With recently diagnosed autism - a neurological disorder that impairs communication and social skills - Ronnie was withdrawn and could say only a few words. He could not identify familiar objects or point to body parts. Developmentally, according to a medical report, he was at the level of a 1-year-old.

Ronnie's behavior was hard to understand. His mother, who is cognitively limited, told a specialist at St. Christopher's Hospital that she was afraid to brush her son's teeth, according to the medical report. As a result, they were so decayed he had trouble eating. He threw tantrums; he was afraid of buses and cars. She hadn't sent him to school because she felt he wasn't ready.

In 2004, when Ronnie was 9, the Philadelphia Department of Human Services removed the boy from his home because of neglect. White, who was his autistic-support teacher at school, and her husband became his foster parents.

Three years later, Ronnie was thriving. The Whites applied for permanent custody.

But they quickly discovered that cases such as Ronnie's defy simple solutions.

Ronnie's case highlights the fundamental dilemma DHS faces in its effort to reform. What is in the best interests of neglected and abused children? Should the emphasis be on working with parents to preserve a family, or removing children from wobbly homes?

"DHS's first mandate is always to reunite children with their biological parents," said agency spokesman Frank Keel, who said he could not comment on the specific case. "All other options are secondary and are only considered when reunification with the parents is clearly not in the best interest of the children."

But that mandate and those options are the subject of passionate debate among child-welfare experts.

Ronnie's case is complicated by two other growing social concerns: How much should and can public-service agencies support cognitively disabled parents? And since about half of all abused and neglected children have some kind of disability, how can these kids get all the services they need?

The Whites and Ronnie's parents are not up on the latest public-policy wrangling. They haven't followed all the drama at DHS, which is under intense scrutiny since The Inquirer ran a series of articles last year about the agency's shortcomings.

But their lives are being buffeted by it.

Pat White said she understood how hard it must be for Ronnie's parents.

Since losing Ronnie, his birth parents have attended classes about autism. They've spent hours on buses to watch him play soccer and meet the Whites at a halfway point to take him home for weekend visits.

But White said she couldn't see how the couple could care for Ronnie's complex needs without an enormous amount of supervision and assistance. She said they cling to the hope that when he's 18, he'll move out and live independently.

"I'm afraid that if he goes back to them," she said, "he'll regress."

John J. Capaldi and Kathy Gomez of Community Legal Services, the attorneys for Ronnie's parents, declined to be interviewed or allow a reporter to speak to their clients.

"I am sure your readers can imagine how painful this separation has been for our client," Gomez wrote in an e-mail. "Everyone involved in this case has the best interests of the child in mind, but determining how the child's best interests are served is a difficult and complicated matter."

Representatives from Children's Choice, the Christian, nonprofit foster-care agency that manages Ronnie's case, also declined to be interviewed.

The Inquirer is withholding the boy's full name and those of his birth parents. Frank Cervone, executive director of Philadelphia's Support Center for Child Advocates, said that because of state and federal laws regarding confidentiality, the foster parents could jeopardize their efforts to maintain custody if they allowed a child to be identified.

At a Family Court hearing in August, DHS recommended that Ronnie go back to live with his birth parents.

White was shocked. She asked a DHS caseworker what had prompted the decision. "She just threw up her hands," White said.

Given the complexity of the case, the gesture of futility is, in a way, appropriate.

Which family will give Ronnie a better future? The answer is as pressing as it is unknowable.

Attention and progress

Rarely do children with severe disabilities end up with just one foster family, said Sheryl Dicker, a lawyer who recently retired as director of the New York State Permanent Judicial Commission on Justice for Children.

"Usually they go from home to home to home, and before you know it the kid has been rejected by more people than you can count."

When the Whites took Ronnie in, they thought it would only be temporary.

Pat, 43, has a master's degree in education and is certified in special education. She and her husband, Gary, a railroad instructor for SEPTA, met 12 years ago in the Marine Corps Reserve. He has a teenage daughter from a previous marriage.

The school where Pat works is in a poor neighborhood, and her students are vulnerable, sometimes frightened, and often in need of basic necessities.

In the fall of 2003, she bought Ronnie a gray hooded sweatshirt. "It was getting cold, and he didn't have anything." His rapture over such a simple thing was heartbreaking. And it pained her to watch, she said, when his teeth hurt so badly he had to drink through a straw.

"He often came to school dirty, hungry and smelling of cat urine," one of his teachers, Anita Crouthamel, wrote in a letter. "My staff and I had to wash his clothes and book bag at least twice a week. He often came in to school withdrawn and sad and would join in activities only after we took the time to wash his face, comb his hair and brush his teeth. ... We referred him to the school nurse several times due to our ongoing concern for his health and nutrition."

That winter, White said, Ronnie's caseworker told her that his parents were having trouble coping.

Ronnie's siblings had been placed with relatives, but he was in some kind of group home. The Whites visited him and applied to become his foster parents.

On March 12, 2004, he moved in.

Since then, he has made dramatic progress, White said.

He has had several teeth removed and more than 10 filled. He gained 20 pounds, although he is still rail thin. He can make his bed, count to 100, write the alphabet, read about 200 words, and sing karaoke at least as well as some of the contestants on American Idol.

