A specialist nurse has told the Central Criminal Court that the child at the centre of a manslaughter trial was one of the most profoundly disabled she had ever come across.
Noreen Roche, who carried out an assessment of Emily Barut three years before her death, said she believed her survival was due to the exemplary care given by her mother.
She also said Bernadette Scully had been reluctant to use the sedative chloral hydrate to help her daughter sleep.
Ms Scully from Emvale, Bachelor's Walk, Tullamore has denied the manslaughter of her 11-year-old daughter by an act of gross negligence on 15 September 2012.
The prosecution alleges she gave toxic amounts of the sedative chloral hydrate to her profoundly disabled daughter.
Ms Roche, who specialised in assessing the needs of children with neurological conditions, said Emily was in a minority of children who would survive with such severe disability.
She said the level of care given to her was exemplary.
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Ms Roche had also noted at the time that Emily had severe epilepsy which was difficult to control and that her mother had used chloral hydrate to help with sleeping difficulties and seizures.
Pain medication did not work for pain spasms she suffered and her mother had to use chloral hydrate to help her sleep.
She noted that Ms Scully was "very reluctant" to use chloral hydrate.
Ms Roche described Ms Scully as being "anxious, tired and run off her feet at all times and finding it increasingly difficult to keep going at this pace".
She noted that Ms Scully was running her own GP practice employing nine people and was responsible for all the administrative work.
She found it difficult to get any time to attend to her own needs.
The evidence in the case is now complete.
The jury was told to return on Tuesday when closing arguments will be heard.