An Educational Blog for Parents

Not All Babies Are Forgotten

Not all babies are forgotten
June 14, 2017

Infant and toddler hot car deaths which we have, in the past, called “Forgotten Baby Syndrome,” is a topic that isn’t going away anytime soon. We’ve tried to raise awareness of these tragedies here at Kars4Kids with postings (here, here, here, here, and here) on the Kars4Kids educational blog for parents. We also created a free downloadable app, Kars4Kids Safety, to alert parents to the presence of a baby in the backseat of the car.

Our favorite resource for these efforts has, without a doubt, been Jan Null’s website, noheatstroke.org. That’s why it knocked us for a loop when Null reached out to us with a comment on one of these blog pieces, as follows:

“I am the creator and author of all of the material on http://noheatstroke.org.  First and foremost, all of the cases cited would not [be] due to infants and children being forgotten in vehicles. Only 54%* are forgotten. Secondly, while Forgotten Baby Syndrome is catchy, I have yet to find it documented as something unique in any peer-reviewed literature. It’s like saying Forgotten Car Key Syndrome is something unique when I’m stressed about going to an appointment! Yes, people do forget things and reminders are a great idea, but only for the just over half the cases where they are forgotten.”

Here’s where I’m going to drop the collective “we” and ‘fess up. I serve as contributing editor of the Kars4Kids educational blog for parents. I saw the phrase “Forgotten Baby Syndrome” some years back and thought: “I need to be using that phrase on the blog to help popularize it and raise awareness.”

To my mind, the biggest obstacle to raising awareness of babies dying in hot cars, is the knee-jerk response of parents who say “I’d never forget my baby,” because they think only bad parents forget their babies.

Parents who don’t understand or recognize the cognitive process behind memory failure don’t take precautions to protect their children from this eventuality, with often dire results. To my mind, branding the phenomenon was critical. It had to have a name for parents to latch onto, one that sums things up neatly.

So there I was, confronted with Null’s comment. “If I post it,” I thought, “that will only exacerbate the problem of parents thinking: this can’t happen to me. On the other hand, If I don’t post it, I’m being dishonest.”

I decided I’d write Null and tell him that. I wanted to see what he’d say. Besides, I wanted to know about the other 46% of babies who die in hot cars, but aren’t forgotten.

I wrote to Mr. Null explaining my conundrum about posting his comment and asking about that other 46 percent. He wrote:

“The other 46% are broken down into two categories, but neither of them are the result of forgetting.

  • 28% happen when children get into a vehicle on their own, typically when a car is left unlocked in the driveway or other nearby location.  This is why parents should be urged to lock cars, keep keys and fob out of reach and if a child is missing to always check cars (including the trunk).
  • 17% are when a parent or other caregiver makes a conscious decision to leave a child in a vehicle when they go do some other activity.  These have included getting their hair done, going to a bar, casino or racetrack, having a romantic rendezvous or going to work.

Null added, “I don’t doubt that 54% are forgotten, just that it is nothing unique.  We all have busy multitasking lives and parents do indeed have additional stresses but other than the tragic consequences is it any different than spacing out and forgetting our freeway exit?

“Finally, I really appreciate your efforts to raise awareness about this issue and for every baby’s life that might get saved is important. I have been involved in the issue, primarily pro bono, since 2001 and obviously feel it is an important one.”

“Forgotten Baby Syndrome” An Inaccurate Catchphrase

I saw Null was right: lots of babies who die in hot cars aren’t forgotten, so it’s inaccurate to say they died of “Forgotten Baby Syndrome.” The cognitive process that makes memory fail isn’t unique to parents, so it’s not correct to call it a “syndrome.”

“So where do I go from here?” I thought. “What are we going to call this thing?”

I decided to ask Dr. David Diamond what he thought. Considered the expert on forgotten babies, Diamond speaks and writes extensively on the subject, and has testified in trials of parents whose babies died in hot cars.

