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Concerned About Unconventional Mental Health Interventions?
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Tuesday, March 19, 2013

More on the Death of Maxim Kuzmin (Shatto)

An announcement at states that the adoptive parents of the Russian-born three-year-old Maxim Kuzmin (Shatto) will not be charged in his death. The case has been closed  by the grand jury and the death ruled an accident, with the speculation that Maxim was in some way struck and injured by a playground glider while his mother briefly went indoors. The district attorney noted that Maxim was small and undernourished, and that “with the behavioral disorder he was prone to hurt himself.” The behavior disorder was not specified.

Texas child protective services is continuing an investigation into the family’s circumstances, according to the news release.

I have no wish to charge Mr. and Mrs. Shatto or anyone else who might be associated with Maxim’s death, unless much different evidence turns up justifying prosecution. I would say, though, that it is a mistake to close the door on this case as an accident, a random event whose causes cannot be ascertained. If this death were an isolated incident, that decision would make sense. However, it is one of a number of deaths that share certain characteristics--   adoption, undernutrition, physical injury, and the claim that a behavior disorder has caused the child to hurt himself.

Prosecution, and judicial findings of guilt or innocence, are desirable if the goal is to punish guilty people. If the goal is to prevent more deaths that follow the pattern described above, however, grand jury investigations and prosecutions may not be the best way to go. Those investigations focus on evidence of law-breaking and direct responsibility for children’s injuries or deaths. Even a successful prosecution of culpable persons fails to examine the possibly systemic causes for these advents.

Can we examine these cases and decide whether the pattern is coincidental, or whether there are indeed systemic reasons for these occurrences? To do so would require examination of a good deal of evidence and would need a broad perspective rather than the narrow focus on persons who may be accused of abuse or even murder. Although the evidence turned up by the district attorney would be relevant, this broader approach could only be managed by an investigative group like the one we have been told that Senator Mary Landrieu would head in the Shatto case, or, to some extent, by the investigation that Texas child protective services is still carrying out.

One important question in all these cases has to do with the claimed behavior disorder that causes self-injury. Certainly some children are impulsive and poorly self-regulated and get many bumps and bruises because of this, but it’s hard to imagine death resulting except in some very unusual situations. Other children injure themselves directly, and self-injurious behavior can be associated with autism, with Lesch-Nyhan syndrome, and with Rett syndrome, which is exceedingly rare in boys and is associated in boys from the time of birth with other problems like breathing disorders. Reactive Attachment Disorder, so often referenced in discussions of adopted children, is not in itself associated with self-injurious behavior. (However, advocates of holding therapy, who claim a version of attachment disorder that only they can detect, do argue that children can injure themselves badly in order to cause trouble and blame to be directed toward their adoptive parents. One chat group in 2001 even suggested that Candace Newmaker had died intentionally, just to cause trouble.)

In the Nathaniel Craver case, and in the ongoing Chritton case, defense attorneys have claimed that injured or dead children had been caused to bring harm to themselves by their Reactive Attachment Disorder. While this is not likely, the statement does raise some important questions. Was Maxim diagnosed as having Reactive Attachment Disorder, and if he was, who diagnosed him? If he had that diagnosis, was he being treated, and by whom? What advice about home care did the Shattos receive, if such a diagnosis was made? And, if there was such a diagnosis, was it by some circular reasoning based in part on the existence of injuries, which were later attributed to the disorder?

If Maxim was not diagnosed with Reactive Attachment Disorder , was he diagnosed with autism, Lesch-Nyhan syndrome , or Rett syndrome? The latter two very serious disorders would have been readily apparent before he left the orphanage, but because children who have been in institutions are often delayed in speech, autism might not have been diagnosed. I think the two syndromes mentioned can probably be dismissed as unlikely, but if they were present Maxim would have had to receive medical and other treatment. Was he receiving such treatment? As for autism, the related developmental delays may not have been obvious to anyone at this point, but it would be important to know whether he was receiving any treatment such as speech therapy or ABA—or whether the Shattos were trying to deal with a serious problem on their own.

Another topic that needs to be dealt with in order to understand Maxim’s death has to do with his poor nutritional status. Children who have been in institutions are often undergrown, as staff and other issues interfere with their taking as much food as they need, and the kinds of food they need. Maxim had only been with the Shattos for 2 ½ months at the time of his death, but surely they are likely to have sought a medical evaluation and should have received advice about his dietary needs and suitable growth goals. (If their pediatrician was not able to manage this, post-adoption services should have provided help such as reference to a group like the SPOON Foundation, which specializes in feeding help for parents who have adopted from abroad.) Were Maxim’s growth and nutritional status where they might be predicted to be after a couple of months in the adoptive home, or were they still at the levels seen when he was first examined? (The growth and nutritional status of the younger adopted child, Kirill, would make a useful comparison here, perhaps showing whether Maxim had some undetected medical problem that could have been implicated in his death.)

