The adoptive parents of a 16-year-old Iowa girl who weighed only 25kg when she died have been charged with first-degree murder.
The 16-year-old girl was found dead May 12 inside her adopted parents' Misty and Marc Ray's home in Perry, which is 35 miles northwest of Des Moines.
Additionally, Marc was charged with two counts of sexual abuse, according to court records. The abuse allegedly occurred in January 2009 and December 2016.
Police say preliminary autopsy results show she was severely malnourished and that she had the average weight of a healthy seven-year-old girl, the MailOnline reported.
The Rays already have pleaded not guilty to charges of child endangerment causing death, child endangerment causing serious injury and neglect. A trial isn't expected until next year.
Police said in June that the girl was unable to walk, talk or eat after being "drop-kicked" by her 21-year-old adoptive brother down basement stairs weeks before her death.
The brother, 21-year-old Justin Dale Ray, has been charged with two counts of willful injury and two counts of child endangerment for the incident, which occurred sometime between April 15 and May 2.
Between March and May, Justin also allegedly kicked his frail adoptive sister in the chin, leaving her with a bleeding cut, according to a criminal complaint.
A cousin who lived with the family, 20-year-old Josie Raye Bousman, has been charged with child endangerment resulting in death and three counts of first-degree kidnapping after she allegedly admitted to injuring Sabrina and denying her food and water, reported the station KCCI8.
The teen's grandmother, 62-year-old Carla Bousman, was charged with aiding and abetting kidnapping, child abuse resulting in death and obstruction for allegedly altering evidence at the crime scene and providing false evidence.
The Rays also ran an in-home child care, and police are investigating whether any abuse occurred with those children, officials said.
Authorities had previously revealed that Sabrina Ray was home-schooled and that she and her siblings had been monitored by the Iowa Department of Human Services following complaints about inadequate nutrition and the use of corporal punishment.
Three other children were removed from the home, including two girls - ages 10 and 12 - who were also adopted and are now under a doctor's care, according to police.
The third child is a boy. Police did not reveal his age, but noted the Rays don't currently face charges concerning him.
According toThe Des Moines Register, Sabrina was placed in Misty and Marc Ray's home in 2011 after her biological father, a recovering methamphetamine addict and alcoholic named Joseph Busch and his wife, Karena, pleaded guilty to child endangerment.
The Rays initially took in Sabrina as a foster child and formally adopted her in 2013.
Sabrina also had an older half-sister, who is now aged 27, and four younger brothers, who went to live with relatives or other foster families.
The girl's birth mother, Vicki Hollander, who for a time lived with a registered sex offender and was investigated for child abuse, died of cancer.