Signs & Symptoms

Signs and Symptoms in a child who has been shake, with and/or without impact

Young children who have been shaken/hit may present with:

  • Poor feeding, can’t nurse, failure to thrive
  • Sleep changes: lethargy, listlessness, can’t be awakened
  • Irritability (high pitched cry)
  • Vomiting without diarrhea or fever
  • Convulsions, seizures or loss of consciousness
  • Fractures of ribs and/or long bones
  • Bruises
  • They may show fear of their caregiver
  • History from caregiver is inconsistent with symptoms

It is important to document all conditions in the infant prior to hospital discharge. Shaking can mimic other conditions, such as viral infections, gastroenteritis, meningitis, hydrocephalus, seizure disorder, metabolic disturbance, congenital heart defects.

Potential Problems:

Age 0-3 years

  • Inability to regulate state, arousal, and sleep
  • Challenges in one or more sensory systems
  • Mood instability leading to emotional lability
  • Need for structure, support, supervision, and modulation by others
  • Limited understanding of cause-effect, time relationships, and consequence-feedback experiences

 Age 3-6 years

  • Difficulty in regulating thinking, emotions, and behavior such as tantrums
  • Early problems with executive function such as poor organizing, planning, and sequencing behaviors
  • Limited emotional control such as immediate expression of feelings and limited inhibition
  • Under-developed language and social skills, may need services through special education

Age 6-12 years

  • Reduced reading, spelling, and math skills
  • Poor performance in school despite hard work
  • Behavior problems during unstructured time
  • Sleep disturbances
  • Unexplained pain, headaches
  • Faulty connections between feelings/emotions and rational thoughts

Shaken Children Can Have Learning Disabilities

We know that even 25% of children who appear to have no bad effects from having been shaken can still experience learning disabilities when they start school.

This list of signs of a learning disability may signal the need for early intervention, before the child goes to school.

If you know a child with many of these signs, encourage the child to be evaluated for the Arizona Early Intervention Program (AzEIP) or ChildFind.

Visit the Arizona Department of Economic Security  or  the Arizona Department of Education, Early Intervention Program

Signs of a learning disability

When a child has a learning disability, he or she:

  • May have trouble learning the alphabet, rhyming words, or connecting letters to their sounds
  • May make many mistakes when reading aloud, and repeat and pause often
  • May not understand what he or she reads
  • May have real trouble with spelling
  • May have very messy handwriting or hold a pencil awkwardly
  • May struggle to express ideas in writing
  • May learn language late and have a limited vocabulary
  • May have trouble remembering the sounds that letters make or hearing slight differences between words
  • May have trouble understanding jokes, comic strips and sarcasm
  • May have trouble following directions
  • May mispronounce words or use a wrong word that sounds similar
  • May have trouble organizing what he or she wants to say
  • Mat not be able to think of the word he or she needs for writing or in conversation
  • May not follow the social rules of conversation, such as taking turns
  • May stand too close to someone speaking trying to listen
  • May confuse math symbols and misread numbers
  • May not be able to retell a story in order (what happened first, second, next)
  • May not know where to begin a task or how to go on from there

Source: National Dissemination Center for Children with Disabilities.

If a child has unexpected problems learning to read, write, listen, speak, or do math, then teachers and parents may want to investigate more. The same is true if the child is struggling to do any one of these skills. The child may need to be evaluated to see if he or she has a learning disability.

Need Help?

24/7 crisis line:  1-800-4A-CHILD
Birth to Five Helpline:  1-877-705-KIDS