CLEVELAND -- A 3-year-old boy who is a victim of suspected child abuse is out of a coma.

Last week, he was taken to MetroHealth Medical Center by his mother. She and her boyfriend were later arrested on assault and child endangering charges.

The little boy has internal injuries, broken bones and severe malnutrition.

How was malnutrition not spotted on the last home visit in February?

Children and Family Services spokeswoman Mary Louise Madigan says no one observed malnutrition. Madigan says they never received allegations of child abuse for this family.

In April of 2013, there was an allegation of domestic violence between adults that was substantiated, and counseling was provided. The department says a social worker visited the family once a month, sometimes more, starting back in 2012.

"Reality can be disguised by an abuser," says Madigan.