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In 2023, the Penn State Health Hershey Medical Center personnel reported to Lebanon County Children and Youth that the Speraws' 3-month-old son had been admitted on three separate occasions for failure to thrive. According to court documents, medical personnel attributed this failure to malnutrition and nutritional neglect.
According to a report by the Lebanon County Detective's Bureau, CYS described the living conditions of the residence as "deplorable."

Photos taken of the South Annville Township residence depicted "extensive clutter, trash strewn about, rotting food, stained floors, and overall extremely unhealthy and unsanitary living conditions." The Detective's Bureau joined CYS on a follow-up visit, and confirmed that the living conditions of the residence were unhealthy.
CYS identified a second child, a 4-year-old male, was also living in the home during the time of the incidents.

"Based on living conditions of the home, CYS removed both children from the home for health and safety concerns," law enforcement said in court documents.
Dr. Kathryn Crowell, a pediatrician on the Center for the Protection of Children team, reviewed all of the 3-month-old's medical records. In a six-page opinion to law enforcement, Crowell concluded there was no medical cause for the child not to thrive.

In follow-up correspondence, Crowell said the child's malnutrition and poor growth were a direct result of his caregivers not feeding him appropriately. Nutritional neglect, such as was seen in the 3-month-old, can put children at risk of serious complications, including death.
"There were multiple points in the medical record that demonstrate that caregivers were provided clear instructions with how to feed the (3-month-old)," Crowell said in officials court report. "He had previously demonstrated good weight gain in the hospital when these instructions were followed. However, caregivers did not follow the provided instructions at home and (he) again lost weight."
Paul Speraw was sentenced to a minimum of 18 months in a state correctional institution. The 41-year-old pled guilty on Nov. 17, the same day jury selection was to begin for his trial.
Speraw did not speak much during his hearing other than to answer direct questions. Attorney Joshua Harshberger, who represented Paul Speraw, said during sentencing that he has been taking steps to allow the children to be adopted by other caretakers.

"I believe this goes a long way in recognizing and accepting responsibility for this, and recognizing the remedy of the harm that had occurred," Harshberger told Jones.
Allyson Speraw was sentence to a minimum of nine months in the Lebanon County Correctional Facility. The 26-year-old pleaded no contest to the charges March 27. A no contest plea allows a defendant to neither admit nor deny guilt, but accepts the court's punishment as if they were guilty.

Allyson Speraw also did not speak much during her hearing, except to apologize to the court for her decisions during these incidents.
 
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