An Ohio mother whose 16 children were rescued from appalling conditions pleaded not guilty to child endangerment and neglect charges in court on Wednesday.

Elizabeth Siders, 34, is one of four family members, including her husband, Gary Siders Jr, charged with 16 charges of child endangerment and neglect after investigators found the children, who were 17 months to 18 years old, in “deplorable conditions” at the decrepit family home in the tiny village of Hamden in July.

The children appeared “almost feral” after having been confined to one 12ft-by-12ft room among human waste for much of the past four years, authorities said. They did not attend school, and some were unable to speak at all. The eldest was developmentally disabled and could not even spell her name.

During her appearance at Vinton county court on Wednesday, Siders pleaded not guilty to all counts. The judge deemed her a flight risk and raised her bond from $250,000 to $550,000.

She and her husband, with whom she has been ordered to have no contact, have also been indicted in a separate case involving two counts of sexual battery and two counts of unlawful sexual conduct with a minor.

Gary Siders Jr pleaded not guilty in August. Last week his father, Gary Siders Sr, was found incompetent to stand trial. Elizabeth Siders, Gary Siders Jr and his mother, Christina Siders, have also filed competency evaluation requests.

The alleged victim was not one of the couple’s children, but another relative between the ages of 13 and 16, according to a copy of the indictment obtained by People, who was in their care for a period in 2022. The charges were among those that Elizabeth Siders pleaded not guilty to on Wednesday.

Birth records obtained by local media outlet ABC6 show that Siders gave birth to a child in February 2022, when the alleged abuse was taking place. She also gave birth prematurely to twins in November 2022, who died shortly after birth.

Her attorney, Tommy Stolly, told the court that his client still asks to see her children. The judge has ordered no contact.

Stolly also argued that she had been pregnant for most of her life since getting married at 15 and had never received proper postpartum care, leaving her “suffering from mental health issues”, leaving him with “competency concerns”.

“We have an individual … who was married at age 15, who has essentially been pregnant for the better part of two decades … [Siders] has never fully gone through any postpartum period and has not been receiving regular medical care that would be appropriate for someone who has had 16, 18 children,” he told the court.

“So, I have concerns about what effects those have had on her, what effect it has had on being married at such a young age, being contained within the environment of the Siders household, and essentially not knowing any life outside of it.”

They have therefore asked for a competency evaluation, which is still pending and will determine the next steps in the case.

“We are not saying that there’s any conduct at this point that has been proven, certainly, by the state to be illegal, but if her mindset was not there, and she didn’t have the ability or the capacity to understand it and make decisions in an informed way, that could certainly negate legal liability,” Stolly said.

There is also speculation that Siders is currently pregnant again, after she appeared in court without handcuffs. Her attorney declined to comment when approached by a reporter from the Columbia Dispatch.