Skip to main content



Child-Maltreatment-Research-L (CMRL) List Serve

Browse or Search All Past CMRL Messages

Welcome to the database of past Child-Maltreatment-Research-L (CMRL) list serve messages (10,000+). The table below contains all past CMRL messages (text only, no attachments) from Nov. 20, 1996 - September 14, 2018 and is updated quarterly.

Instructions: Postings are listed for browsing with the newest messages first. Click on the linked ID number to see a message. You can search the author, subject, message ID, and message content fields by entering your criteria into this search box:

Message ID: 8914
Date: 2011-07-27

Author:Joshua P Mersky

Subject:Re: David Ludwig's recommendation to use foster care to treat obese children

Chris, Thanks for your perspective on this issue. While I generally agree with your conclusion and much of your underlying rationale, I do take issue with your assertion that there is accumulating evidence that foster care is hazardous and traumatic. While this may be the case for some children placed in care, overall the research is mixed on this matter. A few studies have linked foster care to deleterious effects. Ryan and Testa (2005) comes to mind. Doyle (2007) does as well, although his findings do not apply to the broader population of foster children. On the other hand, many rigorous investigations have indicated that the developmental and functional outcomes of foster children do not differ significantly from their appropriately matched peers (e.g., Berger et al., 2009; Berzin , 2010; DeGue & Widom, 2009; Smithgall, et al., 2004). Other studies have revealed benefits associated with out-of-home placement (e.g., Jonson-Reid & Barth, 2000; Stahmer et al., 2009). Faint praise for foster care, to be sure. Nevertheless, it is curious why researchers, practitioners, and even well-meaning crusaders continue to claim that foster care is typically harmful when the data do not support this conviction. Josh ----- Original Message ----- From: "E. Christopher Lloyd" To: "Child Maltreatment Researchers" Sent: Tuesday, July 26, 2011 11:55:28 AM Subject: Re: David Ludwig's recommendation to use foster care to treat obese children Here are some other points to consider: 1. Where is the supply of foster parents willing to take in medically fragile children who require a complete overhaul of foster parental lifestyle to have in their home including significant specialized training to properly care for? M & L assert some states allow removal for removal because of obesity yet it's telling they cannot present evidence that foster care is a curative or even helpful intervention nor can they clearly state a mechanism by which it might be. 2. Foster care is not a cure-all, and there is accumulating evidence it's also hazardous to children, at least from a developmental perspective and possibly a mental health one as well. It's unclear that the trauma of being placed into long-term foster care (and for the child to lose all that weight safely and demonstrate they can keep it off, it has to be long-term) will cause less harm than being obese. M & L claim to be concerned about children's mental health, but strangely they avoided even mentioning this rather obvious issue. 3. Technically, all obesity is life-threatening. That's the definition of obesity. If one's weight isn't threatening one's health, then it's not obesity. So they seem to be calling for the removal of all obese children from their homes of origin, despite their assertions to the contrary. 