CHRISTIANSBURG -- Six children dead. Two critically and permanently injured.

Linda Nisbet says those are the hard, cold facts in Montgomery County.

Since 2006, four infants suffocated while sleeping, one toddler died after being left in a car and another toddler died after being shaken, according to Nisbet, director of the Montgomery County Department of Social Services.

"Our main concern with these cases is our belief that seven of the eight cases -- five of the six deaths -- could have been prevented," Nisbet said.

"This is alarming to us. I would hope it's alarming to the community."

A preliminary hearing for the man charged in connection with the Feb. 9 death of 14-month-old Evan Tucker Lytton-McFalls, known as Tucker, is scheduled today in Montgomery County Juvenile and Domestic Relations Court.

William Schamback Shelton, the boyfriend of Tucker's mother, is charged with second-degree murder in the boy's death, which was ruled a homicide by the Roanoke medical examiner's office. The medical examiner's office and the Montgomery County Sheriff's Office have declined to release the boy's cause of death, but Nisbet referred to the case as a "shaken baby" case.

The trial for a mother whose adopted son died after police say she left him in the family car has not yet been scheduled. Mary Nelson Parks is charged with involuntary manslaughter and child abuse or neglect in the Sept. 7 death of Juan Turner Parks, who was 23 months old. The boy died of heat stroke.

Two other children -- an infant and a 2-year-old -- are now in foster care with brain damage, vision damage, delayed development and physical motor problems because they were shaken, Nisbet said.

In both those cases, a parent or caregiver has been charged with felony child abuse. An August trial is scheduled for Lloyd Wayne Sheppard in a charge resulting from a Jan. 12 incident.

Charges against Carl Sidney Wood of child abuse and malicious wounding stemming from a Feb. 11 incident are expected to go before a Montgomery County grand jury next month.

And the children who social service workers say died as a result of smothering?

No one has been charged in their deaths.

In two of the four cases, Blacksburg police Lt. Joe Davis said, a medical examiner ruled that the deaths of the children -- one boy 4 and a half months old and the other 2 weeks old -- were consistent with sudden infant death syndrome, which is the sudden, unexplained death of an infant younger than 1 year.

Information wasn't available about the other two cases because social services does not release the identities of the families involved.

"SIDS is a very unspecific diagnosis and can be very difficult to work with from a prosecution point of view," Montgomery County Commonwealth's Attorney Brad Finch said.

If a baby's death is consistent with SIDS, which has no known cause, Davis said, it's extremely difficult to prove in court that the baby died of being smothered.

For someone to be convicted of a crime, he or she must be proven guilty "beyond a reasonable doubt." Finch said that means a judge or jury must be about 99 percent sure the person is guilty.

But when social workers make a decision in a case, they rely only on about 51 percent certainty. And in their eyes, all four children died as the result of neglect.

"One had to do with blankets in the crib," Nisbet said. "Three were co-sleeping. All involved drugs or alcohol."

Answering the call

The deaths in Montgomery County haunt the dreams of Pam Basham and her fellow social workers.

From 2001 to 2004, no children died in the county as a result of abuse or neglect. But three fatalities have already occurred in just the 2008 fiscal year.

Basham, 35, has worked for Child Protective Services for 13 years. For the past five years, she has supervised the CPS unit in Montgomery County, which includes three workers who conduct investigations, one who provides ongoing services and four foster care social workers.

The state mandates that doctors or school personnel who suspect abuse or neglect must report it within 72 hours. Basham said the process for responding to a report is prescribed by the state. After a call is received, a worker fills out a complaint form and sends it to Basham, who screens the complaint to determine that some form of abuse or neglect is alleged, that it occurred in Montgomery County and that it involves the abuse or neglect of someone younger than 18 by a caretaker.

Once a case is assigned, Basham said one of two things happens. The first option is to conduct an investigation, something that is always done if there's a claim of sexual abuse or if the suspected abuser has had three or more complaints in a year. The second option is a family assessment.

"The purpose of the family assessment is to meet with all the members of the family and see what services are needed," Basham said, recalling a recent case that came from a call that a 2-year-old was running around in the street. After meeting with the family, a safety plan that involved putting a fence around the yard was developed.

"Our goal is not to remove every child. Our goal is to strengthen families," Basham added.

To serve and protect

Law enforcement officials and the social workers describe a feeling of frustration when it comes to bringing charges against caretakers or parents suspected of neglecting or abusing their children.

Brad Roop, the Montgomery County Sheriff's Office detective in charge of crimes against children, said one of the most difficult aspects of his job is when he encounters a situation that leaves him with "a gut feeling that something isn't right," but he doesn't have evidence to back it up.

"There are limitations on our scope of authority," he said. "Your hands get tied. You can't do as much as you wish you could do to protect these children."

Nisbet said her department has to adhere to federal and state government mandates when it comes to removing children from their caretakers.

"If we remove a child, we have to go to court and prove why that removal was necessary," she said. "We don't always get our opinions ratified. There are times when we have gone to court and the judge has sent that child home."

The checks and balances, Nisbet added, are in place for a reason.

"It's to make sure we're not out there cowboying," she said. "I think a lot of people don't understand. They think we can do whatever we want. But we can't."

What to do

Although child fatalities because of abuse or neglect have remained static statewide in recent years, Rita Katzman, Virginia's program manager for Child Protective Services, said that over the past several years, the rate has risen in the western part of the state. The region includes the New River Valley and counties west of it.

While the number of children who die as a result of abuse or neglect is greater in more populated areas, such as Norfolk, the rate is higher here. Katzman said she can't offer an interpretation as to why that is.

"Some of our smaller localities, such as Stafford, have four reported fatalities so far this year. Can I explain that? No," she said.

"When I look at Montgomery County and I see these numbers, it's curious but not totally unique. ... If we could learn more about these fatalities, my hope is that we could see some trends that would help us formulate prevention programs."

Basham and Nisbet both said substance abuse programs would help cut down on the number of child fatalities, but both staffing and funding for social service programs are limited.

Nisbet estimates that 90 percent of the child protective services unit's cases are connected to drug abuse by parents.

"I feel very strongly that we need drug treatment for moms with their kids," Nisbet said. "Moms don't want to leave their kids to go inpatient, and most treatment services don't allow moms to bring kids. Also, drug treatment for women is different from drug treatment for men. Until we meet the needs, we can Band-Aid forever, but we won't solve things."

She also has been pushing for a program called Healthy Families, the state's social services initiative that provides proactive support for new parents through voluntary home visits and case management services. Such a program, she said, would help prevent poor parenting by treating problems before they occur, rather than afterward when it's often too late.

But Montgomery County will have to wait in line.

The state's priority, Nisbet said, will be to offer these programs in Giles and Pulaski counties first because they have two of the highest incidents of child abuse -- although not deaths.