A message left outside the News Malden house of Gary and Tania Clarence. Picture: Handout/Supplied

Pretoria - A South African mother accused of killing her three disabled children in her London home has been further remanded in a secure hospital for four weeks.

Tania Clarence, 42, was not at the Old Bailey to hear judge Sir Andrew Nicol extend her stay until the end of June when her case will be reviewed.

Clarence is accused of murdering three of her four children, twins Ben and Max, three, and Olivia, four, in their family home in south London last month.

The trio suffered from type 2 spinal muscular atrophy or “floppy baby syndrome” which leaves its victims with little muscular strength and can lead to early death.

She was released from custody at a previous hearing and instead ordered to receive treatment at a secure unit where she will remain for at least the next four weeks.

She was said to be at risk of suicide.

On April 29, during her first court appearance Clarence looked pale and fragile as she appeared via video-link at the Old Bailey.

Wearing black jeans and a black zip-up fleece jumper, her voice shook with emotion as she confirmed her name at HMP Bronzefield in Surrey.

Judge Brian Barker, the Recorder of London, allowed Clarence to be released from prison under the Mental Health Act.

He told the Old Bailey he made the unusual move because it was an “exceptional case” and to allow her to receive hospital treatment.

He said: “There is a combination of circumstances here that makes this an exceptional case and allows this court to take an exceptional course. It isn’t bail, but what we are doing is ordering for her to be subject to a Section 35 Order under the Mental Health Act, so she can then be remanded effectively for review of her condition.”

Gary Clarence, 43, flew from South Africa for his wife’s court appearance after a holiday with their eldest daughter to celebrate her eighth birthday.

Police were called to the family’s five-bedroom home in Thetford Road in the wealthy south west London suburb of New Malden at 9.30pm on April 22 where they discovered the bodies.

Clarence was treated for cuts and later arrested. - Pretoria News Weekend