4. M & L are well-meaning crusaders (or at least appear as such in their paper) but like most crusaders, they tend to think their issue is so important, so acute that it justifies all manner of exceptionalism in responding to it. But really, it doesn't. Obesity is unquestionably bad, but it's one risk among many to children. Other risks present a far more acute threat to children's well-being compared to obesity (like physical abuse or sexual molestation, for example). Social services has very limited resources (something medicine doesn't really understand very often since they get blank checks to provide medical care) and should deploy it's resources to more acute and more serious threats first. That may sound a bit harsh, but consider this exercise: Make a list of all the kinds of maltreatment and their consequences, consider their incidence and prevalence, and the costs associated with intervention. Next consider the budget of your state's child welfare agency. I didn't make it to obesity, did you? The reality is that child welfare is already overburdened with more serious and acute problems, and there's no evidence it has a useful role to play in addressing children's obesity. M & L danced around all manner of legal and moral justifications (much of which was couched in vague, non-refutable terms) for their statements, but what they lack is even a hint of of a whiff of a scientific basis for their proposal. So let's triage (to borrow a medical term) obesity to it's appropriate priority and move on with the work that needs doing. Chris E. Christopher Lloyd, PhD, LCSW Assistant Professor School of Social Work University of Arkansas at Little Rock 2801 South University Avenue Little Rock, AR 72204 501.569.8486 --- On Fri, 7/15/11, Sandra J Bishop-Josef wrote: From: Sandra J Bishop-Josef Subject: Re: David Ludwig's recommendation to use foster care to treat obese children To: Child-Maltreatment-Research-L@cornell.edu Date: Friday, July 15, 2011, 12:28 PM I would urge people to read the original editorial in JAMA (July 13, 2011--Vol 306, No. 2. 206-207), not the news articles reporting on the editorial. Murtagh & Ludwig are talking about life-threatening cases of extreme obesity, where other interventions have been tried and failed, and the only option remaining under consideration is bariatric surgery: "In some instances, support services may be insufficient to prevent severe harm, leaving foster care or bariatric surgery as the only alternatives" (p. 207). They ask if it is ethical to subject these children to a medically risky, irreversible surgical procedure without first considering foster care as a (temporary) alternative. If we are opposed to foster care in these instances, I think our arguments need to be more compelling than the fact that obesity is determined by factors other than parental behavior (such as government policies, social infrastructure, etc). Murtagh & Ludwig acknowledge these factors. Further, couldn't the same argument be made about several forms of maltreatment where children are routinely removed from their homes? (e.g., the role of poverty, lack of access to mental health care, etc in neglect.) It is all too easy to oppose the straw-man position of unbridled state intervention in the families of obese children. But that is not what Murtagh and Ludwig are proposing. Sandra J. Bishop-Josef, Ph.D. Assistant Director, Edward Zigler Center in Child Development and Social Policy Associate Research Scientist, Child Study Center, School of Medicine Yale University 310 Prospect Street New Haven, CT 06511 Phone: 203-432-9935 FAX: 203-432-7147 E-mail: sandra.bishop@yale.edu www.ziglercenter.yale.edu Please be aware that email communication can be intercepted in transmission or misdirected. Please consider communicating any sensitive information by telephone, fax or mail. The information contained in this message may be privileged and confidential. If you are NOT the intended recipient, please notify the sender immediately with a copy to hipaa.security@yale.edu and destroy this message. -- Assistant Professor of Social Work Helen Bader School of Social Welfare University of Wisconsin-Milwaukee P.O. Box 786 Milwaukee, WI 53201 Phone: 414-229-0522 Fax: 414-229-5311