Horribly, apparently at least one person has adopted a Russian child for sexual purposes. I find it difficult to believe, however, that many adoptive parents in the U.S. have obtained children for the purpose of injuring and killing them. (My reasoning is that the number of people who want sex with children is probably a good deal larger than the number who find it pleasant to injure them.) This position leads me to explore the systemic reasons and the context in which adoptee deaths have occurred, with the hope of finding a background to the death pattern I mentioned earlier. Understanding that background could help prevent more deaths of children and disasters to surviving members of the adoptive families, including other children.


  1. Max was injured in a fall from a playground slide and struck the cross bar and then the glider on the way down. The case was thoroughly investigated and the Shatto's were cleared by both law enforcement and CPS because there is NO evidence of abuse in this case. What they have had to deal with instead are three women, one who is no longer employed by CPS because of her lying to the media and the Russians about this case and two women who were releasing information to the media from the Ector County Medical examiners office in such a way as to try to make a name for themselves. Max Shatto was being fed by his parents who were doing everything in their power including seeking medical and psychiatric help for their child for his issues that caused him to injure himself. He was 19 pounds at the time of his adoption (the average weight of a 4-6 month old) which the Russians tried to hide by layering in five layers of bulky clothing and then a pair of overalls. The Shatto's did not even realize how bad his underweight issues were until they changed his clothes on "gotcha day" as the Russian program director was trying to encourage them to take him wearing the clothes he was in (which is unheard of in orphanange situations). People like you, who seem to think they know something about this case might instead want to contact the Ector County (Texas) Sheriff and District Attorney instead of relying on false media accounts perpetuated by these three women.

    1. I'm not blaming the Shattos. If they did anything harmful, I'm sure the problem was a systemic one and not their own decision.

      But you seem to know a lot about the case-- why don't you tell us what you think happened? I don't really suppose the Ector County people are prepared to give individual answers to everyone who calls, but if you're in a position to encourage them to release a fuller report, it could save us all from speculating.

      Just in the interests of accuracy,however, I can tell you that the average weight of a 4-6-month-old is not 19 pounds. The average weight at full-term birth is 7 1/2 lbs. That doubles by 4 months normally and triples by one year. Certainly 19 pounds would be very light for a child over two years, but not as light as you suggest. By the way,could you tell us how you know what his weight was at adoption?

      I have asked a lot of questions about this case, not with the wish to accuse or harm anyone, but out of a desire to bring to public awareness information that could help prevent further harm. Perhaps you could help provide more information.

  2. A person using the name Anonymous also commented on another post on this topic, naming three people the writer considered to have lied about Maxim's experiences. I posted the comment without realizing that it contained names, but now have deleted it. Anon, there could be a good deal of trouble for you as a result of making that kind of accusation on the Internet. It could make trouble for me too if I kept the post up.If you would like to repeat your remarks without naming names, please do. I can only post or not post-- I can't edit.

  3. I know the family. They are beyond devastated over losing Max. You and others like you should think of the lawsuits that can be generated by the Shatto's to you for your "speculation" which sounds amazingly like you are accusing them. When Laura first saw these "speculations" of yours, they tore her up emotionally. This kind of "speculation" as you call it is abusive for someone who claims to be a professional. Max is not your case study and I suggest strongly that you cease discussing him immediately and apologise to this family for the hurt you have caused with your careless disregard.

    1. Dear Anon-- I am sorry for the Shattos, and very sorry for Maxim. However, their tragedies have already occurred, and nothing that is said or left unsaid can undo them. My concern is about the fact that there have been other, somewhat similar deaths, and more may occur. If we cannot find out what they had in common, it is difficult to prevent other similar deaths from occurring in the future.

      My speculation is not about what the Shattos did or did not do or how they should be faulted or praised, but instead it is about systemic issues. What help and support did the Shattos or other adoptive families receive? Was it both appropriate and sufficient-- and if not, why not?

      If you and Mrs. Shatto read carefully, I think you would see that I was not accusing, but questioning, and that the answers to the questions I posed could prevent deaths of other internationally-adopted children.

      As for your remark about lawsuits, we do have a First Amendment in the United States. Writing about an issue is not in itself defamatory, even if specific people are mentioned as examples. (But saying specific people are liars, as you or some other Anon did, is potentially defamatory.)

      Sad though the whole thing is, Anon, Maxim's death did occur and is being discussed. I should think you would want to encourage constructive discussion, but apparently you'd prefer to pretend either that nothing happened or that everything has been explained.