A new study from Harvard University and the University of British Columbia suggests that people who experience abuse as children may carry imprints of that trauma inside their cells, leaving ‘molecular scars’ on its victims.

The study, which is entitled “Exposure to childhood abuse is associated with human sperm DNA methylation”, was published today in Translational Psychiatry. The research team assessed the DNA of 34 men, and found significant differences in methylation between victims and non victims.

Methylation is a biochemical process which acts in part like a dimmer switch on genes, affecting the extent to which a particular gene is activated or not. Epigenetics, or the turning on and off of genes, is a growing area of interest for scientists, who believe the process is influenced by external forces, such as a person’s environment or their life experiences.

The researchers decided to look for methylation in sperm cells, as they suspected that childhood stress could lead to long-term physical health problems not only in the immediate victims, but also in victims’ offspring, which had been demonstrated in previous experiments involving animals.

Though the study was not able to confirm whether these differences were responsible for long term health problems sometimes present in child abuse victims, or whether the methylation patterns could survive the process of fertilisation and pass down to a person’s children, the findings are being viewed as a potential source of evidence for family and criminal courts when trying to establish allegations of child abuse.

One of the senior authors of the study, Michael Kobor, who is a medical genetics professor at the University of British Columbia explains the correlation between methylation and detecting child abuse:

“Methylation is starting to be viewed as a potentially useful tool in criminal investigations – for example, by providing investigators with an approximate age of a person who left behind a sample of their DNA… So it’s conceivable that the correlations we found between methylation and child abuse might provide a percentage probability that abuse had occurred.”

A world famous scientist now working as an expert witness in court rooms around the world is using a theory he developed to disprove claims of non accidental injury in babies and children going through child protection proceedings.

Non accidental injuries, unlike accidental injuries, are deliberately inflicted by another person, and can include physical damage to children like bruises, burns, or fractures. These injuries are often considered to be synonymous with child abuse.

Dr Michael Holick is the Director of the Bone Health Care Clinic at Boston University Medical Center, and the leading authority on Vitamin D. In the last seven years, Dr Holick says he has consulted or testified as an expert witness in over 300 child-abuse cases in the US, the UK, New Zealand, Australia, Germany, and Canada. And in almost every case, he has diagnosed the child in question with a rare genetic disorder called hypermobile Ehlers-Danlos syndrome.

Considered to be one of the most prominent and sought-after expert witnesses in the US for the defense in child-abuse cases, Holick told The New Yorker that around 50% of the parents he helps have a positive experience, such as getting their children back or having abuse charges dismissed. Sometimes he claims a much higher success rate. “Before I started testifying in these court cases on behalf of the family 100% of these cases had been won by the prosecution…. Now that I am testifying on behalf of the family 90% of the cases have been won by the parents and their children have been returned to them without further incident.”

Holick says children with EDS have weaker bones which can fracture much more easily. He also believes that, “thousands, if not tens of thousands,” of parents around the world have been wrongly accused of fracturing their children’s bones. When he doesn’t diagnose a child with EDS, he concludes that the bone fractures are down to rickets or a Vitamin D deficiency. Holick also believes that in every case he has come across, not one child had been subjected to abuse. Crucially, he also says that parents who approach him for help have never tried to fake an illness in their children in order to avoid prosecution.

Not everyone thinks Holick is right. The National Institutes of Health estimates that EDS affects 0.02% of the population worldwide, at most, and so Holick’s near 100% diagnosis rate for the condition does not sit well within that mathematical probability of chance. That Holick often does not see the children he is diagnosing, choosing to attribute conditions over the phone instead, also gives his critics more leverage to query the accuracy of his findings.

A 2008 case Holick worked on, in which he diagnosed a baby who had sustained 26 fractures, with EDS, later led to the father being sentenced to 24 years in prison. Holick maintains that the sheer volume of fractures could not have been caused by external trauma without resulting in the baby’s death. The heightened levels of flexibility in small children too, make it much harder to diagnose EDS, and almost impossible to diagnose children under the age of five, according to other experts in the field.