“I’m reluctant to post Null’s comment,” I wrote to Diamond, “for fear that parents will continue to believe that only bad parents forget their babies, and won’t take precautionary steps to avoid leaving their own babies behind in their cars.”

Diamond, incredibly, responded, suggesting that since the catchphrase is not always well-received and since, “leaving a child in a car is not an act of brain damage or pathology,” he no longer uses the phrase  Forgotten Baby Syndrome.

“I wrote an article here about the phenomenon and I didn’t mention FBS at all,” said Diamond. “There is no need for a peer-reviewed publication on the topic. Forgetting kids in cars is, in theory, the same brain processes involved in any other type of memory failure when the habit memory system outcompetes the conscious fact-based memory system.

“As to the 54% figure – sometimes kids play in cars and get themselves locked in, and other times parents forget kids. I don’t see why it matters. Both types of child deaths are preventable.  There are documented times when parents intentionally leave children in cars because they think the children will be safe. This clearly is poor judgment and is in a different category from forgetting kids in cars. I don’t see why 54% of the deaths caused by memory failures should be trivialized.

“Bottom line – memory is flawed, whether it’s remembering that our headlights are on or that our child’s in the car – being aware it happens to attentive loving parents is necessary to appreciate that we need technology to help us so that kids don’t die in cars and parents aren’t traumatized and incarcerated.”

“Good points all,” I responded in my next missive, “but it does seem like we need a name for this, even if we don’t call it a ‘syndrome.'”

Dr. Diamond heard me.

“I understand the need to have a catchphrase for this phenomenon, that’s why FBS was so appealing. But to have a phrase for it is flawed, first, because the word ‘syndrome’ medicalizes it as a form of brain abnormality, and second, FBS opens it up to ridicule, such as to compare it to ‘forgotten phone syndrome’, etc. It also makes it appear that parents don’t take responsibility for forgetting their kids by blaming it on FBS.

“Bottom line: it is in the general category of a failure of prospective memory, in which we plan to do something in the future, but we forget to do what we planned to do, which is the most common form of memory failure. The reason is not because we don’t care, it’s because we lose awareness of the plan. The insidious aspect of forgetting children is that our brain creates the false memory that we did complete the plan, that we did take the child to daycare. This is why parents go about their normal routine as the child dies in the hot car.

“At a neural level, forgetting a child in a car involves the same brain structures as forgetting to stop at the store on the way home (information is held in temporary memory to be used at a later time while the brain engages in habitual activity). The comparison may offend some, but only the magnitude of the consequences of the memory failures in the two examples is different – the brain structures involved are the same.

Forgotten? Time for a Phone Call

I returned to Null to get his take on Diamond’s position. We decided we had to speak on the phone. My transcript of that call:

Jan Null: If you look at my website, I’ve made a plea not to trivialize forgotten babies. But we have to be careful not to emphasize one factor at the expense of others. We can’t be looking only at that 54% and not be looking at the others.

By the same token, we shouldn’t think that if we have technology to prevent us from forgetting babies in cars, that this alone will solve the problem. It’s like advertising a fat-reducing pill and saying, “Take this, and you won’t be fat anymore,” it’s dishonest.

Every step along the way saves lives, but when one aspect of it is made to be the chief component the other half gets left out of the discussion. When we do that we’re trivializing and saying once we take care of the 54% we’ll only have to worry about the next 46%, as if that’s minor.

Null continued: Take technology and the new legislation: these laws and devices will take some amount of time to make their way to the entire population. It’s not instantly you’re going to have these devices in even 50% of these cars.

Once you have the technology, it’s got a limited application. I’ve written about this on my website: “It is especially important to note that these types of sensors/devices are aimed at the segment of the cases where a child is accidently forgotten (54%), but not the other half of the cases where children gain access on their own or are intentionally left in vehicles.”

The amount of penetration of this technology even within 10 years, well, half the cars on the road are 7 years old, so you’ll be siphoning new technology into maybe half the cars, at best. Even with your technology being put in cars you’re going to have underserved populations who are going to get it last. In areas where people can’t afford to buy cars every year? That’s where you’ll get the technology last. The distribution of technology is going to be skewed to the higher socioeconomic groups.

