The woman who calls 911 says there's a diabetic teen boy in distress, but when police and paramedics arrive at the house in Mesa, Arizona she comes outside to say he's just "pretending that he's dead on the floor" because he wants attention.
When those first responders go inside, they find something tragically different.
Fifteen-year-old Christian Williams isn't breathing. His lips are blue and his heart has stopped.
The small ranch house — lit up from inside in the dark, desert night — is a residential treatment facility for seven young men in foster care. The facility provided specialized mental health care for Christian, who, in the one month since he'd come to the group home, was in and out of the hospital for complications from his Type 1 diabetes.
"I've never even dealt with a diabetic. I don't know anything about that," the woman who called the police, a staffer at the foster care home, tells an officer, recorded on the officer's body camera.
Paramedics begin CPR, steadily pushing on Christian's chest, in an attempt to revive him.
An NPR investigation — including an analysis of federal data on hundreds of thousands of children — shows that kids with disabilities are the largest group that go into foster care.
More significantly, they suffer the worst outcomes in foster care — getting trapped in the system longer than children without disabilities and dealing with lifelong harm.
One reason, NPR found, is the extreme complexity of the system.
"Caring for children with disabilities in foster care involves much more than meeting their medical needs," explained Bobbi Andrew-Green, an Alaska foster parent to children with complex medical needs. She navigates child welfare, mental health, Medicaid, special education, home nursing and other service systems. "It is beyond complex to the point where some days, I'm dizzy," she said.
Disability encompasses a wide range of conditions. In our reporting, we came across children who used wheelchairs, were blind or deaf, had intellectual disabilities or used ventilators and sometimes were sent to foster homes that weren't accessible for them.
But the largest group of children in foster care are those with a behavioral health disability. "Up to 80% of children in foster care enter with a significant mental health need," according to a report from the American Academy of Pediatrics that cites multiple research studies.
Loading...
"This is the group that everybody gives up on and it's because they have disabilities," said Nancy Thaler, who leads a federally-funded program to understand how to better care for "children with complex behavioral health conditions."
These kids "are so hard to understand and, frankly, take some sophistication to treat," said Thaler. Often, they're diagnosed with mental health issues, trauma, brain injuries, Fetal Alcohol Spectrum Disorders, intellectual disabilities and autism and would have lived in state institutions years ago, she said.
They end up in child welfare in large numbers, often in the most institutional settings — including therapeutic group homes and residential treatment centers — because of their "behaviors that are off-putting or scary," according to Thaler.
"It's hurting other people, hurting themselves, damaging property. That's the range of things that they do," Thaler said.
"These kids can recover and be very successful," Thaler said, "This is doable."
But there's one big roadblock: Child welfare programs largely depend on 100-year-old models of therapy that, Thaler said, don't work with these disabled children.
Instead, that treatment often makes their behaviors worse.
Missing numbers, worse outcomes.
There aren't even clear numbers on how many children and youth in foster care have disabilities. Researchers use a broad range: From 25 to 80%.
The lower percentage reflects how disability is counted in federal foster care data. The higher one reflects research suggesting that the vast majority of children and youth in foster care have some mental health issue — either one that contributed to them going into care, or one that resulted from the trauma of being removed from family and going to a foster home.
The federal government keeps and analyzes extensive data on foster care demographics and knows a lot about other populations. Black children make up 24% of the foster care population, according to NPR's analysis. (Add biracial ones, according to the research group Child Trends, and it's 35%.) Hispanic kids represent 21%.
These numbers have helped researchers and policymakers understand how children from these groups, especially from poor families, are disproportionately represented in foster care, and the harm that often results for them and their families. One research study, for example, shows that 53%of Black children in America will be the subject of a child protective services investigation by the time they turn 18.
But the numbers that could give clarity on disabled kids in foster care are harder to come by — partly because of the sometimes hazy definitions of disability but also because of the failure of child welfare providers to even count them.
