Bowen Levy was a boyish-looking teenager with curly brown hair who was diagnosed with autism at an early age. He was gentle and spirited, his family said — laughing infectiously when his sister danced with him or when he thought he might get tickled.

One day in November, he went to school and never came home.

Bowen boarded a school bus in his Annapolis neighborhood, riding it to the public school he had attended for more than a decade — Central Special in Edgewater, Md., where most of the students have severe disabilities.

That afternoon, Bowen choked on a thin rubber glove and lost consciousness. Family members say the doctors and nurses who treated the teen told them he was probably without oxygen for 10 minutes or more.

The teenager’s death Nov. 10 came amid long-standing concerns nationally about the care and education of some of the most vulnerable students in schools.

It shook the disability community and sparked concerns among family members and advocates about school staffing levels and supervision practices, and whether other children could be at risk. One major issue for Bowen’s family is whether he had the one-to-one aide they say he was supposed to be assigned that day.

Educators and advocates nationally point to the critical importance of aides when safety is at issue, as it was for Bowen; the teen was nonverbal and had pica, a propensity to chew or eat nonfood items. Training and support for aides vary widely, they say.

“They are some of the lowest-paid members of the educational team, often with the least amount of formal education, and there are no national licensing standards,” said Emily Nusbaum, a researcher who has long worked in special education and teaches in the field.

In Maryland, Bowen’s family members say that much about the day he choked remains unclear — how closely he was monitored, how quickly his distress was noticed, how soon 911 was contacted — and are calling for answers. They say they want to make sure what happened to Bowen never happens to another child with special needs. School system officials say the death is under investigation, describing the loss of a child as anguishing but declining to discuss specifics.

The teenager died at Johns Hopkins Children’s Center in Baltimore on Nov. 10, eight days before his 18th birthday.

“How long did he suffer before someone noticed?” Bryan Levy, his father, asked. “That’s what keeps me up at night.”

An investigation by the county’s social services department found evidence of child neglect, but investigators were unable to determine who was responsible for Bowen’s access to the glove, according to a Jan. 31 statement from the Maryland Department of Human Services.

Investigators concluded “more likely than not that someone was not providing the child with proper care and attention,” the statement said.

For the family, the lack of detail was striking.

“Why did it take them two months to tell us somebody wasn’t watching him?” Levy asked. “If somebody was watching him, he wouldn’t have gotten the glove. He would be here right now.”

Bowen’s autism affected almost all aspects of his life. The family says a school official apologetically told them in August that Bowen did not yet have an aide for the school year, explaining that aide jobs were hard to fill because the pay was so low. The school was trying to hire someone and filling in with other staff when possible, Levy said the family was told.

Nine weeks into the school year, they had not received word that Bowen had been assigned an aide, they said.

Documents related to the school’s 911 call, obtained by The Washington Post, indicate the school did not initially know what Bowen had choked on. Family members say doctors told them the rubber glove was discovered by medics attempting to insert a breathing tube.

“This appears to be part of a larger failure to provide adequate resources to our special schools,” Levy wrote in a Dec. 3 letter to Anne Arundel County Public Schools Superintendent George Arlotto, calling for an independent investigation of Bowen’s death.

Anne Arundel County school officials said in late January that the school system is investigating the matter. They have declined to provide details on what happened Nov. 5 or whether Bowen had an aide.

One-to-one aide services are provided by “temporary support assistants” who are paid $12 an hour, do not receive benefits and are not part of any union bargaining unit, according to the school system.

“We are devastated by the loss of a child,” said Bob Mosier, spokesman for the 85,000-student school system, which includes Annapolis and borders the Chesapeake Bay. “We are supporting the family, the students and the staff at Central Special as best we can.”

Speaking generally, Mosier said students with special needs are adequately supervised in county schools. He declined to discuss whether there was a shortage of aides at Central Special but said that across the school system, there is not. The school system regularly advertises the positions, he said, so schools have a pool of people from which to draw.

Adequate staffing is a problem in many school systems nationally, advocates said.

Kim Musheno, vice president of public policy at the Autism Society of America, said she hears complaints “all of the time” about a lack of qualified special-education teachers and trained support staff across the country.

“There’s not enough people in the pipeline, and they don’t get paid enough,” she said, adding: “We definitely need to provide more funding for professional development and specialized training.”

In Levy’s Annapolis home one December day, photos and videos of his son — nicknamed “Bo” — flash across a monitor near the family room, and Bowen’s red Christmas stocking hangs beside those of his sisters. The eldest of three children, he was big-hearted and close to his grandmother. His parents organized their home and work around his needs.

“He was a great kid, he was gentle, he loved Elmo,” Bryan Levy said. “All he ever wanted to do was spend time with his sisters and his family. He had a great sense of humor.”

It was 2016, he said, when he and his wife, Tanya, went to school system officials saying their son needed more attention and supervision.

They argued that a private placement might be better. They had been getting reports of Bowen putting items in his mouth — rocks, chalk, certain foods he was not supposed to have — and also believed he should be making more progress educationally.

School officials pledged additional services, including more speech therapy and a one-to-one aide — and the family opted to stay, Levy said.

Levy shared a school document from June 2016 that references a plan to “maintain close/direct 1:1 supervision at all times” and “attempt to keep environment free of inedible items (dirt, chalk, mulch, buttons, etc.).”

Bryan Levy recalls thinking: “At least now he’s going to be safe.”

The troubling incidents declined significantly in 2017 and 2018, Levy said, but in 2019, “we started to see the problems we had before.”

