Brandt F Steele
Authors: Laura Newman
Journal: BMJ (2005)

Brandt Steele played an instrumental role in the creation of the child protection movement, devoting his life's work to the quest for understanding child abuse and developing rational and humanistic treatments. He was well known for taking his time to interview parents and carers fully to understand each individual case.

At the American Academy of Pediatrics annual meeting in 1961, Steele and C Henry Kempe, a paediatrician and close colleague, organised a plenary session on what they named “the battered-child syndrome.” The session took up one morning of the programme and more than 1000 paediatricians attended it. Experts in the child abuse field remember it as a watershed moment when people realised that something had to be done to help the parents and the children.

The panel's findings were published the following year in the 7 July 1962 Journal of the American Medical Association. The journal ranked the article among the 50 most important medical papers of the 20th century. In it, the authors wrote, “The syndrome should be considered in any child exhibiting evidence of fracture of any bone, subdural hematoma, failure to thrive, soft tissue swellings or skin bruising, in any child who dies suddenly, or where the degree and type of injury is at variance with the history given regarding the occurrence of the trauma.” Although they acknowledged that there was significant variation in diagnosing a child as battered, they observed that “more often the child's general health is below par, and he shows evidence of neglect including poor skin hygiene, multiple soft tissue injuries, and malnutrition.”

The article grabbed the attention of the public, which pressed for legislative action. Within four years of publication, nearly every state had mandated that doctors report child abuse. The mandate was eventually extended to teachers, social workers, and clergy in many states. Home visitation of high-risk families grew out of Steele's research.

Steele became interested in child abuse in the late 1950s, when paediatricians asked him to take patient histories in suspicious cases. Early on, he realised that parents who were abused as children were at increased risk of abusing their own children. However, he was quick to stress that not all abused children became abusive parents. According to Ruth Kempe, the widow of Henry Kempe, he had a keen ability to see the parents as people not to be blamed, but understood. His interviews provided the building blocks for humanistic interventions for both parents and children.​children.




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Colleagues remember him as an excellent diagnostician, able to discriminate between accidental and intentional injury. Physicians came to Colorado, where Steele worked, to learn how to interview. Robert Kruger, dean of University of Colorado School of Medicine, said, “He taught me a lesson about human behaviour that has helped me immeasurably through the years,” adding, “If you don't understand someone, you don't have enough history.”

Steele demonstrated an immense sensitivity and inquisitiveness in gathering psychiatric information from parents and carers in whom there was a high index of suspicion of battering or neglect. Besides co-authoring the JAMA article, he was a mentor and author throughout much of his professional career. Steele contributed a chapter on psychodynamics to several editions of The Battered Child, edited by R S Kempe, R D Krugman, and M E Helfer (University of Chicago Press). In the 1980 edition, he wrote, “Although my original work began in relation to seriously injured children described under the title `the battered-child syndrome,' within the last five years, I have turned more of my energies to children who are failing to thrive, parental deprivation, neglect, and emotional and sexual abuse.” He also wrote about infanticide and effective treatments for abusive parents and an increased prevalence of child abuse among prisoners in Colorado.

The prolific partnership of Steele and Kempe continued in Colorado until Kempe's death in 1984; Steele addressed the psychosocial component and Kempe focused more on shepherding the child welfare laws.

Steele was born in Indianapolis in 1907 and earned both his bachelor of sciences degree and his medical qualification from Indiana University. At Indiana, he studied entomology under Alfred Kinsey, later famous for his work on sexology. Steele completed his internship at Boston City Hospital on a Harvard research fellowship and was chief resident on a Cornell University fellowship at Bellevue Hospital in New York. He completed his residency at the University of Pennsylvania and then taught as a lecturer there. In 1958 he provided psychiatry liaison to the medicine service at what was then Colorado General Hospital, remaining in Colorado until his death. He also figured prominently in the development of the National Center for the Prevention and Treatment of Child Abuse and Neglect, now called the Kempe Children's Center, in Denver, Colorado. During the second world war, he served in the US army and took part in the Normandy invasion and the Battle of the Bulge.

Predeceased by his first wife, Margaret, and his second wife, Eleanor, he leaves two sons and eight grandchildren.

Brandt Steele, emeritus professor of psychiatry University of Colorado School of Medicine and Kempe Children's Center, Denver, United States (b Indianapolis, United States, 1907; q Indiana University School of Medicine), d 19 January 2005.