Girl in vegetative state reported to improve

A day after the state's highest court ruled that the Department of Social Services could withdraw life support from a brain-damaged girl, the agency said yesterday that Haleigh Poutre might be emerging from her vegetative state.

DSS also said it has no immediate plans to remove her feeding tube.

''There has been a change in her condition," said a DSS spokeswoman, Denise Monteiro. ''The vegetative state may not be a total vegetative state."

Monteiro said Haleigh is breathing on her own, without the ventilator she has depended on for four months. Monteiro also said that doctors at Baystate Medical Center in Springfield elicited responses from Haleigh during tests performed yesterday.

They will begin more medical tests today to determine her neurological activity. Further tests, Monteiro said, could show whether Haleigh is going to be ''a miracle child."

Monteiro said that doctors did not tell DSS, which has custody of Haleigh, that her condition had changed until yesterday afternoon. She also said the agency's decision to seek court approval to remove life support was based on the ''best diagnosis that we thought we had at the time."

Monteiro declined to give further details about the condition of Haleigh, an 11-year-old Westfield girl who had been on breathing and feeding tubes since she suffered a beating last September, allegedly by her adoptive mother and stepfather.

Last fall, doctors described Haleigh as being in a persistent vegetative state and ''virtually brain dead," district court records said. Physicians said her brain stem was severely injured, leaving her unable to think or feel and in an ''irreversible coma," according to an opinion Tuesday by the Supreme Judicial Court.

Many neurologists say it is rare for a patient with severe brain-stem injuries to fully recover from a persistent vegetative state that lasts for more than a month. Sometimes, patients can partially recover, such as showing increasing responsiveness to touch by frowning or moving their hand, said Dr. Steve Williams, chief of rehabilitation medicine at Boston Medical Center.

But rarely do these patients fully recover so they can communicate, feed themselves, and live ordinary lives, he said.

He added, however, that the recoveries, when they happen, are more likely with children than adults. ''There's more plasticity to their brain," he said. ''There's potentially other areas of the brain that can take over."

Allison Avrett, Haleigh's biological mother, said yesterday that she saw improvements in a hospital visit last week, but was convinced by doctors and DSS workers that hand movements that she had seen were involuntary.

When Avrett visited Haleigh yesterday morning, Avrett said she again observed movement that caused her to reconsider her previous view that Haleigh was better off if allowed to die.

Avrett said she cannot give any more details about Haleigh, because the DSS has told her not to discuss the case.

John Gamelli, a family friend from Westfield, said he was told by Avrett yesterday that Haleigh was able to respond to commands, such as releasing an object from her hand when she was asked.

Gamelli said he is holding back from celebrating this as a sign that Haleigh will fully recover.

But he expressed frustration that DSS, which acknowledges missing signs over the past few years that Haleigh was being abused, had now possibly made the wrong call about the removal of life-support systems.

''Right now, things just don't make sense," he said.

In the Western Massachusetts town where Haleigh was raised, some had compared her case to that of Terri Schiavo, a Florida woman who was on life support for 15 years before a court ordered her feeding tube removed last spring. She died 13 days later at the age of 41. Schiavo was deemed by doctors to be in a persistent vegetative state, breathing on her own with her eyes open, but unconscious. Her parents, who sought to keep her alive, had insisted she sometimes responded to stimulation. Her husband said she would have wanted her feeding tube removed.

Before yesterday's disclosures, Haleigh was thought to have more serious brain damage than Schiavo, in part because she was not breathing on her own. Haleigh was brought unconscious to Noble Hospital in Westfield last Sept. 11.

Afterward, doctors diagnosed traumatic brain injuries and many bruises in various stages of healing. In the past few years, the DSS had received more than a dozen complaints from people whom the agency has declined to name, saying Haleigh was being neglected or abused, but social workers said many of the injuries were self-inflicted or childhood mishaps.

On Sept. 20, Holli and Jason Strickland, the girl's adoptive mother and stepfather, were arrested on child abuse charges. The adoptive mother was released two days later, and within hours, was found dead with her grandmother. Police continue to investigate the deaths, but say it seems to be a murder-suicide.

In October, DSS officials, saying that Haleigh's medical condition was hopeless, won a juvenile court order to have her ventilator and feeding tube removed. Jason Strickland, who could face murder charges if Haleigh dies, filed a motion to keep her on life support.

On Tuesday, the Supreme Judicial Court rejected Strickland's claim to be a ''de facto" parent, saying it was ''unthinkable" to give a say to someone who allegedly helped put Haleigh in a coma. The justices also gave DSS authority to remove Haleigh's breathing and feeding tubes.

Jack Egan, a Springfield lawyer for the girl's stepfather, said yesterday's medical news confirms their view that DSS was too hasty in determining that Haleigh's condition was irreversible. He noted that DSS asked the courts to withdraw life support after Haleigh had been in the hospital for less than a month.

Patricia Wen can be reached at wen@globe.com.