NPR obtained data from the government's mandated data collection system, the Adoption and Foster Care Analysis and Reporting System (AFCARS). But our analysis found there was too much missing data to get a statistically valid count of kids with the label "emotionally disturbed," the one category of foster youth with mental health conditions.
NPR analyzed the federal data on 505,591 children in foster care in 2025 and quickly found limitations to those numbers. Only 60% of the children are marked as disabled or not disabled. Of the group that was left, almost half have a disability.
Despite the data's limitations, NPR's analysis and reporting show that disabled children and youth who go through foster care have some of the worst outcomes. Among the findings:
As the foster care population ages, children with disabilities make up a larger and larger percentage of the total. They stay in foster care 50% longer than kids without disabilities. They are the least likely to be reunited with their parents or to be adopted.
Among children who don't have a disability, 32% live with a relative, a preferred foster care placement. But only 20% of disabled children stay with a relative.
Disabled children are more likely to go to the largest residential living facilities — including group homes, treatment centers, psychiatric institutions and in-patient hospitals. About 10% of disabled kids in foster care live in these institutional settings, more than double the rate (4%) for children without a disability. Other researchers have shown that disabled foster children are also more likely to be sent to treatment programs out of state, often far from their families.
They're more likely to move from place to place. NPR's analysis found disabled children in foster care move to an average of 4.6 placements, while children without disabilities go to a more-stable 2.7 places.
And they're more likely than other kids in foster care to die. One researcher found children with physical disabilities die at nine times the rate of other children in foster care.
The leftover kids: Children with disabilities
NPR took its findings to Alex Adams, the assistant secretary of the U.S. Department of Health and Human Services in charge of the Administration on Children and Family.
"There's no question that kids with disabilities are entering into foster care at a higher rate," Adams said. "They stay in foster care longer. They are more likely to be placed in congregate care facilities than family homes."
Congregate care refers to a common placement for disabled youth — a highly-structured and supervised group-living residential setting that is intended to provide temporary care for a child until they can be reunited with family — a primary goal of foster care, when possible — or placed in a smaller foster home.
Over the last two decades, child welfare agencies have tried to reduce reliance on these institutional settings. Still, about 12% of all children in foster care live in congregate settings, and those kids are far more likely to be disabled.
States are "overusing" these expensive congregate care facilities, said Adams.
At HHS, Adams has started a campaign called A Home for Every Child to address the national shortage of family foster homes. To increase homes for children with disabilities, he said states, which run foster care programs with federal funding, need to take additional steps, including raising payment rates for those foster parents.
Adams said he saw this problem acutely in Idaho, where he previously ran the Department of Health and Welfare. He was puzzled when, after 2021, the number of children going into foster care dropped, but the state's costs for child welfare were rising.
An examination showed that children with no disabilities were leaving foster care while disabled ones stayed. Many of them were in large, congregate care facilities that were expensive to begin with and charged "skyrocketing" rates starting with the pandemic.
"A lot of states are dealing with the paradox of shrinking kids, but increasing budgets. And I think you've identified one of the primary drivers of it," Adams said of NPR's findings of the disproportionate number of disabled children in foster care.
Hugs of greeting, hugs of restraint
Adults who knew Christian Williams described him as a sweet and loving kid, with a round, cherubic face.
"Especially at church, everybody loved Christian," said his mother, Bobbie Williams. "They looked for him every Sunday just to get that big Christian hug."
Christian was also plagued with an occasional, explosive temper. Sometimes, when he was frustrated and upset, he'd hit or push the object of his anger — usually his mother or father.
Different doctors gave Christian multiple diagnoses: Bipolar disorder, Disruptive Mood Dysregulation, Oppositional Defiant Disorder, and ADHD.
In addition, he was diabetic.
Christian was just four when he was diagnosed with Type 1 diabetes — when he became lethargic at preschool and ended up hospitalized for three days. While their son was in the hospital, Bobbie and DeForrest Williams got a crash course in how to check their son's glucose levels and administer insulin. By the time he was 10, Christian was doing these things himself.
