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Rebecca Cadogan, a contact supervisor for Barnardos Dunedin, told Chief Coroner Judge Deborah Marshall the children were "quiet and withdrawn'' during the first meeting at Barnardos Dunedin on November 13, 2013.
Earlier, the court heard Livingstone had been drinking alcohol in the hours before he shot his children, Bradley (9) and Ellen (6) Livingstone in their beds on January 15, 2014, in the St Leonards home the children shared with their mother.
Despite this he was well under the legal limit to drive and the dosage of antidepressant in his blood was below the therapeutic dose, the court heard.
Blood analysis taken after he died found 47mcg of alcohol per 100ml of blood. The legal limit for drink driving at the time was 80mcg.
Anne Stevens, counsel for Katharine Webb, said the evidence to date painted a picture of Mr Livingstone "deliberately deceiving'' healthcare professionals.
His one-time flatmate, Philip Mans, said he felt Livingstone "played'' him to gain access to the firearm used to kill his children.
"I believe Mr Livingstone manipulated me quite well with his behaviour leading up to this,'' he said.
Livingstone shot Bradley and Ellen with a 12-gauge Stoeger shotgun.
He was found dead in the bedroom he formerly shared with his estranged wife, Ms Webb; a shotgun was found next to his body.
Livingstone stole the Stoeger shotgun used in the shooting from his one-time flatmate Philip Mans.
Livingstone stole the gun from Mr Mans' firearms cabinet using a key to Mr Mans' Milton house which was stolen at an earlier date, the court heard yesterday.
Dr David Chaplow told the coroner's inquest it appeared Livingstone was weighing up his options in the days leading up to the killings.
Livingstone spoke to his new partner, Karen Wright, while drinking on a park bench little more than an hour before he shot his children with a 12-gauge shotgun, Dr Chaplow said.
"What we know from the lady friend [Ms Wright] is by half past 8[pm on January 15, 2014] he was sitting in a park feeling quite morose and thinking about what he's going to do,'' he said.
It appeared Livingstone was "hedging his bets" for sometime before the killings.
"It seemed to me he had been thinking about his options, so to speak, for a day or two - hence stealing the gun, stealing they key,'' Dr Chaplow said.
Despite a number of "red flags'' coming to the attention of the clinicians dealing with Livingstone, the slayings were ultimately unavoidable, Dr Chaplow said earlier today.
Robin Bates QC, counsel for police, asked "if somebody makes up their mind to do this sort of thing, there's a high likelihood they will do this despite all the interventions, is that a correct comment?''.
"That is a correct comment,'' Dr Chaplow said.
Livingstone seemed to "impression manage'' his clinicians, not allowing them to gain a full insight to his personality.
"Different people had their own snapshots of those personality characteristics,'' he said.
"Some saw him as self-serving, others as deceptive, others as an alcohol abuser, others as narcissistic, but others as . . . a loving father,'' he said.
Livingstone's duplicity became apparent during day one of the inquest when the court heard he had deceived his psychiatrist Dr Christopher Wisely.
A co-worker told the court on Tuesday she felt Livingstone knew "what to say to the right people to get them off his back''.
This morning the court also heard that the Department of Corrections, Livingstone's employer, were aware of his diagnosis of narcissistic personality disorder, that he often smelt of alcohol at work, he often appeared dishevelled, he presented real risks, gave bullet casings to his children as a gift and had breached his protection order twice.
Despite this Corrections did not dismiss him from employment, Mark Godwin, of Corrections, said.
Corrections did not know Livingstone had convictions in Australia or had raped Ms Webb.
Livingstone was convicted of arson and assault in Australia in 1988.
In May 2013, Livingstone trapped Ms Webb in their bedroom and brutally raped her over a period of five hours, even as their distraught daughter banged on the door.
Police were made aware of that information when they attended an incident at the residence on May 27, 2013.
Ms Webb sought a protection order and it was first issued on May 31, 2013, and finalised on August
On August 7, 2013, Livingstone breached the order for the first time.
While reporting the matter to police, Ms Webb presented a number of empty bullet cartridges which Livingstone had given to Bradley and Ellen during an earlier supervised visit.
Police disposed of the cartridges and did not take the matter further.
Livingstone's one time flatmate Philip Mans, the owner of the shotgun used in the shooting, is expected to give evidence later today.
The court also heard Livingstone's depression was "atypical'' and his happiness tied to the hope of reconciling with his estranged wife
Dr Chaplow said Livingstone's depression was not biological and his responsiveness to medication was too convenient.
The inquest into Livingstone's death and that of his children, Bradley and Ellen, is now in its third day.
Livingstone had twice breached a protection order preventing him from contacting Ms Webb in the months before the deaths.