 I've been seeing infants, children and adults in my clinic now more than 40 years and it's always focusing on bone disease related to different metabolic disorders, calcium, vitamin D and the like. Probably about 8 to 10 years ago I got this frantic phone call from a mom. She and her husband had just been accused of abusing their child and I said that I'm not sure how I can help you because I have no experience with child abuse. And she said but we've heard that you are an expert in metabolic bone disease and the reason we're being accused of child abuse is that we had innocently brought in our child to the emergency department with an upper respiratory tract infection only to find out that the child had several fractures of the ribs and other skeletal areas in various stages of healing and it was concluded by the pediatrician and child abuse expert this had to have been caused by child abuse. So I said to them I'll be happy to see you but I really don't know if I can help. So after talking to her on the phone and going through various of the symptoms that I typically ask on the phone to see if in fact she has any evidence for this she actually came to my clinic and there was no question that she has Ehlers-Danlos syndrome hypermobility type 3. So Ehlers-Danlos syndrome is a autosomal dominant genetic disorder and that's important because that means that if a parent has it they have a 50% chance of transferring and Ehlers-Danlos syndrome is a genetic defect of the collagen elastin matrix and basically the collagen elastin matrix keeps you together and that's why it's well documented in the literature that Ehlers-Danlos patients adults have a 10 times higher risk of having a fragility fracture and so to me it wasn't much of a stretch that if you have an infant that has much smaller skeleton that they're going to also be at extremely high risk of fracture which is normal handling. So I went and testified in the family court to the judge and the judge thought that I made sense and so as a result returned parental care to both of the parents and all charges were dropped. Many of the child abuse cases that I see the abuse charge is based on only one observation not realizing that the child abuse expert and often the pediatrician doesn't have the expertise in metabolic bone disease. Now you would think that that would be incredibly important if you are making the diagnosis of child abuse associated with multiple fractures. Just because you have Ehlers-Danlos syndrome and can explain these fractures doesn't mean that they're not abusing their child and I explain that to the court all the time that I personally don't know the family and so I can't vouch to say that they did not abuse their child but what I will explain to the court is that there's clear evidence of vitamin D deficiency and insufficiency that's compromising the skeleton of that infant. If I find that I'm able to see the parents and make the diagnosis of Ehlers-Danlos syndrome get a family history of siblings and other children having evidence for it and if I'm permitted to see that infant or child in my clinic and able to make that diagnosis then I can write to the court that there is this additional mitigating circumstance that should be taken into account. So my hope is after all the experience that I've been now collecting in our clinical research program is in fact to start publishing papers to outline how you can make definitive diagnosis of Ehlers-Danlos syndrome in infants and young children. Right now the mantra is that you can't make the diagnosis until the child's around five years of age and in my opinion to know that this is autosomal dominant that you know that these infants have a 50% chance of acquiring it and that all of these other symptoms of masto-hypersensitivity, gastroparesis and easy bruiseability just for a few that infant has that and a parent that has EDS I think that is pretty good likelihood that that infant has EDS.