The loss of these functions can cause learning disabilities and behavioral disorders.
3. At the third level of forceful shaking, injury to the brain is extensive. The sides of the simulator’s brain light up in addition to the back and front. The baby would lose the ability to speak and hear, and would be paralyzed on one or both sides. This level of force can result in death.

10. SBS baby simulator
The simulator measures three levels of acceleration.
As the acceleration increases during a prolonged shaking,
first one area lights up to show injury,
then the second area, and then the third area.

11. Baby toss-up While this really is potentially hazardous,
And not recommended
especially for very young infants who cannot support their heads
This common type of motion is not enough to cause the injuries of SBS.

12. Shaken baby demo
See how my hands grasp the baby—thumbs in front, and fingers in the back, on each side of the spine.
Babies with SBS sometimes also have broken ribs.
In SBS, the ribs are broken in a unique way—in the back, where they connect to the spine.
The ribs can break in that area because of the combined pressure of the shaker’s grasp and the force of the shaking.
SBS victims sometimes also have fractures of the long bones in the upper arm and the upper leg.
During a prolonged shaking, the top ends of these long bones can tear away from the shoulder and hip sockets,
causing a separation of the bones at the top.

13. Shaken baby demo When the Simulator Baby is turned on:
The lights cycle three times around the head and then go into a standby mode, and the simulator begins to cry
The lights represent areas of the brain injured by shaking

14. Shaken baby demo
Simulator Baby shaken until the lights turn on in the back of the brain.
The first level of injury has occurred,
a real baby would become visually impaired or blind

15. Shaken baby demo
Shaking continues (until the lights also turn on in the front of the brain)
The second level of injury has occurred,
and a real baby would now have lost the ability to remember and to feel emotion.
The loss of these functions commonly causes learning disabilities and behavioral disorders

16. Shaken baby demo
The crying has stopped because of the increasing severity of the brain injuries.
Because the injuries are hidden and the crying has stopped,
caregivers can mistakenly think that shaking is an effective way to stop crying

17. Shaken baby demo
Shaking again continues (until the lights in the middle also turn on)
At this point,
a baby would become paralyzed,
unable to speak,
and unable to understand what she or he hears.
Death would occur if shaking continued.

18. Brief review:
Explain why babies are uniquely vulnerable to being injured by shaking.
Answer: Large head, weak neck, extra space inside skull, delicate veins

19. Brief review:
Recall which area of the simulator’s brain lights up first during a shaking,
And name the disabilities that result from injury in that area of the brain.
Answer: Back of the brain; vision

20. Brief review: Which area lights up next as shaking continues,
And name the disabilities that result from injury in that area of the brain.
Answer: Front of the brain; memory and emotion

21. Brief review:
Which area of the simulator’s brain is the last area to light up,
And name the corresponding injuries.
Answer: Middle of the brain; movement of arms and legs, speech, death