ST. LOUIS - A 9-year-old who struck his teacher in the chest has been handed over to juvenile court after the St. Louis medical examiner ruled the death a homicide.

Homicide detectives have recommended that the boy, who was not identified because of his age, be charged with involuntary manslaughter under the juvenile code. The court will decide later this week what to do with the boy.

Substitute teacher Nedra Morris, 51, died Oct. 10 after the fourth-grader at Marshall Elementary School struck her in the chest after refusing to do an assignment she'd given the children, police said. She collapsed shortly afterward.

The medical examiner, Dr. Michael Graham, found Morris had significant heart disease due to high blood pressure. But, he said, her condition was aggravated by the physical exertion and emotional stress of the altercation, as well as by the blows to her chest.

The juvenile court has several options, ranging from releasing the boy to charging him and holding him in custody for several years.