According to the family, a log book sent home by the school with notes about Bowen’s days arrived in mid-September with the words: “Still waiting for help” beside a drawing of a sad face.

Still, Levy said, he would not have let Bowen attend if he believed his son was in danger. “Never in your wildest dreams do you ever think this could happen,” he said.

Bowen died at the hospital five days after he choked, when doctors said he had no chance of recovery; his ventilator was removed so that his organs could be donated.

“That’s what he would have wanted,” his father said.

Levy said he thought the school system would call with an account of the events of Nov. 5. Teachers sent the family cards, and the principal attended Bowen’s service, which was private, Levy said.

But when four weeks went by since Bowen had choked, he wrote the letter to Arlotto.

“Why did Bowen die?” he asked. “What happened? How could this have happened? Where was the supervision on November 5th?”

Levy said the superintendent replied by email, saying he would meet with the family but probably would not be able to answer all of their questions.

According to Levy, he wrote back that the family should be able to get basic facts — whos, whens, wheres — and Arlotto replied that giving details before investigations are completed would not be prudent or fair to anyone involved.

“I need to know what happened to my son so I can do my best to continue living my life,” Levy said. “And more importantly than how it affects me is that every day we don’t get answers and changes aren’t made, it’s putting other children at risk for the same fate as Bo.”

School officials confirmed Arlotto wrote to the family twice, but they declined to discuss what was said or provide emails.

Ashley Levy Hibshman, Bowen’s aunt, said it’s important to know whether staff at the school knew what to do in the critical moments after he began to choke.

“No one wants to point fingers at the staff at the school, but I feel very strongly the lack of transparency from the school system is robbing us of an opportunity to identify areas for improvement and make sure this won’t happen to somebody else’s child,” she said.

She recalled her nephew’s unconditional love and how he would touch a face, hold a hand, lead someone on a walk. “If he loved you, you knew,” she said.

Police have not been involved in the case, said Sgt. Jacklyn Davis, spokeswoman for the Anne Arundel County Police Department. The 911 request was handled as a medical matter, with fire-rescue workers responding, she said.

Fire department records show the school placed a 911 call at 3:10 p.m. Nov. 5, which was quickly raised to a level-one priority; choking was cited. Records released to The Post were heavily redacted because of medical privacy laws, fire officials said.

Michelle Corkadel, president of the Anne Arundel County Board of Education, said in an email that the county’s Department of Social Services was notified at the time of the incident, as required by law. “We continue to do what we can to support Bowen’s family and our students and staff members who have been impacted by this tragedy,” she wrote as the case was under investigation.

Russell Leone, president of the Teachers Association of Anne Arundel County, said recruitment and retention of teachers is challenging overall and especially in special education. Some positions go unfilled in county schools, which leaves other educators to work with larger numbers of students, he said.

Leone said that he did not have information about Bowen’s case but that teachers countywide feel for the Levys.

“Our hearts go out to the family,” he said.

Advocates for students with disabilities said Bowen’s death has gained notice far beyond Central Special.

“It’s just so upsetting to hear about this when it could’ve been, and should’ve been, entirely preventable,” said Lyda Astrove, a longtime advocate for students with special needs in neighboring Montgomery County, who said Bowen’s death stirred concern in online discussions and on Facebook.

“The whole community has been heartbroken for them,” she said of the Levys.

The compulsion to swallow objects is not uncommon in children with autism, Astrove said, which is why supervision is so important. Problems can happen “in a blink of an eye,” and some objects — balloons, gloves, sandwich bags — can block airways if swallowed, she said.

Bowen’s life depended on close supervision, “especially if you know he is prone to putting things in his mouth that are not food items,” she said.

Similarly, Melissa Rosenberg, executive director of the Howard County Autism Society, said the reaction has been a mix of sympathy for the Levys and concern more broadly.

“What it drives home for us,” she said, “is the need for adequate funding for all Maryland schools to ensure there is an appropriate staff-to-student ratio in every classroom, especially for students who need close supervision.”

Nationally, it’s not uncommon for school systems to fall short in meeting obligations that are part of individualized education programs, known as IEPs, said Leslie Seid Margolis, managing attorney at the nonprofit Disability Rights Maryland. But she emphasized that whatever is on the IEP is required by law to be provided.

“They can’t just go to parents and say, ‘We’re sorry, we can’t do this, or we’re not going to do this,’ because everything on the IEP is necessary for that child with disabilities to attend school safely and make educational progress,” she said.

For the Levy family, autism has been a cause for years.

In 2007, hoping to ease financial strains faced by families of children with autism, they founded the Bowen Foundation for Autism, which provides grants to help pay for medical appointments, therapy sessions, summer camps, safety equipment and other needs. The foundation has raised more than $400,000.

Since November, more than $50,000 has been donated in Bowen’s memory.

At Central Special, the Bowen Foundation stepped up to cover the cost of equipment for a therapy room eight or so years ago, Bryan Levy said.

Now, he said he finds it “appalling” that a charitable organization funded what was needed for the school system’s most vulnerable students.

Levy said over the years he has had “nothing but love and respect” for teachers and therapists at his son’s school.

“The problem is, they are completely undersupported,” he said.

School system officials said they had no comment on Levy’s assertions about resources or support at Central Special.

Levy said the family is speaking out about Bowen as a way to help other children.

“Hopefully,” he said, “it will be that he affects many, many, many children and families moving forward because the county recalibrates these kids’ importance and the care that they need.”