By THOMAS HARGROVE
Scripps Howard News Service

The first child death review team was created in California in 1978 under the leadership of pediatric psychiatrist Michael Durfee, medical coordinator for the Child Abuse Prevention Program at the Los Angeles Department of Health Services.

The goal was to detect fatal child abuse and to get a more accurate accounting of how infants, children and young teenagers die so that future deaths could be avoided.

"We know a lot more about how many BMW's are stolen than we do about how many children are murdered," Durfee has said many times.

There was no hard evidence that such reviews would improve the detection of homicides or other avoidable causes of death. But so compelling was the idea that similar programs popped up the same year in Oregon and North Carolina. Many other states joined the movement through the 1980s.

The first attempt to statistically analyze the problem was the landmark Missouri Child Fatality Study in 1990 that concluded child-abuse deaths in the state were grossly under reported. The Missouri Legislature passed a law mandating review of the deaths of every child 14 and younger.

The following year, the American Bar Association's Center on Children and the Law obtained funding to create the Child Maltreatment Fatalities Project and published a manual on how to create Child Death Review Teams including model state legislation.

In 1992, the Journal of the American Medical Association published an article calling for a greatly expanded use of Child Death Review to meet "the critical need for the systematic evaluation and case management of suspicious child deaths."

But Child Death Review programs developed unevenly and without uniformity. Without recommended standards, some states opted to rely exclusively on a single, statewide board while others rely on teams of local reviewers. Twelve states developed a multi-layered local and statewide review program.

Despite the lack of conformity, there were signs that the review boards were making changes.

Around 2000, crime statisticians began noticing an astonishing trend. The number of homicides of very young children rose 38 percent in a single decade during a time when violent crime generally was on the decline.

"Because of the difficulty of confirming homicide in the deaths of very young children, many states established Child Death Review teams in the 1980s," wrote David Finkelhor, director of the Crimes against Children Research Center at the University of New Hampshire. "The greater scrutiny by such teams may have elevated official child homicide rates without any true underlying increase in the incidence of child homicides."