However, the report said that social workers also may have missed opportunities to assess the boy's home life in ways that could have led to earlier, more assertive intervention.
The fatality review, obtained by The Herald from the Department of Social and Health Services, is an assessment of social services, not a medical or legal determination. It was prepared by DSHS's Children's Administration division.
"This is basically reviewing all of the circumstances we have and the processes we went through to see if we could improve them," administration spokeswoman Chris Case said Tuesday.
"A.J." was severely developmentally disabled. His family had a history of parental neglect before Jan. 30, when the boy's father brought him into a Monroe hospital emergency room.
The boy wasn't breathing, and his body was stiff and cold.
His parents stopped speaking with detectives soon after he was declared dead. It's still not clear what happened in the hours before he was brought to the emergency room.
Police continue to investigate A.J.'s death. His older brother, who also is developmentally disabled, remains in foster care.
The fatality review was required by state law because A.J. received state care in the year before he died.
The boys were taken from their parents' care for three months in 2010 after they were found living in squalor. Their father later pleaded guilty to reckless endangerment.
CPS also investigated reports of the parents giving their children improper or inconsistent amounts of prescribed medication.
Since A.J.'s death, records obtained during police and DSHS investigations show a history of the parents not following up on the boys' medical appointments or doctors' recommendations.
Fatality reviews seek to examine the state's involvement in the child's life and determine whether policies were followed or changes need to be made.
The main concerns addressed in the report regarding A.J.'s death involve social workers' assessments of the family and their living situation during contacts between 2006 and 2008.
Those assessments changed dramatically after the 2010 criminal case and after CPS changed the way it evaluated safety conditions for children in late 2007.
The boys were returned home in June 2010, a decision made by the court. The boys' case worker disagreed with the court, but the fatality review team found that social workers at the time could have done more to monitor the family as the boys moved back in.
Communication also could have been better between the state and the boys' court-appointed guardian, the report said.
One thing not addressed in the report is the confusion over why an autopsy wasn't done.
At the time of A.J.'s death, several social workers involved in the case were under the impression that an autopsy had been ordered, Case said.
The Snohomish County Medical Examiner's Office released the boy's body for cremation without ever conducting an autopsy.
An autopsy could have determined whether the boy's death was an accident or a potential crime. It also could have yielded evidence about how the boy ended up with lethal amounts of salicylates in his blood. Salicylates are common in aspirin and other over-the-counter drugs.
Monroe police said they repeatedly asked the medical examiner's office for an autopsy. At the hospital, social workers urged A.J.'s parents to request an autopsy, but they did not.
The medical examiner's office is governed by the Snohomish County Executive's Office, where officials have said that medical examiner staff was not adequately informed of the family's history.
Rikki King: 425-339-3449; email@example.com.
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