Could the shaking of infants in early childhood be a leading source of unexplained intellectual disability in India?

Abstract Background Data from India and other low and middle-income countries reveal high rates of parent-reported shaking of infants. Very high rates of developmental disability have been reported in India. The convergence of these observations provides an opportunity to understand the nature and c...

Full description

Saved in:
Bibliographic Details
Main Authors: Viswanathan Shankar, Desmond K. Runyan, Chandrakanta Kumar, Soumya Pandey, Neera Kohli, Rashmi Kumar
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Public Health
Subjects:
Online Access:https://doi.org/10.1186/s12889-025-23479-5
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849389204727922688
author Viswanathan Shankar
Desmond K. Runyan
Chandrakanta Kumar
Soumya Pandey
Neera Kohli
Rashmi Kumar
author_facet Viswanathan Shankar
Desmond K. Runyan
Chandrakanta Kumar
Soumya Pandey
Neera Kohli
Rashmi Kumar
author_sort Viswanathan Shankar
collection DOAJ
description Abstract Background Data from India and other low and middle-income countries reveal high rates of parent-reported shaking of infants. Very high rates of developmental disability have been reported in India. The convergence of these observations provides an opportunity to understand the nature and consequences of a potentially harmful child discipline practice. Objective To study whether caregiver shaking of an infant, even shaking insufficient to lead to an acute medical encounter, is associated with subsequent intellectual disability (ID). Methods We conducted a matched case-control study at an academic medical center in Lucknow, India. We compared 75 children with ID of unknown etiology to 75 control children aged 24–72 months, matched by age, gender, maternal age, and maternal education. All children received a neurological evaluation and were IQ and lead tested. We questioned parents about early discipline practices, including shaking. If parents reported shaking, we asked them to demonstrate using a shaken baby simulator. We examined the association between ID and shaking using conditional logistic regression. Results Children’s median age was 43.4 (IQR: 25.1) months; 64% were boys. 24% of all study children were reported shaken before 24 months: 38.% of the case children and 9% of the controls. The adjusted odds of reported shaking of children with ID, before age 24 months, is 8.3 (95% CI: 2.4, 28.2) times higher than controls. Conclusion Shaking children < 2 years of age in northern India is common; a strong association exists between early shaking and unexplained intellectual disability. Possibly contributing to intellectual disability, the role of infant shaking needs to be explored further.
format Article
id doaj-art-6b9fea5e7a184bfead1c2a230fafe567
institution Kabale University
issn 1471-2458
language English
publishDate 2025-07-01
publisher BMC
record_format Article
series BMC Public Health
spelling doaj-art-6b9fea5e7a184bfead1c2a230fafe5672025-08-20T03:42:02ZengBMCBMC Public Health1471-24582025-07-0125111110.1186/s12889-025-23479-5Could the shaking of infants in early childhood be a leading source of unexplained intellectual disability in India?Viswanathan Shankar0Desmond K. Runyan1Chandrakanta Kumar2Soumya Pandey3Neera Kohli4Rashmi Kumar5Department of Epidemiology and Population Health, Albert Einstein College of MedicineDepartment of Pediatrics, The Kempe Center, The University of Colorado School of MedicineDepartment of Pediatrics, King George’s Medical UniversityDepartment of Psychology, Faculty of Humanities and Social Sciences, Integral UniversityDepartment of Radiodiagnosis, King George’s Medical UniversityDepartment of Pediatrics, King George’s Medical UniversityAbstract Background Data from India and other low and middle-income countries reveal high rates of parent-reported shaking of infants. Very high rates of developmental disability have been reported in India. The convergence of these observations provides an opportunity to understand the nature and consequences of a potentially harmful child discipline practice. Objective To study whether caregiver shaking of an infant, even shaking insufficient to lead to an acute medical encounter, is associated with subsequent intellectual disability (ID). Methods We conducted a matched case-control study at an academic medical center in Lucknow, India. We compared 75 children with ID of unknown etiology to 75 control children aged 24–72 months, matched by age, gender, maternal age, and maternal education. All children received a neurological evaluation and were IQ and lead tested. We questioned parents about early discipline practices, including shaking. If parents reported shaking, we asked them to demonstrate using a shaken baby simulator. We examined the association between ID and shaking using conditional logistic regression. Results Children’s median age was 43.4 (IQR: 25.1) months; 64% were boys. 24% of all study children were reported shaken before 24 months: 38.% of the case children and 9% of the controls. The adjusted odds of reported shaking of children with ID, before age 24 months, is 8.3 (95% CI: 2.4, 28.2) times higher than controls. Conclusion Shaking children < 2 years of age in northern India is common; a strong association exists between early shaking and unexplained intellectual disability. Possibly contributing to intellectual disability, the role of infant shaking needs to be explored further.https://doi.org/10.1186/s12889-025-23479-5Abusive head traumaShakingIntellectual disabilityLow and middle-income countriesMatched case-control studies
spellingShingle Viswanathan Shankar
Desmond K. Runyan
Chandrakanta Kumar
Soumya Pandey
Neera Kohli
Rashmi Kumar
Could the shaking of infants in early childhood be a leading source of unexplained intellectual disability in India?
BMC Public Health
Abusive head trauma
Shaking
Intellectual disability
Low and middle-income countries
Matched case-control studies
title Could the shaking of infants in early childhood be a leading source of unexplained intellectual disability in India?
title_full Could the shaking of infants in early childhood be a leading source of unexplained intellectual disability in India?
title_fullStr Could the shaking of infants in early childhood be a leading source of unexplained intellectual disability in India?
title_full_unstemmed Could the shaking of infants in early childhood be a leading source of unexplained intellectual disability in India?
title_short Could the shaking of infants in early childhood be a leading source of unexplained intellectual disability in India?
title_sort could the shaking of infants in early childhood be a leading source of unexplained intellectual disability in india
topic Abusive head trauma
Shaking
Intellectual disability
Low and middle-income countries
Matched case-control studies
url https://doi.org/10.1186/s12889-025-23479-5
work_keys_str_mv AT viswanathanshankar couldtheshakingofinfantsinearlychildhoodbealeadingsourceofunexplainedintellectualdisabilityinindia
AT desmondkrunyan couldtheshakingofinfantsinearlychildhoodbealeadingsourceofunexplainedintellectualdisabilityinindia
AT chandrakantakumar couldtheshakingofinfantsinearlychildhoodbealeadingsourceofunexplainedintellectualdisabilityinindia
AT soumyapandey couldtheshakingofinfantsinearlychildhoodbealeadingsourceofunexplainedintellectualdisabilityinindia
AT neerakohli couldtheshakingofinfantsinearlychildhoodbealeadingsourceofunexplainedintellectualdisabilityinindia
AT rashmikumar couldtheshakingofinfantsinearlychildhoodbealeadingsourceofunexplainedintellectualdisabilityinindia