In the years that Christian lived at home, his mother and father say they and their son kept his glucose levels under control and he was never again hospitalized for dangerous hypoglycemia or hyperglycemia.
"In those years between four and 15, he never went to the hospital in diabetic distress — from us," DeForrest said.
Christian liked school, had good friends, and enjoyed sports. He played video games with his younger brother. Although he was small, 5' 4'' and 140 pounds when he was 15, he dreamed of one day becoming an NFL running back.
The family sought help to handle Christian's behavioral issues and got assistance from the state. The Arizona Department of Child Safety paid for therapists who taught Christian ways to control his anger and gave the family support, including respite workers who would spend afternoons taking Christian out for some activity, like playing basketball.
When he was 10 years old, the state paid to send Christian to a residential mental health care facility in Utah. His stay ended nine months later, his parents said, when a staffer sat on Christian roughly to restrain him, injuring his hip and sending him to the hospital for surgery. His parents took Christian back home to Arizona.
Sometimes, Christian's frustration ended in aggression. There were three meltdowns close together that were worse than usual. Police were called. Late on the night of Nov. 7, 2023, four police officers came to the family's modest ranch house in Buckeye, a fast growing suburb in the desert west of Phoenix.
His parents told the officers they feared he was planning to run away. Christian, according to the police report, tried to break a window in his room to get out. The boy pushed his mother and, when his father, much larger than Christian, held him in a bear hug, he started hitting his father in the chest and stomach. Bobbie and DeForrest told the officers that they were not injured.
Police asked Christian if he wanted to go to a walk-in mental health crisis center. He agreed and an officer took him there.
Two days later, at his school, he started hitting his mother again when she went with him to the nurse's office for his insulin shot. Two staff members restrained Christian and the school receptionist called 911.
Then there was the incident at church, Bobbie explained, when Christian got upset that she wouldn't let him drink a soda, because it wasn't a diet soda, and he started hitting and choking her. A member of the church, she said, called police.
As a result, Christian was charged with disorderly conduct and damaging property.
The family agreed to let child protective services remove Christian from his parents' home, on the grounds that they were overwhelmed and had an "inability to control the child's behaviors." There was "no abuse or neglect" by the parents, a court document noted.
Five percent of all children in foster care enter this way, according to a 2025 government report. They are children with behavioral health disabilities who need treatment but their family's health insurance won't pay. So parents agree to "relinquish" custody to the state in order to get that care.
Bobbie and DeForrest said they were reassured that the state's Department of Child Safety would find facilities to provide the care that had eluded them. The plan was for Christian to then return to his family.
"We loved him and any decisions that we made, we made to try to get him help with the behavioral issues," said DeForrest. "Everything we did was to try to get help for him."
Abandoned at the hospital
At first, the parents say, Christian seemed to make progress — at a juvenile detention facility, where he responded to the regimented daily expectations, then at a detention high school, where he enjoyed playing on sports teams.
On June 6, 2024, he was moved to a smaller, less restrictive therapeutic group home in Mesa. Logos House is run by the Catalyst Community Corporation. It is a "qualified residential treatment program," a federal designation for a congregate-care facility with staff trained in mental health issues and a nurse available around the clock.
In 2018, Congress passed a foster care reform act that put a priority on serving children in foster families, not in institutions. But in a controversial compromise, it created these "QRTPs," meant to be smaller congregate care settings, for up to 16 kids, where it was believed they would get more individualized attention.
The new settings had many critics.
"Kids are not going to get their needs met in that type of setting," said Jennifer Mathis, of the Bazelon Center for Mental Health Law, which opposed the new kind of therapeutic residential facility. "You have to impose lots of restrictions and rules. And those are things that end up aggravating behavioral health disabilities."
Logos House was set up to deal with behavioral health issues, but Christian's more constant and daily problem was his Type 1 diabetes. To stay healthy, he needed to take two types of insulin, multiple times a day, and to monitor his glucose levels.
