Dwarfism linked to neglect: Oklahoma child's health at the center of custody battle
BY ZIVA BRANSTETTER World Enterprise Editor
Friday, February 03, 2012
2/03/12 at 7:35 AM
JAY - State and court officials are grappling with an eight-year-long Delaware County custody case involving a boy who is believed to have a rare dwarfism disease in which children fail to grow due to neglect.
Although a doctor has recommended that the boy be removed from his home, years of delays and possible conflicts of interest have resulted in a system that has failed L.J. Angelo, said his father, Jerry Angelo.
"It breaks my heart because I cannot do anything about this," said Angelo, a licensed minister. "The courts have failed me; DHS has failed me; man's system has failed me. That's why we rely that God's going to turn something around."
L.J. is 11 but about the size of a 7-year-old and may be suffering from "psychosocial dwarfism," according to court records obtained by the Tulsa World. The disorder occurs when children stop growing because of emotional neglect and related factors.
The boy's 10-year-old sister has also made two allegations of abuse, according to records filed in the case.
The abuse allegations were reported to the Department of Human Services, but both children remain in their mother's home, despite a doctor's recommendation that they be removed, records show.
Angelo said his battle to regain custody of his son and daughter has been stymied by apparent conflicts of interest. He filed a motion almost a year ago seeking an emergency order removing the children from his ex-wife's home, but multiple delays have held up the case, he said.
Associate District Judge Barry Denney recused himself from the case Jan. 23 after Angelo's attorney raised a possible conflict of interest issue, court records show. Denney explained the recusal, writing: "Circumstances are of such a nature as to cause doubt as to Judge's partiality, bias or prejudice."
The guardian, Christianna Lincoln Wright, was removed by the new judge, Special Judge Alicia Littlefield, four days later, records show.
Angelo said his son is about 48 inches tall but should be 57 inches tall, according to growth charts for boys his age. Doctors have told Angelo that if the factors causing the condition are not remedied, his son stands to lose 10 inches off his predicted adult height.
"He should be a normal growing boy," said Angelo, 38. "He only has a finite amount of time to grow. Every day is a day lost."
A trial on the motion to modify custody due to the alleged abuse and the boy's diagnosis is set to start Friday in Delaware County District Court.
Kathy Baker, attorney for the children's mother, Mekela Smith, declined to comment, and Smith could not be reached.
Angelo now lives in Carthage, Mo., where he works as a network engineer. He said he and his wife, Kate Angelo, are licensed ministers who volunteer in a marriage counseling ministry at their church in Miami, Okla.
Angelo said he has been fighting for custody of his children since 2004, when his then-wife filed for divorce.
The two shared custody until 2005, when Angelo had to move across the state line for a new job. He said his ex-wife had primary custody then at the home she shared in Grove with her new husband and his children.
Angelo said he stayed involved with his children's school and extracurricular activities, and that the children spent time at his home during weekends, holidays and the summer.
In March 2007, after their daughter, Haley, made an allegation of abuse involving a family member at her mother's home, Angelo filed a motion to modify custody, records show.
Court records show that Denney, the judge who recently recused himself, ordered Haley and L.J. removed from their mother's home "unless and until" the family member accused of the abuse was removed. He appointed Wright as guardian to represent the children in the case.
Records show that Denney served on the Grove United Methodist Church board with the children's mother and her attorney, Baker, last year while Denney was still assigned to the case.
Meanwhile, Wright has testified that she recommended Smith for a job at a state agency and reported that their sons play on the same baseball team, records show. Wright declined to comment.
About a month after L.J. and Haley were ordered removed from their mother's home in 2007, Wright submitted a report to Denney. It recommended that the family member accused of abusing Haley be allowed to return to Smith's home if a "safety plan" were put in place.
Angelo said he was unaware of the possible conflicts of interest in the case at the time. He said he gave up his efforts to modify the custody arrangement in 2008 on the advice of his attorney at the time.
In April 2011, Haley reported a second allegation of abuse to a teacher, and the school informed the Department of Human Services.
"DHS was OK with the family going through the proper channels with their family therapist. ... They will keep her safe this weekend and get into Dr.," a school record filed in the case states.
