Denialism Preserves Scientific Controversies: a Case Study of Abusive Head Trauma Research

The traditional theory of abusive head trauma requires scientific scrutiny. Those who question the validity of this theory have been accused of denialism for the purpose of obfuscating evidence in legal settings and supporting abusive caregivers. The tradi­tional theory holds that abusive head trauma results from “shaken baby syndrome”. In reference to abusive head trauma in the absence of external signs of trauma, we argue that it is the child-protection clinicians and concerned researchers who represent denialism. We have identified three types of denialism in this area: (i) denialism of the presence of a scientific controversy; (ii) denialism of relevant scientific distinctions between abusive head trauma cases with versus without external signs of trauma; and (iii) denialism of circular reasoning as a major risk of bias. The analysis discloses that the scientific controversy pertaining to abusive head trauma is real and that it is problematic to lump together all alleged abusive head trauma, with and without exter­nal signs of trauma. Further, it has been ignored that circular reasoning results in a high risk of bias. We conclude that denialism preserves rather than promotes scientific developments on abusive head trauma research.