Diabetes is one of the most common physical disabilities among kids in foster care, according to a survey of states by The Link Center, a federally funded program to "link" the separate service systems for people with developmental and mental health disabilities.
Christian arrived at Logos House with a list of his medications but not, a state investigator would later testify, a written-down plan for managing his diabetes.
There was no notice to staff that swings in blood sugar levels can cause the kind of emotional distress and behavioral outbursts that got Christian in trouble.
Or that antipsychotic medications used to treat behavioral health issues, like the Thorazine prescribed to Christian, can also raise blood sugar levels.
Within days of his arrival at Logos House, Christian's glucose levels rose to dangerous highs.
On the morning of June 12, Christian's level was so high that his monitor couldn't even take a reading. Staff at the group home got him into a van and drove him to the nearby hospital.
Christian had refused to take his insulin and resisted going to the hospital, said Jennifer Trainor, the manager of Logos House. "We at the group home are not allowed to force a youth to take their medicine," she explained in an email to Christian's care team.
Other documents from that day tell a competing narrative. The group home didn't have Christian's basic diabetes supplies.
Christian had gone days at Logos House without some of the tools he used to control his blood sugar levels. He didn't have his continuous glucose monitor, which tracked his blood sugar levels every five minutes and sent the data to an app. The house manager explained it had not come with him from his previous placement. A staffer would later testify that it came but stopped working after a few days.
Either way, now Christian's health insurance was provided by the child welfare system and its insurer refused to pay for a new one, staffers would testify.
Without the monitor, Christian needed to check his levels with a more traditional fingerstick meter — pricking a small drop of blood and placing it on a disposable test strip.
Staff at the group home said Christian resisted doing this and sometimes Christian would miss the insulin he needed because he refused to take it. Staff admitted, in testimony, that they didn't keep accurate logs of when or whether Christian got his insulin. His roommate told police that at one point the house ran out of insulin altogether.
It's "very alarming they may or may not have appropriate supplies to care for his high medical needs," a "high needs care coordinator," who the state added to Christian's care team, responded in the June 12 email chain. "Is there any way to advocate for a home nurse for him?"
"Christian said he was not able to check his sugars because they didn't have any test strips so they have just been giving insulin for what he's eating!," Bobbie Williams, alarmed, responded She gathered the strips, syringes and other diabetes supplies they had at their home and drove them to the group house on the other side of Phoenix.
NPR asked the Catalyst Community Corporation, the owner of Logos House, for a response to our reporting. Attorney David Potts said: "We have no comment."
Christian was discharged from the hospital the next day, June 13, and returned to Logos House.
But the following morning, on June 14, he became hyperglycemic again. This time, staff called 911 and an ambulance, not group home staff, took Christian back to the emergency room.
Medical staff got his blood sugar levels stabilized quickly and six hours later he was ready to be discharged.
This time, though, staff at Logos House did not come to pick him up.
Late that afternoon, a social worker at the hospital, unsure what to do, called the Department of Child Safety's (DCS) Child Abuse Hotline. "We have a kiddo in DCS custody in our emergency room," she explained on the call obtained by NPR. "And the group home is refusing to take him back."
On the call, which was recorded, the social worker explained that when a nurse called the group home, a Logos House staffer said they would not take Christian back and said the hospital should contact the state to get him placed at another facility.
Christian had been left alone at the hospital, although state policy, the social worker explained, required someone to be there with him. And now that he was ready to leave, "they refused to pick him up … they're not even answering our calls at this point either."
At the moment that Christian was waiting, Trainor, the treatment facility manager, wrote to his case managers and care team. She said Christian was hospitalized because of his continued "refusal to take his insulin." She added: "We are very concerned that Christian keeps doing this and this will result in his death. He states to the hospital that he is not doing this to hurt or kill himself, yet he tells us that he doesn't need to live."
After the social worker complained to the abuse hotline, Christian's state caseworker went to the hospital and returned him to Logos House.
