This document was printed from the website of the California Evidence-Based Clearinghouse for Child Welfare (CEBC), which you can access at http://www.cebc4cw.org/
This document was printed from the website of the California Evidence-Based Clearinghouse for Child Welfare (CEBC), which you can access at http://www.cebc4cw.org/
Type of Maltreatment: Physical abuse
Target Population: All mothers of new infants and society in general in their understanding of early infant crying and shaken baby syndrome
Brief Description:(The information in this program outline is provided by the program representative and edited by the CEBC staff.)
Period of Purple Crying has been�rated by the CEBC in the area of Prevention (Secondary). It is a shaken baby syndrome prevention program that educates parents and caretakers on normal infant crying, the most common trigger for shaking an infant. It was designed to be used primarily in primary prevention settings, but is applicable to secondary prevention as well. The letters in PURPLE stand for the common properties of crying, including unsoothable crying, in infants during the first few months:
Peak pattern (crying peaks around 2 months, then decreases)
Unpredictable (crying for long periods can come and go for no reason)
Resistant to soothing (the baby may keep crying for long periods)
Pain-like look on face
Long bouts of crying (crying can go on for hours)
Evening crying (baby cries more in the afternoon and evening)
The program also contains a public media component aimed at changing cultural attitudes about crying, especially inconsolable crying.
Period of Purple Crying was not designed to be conducted in a group.
Period of Purple Crying has not been tested for use in a group setting.
Recommended intensity: Three 5-10 minute “doses”: 1. In the maternity ward, given separately from other materials; 2. Either pre- or post- birth as a second “dose” (e.g. in prenatal classes, and in the first pediatric office visit); 3. Via media campaign.
Recommended duration: Through the three contacts, the duration of the program is at least a week and can last much longer since a key element of the program is that each parent receives a copy of the DVD and booklet to take home with them. This way they can refer to the DVD again when the infant is crying, and show it to other temporary caregivers.
Period of Purple Crying does not include a homework component.
Period of Purple Crying is typically conducted in a(n): Birth Family Home and Hospital.
Period of Purple Crying was designed with a Parent Component.
Period of Purple Crying addresses the following presenting problems and symptoms: Parents of a newborn
Period of Purple Crying was not designed with a Child Component.
Period of Purple Crying was not developed for children with developmental delays.
Period of Purple Crying has not been tested for children with developmental delays.
Period of Purple Crying does not have materials available in a language other than English.
There is a manual that describes how to implement this program.
There is training available for Period of Purple Crying.
Training contact: National Center on Shaken Baby Syndrome (NCSBS), Phone: 801-627-3399, Email: purple@dontshake.org
Number of days/hours: 1 to 3 hours depending on need.
Training is obtained: Onsite training determined by need.
There currently are not additional qualified resources for training.
The typical resources for implementing Period of Purple Crying are: Materials provided by the National Center on Shaken Baby Syndrome and Internet access.
There are no educational requirements, but the provider must take the training online or in person and be in a position where they have authority to give programs to new parents. The provider should protect the fidelity of the program by complying with the protocol required.
Period of Purple Crying is rated a "3 – Promising Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least one study utilizing some form of control (e.g., untreated group, placebo group, matched wait list) establishing the practice's benefit over the placebo, or found it to be comparable to or better than an appropriate comparison practice. For more information on the rating of a “3 – Promising Research Evidence,” please see the Scientific Rating Scale.
Barr, R. G., Rivara, F. P., Barr, M., Cummings, P., Taylor, J., Lengua, L. J., et al. (2009). Effectiveness of educational materials designed to change knowledge and behaviors regarding crying and shaken baby syndrome in mothers of newborns: a randomized controlled trial. Pediatrics, 123(3), 972-980.
Type of Study: Randomized controlled trial
Number of participants: 1374 experimental; 1364 control
Population:
Location/Institution: Washington State
Summary: (To include comparison groups, outcomes, measures, notable limitations) Mothers were randomly assigned to receive either the PURPLE crying materials or information on infant safety and safe sleep. Some mothers received materials prenatally and some at pediatric sites. Knowledge was assessed with a baseline interview. Mothers were also given a diary to complete during the fifth week. At two months post-intervention knowledge was assessed. Mothers receiving the PURPLE intervention showed higher knowledge scores about crying and shaking the baby, more positive reported behavioral responses to crying and more likelihood of sharing information with other caregivers about walking away and the dangers of shaking. They also reported more minutes of contact during crying. However rates of picking up the baby, walking away when distressed and daily frustration scores were not different across groups. The intervention group reported longer periods of distress in their babies than the control group. The authors speculate that increased reports of distress may be a result of the focus on crying in the PURPLE materials but suggest that this result needs to be followed up.
Length of post-intervention follow-up: 2 months.
Barr, R. G. (2006). Crying behaviour and its importance for psychosocial development in children. In: Tremblay R. E., Barr R. G., Peters R. D., eds. Encyclopedia on Early Childhood Development [online]. Montreal, Quebec: Centre of Excellence for Early Childhood Development, 1-10. Retrieved on August 31, 2009, from: http://www.dontshake.org/pdf/Crying_Behaviour___CEECD_Encyclopedia.pdf.
Barr, R. G., Trent, R. B., & Cross, J. (2006). Age related incidence curve of hospitalized Shaken Baby Syndrome Cases: Convergent evidence for crying as a trigger to shaking. Child Abuse and Neglect, 30, 7-16.
Lee, C., Barr, R. G., Catherine, N., & Wicks, A. (2007). Age-related incidence of publicly reported Shaken Baby Syndrome cases: Is crying a trigger for shaking? Journal of Developmental and Behavioral Pediatrics, 28(4), 288-293.
Contact name: Marilyn Barr, Founder and Executive Director
Affiliation/Agency: National Center on Shaken Baby Syndrome
Email: mbarr@dontshake.org
Phone: 801-627-3399
Fax: 801-627-3321
Website: http://www.dontshake.org