CASA of Los Angeles volunteers are used to encountering shocking things in their work with abused and neglected children. But when Mariann Fragner took a seat at the back of a courtroom in the L.A. County Dependency Court last fall, she was about to see something she had never imagined.

“Here was an eight-year-old child who was 175 pounds, and he had a tracheostomy,” she says. “I can’t explain the emotion I felt when I saw him. He looked so sad.”

And if the boy’s appearance hadn’t already unsettled her, the hearing itself would have.

The boy, Daniel, had been taken into protective custody by the L.A. County Department of Children and Family Services (DCFS) about a year and a half before, when a health care provider felt that his mother was unable to properly care for his tracheostomy, which he had received because of his sleep apnea and morbid obesity. He was hospitalized and placed on a 1,400-calorie restriction, which helped him lose 40 pounds. But within six months of returning to his mother’s custody, he had gained it all back. The only weight management resource the family had was a monthly pulmonary clinic, where Daniel was weighed and met with a nutritionist.

The judge gave Daniel’s mother, Dolores, a lecture, which was capped off by an order: lock the refrigerator and the cabinets at home.

“I sat there thinking, ‘The system isn’t equipped to deal with this issue.’ Not that I knew exactly how to handle it, but it was clear that communication had broken down,” Mariann says. “They really needed someone to come in and dissect the situation, to see what was going on in the family, and then suggest some solutions. I thought, ‘If this isn’t a CASA case, I don’t know what is.’”

But Mariann wasn’t there that day as a Court Appointed Special Advocate (CASA). She had recently been trained by CASA of Los Angeles as an Early Childhood Court Liaison—a volunteer who observes hearings in selected courtrooms to help get the neediest children ages 0 to 5 assigned to CASAs as early as possible.

Daniel, of course, was well outside of the early childhood age range. So during a pause in the hearing, she took the opportunity to introduce herself to one of the lawyers and suggest that a CASA might be helpful to everyone involved. The lawyer agreed, and the judge granted his request for a referral.

Soon after, veteran CASA Betty Freitag was assigned to Daniel’s case. She started with just the kind of investigative work Mariann had envisioned—she interviewed everyone involved.

“It turns out the core issue was that Dolores simply felt under siege by the system,” Betty says. “Just about everyone she had come in contact with had treated her like she was a bad mom and the cause of Daniel’s obesity. She was afraid to bring him in for appointments, and it snowballed from there.”

Plus there was the unanswered question of how to best manage Daniel’s weight. Daniel and Dolores didn’t just need a change of venue; they needed a different program altogether.

“I thought there had to be some other resource out there, so I started researching programs and eventually found a weight management program at UCLA,” Betty says. “Dolores said she would be willing to give it a try, and when we had our next hearing the judge was very enthused to hear that there was, in fact, a resource for her that hadn’t been uncovered before.”

Besides teaching Daniel and Dolores how to gradually develop a healthier lifestyle, staff in the UCLA program explained to Dolores the importance of her finding counseling to help her work out her own issues. The DCFS family preservation social worker took the lead and found her a therapist.

In addition, UCLA had a pediatric pulmonary clinic nearby, so when Daniel went for his weight management appointments, he also got treatment for his sleep apnea. Suddenly, all of his medical care was in one place.

“Pretty soon, Dolores didn’t feel like a bad mother anymore,” Betty says. “And that’s because she had a team of people who were partnering with her instead of against her.”

Daniel was feeling better, too. His heart used to race when he would go to the doctor—he was afraid of being taken from his mom again—but he was happy going to UCLA and he was even thriving at school, despite having missed so many days in the previous school year.

Not everyone could have appreciated the family’s transformation, though. While the original judge was back behind the bench, three others had heard the case since it was assigned to Betty, and both Daniel and Dolores would have new attorneys representing them at the next hearing. Everyone was relying on Betty to provide continuity to the case and to be the voice for Daniel.

“We got to the April court hearing and I explained to the judge and the lawyers that there really was nothing more that DCFS could do, that I thought Daniel should remain permanently in his mother’s custody and his case should be closed,” Betty says. “All the protective factors were in place. Dolores was getting therapy, Daniel was getting therapy, and he was in the weight management program for the long haul. I said, ‘I’m asking you, Your Honor, to change your previous orders and allow the medical professionals to handle this.’ He wholeheartedly agreed and said he was thankful this didn’t have to be legislated from the bench.”

Mariann, the Early Childhood Court Liaison, was at the final hearing, too. Since that day when she first saw Daniel, in October, she had continued observing hearings and could see firsthand that the physical presence of liaisons in the courtrooms was helping to increase referrals of the neediest children to CASAs—even older kids, which had been one of the goals of the program from the start. The change in Daniel’s appearance was emblematic of the difference a CASA can make.

“He was like a new person, and not because he was svelte,” Mariann explains. “It was because he had had some anxiety removed from his life. It was so touching to see somebody set on the right course.”