I'm reluctant to accept a finding of abusive head trauma without more details.
I agree with the poster who pointed out possible physiological anomalies. The one ear is noticeably low set, posteriorly rotated, and it looks as though there is a preauricular mass. The helix is unusually prominent and lobes are thick.
Ears are one of the first external features to take shape in utero. Typically, very early ear and cardiac development occur within the same timeframe. If a child is observed to have external ear defects, specifically a preauricular cyst, pit, or tag in tandem with posterior rotation, there is a high probably of internal organ defects, ie. ventricular malformations, serious murmurs, and so forth.
He may have had previously undiagnosed defects of the skull which could initially be taken for abusive head trauma. Those same defects could be linked to a seizure disorder, Chiari malformation, or brain stem compression. As for the father having a history - perhaps he had a medical condition or intellectual disability.
Agree strongly with all of this!
Unilateral hearing loss in a newborn that was not premature, combined with external ear malformations, is due to genetic mutations or a syndrome (combination of other associated conditions). One of the good things we know is that MA had good prenatal care beyond the initial 5 months of pregnancy, which is when she discovered/ acknowledged she was pregnant. The docs and adoptive parents were on top of assessments of the newborn right away, and the baby had already been thru evaluations and fitting for a first hearing aid when he was reclaimed by MA, according to the adoptive parents interviews. That means that the baby has some pretty comprehensive information already in his medical records, that will be able to be used by docs and prosecutors to determine what happened to cause his head trauma.
Hearing loss in newborns is NOT just a benign condition easily solved with a hearing aid. These children have a lot of issues to be attended to as they grow and develop, and need a good multidisciplinary team of specialists right from birth, as well as a parent committed to the process of care.
A large proportion of these kids (around half), have significant academic, social, behavioral, and developmental problems (including balance and coordination issues), in addition to any related medical problems, that need ongoing intervention. This is especially critical in the first months, and the early years of toddlerhood, as kids are learning language, and growing and developing. Binaural hearing (hearing from both ears) is a big part of attention and comprehension development.
These kids need ongoing and regular (every few weeks to months in the early treatment) evaluation of their hearing aids, and usually need several different types of hearing aids as they grow. They often need speech therapy, and other early childhood interventions to help them perform as near as possible to their non- hearing impaired peers. Many of these kids have IEPs and 504s (special education and special accommodations) once they start school, and parents need to learn how to work together with schools to carry out these educational plans.
I really wish that the adoptive parents had been advised a little better during the reclaiming process, because they could have advocated much more stridently for this childs current and future needs, even if he still went to the birth mom. IMO, he should have had a guardian ad litem appointed, and the teen mom should have had ongoing mandatory contact with social workers to ensure she was being educated on how best to meet his needs. And following through with appointments and evaluations. (If the baby had already been evaluated and was going to receive a hearing aid, did MA ever bring Gabriel to that clinic to receive it?)
If any of that had happened, at least there would have been contact with social workers and docs and therapists during the initial 40 days he was with MA, and possibly MA would have been enrolled in some parenting classes, etc. It may not have made a difference in the outcome, but it might have. And it would have been a much better beginning for both baby Gabriel and MA.
The baby also would have needed to be enrolled promptly in some kind of medical insurance or medicaid once reclaimed by the mom, as I doubt the adoptive parents insurance would have continued to cover him. They would have had to do paperwork and approvals to share medical records with new providers, etc.
Because of the very high risk situation this baby was in, (being reclaimed from adoptive parents after 3/4 of his life, a significant disability, a single mom, 16 years old, unemployed, etc,) a pediatrician, NP, or family doc would have wanted to see the baby in the clinic probably at least once a week in the first weeks, to make sure all was well with the baby and mom, and their needs were met. There would have been referrals to appropriate services for both mom and baby. From the sound of things, I sincerely doubt any of that was done, as MA states she spent her days watching cartoons and Law and Order with the baby.
There is probably not much in the way of medical appointments/ condition of the baby documented in the last 40 days of his life, but at least the first 3 months are probably documented very well. Those records will be very important as they continue the investigation, and prepare for the murder trial.
