PEINKOFER, James R., SILENCED ANGELS; The Medical. Legal, and Social Aspects of Shaken Baby Syndrome. Westport, Connecticut: Auburn House Publishers, 2002, 291 pp., $44.95 hardcover..This has got to be one of the most distressing and sad books I have ever reviewed. It is dedicated shaken babies past and present: Your silence is heard. The book is an extremely well-written and detailed overview of everything we currently know about SBS or shaken baby syndrome, something which seems difficult to diagnose accurately in every instance and which community members, police and physicians may be reluctant to consider as a diagnosis.The book is divided into three parts and does an in-depth analysis of medical, legal and social aspects of SBS. Under medical aspects, in addition to all of the CT scans and X-ray evidence, the author also includes amazing chapters on the history and evolving understanding of SBS [it has been a long time coming, let me tell you] as well as myths and controversies surrounding the topic, missed cases and the impact on survivors. Under legal aspects, the author looks at the investigation of SBS as well as SIDS vs. SBS. Under social aspects, he provides a fascinating chapter on what we know about the perpetrators, the families of SBS victims, the psychological aspects, government interventions and prevention. The book ends with conclusions and recommendations but also appendices with developmental milestones in babies from birth through twenty-four months, a glossary of terms [needed in the rather more technical medical analysis of this syndrome] and a list of printed and online resources and support groups.SBS is not something that happens by accident as parents play with children; it involves the violent and repetitive shaking of an infant or toddler that causes brain injury and bleeding within the head and the retinas. To give you some sense of proportion about how violent this shaking is, research now shows that a child falling from a third-story window has about a 1% chance of dying while in SBS there is a 25% risk of death. Child abuse is the second leading cause of death in children and SBS is one of the leading causes of child abuse fatalities. A typical SBS case costs at least $100,00 or more in the first year, but more than that, we as a community and as a society should care deeply about the health, well-being, safety and future of all children.SBS is totally preventable and often occurs when several family risk factors are present: being the firstborn child to young parents who do not have adequate parenting skills; being male, since infant boys have a 60% greater risk of being shaken than infant girls; being young; a disruption [such as prematurity and hospitalization after birth] in the normal process from being born to going home; multiple births; any kind of physical impairment or chronic illness; and being unwanted or unaccepted by the new parents.The goal of this book is to save lives and to help bring justice to those who permanently damage and alter the lives of families through a moment of extreme violence. Those who suffer SBS can live with a number of consequences such as attention and balance problems, blindness, deafness, cerebral palsy, death, emotional problems, GI problems, and many different kinds of learning disabilities and mental retardation. …