The New Jersey Supreme Court held that expert testimony regarding Shaken Baby Syndrome/Abusive Head Trauma (SBS/AHT) is not sufficiently reliable to be presented to juries in criminal cases, affirming lower court decisions that excluded such testimony in two separate child abuse prosecutions.
In *State v. Darryl Nieves* and *State v. Michael Cifelli*, decided November 20, 2025, Justice Pierre-Louis wrote for the court in consolidated cases involving two fathers charged with criminal offenses after their young children exhibited what medical professionals call the "triad of symptoms" associated with SBS/AHT: subdural hematoma, retinal hemorrhages, and encephalopathy.
Both children were in the care of their fathers when they began showing these symptoms. The same doctor in both cases determined that the children were victims of child abuse, specifically SBS/AHT, leading to criminal charges against both men.
The state sought to present expert testimony from a doctor who would have testified that shaking by a caregiver was the only explanation for the children's symptoms "to a reasonable degree of medical certainty." However, defense attorneys in both cases moved to exclude this testimony, challenging the scientific basis and reliability of the theory that shaking alone, without impact to the head, can cause the symptoms associated with SBS/AHT.
The legal challenge focused on fundamental questions about the scientific foundation underlying SBS/AHT diagnoses. Defense attorneys argued that the medical theory linking the triad of symptoms exclusively to intentional shaking lacks sufficient scientific support to meet legal standards for expert testimony.
After conducting detailed hearings to explore the admissibility of the evidence, the trial court in *Nieves* excluded SBS/AHT testimony from the trial. The trial court in *Cifelli* followed the same approach, also excluding the expert testimony. Both decisions were based on findings that the scientific basis for SBS/AHT theory did not meet reliability standards required under New Jersey evidence law.
The Appellate Division affirmed both trial court decisions, finding that the lower courts correctly excluded the expert testimony. The state appealed both cases to the New Jersey Supreme Court, which granted certification in *Nieves* and leave to appeal in *Cifelli*, consolidating the cases for review.
The Supreme Court's opinion traces the history of SBS/AHT theory over the past six decades, beginning with research conducted in 1968 by neurosurgeon Dr. Ayub Ommaya. Dr. Ommaya's experimental study focused specifically on whiplash injuries from car accidents, though the court noted that his research formed part of the foundation for later SBS/AHT theories.
The court's analysis examined whether the state met its burden of establishing the reliability of SBS/AHT testimony. Under New Jersey evidence law, expert scientific testimony must meet certain reliability standards before it can be presented to a jury. These standards require that the underlying scientific theory be generally accepted in the relevant scientific community and that the methodology used be reliable.
In reaching its decision, the court agreed with the trial courts and Appellate Division that the state failed to meet its burden in establishing the reliability of SBS/AHT testimony. This finding represents a significant development in how New Jersey courts will handle cases involving allegations of child abuse based on SBS/AHT diagnoses.
The ruling has important implications for both criminal prosecutions and the medical community's approach to diagnosing suspected child abuse. While the court's decision does not prevent prosecution of child abuse cases, it does require that such prosecutions rely on evidence that meets established scientific reliability standards.
The decision reflects growing scrutiny of SBS/AHT testimony in courts across the United States. Legal challenges to this type of expert testimony have increased as defense attorneys and some medical professionals have questioned whether the triad of symptoms necessarily indicates intentional abuse rather than other potential causes.
For prosecutors, the ruling means they must develop alternative approaches to proving child abuse cases that previously relied heavily on SBS/AHT expert testimony. This may include presenting evidence of other injuries, witness testimony, or alternative medical explanations that meet reliability standards.
The ruling also affects medical professionals who work in child protection cases. While doctors can still diagnose and treat children with these symptoms, their ability to testify in criminal cases about the cause of injuries may be limited unless they can establish a more reliable scientific foundation for their opinions.
The consolidated decision in *Nieves* and *Cifelli* establishes binding precedent for all New Jersey courts, meaning that similar expert testimony challenges in future cases will likely be resolved consistent with this ruling unless the underlying scientific evidence changes significantly.