The 5-year-old boy who authorities say was killed by his foster brother died due to blunt-force head injuries and drowning, according to the Iowa State Medical Examiner.
The body of Dominic Elkins was found in a wooded ravine north of Logan, Iowa, over Labor Day weekend.
Cody Metzker-Madsen, 17, a foster brother of Dominic, has been charged with first-degree murder in the child’s death.
Officials have said Dominic was killed as the two boys played outside Aug. 31 at the rural home where they were staying.
Metzker-Madsen has pleaded not guilty and is being held at the Harrison County Jail.
Both boys were in the care of foster parents Don and Julie Coolman.
Metzker-Madsen is “mentally challenged” and has “anger issues” but seemed to respond well to the Coolmans’ guidance, according to relatives of the couple. The public defender, Michael Williams, said in court documents that his client has a “variety of psychological difficulties.”
Dominic also had a history of behavior issues, his family has said.