Doctor raises questions about boy's development

Relates to:
Date: 2004-06-11
Source: Sun Journal

AUBURN - Nathaniel Allen could have had an undiagnosed condition, such as a minor seizure disorder, that contributed to his death, according to a New Hampshire pediatrician.

Roger Wicksman, a doctor from Concord, N.H., was hired by Sarah Allen's lawyer to offer an expert opinion on her son's death. Wicksman testified Thursday that Nathaniel could have suffered from some type of pre-existing condition that slowed his development.

The doctor based his opinion on clips from several home videos of Nathaniel and his parents.

The videos, which showed Nathaniel at 12 months old, 14 months old and 16 months old, were shown Thursday to the jurors who will decide at some point next week if Sarah Allen is guilty of manslaughter in the death of her son.

Nathaniel, who was adopted by the Allens from Guatemala, was 21 months old when he died of severe head trauma. The state alleges that Sarah Allen caused his injuries by shaking him.

Until Thursday, testimony at Allen's trial was dominated by doctors who examined Nathaniel before and after his death.

Those doctors, including the state's final witness, a neuropathologist who testified Thursday, concluded that a series of household falls, as described by Allen as a potential cause of her son's death, would not have resulted in the his death, and that a violent jerking or shaking was the more likely cause.

Wicksman was the first doctor to testify that a simple fall coupled with some type of other condition could be to blame.

"I've seen kids fall from three stories and be fine," Wicksman testified. "I've also seen kids fall, hit their heads on the coffee table and require neurosurgery."

Wicksman acknowledged that he never examined Nathaniel and had no way of knowing for sure how he died. He simply raised questions about the boy's health and development based on the home videos.

One of the videos was taken in April 2002 when the Allens went to Guatemala to pick up Nathaniel.

The boy was 12 months old at the time, and Wicksman commented on how he was "commando" crawling, using his elbows instead of his hands to drag himself across the floor.

"It's a very early stage of crawling," Wicksman said.

The doctor also pointed out that Nathaniel didn't seem able to use his neck or torso to keep himself stable, he didn't hold his own bottle and he appeared to have a lazy eye.

In a later video, Nathaniel is shown walking back and forth from one parent to the other in the living room of their home on Lincoln Street in Lisbon Falls.

"I expect children to be standing flat-footed at this point," Wicksman said. "Nathaniel is toe-walking. It makes you much more unsteady."

Assistant Attorney General Lisa Marchese made an unsuccessful attempt to keep Wicksman off the stand. She argued that his testimony would be irrelevant because the most recent video was taken five months before he died. Justice Ellen Gorman denied her request.

While cross-examining Wicksman, Marchese said, "Growth and development of a child can change month to month, can it not, doctor?"

Wicksman acknowledged that he wasn't providing any recent videos of the boy.

Marchese also pointed out that Nathaniel's pediatrician described him as a well toddler and that he never diagnosed the boy with a seizure disorder or any other problems that could have affected his development.

Referring specifically to seizure disorders, Wicksman testified, "Many of the subtle types of seizures can go undiagnosed for a long period of time."

Then, Marchese asked if he knew any children who died as a result of those types of seizures. Wicksman said no.

But, he testified, Nathaniel's apparent problems with his coordination "broaden the field of what could have happened."

Allen's trial is expected to continue until the middle of next week.

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