updated 11/15/2006 7:31:09 PM ET 2006-11-16T00:31:09

All five Amish girls who survived last month's schoolhouse massacre that killed five of their classmates suffered severe gunshot wounds with long-term implications, a physician familiar with their medical treatment said Wednesday.

Two were severely wounded in the head, said Dr. D. Holmes Morton, a pediatrician and director of the Clinic for Special Children in Strasburg.

A neurosurgeon told him about a week ago that one of the two was expected to remain in the rehabilitation facility at Children's Hospital of Philadelphia until December. The other is living at home, being tended to by her family, but her prognosis is not good, said Morton, who has been closely involved in her treatment.

"Hers is almost a case of palliative care," he said.

Morton said the other three survivors have "face and limb wounds that will be disabling for a long time, if not permanently."

"They're kids who are pretty damaged and will have long-term consequences for these wounds," he said.

Morton described the girls' injuries to The Associated Press on Wednesday, the first time a physician with firsthand knowledge of their care talked about their recoveries.

Morton's clinic is about four miles from the scene of the Oct. 2 attack at West Nickel Mines Amish School in which five girls were killed. The 32-year-old gunman, Charles Carl Roberts IV, committed suicide as police surrounded the one-room Amish schoolhouse where he had barricaded himself.

One girl's shoulder joint was so badly damaged she may not recover the use of her arm. Another girl was wounded in the face, but did not suffer brain damage and is recovering "pretty well." There were also pelvic and hand wounds, he said.

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