Null: The Guy Bringing Tools and Trends

As for finding a good term to describe forgotten babies, well, that’s not my specialty. I’m the guy bringing tools and trends. I’ve spent 17 years of my service as a weather forecaster and meteorologist looking at this issue. But that term “Forgotten Baby Syndrome” is misleading. It made people think it was something specific to parents and babies.

I think it was Weingarten who used “forgotten baby syndrome” first, but that’s branding. I’m the one presenting the data for the people who are in the sphere of heatstroke death, people going to congress, people running heatstroke prevention campaigns. Trends and patterns, that’s my part.

I develop trend lines.  If we’re looking at weather and heat patterns, the trend line is going up. The total number of deaths, on the other hand, has been flat for 17 years. The numbers have stayed at 37 or 38 average heatstroke deaths per year.* But it’s pretty much been a flat trend all the way back to 1998. That’s discouraging.

Me: Discouraging? I would have thought encouraging. That the number of deaths isn’t rising. That the trend line is flat rather than going up.

Jan: It shows we’re not doing a good job with awareness, of making parents aware of the problem. Things haven’t changed.

Me: Well, that’s why I say you have to have a name. If not Forgotten Baby Syndrome then something else. But you need to have a name.

Jan: But we have the words. We have campaigns. Phrases like “Look before you lock.”

Me: And the parents say, “I’d never leave my baby so I don’t have to look before I lock.”

Jan: It’s definitely a problem to make parents understand it could happen to them. There’s an urban myth, a story, don’t know if it’s true, that a spouse saw a device and bought two of them, one for the other spouse. The other spouse made the first one take his back. Because he’d never leave the baby in a car. You know where this is going, right?

But again, the branding of it, that’s not for me. What is important is we continue to educate people with statistics and blogs like yours. It’s not going to be a short process or a single device.

Me: How do kids get into cars on their own? They take the keys and find their way in?

Jan: Sometimes. Sometimes the car doors aren’t even locked. They just go into the car.

Me: And then can’t get out? Is that because of child locks?

Jan: Sometimes. They climb over into the backseat and then can’t get out. They don’t know they can get out of the car from the front seat at any time. And sometimes they just don’t make it out.

Me: They’re overcome?

Jan: Overcome by the heat, yes. Sometimes they want to get hold of the key fob and click. Was it Volkswagen that had the Darth Vader commercial of the kid with the key fob, who kept clicking [yes. V.E.]?

Sometimes the kid is looking for a quiet place. Or the parent has an appointment and can’t get childcare, so leaves the child in the car. Sometimes parents are going to a bar or a casino—they think they’re leaving the kids in a “safe” place. It’s intentional. There was a story of someone who had a court appearance, couldn’t get childcare, and left the child in the car.

Me: And when a child dies due to a parent leaving him a car, you never get over it. How can you live with yourself after that?

Jan: There’s a whole sociology to this. For instance it was a spouse or a childcare provider who left the child in the car. Whether or not the childcare provider was paid or just doing a favor.

There’s the crime and punishment issue. Allen Breed looked at this 10 years ago. How are these cases prosecuted? Do you say that causing the inadvertent death of a child is punishment enough? Or do you look at it like a murder? There’s a whole discontinuity in the way these cases are prosecuted. One court calls it a crime and another says it’s a memory failure.

“Forgotten Baby Syndrome” Officially Discarded

I thanked Jan Null for the generosity of his time. Essentially, both Null and Diamond agreed with each other. Forgotten Baby Syndrome was a catchphrase to be discarded. It’s inaccurate. And trivializes the other 46 percent of babies who die in hot cars for other reasons.

It seems we may never find the perfect catchphrase for this terrible thing. But raising awareness, now that’s a goal we can hold onto. We need to make Null’s trend line go down. Way down.

Starting now.

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*Source: Jan Null, CCM, Department of Meteorology and Climate Science, San Jose State University, http://noheatstroke.org

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