At an emergency meeting of Christian's care team the next week, staff from Catalyst urged state workers to move Christian to "a higher level of care due to his medical concerns and mental health."
Christian stayed at Logos House and problems with his blood sugar persisted. On July 23, he again returned to the hospital to be treated for hyperglycemia.
But he wasn't pretending
He'd return to the hospital, for the last time, on July 7.
That morning, Christian woke up feeling nauseous. He vomited,
That was likely the first sign that his glucose levels were not right. But because Christian "wasn't refusing to take his insulin or anything," the overnight staffer told police he figured it was a "tummy ache type of deal."
A staffer who took the next shift that morning would later tell a state investigator that he'd been asked to fill in at Logos House that day because it was short-staffed. He'd never worked there before, had never met Christian, and had never dealt with someone sick from high blood sugar levels. Christian, he said, "was throwing up about 6 times".
Throughout the day, Christian complained of feeling sick. He said he was hungry but he couldn't eat because his stomach was upset, the substitute staffer told police, and he was "in and out of the bathroom all day" or he'd lay down in front of the air conditioner saying, "I just need to be cool."
These were symptoms not only of hyperglycemia but of the dangerous result of when it goes untreated — diabetic ketoacidosis (DKA), an emergency condition that can lead to coma or death.
Among the routine diabetes supplies missing at Logos House: Test strips to check ketone levels, an indicator of DKA. A staff member would later say in a deposition that the facility never obtained them.
Staff would tell police they asked Christian throughout the day to take his insulin, to check his glucose levels and to go to the hospital — all of which they said he refused.
This back and forth went on until just before 9 p.m. when Christian fell on the floor in distress and a staffer called 911.
That's when police and medical units showed up and the staff member told an officer that Christian was faking it. "He's fine, he's holding his breath," she told the officers, as recorded on police body cameras. He's "pretending that he's dead on the floor."
But he wasn't pretending.
Paramedics entered and quickly began CPR, the body camera footage showed.
The first responders asked Logos House staff for the file on Christian that would show his medical information — his diagnoses, treatment plans, the names of his doctors and other relevant information. But, as the state investigator would later testify, the file was incomplete. A police officer expressed surprise.
"I asked him at least two hundred times to take his blood sugar. He refused," a staffer told a police officer about the moments before she called 911. "He does it for attention." But then he fell on the floor and "says he can't breathe. And then I'm calling 911."
Christian's roommate told a different story. He was with Christian all day, he explained to the Mesa Police Department officer who later wrote up the incident report. It noted the roommate's version: "Christian laid on the floor in the house for approximately 4 hours, and was asking him to call 911 and get him to a hospital, but staff would not allow him to call 911."
Later, in a deposition, the roommate said the staffer refused to call an ambulance because, she said, Christian was "faking." Three staffers at Logos House told police that state policy prohibited them from forcing Christian to take his insulin. "It's the kid's choice," one woman told an officer.
NPR asked health professionals for the best practice when a child resists taking insulin. "You cannot force somebody to take insulin," Lynn Nelson, president of the National Association of School Nurses, agreed. "That would be assault."
But "nurses are trained not to wait around" but to call 911 at the first sign of illness, she said. "It takes a few days, usually, to get to a life-threatening point, but you don't wait that long."
While police officers interviewed people in Logos House, paramedics revived Christian with chest compressions and rushed him to the hospital, Banner Children's at Desert in Mesa.
But the blood flow to the teen's brain had stopped. At the hospital, Christian was put on life support.
No one notified Bobbie and DeForrest Williams that their son was in the ICU, with machines helping him breathe and keeping his blood flowing.
Early the next morning, the state child abuse hotline got another call about Christian Williams. This time it was a doctor, calling from the pediatric intensive care unit. He explained that no one from Logos House or the state had given him contact information for the parents.
The doctor wanted to "let this, this poor child's family know that he's in pretty critical condition here at our facility," according to audio of the call to the hotline.
Later that morning, Bobbie's phone rang on the other side of Phoenix. It was another doctor from the hospital. "'I need you and dad to come down," Bobbie recalled the doctor saying. "It has to do with Christian."
