Warning: Some of the details in the story below are graphic and may be disturbing to some readers.
A pediatrician testifying in the Blackstone "House of Horrors" trial said the allegedly neglected children discovered in the squalor home showed severe vitamin D deficiency.
Dr. Howard Kay reviewed medical records of Erika Murray's 5-month-old and 3-year-old daughters after a neighbor found the girls living in the insect and feces infested home.
Murray, 35, faces charges that include assault and battery and child endangerment in connection to her youngest living children. She was previously charged with two counts of second-degree murder for two of the three dead babies found in the Massachusetts home, but Judge Janet Kenton-Walker tossed one of the charges on Tuesday.
Prosecutors suggested the children likely suffered from the deficiency because they "never left her home." The baby had a flattened head, which suggests she spent much of her time laying on her back and the toddler showed signs of autism, according to Kay.
Kay also said the baby didn't have the muscle tone a typical infant her age would have. He said that was resolved within the six weeks she was discharged.
The witness testified that the 3-year-old toddler had a lack of speech, often fanned her fingers and was fixated on lights, likely due to her autism. He also agreed that those symptoms could have been caused by neglect, a combination of autism and neglect or simply just her autism.
Prosecutors read from the girls' record, which stated the toddler preferred to lay down as often as possible and would bit down on a spoon as if she had never been spoon-fed before. The record stated that the baby "has profound extensor tone...prefers to lay on her back" and doesn't grip her hands, which is an age-appropriate thing to do.
On Tuesday, pediatrician Dr. Heather Forkey of UMass Memorial Medical Center said the 3-year-old girl "experienced a profound amount of neglect."
"When she would sit she would curl her legs into a fetal position that you would expect to see of someone in utero and again not typical of a 3-year-old who at this point normally has learned to walk."
Forkey said there was so much wax in the girl's ears they had to call in an ear, nose and throat specialist to remove it.
"They found a maggot in the wax in her right ear as well," she said.
The girls were found by a neighbor who responded to the home after her son asked if she could help him shush a crying baby. The neighbor, Betsy Brown, said she was unaware of any babies in the neighborhood.
Brown testified last week that the infant found in the home was in a room with "dirty, diapers, lots of dirty diapers, there were bottles with maggots in them, it was dark, very dark, it was horrible."
Blackstone Police Department Acting Chief Gregory Gilmore testified last week and said Murray concealed the fact that the two children were hers. She had been telling her two oldest children, ages 10 and 13, that she was babysitting the younger kids.
"Said she was embarrassed to have them and that she couldn't afford to have them," Gilmore said. "That's why I believe she told her children she was just babysitting."
All living children have since been removed by authorities.
Following a break, clinical and forensic psychologist Dr. Lisa Rocchio spoke of alleged abuse Murray endured by her partner Ramon "Ray" Rivera. Rocchio testified that Rivera was controlling of Murray.
The psychologist said Rivera isolated the defendant from friends and family.
"The relationship was consistent with a pattern of intimate partner violence that was characterized by coercive control, psychological and emotional abuse, and economic abuse and financial control, as well as by a profound physical and social isolation," said Rocchio.
He would allegedly track her down when she was out and pressured her to quit her job to prevent her from having access to resources.
"The rules were always changing which creates an environment where she could never get it right," Rocchio said. "He would check in with her throughout the day...surveillance behaviors."
Rocchio said Murray couldn't appreciate the severity of her situation due to mental health issues, which is what spiraled the home's condition into squalor.
The trial will resume on Friday when the prosecution will offer a rebuttal witness before closing arguments.
For live updates on the trial, click here for NBC10 Boston reporter Alysha Palumbo's Twitter feed.