Nancy Kellogg, a Texas-based pediatrician who studies intentional starvation, said the condition and weight of Rachel Perez’s son when found was one of the more severe cases of child starvation she’s ever known.
To put it in perspective, Kellogg said the boy was the average weight of an 8-month-old infant. He was 6 years old. Prosecutors allege Perez intentionally starved the boy over an unknown period of time. Intentional child starvation is one of the rarest forms of child abuse, Kellogg said, but cases do happen.
That type of abuse brings significant physical and psychological concerns as a child recovers, she said.
When a starvation victim is found, Kellogg said the initial impulse from the rescuers is to feed the victim, which can be fatal. A victim’s system is so compromised that any food can pose a threat known as “refeeding syndrome.” Treatment starts with small amounts of fluids and nutrients, then moves onto smaller amounts of food over the ensuing weeks and months.
In most cases, a child is able to regain lost weight, but will never be able to regain the height growth lost during the time they were malnourished. Starvation victims also run the risk of hoarding food and becoming overweight, part of the psychological damage caused by the abuse.
There are numerous other psychological challenges victims of severe child abuse face, said Jim Henry, director of the Child Trauma Assessment Center at Western Michigan University.
Henry said such abuse affects a victim’s perception of the world.
“People are not to be trusted. People will hurt me,” he said of the altered reality seen in severe abuse cases.
Those issues require intense therapy and intervention, something Henry said is made more difficult in children with underlying disabilities, such as Perez’s son, who has Down syndrome. Henry also spoke of the psychological trauma inflicted on witnesses to such behavior — Perez’s two daughters testified about seeing their brother abused.
“They’re also facing the guilt,” Henry said. Some witnesses are left with believing they’re somehow responsible for the abuse, or that they could have stopped such treatment.
Henry said research provides some clues into the mindset that leads people to severely abuse their child — something unfathomable to many parents.
A “projected out anger” leads to a distorted thought process, Henry said. That anger could result from shame about a child’s disability, or anger meant for the birth father.
Regardless of the source, the anger leads to an emotional disconnect.
“The child becomes an object,” Henry said. “There’s no emotional connection.”
Once it reaches that point, Henry said, nearly any action or abuse can be justified in an abuser’s mind.
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