Bobbie said her first words were: " 'Is he still alive?' And she said, 'Yes, but when he came in he was in cardiac arrest. And we need to speak with you regarding Christian.' "
The parents hurried to the hospital where they found Christian in the pediatric ICU, unresponsive and on a ventilator. The doctor explained that Christian suffered a massive brain injury. There was little hope for a recovery.
Bobbie and DeForrest spent hours at Christian's bedside. He was declared "brain dead." The parents made the decision to withdraw life support.
On July 10, 2024, Christian Williams — 15-years-old, son, brother, foster child — was pronounced dead. Cause of death: "diabetic ketoacidosis," caused by a lack of insulin.
Not one staffer trained in diabetes care
An investigator for the Arizona Department of Child Safety found that — even after the weeks of Christian being in their facility and struggling — staff at Logos House said they'd never received training in diabetes care.
"All of the direct care workers interviewed denied any training or knowledge of Type 1 diabetes," the investigator wrote. "Not one staff member could explain what the signs or symptoms of hypoglycemia are or the range for blood sugar levels."
The facility didn't keep complete medication logs, the investigator found. Nor were there records that tracked when, or if, Christian took his insulin and the readings from his glucose monitors.
After Christian Williams died, the director of the Arizona Department of Child Safety (DCS) told Phoenix news station, ABC15, that the agency was consulting experts to revise its diabetes care guidelines.
NPR asked DCS to respond to our findings. Public Information Officer Darren DaRonco said: "We are going to decline to comment due to the pending litigation."
The month after Christian died, the Catalyst Corporation won accreditation from the state and an accreditation agency to operate for another three years.
How many other children have been harmed?
It shouldn't have been a surprise to Arizona officials that the state's training for diabetes care in foster care was lacking.
Another Arizona foster child — 9-year-old Jakob Blodgett — died under similar circumstances a few days before Christmas in 2022.
He had been living in foster care less than two weeks when he was rushed from a foster care group home to the hospital. The boy's parents said he was unable to manage his insulin on his own. In depositions, group home staff members said that the home never trained them on the care and management of Type 1 diabetes.
"How many other children are there who have been harmed and that we don't know about?" asks Phoenix attorney Robert Pastor who represents the Williams family and the Blodgett family in separate lawsuits against the state and health care providers. "For the children who find themselves just bouncing from group home to group home or foster placement to foster placement, they must truly be alone in whatever it is that they are going through."
The high rate of death for disabled kids in foster care
All children in foster care face a significantly elevated risk of death — and those with disabilities are at substantially higher risk. One study found foster youth are 42% more likely to die, compared to other children.
Other research found children in foster care with physical disabilities, which include diabetes, are nine times more likely to die than non-disabled children in foster care. Children with intellectual disabilities are more than three times at higher risk of death.
The researcher, Jill McLeigh at Rees-Jones Center for Foster Care Excellence at Children's Health in Dallas, looked at data for more than 3 million children in foster care from 2005 to 2019, one of the only studies to use federal data to measure outcomes for disabled foster youth over a long period of time.
McLeigh told NPR she was stunned by the extreme differences in death rates. "Although we had hypothesized that mortality rates would be higher," she said, "we were surprised by the degree to which risk levels for dying while in care were higher for children with physical disabilities, emotional disabilities, and other medical conditions relative to children in care without disabilities."
NPR found many cases of children and youth with disabilities dying in foster care, including other children with diabetes — the result of poorly trained staff or the lack of proper support for a child's disability.
Other common problems that contribute to deaths include shortages of staff and a lack of adequate housing, especially for children with behavioral health disabilities.
Last September, 16-year-old Kanaiyah Ward died by suicide in Baltimore when she was able to grab a bottle of pills, unseen by a staffer who was working a 53-hour shift.
Ward, on a suicide watch, was living in a Baltimore hotel with a staffer who was forced to work for more than two days straight when other staff didn't show up.