Chris, Thanks for your perspective on this issue. While I generally agree with your conclusion and much of your underlying rationale, I do take issue with your assertion that there is accumulating evidence that foster care is hazardous and traumatic. While this may be the case for some children placed in care, overall the research is mixed on this matter. A few studies have linked foster care to deleterious effects. Ryan and Testa (2005) comes to mind. Doyle (2007) does as well, although his findings do not apply to the broader population of foster children. On the other hand, many rigorous investigations have indicated that the developmental and functional outcomes of foster children do not differ significantly from their appropriately matched peers (e.g., Berger et al., 2009; Berzin , 2010; DeGue & Widom, 2009; Smithgall, et al., 2004). Other studies have revealed benefits associated with out-of-home placement (e.g., Jonson-Reid & Barth, 2000; Stahmer et al., 2009). Faint praise for foster care, to be sure. Nevertheless, it is curious why researchers, practitioners, and even well-meaning crusaders continue to claim that foster care is typically harmful when the data do not support this conviction. Josh ----- Original Message ----- From: "E. Christopher Lloyd" To: "Child Maltreatment Researchers" Sent: Tuesday, July 26, 2011 11:55:28 AM Subject: Re: David Ludwig's recommendation to use foster care to treat obese children Here are some other points to consider: 1. Where is the supply of foster parents willing to take in medically fragile children who require a complete overhaul of foster parental lifestyle to have in their home including significant specialized training to properly care for? M & L assert some states allow removal for removal because of obesity yet it's telling they cannot present evidence that foster care is a curative or even helpful intervention nor can they clearly state a mechanism by which it might be. 2. Foster care is not a cure-all, and there is accumulating evidence it's also hazardous to children, at least from a developmental perspective and possibly a mental health one as well. It's unclear that the trauma of being placed into long-term foster care (and for the child to lose all that weight safely and demonstrate they can keep it off, it has to be long-term) will cause less harm than being obese. M & L claim to be concerned about children's mental health, but strangely they avoided even mentioning this rather obvious issue. 3. Technically, all obesity is life-threatening. That's the definition of obesity. If one's weight isn't threatening one's health, then it's not obesity. So they seem to be calling for the removal of all obese children from their homes of origin, despite their assertions to the contrary. 4. M & L are well-meaning crusaders (or at least appear as such in their paper) but like most crusaders, they tend to think their issue is so important, so acute that it justifies all manner of exceptionalism in responding to it. But really, it doesn't. Obesity is unquestionably bad, but it's one risk among many to children. Other risks present a far more acute threat to children's well-being compared to obesity (like physical abuse or sexual molestation, for example). Social services has very limited resources (something medicine doesn't really understand very often since they get blank checks to provide medical care) and should deploy it's resources to more acute and more serious threats first. That may sound a bit harsh, but consider this exercise: Make a list of all the kinds of maltreatment and their consequences, consider their incidence and prevalence, and the costs associated with intervention. Next consider the budget of your state's child welfare agency. I didn't make it to obesity, did you? The reality is that child welfare is already overburdened with more serious and acute problems, and there's no evidence it has a useful role to play in addressing children's obesity. M & L danced around all manner of legal and moral justifications (much of which was couched in vague, non-refutable terms) for their statements, but what they lack is even a hint of of a whiff of a scientific basis for their proposal. So let's triage (to borrow a medical term) obesity to it's appropriate priority and move on with the work that needs doing. Chris E. Christopher Lloyd, PhD, LCSW Assistant Professor School of Social Work University of Arkansas at Little Rock 2801 South University Avenue Little Rock, AR 72204 501.569.8486 --- On Fri, 7/15/11, Sandra J Bishop-Josef wrote: From: Sandra J Bishop-Josef Subject: Re: David Ludwig's recommendation to use foster care to treat obese children To: Child-Maltreatment-Research-Lcornell.edu Date: Friday, July 15, 2011, 12:28 PM I would urge people to read the original editorial in JAMA (July 13, 2011--Vol 306, No. 2. 206-207), not the news articles reporting on the editorial. Murtagh & Ludwig are talking about life-threatening cases of extreme obesity, where other interventions have been tried and failed, and the only option remaining under consideration is bariatric surgery: "In some instances, support services may be insufficient to prevent severe harm, leaving foster care or bariatric surgery as the only alternatives" (p. 207). They ask if it is ethical to subject these children to a medically risky, irreversible surgical procedure without first considering foster care as a (temporary) alternative. If we are opposed to foster care in these instances, I think our arguments need to be more compelling than the fact that obesity is determined by factors other than parental behavior (such as government policies, social infrastructure, etc). Murtagh & Ludwig acknowledge these factors. Further, couldn't the same argument be made about several forms of maltreatment where children are routinely removed from their homes? (e.g., the role of poverty, lack of access to mental health care, etc in neglect.) It is all too easy to oppose the straw-man position of unbridled state intervention in the families of obese children. But that is not what Murtagh and Ludwig are proposing. Sandra J. Bishop-Josef, Ph.D. Assistant Director, Edward Zigler Center in Child Development and Social Policy Associate Research Scientist, Child Study Center, School of Medicine Yale University 310 Prospect Street New Haven, CT 06511 Phone: 203-432-9935 FAX: 203-432-7147 E-mail: sandra.bishopyale.edu www.ziglercenter.yale.edu Please be aware that email communication can be intercepted in transmission or misdirected. Please consider communicating any sensitive information by telephone, fax or mail. The information contained in this message may be privileged and confidential. If you are NOT the intended recipient, please notify the sender immediately with a copy to hipaa.securityyale.edu and destroy this message. -- Assistant Professor of Social Work Helen Bader School of Social Welfare University of Wisconsin-Milwaukee P.O. Box 786 Milwaukee, WI 53201 Phone: 414-229-0522 Fax: 414-229-5311