In a letter to Family Court Judge Charles Cunningham, who is presiding over the custody case, Crouthamel reported, "He appears more alert, eager to learn and aware of his environment."

The school librarian wrote, "He no longer looks unhealthy. . . . His dark under-eye circles are gone. . . . He can now speak and focus on a conversation."

The Whites said they had enrolled Ronnie in soccer and basketball teams for autistic children and a Boy Scout troop. He received regular speech and occupational therapy and went on family vacations to Florida and North Carolina.

Just before Christmas, he climbed onto the living room couch between the couple he calls Mommy and Daddy White to read a Spider-Man book.

Grinning and giggling, he gripped the book and scoured the pages.

Pointing to an illustration, Gary asked Ronnie, "What's he doing here?"

"Climbing the wall!" Ronnie shouted.

"Who's the best boy?" Pat White asked.

"Ronnie!"

"Who's the smartest boy?" she asked.

He scrunched his bony shoulder against her, jerked his chin skyward and, jubilant, shouted, "Ronnie!"

Torn in two directions

"When the state raises children," he said, "it's just not pretty. . . . I've seen too many situations where the foster parents decide after a while this is too hard. Or adoptive parents say, 'Here, you take them back.' "

But Schwartz agreed with experts like Dicker, the child-welfare lawyer, who insisted that every case must be judged on its own merits, and that the child's needs must come first.

"We tend to look first at the parent and ask, 'Is that parent really bad, or a victim of their circumstances?' " Dicker said. "God knows, people in awful circumstances deserve help. But the child-welfare system is not the parent-welfare system."

Fortunately, she said, the best interests of children and their parents are often the same, but Philadelphia's DHS reform panel will have to decide what to do when they're not.

"If they say we need to focus on the needs of children, it really changes the way you approach these cases."

As an advocate for parents who feel their children have been unfairly taken from them, Gomez, of Community Legal Services, sees the problem from a different vantage point.

Her agency publishes a pamphlet for families involved with DHS. "Don't give up!" it says. "Take action to keep your children with you or get them back from DHS."

Ideally, parents with cognitive limitations get help early on: parenting classes during pregnancy and careful health screenings for their children, said Megan Kirschbaum, director of Through the Looking Glass, a national advocacy group for parents with cognitive disabilities. Across the country, 40 percent to 60 percent of these couples lose custody, she said.

"Some parents with intellectual disabilities - just like some parents, period - can't parent," Kirschbaum said. "But in general, with the right services, people can do quite well."

The key phrase is "with the right services."

Few cities, Philadelphia included, she said, are able to identify families who need support early enough, and when they do learn about a family like Ronnie's, the services are often inadequate.

Another problem is that the plans that neglectful parents are given to regain custody are often too formulaic.

Judith Silver is a pediatric psychologist at Children's Hospital of Philadelphia who runs a training program for DHS.

"Rarely does the system take the individual needs of the child into account in conjunction with the parents' capacity to care for this child with special needs," she said.

According to the federal Adoption and Safe Family Act of 1997, Ronnie's case should have been resolved by now. The law was designed, in part, to limit the time children spend in the limbo of foster care.

The general rule is that after a child has spent 15 of the last 22 months in foster care, his parents' rights should be terminated.

Ronnie has been with his foster family for 35 months. The Whites are seeking permanent legal custodianship rather than adoption, because they don't want to cut off all contact with the birth family.

"We would never keep Ronnie from them," Gary White said. "That would hurt Ronnie."

The harder she fights for him, Pat said, the more she worries that she will lose him.

Hope at a court hearing

Half an hour later, they were led into the courtroom, which is closed to the public. They had no idea what to expect.

Pat listened, astonished, as the city solicitor, speaking on behalf of DHS and the foster-care agency, recommended that Ronnie remain with the Whites permanently.

She bit her lip, determined to stay silent, to not jinx it.

The judge asked why DHS had changed its recommendation, the Whites said, and was told that Ronnie's birth parents were in a more difficult position now. Their oldest son was having emotional problems, and they had recently learned that their 3-year-old son was also autistic.

According to an internal DHS memo, adoption wasn't appropriate either, because the parents had complied with all training requirements and the boy's bond with them was strong.

"In this difficult situation," the memo said, "permanent legal custody seems to be the right and fair decision."

Ronnie's mother agreed to let Ronnie live with the Whites. His father, however, is contesting the decision.

The next hearing is scheduled for May.

"I feel so sorry for his parents," Pat White said. "But their disabilities are never going to change. And neither will Ronnie's needs. He's a complicated kid."

This month, worried over losing custody to Ronnie's father, the Whites thought about hiring a lawyer. Then the foster agency called.

"I thought it was a new caseworker," Pat said. But no. The woman said she was "the permanency worker."

Permanency. As in forever.

"She said she needed to come out to the house and make sure it was suitable for Ronnie. Then they will have to do another round of criminal and background clearances," Pat said.

With Ronnie, the Whites said, they already feel, and act, like a family. By the spring, they hope, this ordeal will be over and they'll officially be recognized as one.

"I always tell her not to get her hopes up," said Gary, "but I think this time, it's a lock."

Read The Inquirer's report on the city's handling of child-abuse deaths and other recent articles at http://go.philly.com/dhs