A woman who was severely injured when a gunman killed five girls and wounded her and four other girls during an attack on their one-room Amish schoolhouse in Pennsylvania has died 18 years later.

The Associated Press reported Rosanna S. King, 23, died at her home Sept. 3 in the farming community of Paradise. She was among those shot at the West Nickel Mines Amish School in October 2006.

Charles Carl Roberts IV, a 32-year-old milk truck driver, barricaded himself inside the schoolhouse and let boys and several adults go as he tied up 10 girls and shot them before taking his own life.

Rosanna King, who belonged to an Old Order Amish Church community, was 6 years old at the time and was the most severely injured survivor. She had been shot in the head, leaving her unable to talk and needing a tube to be fed. She was dependent on others for personal care and mobility.

A year afterward, her family said in a statement she was able to recognize family members, smiled a lot and had limited physical movement. They said in 2007 that “the hardest part has been to see her suffer.”

Roberts’ mother, Terri Roberts, regularly visited Rosanna King, inspired by the forgiveness the Amish community expressed to her and her family after the attack.

The schoolhouse was torn down 10 days after the killings and a new one constructed nearby.