DHS spokeswoman Sheree Powell said she could not comment on the case specifically, but she said DHS often works with therapists and other professionals in cases of alleged abuse. DHS combines the information with its own reports and forwards the case to the local district attorney, she said.
In April, Angelo's attorney, Erik Johnson, filed motions seeking an emergency court order returning custody to Angelo and seeking Wright's removal as court-appointed guardian, records show.
"This is the second known report" of abuse involving Haley, the motion states. "This failure to protect the child from abuse ... in her home is causing serious and severe harm to the minor child."
Angelo said that during a visitation with his children, he took L.J. to doctors because he was concerned about his growth. Although the boy had always been small for his age, Angelo said doctors were concerned that he was losing ground.
Records obtained by the Tulsa World show that two specialists in pediatric endocrinology ruled out causes of L.J.'s growth delay other than psychosocial dwarfism.
A report by Dr. Richard Sandler of Springdale, Ark., notes that L.J. was at the low end of growth charts at age 2. Since age 8, he was "way below" the third percentile "and appears to be deviating further away from the normal curve," Sandler said in the report, written July 11, 2011.
"The possibility of psycho-social dwarfism is raised. ... Rapid 'catch-up' growth in the father's house would lend credence to this idea," Sandler's report states.
A second report by Dr. David Jelley of Tulsa, written July 14, 2011, states that he found no physical reasons for the boy's abnormal growth pattern.
"The only way to confirm suspicions of psychosocial dwarfism is to place L.J. in a different living situation for at least six months and monitor his growth," Jelley said in the report.
A third expert, psychologist Deborah Holmes, submitted a report recommending that Haley and L.J. "be primarily placed, at least temporarily, in the Angelo home."
She noted that two pediatricians had supported a diagnosis of psychosocial dwarfism.
"L.J. does demonstrate the psychological factors related to this diagnosis," states her report, obtained by the World.
Holmes wrote that both parents "provide their children with adequate living conditions and a good home."
However, "L.J. says that he gets into a lot of trouble at his mother's home. He reported they yell at him a lot."
Despite the reports, Denney granted several motions for continuances in the case and made no ruling on Angelo's motion to modify custody.
In her final report before being removed from the case last month, Wright recommended that Smith retain sole custody of the children. Wright said she was suspicious of the diagnosis of psychosocial dwarfism and concerned about "the effect it is having on L.J."
"I have no concerns that Haley and L.J. are being physically or emotionally abused in the homes of either of their parents," her report states.
Angelo said his faith has kept him motivated as he has spent thousands of dollars and years trying to gain custody of his children.
"God has shown us how to keep forgiveness in our hearts for those people who have wronged our family regarding this situation, and we will never forget that because of what Christ has done for us, but we cannot sit by and allow this kind of behavior to continue in the system," he said. "We must stand up for those who cannot speak for themselves."
What is psychosocial dwarfism?
Psychosocial dwarfism, or PSD, is a disorder of "growth failure and/or delayed puberty ... observed in association with emotional deprivation, a pathologic psychosocial environment, or both. A disturbed relationship between child and caregiver is usually noted," according to a 2010 medical journal article by Dr. Andrew Sirotnak, director of the University of Colorado's Kempe Child Protection Team.
Various types of the disorder have been noted, including Type II, which usually begins at age 3. Children often have depression and can exhibit "bizarre behaviors" involving food and water, the article states.
PSD is not caused by inadequate nutrition. Diagnosis is confirmed by improvement in growth and behavior after "removal of the child from the unsafe or non-nurturing environment," the article says.
A study in the 1970s involving 35 children with PSD found that 31 of them "had evidence of rapid weight gain" after being removed from their homes.
Original Print Headline: Standing up for L.J.
Ziva Branstetter 918-581-8306
Jerry and Kate Angelo are pictured in their home in Carthage, Mo. Jerry Angelo is seeking custody of his son, who may have a rare dwarfism disorder caused by emotional neglect. GARY CROW / For the Tulsa World
In this photo from December, Haley Angelo (left) is 9 years old and L.J. Angelo is 11 years old. Doctors believe L.J. could have a rare disorder called psychosocial dwarfism, caused by emotional neglect and related factors. Courtesy