A recent federal audit, by the inspector general for the U.S. Department of Health and Human Services, found that thousands of foster children sleep in hotels, child welfare office buildings and other unlicensed settings because state agencies don't have enough suitable places for them.
Most of those children, according to the federal audit, go to those temporary placements because they have disabilities that need attention — like behavioral health conditions. But then sometimes the children end up being watched by staff with little or no training to help them.
State child welfare directors say providing care for children with behavioral health needs has always been difficult — and has gotten harder in recent years, especially as states deal with cuts to social service budgets.
"We never have enough money. We never have enough quality services," said Christine Norbut Beyer who ran New Jersey's system until earlier this year and now works for Think of Us, a child welfare reform group.
And Mike Leach, who ran South Carolina's department until last year and also works for Think of Us, said problems start for families long before children even go into the child welfare system. In many states, there are long waiting lists for services that can help families stay together. "Over time, you've seen a decrease in budgets, a decrease in high-intensive psychiatric treatment," said Leach.
We were promised
Avery Habelitz, at four, finally was sleeping through the night. The autistic girl had stopped hurting herself by banging her head on the floor when she was frustrated.
She didn't speak but she had ways to communicate, like taking her mother's hand and walking her to the refrigerator when she was hungry.
"She can't say, 'Hey, my stomach hurts.' Or, 'I'm hungry,' " her father, Jeremy Habelitz, explained. "So it took time to learn what certain things were with her. But we actually got to a point where we were really good at that. When she was having her moments of disarray, if you will, we were able to quickly soothe her."
Avery was making friends at her preschool and the three hours of speech therapy and Applied Behavior Analysis therapy in the afternoons seemed to be helping, her parents said.
Avery, at four, said her first word: "Da da."
"Avery was just a bundle of joy," said her father. "She loved her family. She was just a happy kid."
But someone unknown to the parents reported Habelitz and Kaitlyn Morrow to child protective services in San Bernardino County, California, for using drugs.
Avery and her younger sister were removed from the family — even though they lived with Habelitz's mother and grandparents, who, he noted, weren't using drugs — and placed with a foster family.
That was on September 25, 2025. On the morning of December 23, 2025, the girl was found unresponsive and struggling to breathe in her room at the foster home, tied up in the sweatshirt her foster mother had used to restrain her to keep her in bed.
Habelitz and Morrow are suing San Bernardino county for the wrongful death of their child.
"We were promised that her needs were going to be met," said Habelitz.
But, according to court documents, when Avery moved to foster care, her schooling and the many hours of therapy stopped.
The girl became anxious and her behavior regressed. She started banging her head on the floor again. She slept only an hour or two a night. She ran out of her bedroom and through the house of her foster parents.
On one difficult night, the foster mother put both of the girl's legs into the single leg of her pajamas to stop her from kicking and tied her in an adult sweatshirt with both of her arms restrained inside. She put on the girl's protective helmet with the hood of the sweatshirt over it, to prevent Avery from taking off the helmet.
In the morning, the foster mother found the girl unresponsive. When Avery was whisked to the hospital, Habelitz and Morrow were notified and rushed there, too. But by then, the girl was being transported, by another ambulance, to a hospital in Loma Linda.
Habelitz and Morrow drove frantically to that hospital to be by their daughter's bedside — but the hospital would not let them see her.
Hours later, the girl was pronounced dead.
The county coroner would declare the cause of death: "combined hyperthermia with positional restraint, hours."
"Just caring for Avery as long as we did, I've always said that we live in a world that is not meant for or willing to work with kids and teens and adults with disabilities," said Morrow. "It's just not a world made out for them."
For foster youth, an ignored awareness about treating trauma
At her clinic in Arkansas, Elizabeth Cleveland treats a young boy in foster care who gets in trouble for frequent meltdowns.
The boy, she said, has a sensory processing disorder. He gets overwhelmed by loud sounds. Noise-canceling headphones can keep him calm.
