The evening of June 9, 2002, Springville emergency medical technicians responded to the home of Richard and Jennete Killpack. When they arrived, they found the couple's 4-year-old daughter lying on the floor, her belly swollen, her breathing sporadic. Pink foam spilled from her mouth.

"It was coming out so fast I couldn't suction it," medical technician Terri Shuler testified at a court hearing the following May. She used four towels to soak up the foam.

"Three of the towels, I could wring water out of," Shuler testified.

The girl suffocated on her own vomit shortly after arriving by helicopter at Primary Children's Medical Center.

Her drowning was well under way hours earlier.

The girl's hands were tied behind her back with rope by her adoptive mother, and she was forced to drink water, according to videotaped testimony from a 7-year-old sister. When her father came home, the sister testified, he held the 4-year-old's head back as the couple forced more water down her throat.

She was being disciplined for taking a soft drink from a younger sibling.

"They make her drink a glass of water until she pukes," the sister told police.

Pathologists at the medical center listed the cause of death as water intoxication. The overdose of water caused the girl to vomit water and then breathe it into her lungs.

During the flight to the medical center, Cassandra Killpack also excreted and urinated large quantities of fluid.

When her parents go to trial next September, they are expected to blame Cassandra's death on the Cascade Center for Family Growth, a child behavior modification clinic in Orem that provides both traditional and unorthodox treatments.

The Killpacks claim they learned the bizarre hydrotherapy discipline method there.

A three-month investigation by the Utah County Attorney's Office cleared the center of any responsibility in Cassandra Killpack's death.

But the incident is proving fatal to the clinic. For several years, public and government scrutiny has been closing in on the state's lone provider of "holding therapy," a behavior modification treatment for severely traumatized or abused children that is reviled by some traditional child therapists but revered by many parents.

Social workers have stopped referring clients. The state Division of Child and Family Services no longer helps pay for treatment at Cascade. Directors Larry VanBloem and Jennie Gwilliam still have licenses to practice, but the state may revoke them in January.

VanBloem is nearly bankrupt. His family doctor buys his children shoes. His children must work to buy the family groceries.