There are four studies which Holick uses to support his conclusions, and while the authors of those studies say his approach is not backed by published scientific research, they are not entirely dismissive of his theory. Cristina Eller Vainicher, who is the lead author of one of the paper’s that Holick often references, told The New Yorker that “she can’t entirely discount his thesis, because some studies have suggested that a subset of EDS patients do experience fragility fractures during childhood. Still, she wrote in an e-mail, “This does not mean that we could state all children with hypermobile EDS are at high risk of fractures.””

The current scientific gaps in Holick’s theory have not prevented him from being deeply influential in non accidental injury cases, which is most likely down to his formidable reputation as the man who discovered the active form of Vitamin D, resulting in treatments for bone disease in kidney patients and for psoriasis. He went on to discover that orange juice helped the body absorb Vitamin D, and was invited to consult for NASA, who asked him to examine bone loss in space. That he was called a “legend” at the last annual meeting of the American Association of Clinical Endocrinologists perhaps sums up his powerhouse status in America.

BAILII offers three public judgments in which Holick has been referenced, either as a consultant to the case or because of his 2017 research paper, entitled, “Multiple fractures in infants who have Ehlers-Danlos/hypermobility syndrome and or vitamin D deficiency: A case series of 72 infants whose parents were accused of child abuse and neglect.”

All the cases have been heard in family courts, with the first taking place in Northern Ireland at the end of last year: A Health and Social Care Trust v A Mother and A Father (In the matter of two children: Non-accidental Injury: Causation).

The second case published lists a hearing at the Family Court in East London in March: A, Re [2018] EWFC B34 (16 March 2018).

The final case mentioned, ES (A Child), Re [2017] EWFC B96 (03 November 2017), was heard in the Family Court at Milton Keynes.

His views don’t appear to be well received by judges in the above cases, with one judge even going so far as to say that Holick was unable to produce evidence of any prior cases he assisted on.

You can access Dr Holick’s research papers here, and follow him on Twitter @VitaminD_Holick and Facebook at  DrMHolick.

Dr Holick can also be contacted via his website (scroll down to the bottom to access the form) or emailed at mfholick@bu.edu.

Dr Michael Holick. Image Credit: Boston University.

The Justice Committee, a parliamentary group set up to examine the policies, spending and administration of the Ministry of Justice and related public bodies, published a report on 3rd July, which recommends reworking the current criminal law guidelines for sentencing around child cruelty offences, including the need to obtain expert evidence on psychological harm, and developmental harm on a child.

The recommendations were made after the government floated a consultation on the topic. Respondents included judges, criminal justice organisations, local government, members of the public, lawyers and NHS bodies.

The report tells us that 623 offenders were sentenced for child cruelty crimes, in 2016, with 6 offenders sentenced for causing or allowing the death of a child, and 23 for causing or allowing serious physical harm to a child. To date, there have been no convictions under Section 3A of the FGM Act 2003.

The report also confirms that more women than men have been sentenced for these offences.

Cruelty to a Child can be broken down into four categories; assault and ill-treatment, neglect, abandonment and failure to protect.

Key proposed changes to the guidelines:

• The addition of two further offences: causing or allowing a child to die or suffer serious physical harm, and failing to protect a child from the risk of female genital mutilation (FGM);
• Setting a lower starting point for offenders who have failed to protect a child from cruelty, as opposed to inflicting it;
• Engaging expert evidence to determine psychological harm/developmental harm
• A new range of aggravating factors: for example, those in positions of power, such as a teacher or priest;
• A new range of mitigating factors, such as remorse and good character
• Looking at ways to clarify the law around failing to protect a child and committing an act against that child. The guidelines currently combine the two elements when the perpetrator of direct harm in the household is not known;
• Taking into account the complex cultural and social context which leads parents to mistakenly believe that FGM is in a girl’s best interests, during the sentencing process

The report’s findings and recommendations are likely to engage child abuse campaigners and family law reformers, who would like to see tougher sentencing for child abusers and a great deal more solid evidence in risk of future harm cases.

You can access the report here.