The pediatrician who cared for Jeffery and Rebecca Trebilcocks' adopted son testified Monday that the suspected abuse against the boy is "the worst case in severity of neglect that has not resulted in death" he has ever seen.
Dr. Blaine Tolby, who began testifying Friday afternoon, continued his testimony under cross-examination Monday morning as the Trebilcocks' child-neglect trial entered its second week.
Tolby resisted defense attorneys' attempts to get him to concede that the boy's short stature might have been caused by fetal alcohol syndrome.
Tolby saw the boy at the Child & Adolescent Clinic in Longview from 2002 — when he was placed in foster care with the Trebilcocks — to 2011 (he was formally adopted in 2004). He testified that the boy suffered from "psychosocial dwarfism," in which heavy stress stops a child's growth. He said the boy was above average in height and weight in 2002, but by 2008 Tolby grew concerned about the boy's failure to grow and advised state Child Protective Services workers.
In 2011, when the boy was 13 and authorities took him from the Trebilcocks' home, he was 4-foot-4 and weighed 49 pounds. Tolby said that based on projections from the boy's height at 5 years old, he should have been about 7 inches taller.
Defense attorney Ted DeBray asked Tolby why he didn't stress urgency when he made his first report to CPS about the boy in 2008.
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"I didn't have all the facts," Tolby said. He said he told CPS he was concerned about the boy's lack of growth, "but it was not reported in a 'get him out of the house tomorrow' fashion."
He said if he had known what the boy's condition would be on March 1, 2011, he would have acted with more urgency in 2008.
When he examined the boy in 2011, the child was "incredibly malnourished," Tolby said. According to the boy's body mass index (the relationship of weight to height), "99 out of 100 children would have weighed more," Tolby said.
Cowlitz County sheriff's deputies removed the boy and his three adoptive sisters at that time. Authorities reported that within two months of being removed from the home, the boy had grown an inch and gained 25 pounds.
DeBray and co-defense attorney Kevin Blondin asked Tolby if the boy's small stature could be caused by fetal alcohol syndrome, showing a letter from a medical expert who diagnosed the condition.
Tolby said he disagreed with that diagnosis. He said that although heavy drinking during pregnancy can result in small babies, some of whom grow slowly, "there's no interruption of growth halfway through childhood" as with the Trebilcock boy.