I’ve been meaning to bring Karl Weick into this space. I think today is the day. In his book, Sensemaking in Organizations, Professor Weick tells us that the problem of children being harmed by non-accidental injuries was first suggested in 1946. That happened when a pediatric radiologist wrote an article based on six cases in which parents were silent about how their child’s injuries, which could be seen in x-ray photographs, could have occurred. The author speculated that “intentional ill treatment” might have been the cause. Significantly, the article was published in a radiology journal – not a pediatric journal. Nothing else was written on this topic until three similar articles appeared in the 1950s – also without attracting much attention from the medical profession.
All that changed in October 1961, however, when the American Academy of Pediatrics hosted a panel discussion on “The Battered Child Syndrome.” That was a more attention-getting name than intentional ill treatment.” But that wasn’t all: this panel was also equipped with a national survey of 77 district attorneys and 71 hospitals that was reporting 749 cases of battered children. These results – plus an editorial – were published in the Journal of the American Medical Association, which put the vivid mental picture of battered children in front of the right people to start looking for the syndrome in their practices.
Within a few years, laws in all 50 states required the reporting of all suspected cases of BCS (it now had its own acronym!). By 1967, with better reporting channels in place, estimates placed the number of cases at 7,000. By 1972, the number was 60,000. By 1976, it was 500,000. Twenty years later, in 1996, more than three million alleged cases were reported and more than one million were substantiated.
So, we went from an article based on six cases in 1946 to the reporting of three million cases in 1996? Do we believe there was suddenly an explosion of BCS cases – or were they always there and not being reported? Probably the latter.
I went looking for this story because I remembered it as a great example of Articulation at work: major change can be initiated when you replace temperate words with evocative words. Upon rereading it, I found it to be just as I expected – an excellent Articulation story. But wait! At the same meeting where the new name was introduced, they also brought out the results of the first national survey on BCS. And as a follow-up to the meeting, the conversation moved from the radiological community into the pediatric community, and from there to the membership of the entire AMA (American Medical Association). And that’s when everything took off. So it wasn’t just Articulation! It was also Inquiry and Mobilization – all three sr4 practice areas! By George, we might be onto something: get the data, get the words right, and get things started in the communities that are most likely to embrace something new and different!