Gina Bertocci, professor and endowed chair of biomechanics in the bioengineering department, recently received a grant for��$599,876��from the National Institute of Justice for research that could help detect child abuse in young children.

The research project is called, “Biomechanical characterization of video recorded short distance falls in children.” Its purpose is to provide forensic data that will help identify the causes of trauma in young children who may not be able to communicate instances of abuse. Bertocci’s research looks to even the field, not only serving to identify victims of physical abuse, but to aid parents who were wrongly accused.

“We know that falls do happen and those falls sometimes do produce injuries. We also know that the history of the fall is that the fall is the most commonly given excuse by caregivers to hide abuse,” Bertocci said. “We want to be able to intervene early for those kids who have been abused.”

Bertocci’s research into pediatric injury has evolved to delineate between abuse and accidents specific to falls, the most commonly attributed cause of injury in cases of suspected abuse.

For her newest research, Bertocci is working with a local daycare to capture, safely and with parental permission, video of children falling in a controlled environment. ��

“We use crash test dummies,” said Bertocci. “We have studies that are ongoing where we are working with clinicians working with children who have come into an ER setting, to better understand a lot of injuries associated with a fall.”

As part of that process, members of her team have selected a location that features a variety of surfaces, which can account for any potential differences upon impact, as well as mounted head cameras that can help identify the velocity of a fall from standing position. It’s through that data, along with several other factors, that Bertocci hopes to develop a database for future use in legal or criminal cases.

“There is an absence of evidence-based data, which has led to a controversy in biomechanical compatibility. Our goal is to improve the accuracy in forensic biomechanical compatibility,” Bertocci said. “In order to plug this gap, related to not having witnessed short distanced falls, how can we fill that gap? The one way is to video record kids in a natural setting. And to capture them in a natural environment, while they’re playing.”

Ultimately, this research allows Bertocci to help children without a voice, by providing reproducible evidence to a common problem in distinguishing abuse from an accident, which is often difficult to determine with children who are not only incapable of communication, but are still developing their basic motor skills.

“The children who are at greatest risk are those who are between 0-1 year old and they are not able to communicate,” said Bertocci.

“Defense attorneys (in child abuse cases) are saying ‘well here’s this 1987 study Dr. Bertocci and it says that you could shake a baby and there would not necessarily be any injury,’” said Bertocci who occasionally testifies in child abuse cases. “Now I’m going to be able to counter that and be able to say ‘guess what – here’s our study that says differently.'”

The research involved an adult shaking what Bertocci described as “an infant crash test dummy” with lots of instrumentation to record the baby’s head acceleration. The UofL research found head accelerations 10 times higher than the 1987 study with the most violent coming when the baby’s chin struck its chest.

Bertocci hopes the results of her research will be used by prosecutors of child abuse cases “to assure that justice is delivered to those that have perpetrated these horrible crimes.”

You can hear more about Bertocci’s research in her on “UofL Today with Mark Hebert.”

In a study led by University of Louisville biostatistician , associate professor, , the reliability and accuracy of a nine-member expert panel was measured in determining the likelihood of abuse in more than 2,000 cases. The results of the study that published recently in the found nearly perfect reliability and accuracy of the panel both individually and as a composite.

“Decision rules for identifying injuries from abuse are valuable for settings such as pediatric emergency departments — in these cases, reliability and accuracy of human judgement is needed since victims of child abuse are at high risk of future abuse and death,” Lorenz said.

The study examined injuries involving children less than 4 years old who visited pediatric emergency departments between 2011 and 2016 at five children’s hospitals in the United States. The expert panel included four child abuse pediatricians, four emergency medicine physicians and one bioengineer with expertise in pediatric injury.

Each panelist received de-identified case information, including current and past data of the patient’s visit to a pediatric emergency department. The panelists independently rated the likelihood of abuse on a 5-level classification scale as “definite abuse,” “likely abuse,” “indeterminate,” “likely accident,” and “definite accident”. Each individual also provided a “yes” or “no” answer to a question on whether to report the case to state child protective services.

At least two panelists reviewed each of the 2,166 cases. There was unanimous agreement in 852 cases (39 percent). An additional 1,048 cases (48 percent) exhibited partial agreement, where all panelists provided classifications of abuse (definite or likely) or accident (definite or likely). There were 44 instances (2 percent) of abuse-accident disagreement, none of which were in the definite category. In the remaining 222 cases (10 percent), all panelists gave classifications of indeterminate.

The study tested the accuracy of the expert panel based on 584 of the 2,166 cases that could be more definitively classified as abuse or accidental based on other information learned after the child’s visit to the emergency department. This included video of an event, a third-party account and a confession of abuse or criminal conviction of abuse. Individual panelists accurately classified between 95 and 98 percent of the abuse cases and between 99 and 100 percent of the accident cases.

“We have demonstrated the reliability and accuracy of the expert panel approach, and suggest this method provides a suitable set of criteria for the future evaluation of clinical decision rules for identifying child abuse,” Lorenz said.

Lorenz collaborated with other UofL colleagues in the and . The study also involved researchers at the Northwestern University, University of Pittsburgh, University of Utah, University of Washington and Yale University.

Sponsored by the Family & Children’s Place, Kosair Charities’ Face It Movement and other Metro Louisville children’s organizations, the Rally to End Child Abuse kicks off Child Abuse Prevention Month in April.