But when he acts out, he gets disciplined. The residential facility where he lives takes away the headphones and requires him to build up points with good behavior to get them back.
Deprived of his headphones, the boy gets more anxious and acts out more, creating a cycle of more stress and more discipline — and moving him further and further from the reward he needs to stay calm.
"I probably hear a story like that once a month," said Cleveland, an assistant professor in the department of pediatrics at the University of Arkansas for Medical Sciences. She runs a clinic that specializes in treating children with Fetal Alcohol Spectrum Disorders, a vastly underestimated disability in foster care, she believes.
There's been a revolution in recent decades in understanding how children's brains develop and are changed by trauma. But foster care lags far behind in adopting the new thinking, said psychologist Karyn Harvey.
Behavioral therapies, which are standard in foster care settings, use punishments and rewards to get children to control outbursts, anger and other problematic behaviors.
This kind of behavior modification technique dates to the early 20th century.
But a disciplinary approach is often the opposite of what works with "neurodiverse" children — kids whose brains work differently because of disability or trauma, argued Harvey, who, for 35 years, has specialized in treating children and adults with disabilities.
Meltdowns are often an involuntary reaction to severe stress and anxiety. These children are "in states of hyper-arousal because their amygdala is firing danger signals and they're freaking out and their brains are filled with cortisol and adrenaline," according to Harvey. "And so they're breaking things and running away because they're in this heightened state due to the trauma and their trauma responses. And that's looked at as manipulative. It's looked at as attention seeking. They're punished repeatedly."
At school, kids who have a meltdown are sometimes put in physical restraints or secluded in closets and classrooms, creating more stress. In foster care, they're then moved from one placement to another and often end up in therapeutic group homes or residential treatment centers that use more punishment techniques.
They're "almost couch surfing facilities in foster homes," said Nancy Thaler who leads a federally-funded project through The Link Center to understand these "complex" children and how to best help them.
A gift of life
The gravestone for Christian Williams, flush to the ground, is a rectangular, gray piece of marble, decorated with a cross, a basketball and a football. It reads: "In Loving Memory of Christian Avery Williams. January 3, 2009 - July 10, 2024."
Bobbie and DeForrest Williams visited their son's grave on a summer evening after the 100-plus degree temperature began to drop. The sky was blue and pink as the sun set.
DeForrest likes to visit here, usually once a week, after he's finished his job driving a school bus. He brings a rag to wipe down the headstone, and scissors to cut back the grass.
Bobbie, a school aide, and DeForrest heard that their son's donated organs — his lungs, liver and kidneys — went to four women on transplant lists. One woman sent them a hand-written card, expressing her sorrow at their loss and her thanks for the kidney she had waited for.
"He helped people," said his mother. "That's what he would have wanted."
"It means that he went away leaving a legacy and that he was a hero," said DeForrest. "He helped to give the gift of life to others."
These kids can recover
JoJo Kimble, a former foster youth in South Carolina, found a path to success — but largely on her own.
Kimble was diagnosed as autistic when she was 12. At school, she got an individualized education plan and accommodations around her autism. But when she went into foster care at 15, she said the system erased her autism diagnosis and gave her new labels: Depression, bipolar disorder, ADHD, borderline personality disorder.
She was prescribed antipsychotic medications — the overuse of such powerful drugs is a long-time problem in foster care — and sent to therapeutic treatment facilities and psychiatric hospitals.
Kimble, 23, has no doubt — nor do her current medical providers — that she is autistic. "It's easier to treat," she says of a behavioral health issue. "You can't treat autism with medication," she says. But you can "treat depression … with medication and all types of therapy."
Now she's living on her own and going to Coker University where she is studying nursing. She helps a professor research the impact of childhood cancer on families.
The "goal" of foster care, she says, "should be to raise healthy citizens for your society and to have people who are contributing." Instead, Kimble said, "you're just shoving these people back into a corner so that you don't have to deal with them."
NPR's Robert Benincasa contributed to this story.
Copyright 2026 NPR
