Unfortunately, as in Laura's case, Justin's problems were exacerbated by a fragmented medical system. Over the years, even though he'd been given tests as complicated as chromosomal analysis to look for genetic problems, and high-tech brain scans, he rarely saw the same doctor twice. No one followed his case over time or learned about his living situation. By age 5, a repeat screening showed that he had made minimal progress in fine motor, large motor, behavioral, cognitive or speech and language capabilities.
He still couldn't walk or talk. To the doctors, who didn't know about the deprivation the child was experiencing, it appeared as if most of his brain-mediated capabilities just did not work properly. They assumed that Justin's "static encephalopathy" was due to some, as of yet, unknown and untreatable birth defect. The unspoken conclusion with children exhibiting this kind of severe brain damage is that they do not respond to therapeutic interventions. In essence, the doctors had told Arthur that the boy was permanently brain-damaged and might never be able to care for himself, so he wasn't given any incentive to seek further help.
Whether because of this medical pessimism or because of his irregular care, Justin was never provided any speech therapy, physical therapy, or occupational therapy-and no in-home social services were offered to his elderly caregiver. Left to his own devices, Arthur made care-giving decisions that fit his understanding of childrearing. He'd never had children of his own and had been a loner for most of his life. He was very limited himself, probably with mild mental retardation. He raised Justin as he raised his other animals—giving him food, shelter, discipline and episodic direct compassion. Arthur wasn't intentionally cruel: he'd take both Justin and the dogs out of their cages daily for regular play and affection. But he didn't understand that Justin “acted like an animal” because he'd been treated as one—and so when the boy "didn't obey," back into the cage he went. Most of the time, Justin was simply neglected.