Williams had once lived with her mother, but left because the mother did not approve of Williams' boyfriend, the father of her four youngest children, Pagano said. Williams then went to live with a church friend, but was thrown out after a dispute about religion.
Left to roam the streets with her four children, and pregnant with the twins, she slept one night in the lobby of the city's Department of Human Services in search of help, Pagano said.
She ended up at a shelter run by Travelers Aid Family Services of Philadelphia in September, and gave birth Oct. 22. The twins were sent home on Oct. 25, along with information about food stamps and a car seat program, and advice on their feeding and sleeping needs.
But Pagano questioned how much Williams understood, given what he called her IQ of 65.
Common Pleas Judge M. Teresa Sarmina, though, questioned the relevance of that finding, given Williams' apparently cogent statements to police about her hopes and dreams, her parenting efforts and her enjoyment of a job she once held at a day care center.
"At this moment, I don't understand why IQ is relevant," Sarmina said in a pretrial hearing earlier Thursday.
Williams has been in prison for two years, and her children have been removed from her custody.
Lutheran Children and Family Service, which provided social services at the shelter, terminated two case workers after Quasir's death, but no one else has faced criminal charges.
The case has echoes of the 2006 starvation death of another child under the city's watch, a 14-year-old disabled teen named Danieal Kelly. Her family's case workers skipped home visits altogether, while the owner of a contract firm hired to coordinate services for Danieal and her eight siblings forged documents after she died. They are serving long prison terms for defrauding the city.