Reflections on Sandy Hook

An Analysis of the Findings from CCFRP
by Dr. Yael Banai

[Editor’s Note: This article concerns the findings in reports by the Office of the Child Advocate regarding the shootings at Sandy Hook Elementary. The reports were by the State of Connecticut. Dr. Yael Banai is a member of the Louisiana Coalition for Violence Prevention, and a contributing reporter to the Times. Her PhD is in Educational Psychology and she is a Nationally Certified School Psychologist. She is past president of the Louisiana School Psychological Association.]

On the morning of December 14, 2012, armed with two powerful handguns and three rifles, one of which was a Bushmaster AR 15 (a military assault rifle), after having pumped four rounds into his mother’s face as she slept, 20 year old Adam Lanza shot open the locked entrance doors of the Sandy Hook Elementary School in Newton, Connecticut. Responding to the commotion, the school psychologist and the principal ran towards the sound and were shot dead on the spot by the gunman. Lanza proceeded to the first grade classrooms. Before he put one of the pistols in his mouth, he slaughtered 20 defenseless six-year olds and four adults. The entire rampage took 8 minutes.

Directed by the Connecticut Child Fatality Review Panel, the Office of the Child Advocate prepared two reports on the massacre which were published this past November, one of which focuses on a review of the circumstances which led to Lanza’s act of mass murder at Sandy Hook Elementary. The authors chronicle Lanza’s educational and medical histories and observe that all along the way there were “red flags” signaling disaster. However, they are quick to point out that they did not conclude that those factors, either singly or together, added up “to an inevitable arc leading to mass murder… In the end, only he and he alone, bears the responsibility for this monstrous act.”

Among the several “red flags” in Lanza’s history are significant failures of the educational and mental health systems to coordinate their efforts to compose and enact a thoroughgoing, comprehensive set of interventions, both educational and therapeutic, to address Lanza’s significant needs, particularly in terms of social interaction and unmet behavioral and emotional concerns.

Reviewing Lanza’s special education classification and IEP [Individual Education Plan] history, which included services that begun in the “Birth to Three” category in New Hampshire, it appears to this aging school psychologist that the evaluation teams consistently missed correctly classifying this young man. Despite a reported history of early seizure activity, behavioral dyscontrol (repeated temper tantrums including head-banging), a suspected “sensory integration disorder” and significant speech-language deficits which required that his mother act as interpreter for the examiners during his preschool evaluation, Lanza’s earliest classification which continued through to middle school was Speech Language Impairments, for which minimal services of speech and articulation therapies were offered once or sometimes twice a week.

Although Lanza’s difficulties were significant enough for his mother, Nancy, to quit her job to be at home with him full time, it did not seem that she pushed for additional assessment, except when the Connecticut evaluators deemed that his speech difficulties did not interfere with his educational progress and withdrew services. An independent evaluation was sought and speech services were resumed.

However, it should be noted that during this period, Lanza was diagnosed (according to his mother’s report) with a “sensory integration disorder.” He was observed to resist participating in group activities, to speak and interact with peers on a very limited basis, and to engage in “repetitive behaviors.” Somehow the evaluation team apparently did not consider inviting a school psychology consult. No consideration or evaluation of the possible presence of an Autism Spectrum Disorder (which surely would have been signaled at a minimum by the “sensory integration disorder”) was apparent.

What consistently struck me throughout this review was a persistent minimizing of the magnitude of this young man’s difficulties both through mis-classification and restricting his IEP recommendations to speech language and occupational therapy concerns. (Clearly the commission authors thought so too.) Although Lanza appeared to attend elementary school with noted supports in speech and OT (occupation therapy), and participated in the usual age appropriate activities such as soccer, his condition markedly deteriorated in his early adolescent/middle school years to the extent that Mr. Lanza (who was separated and eventually divorced from Mrs. Lanza) requested an evaluation through the Yale Child Study Center.

By far the most comprehensive evaluation to this point, identifying both an Autism Spectrum Disorder as well as Anxiety and Obsessive Compulsive Disorder with possible attendant Depression, the Yale evaluators recommended extensive mental health and special education supports as well as mediations to ease Lanza’s obsessive compulsive symptoms. Presciently, the Yale evaluator noted that should appropriate and extensive therapeutic interventions not be implemented, a deteriorating spiral of functioning was predicted with a poor outcome.

Lamentably, Mrs. Lanza did not accept the Yale conclusions and terminated a brief attempt at medication (Celexa for three days) due to side effects which the consulting psychiatric nurse did not conclude were due to the mild dose of the medication. Mrs. Lanza terminated the relationship with the center and sought consultation with a “community psychiatrist” who ultimately provided her with the necessary documentation for provision of “hospital homebound services” through the school system.

However, as the commission authors noted, these services were woefully inadequate, primarily consisting of speech/language services proffered once per week. Lanza’s classification by that time had morphed into “Other Health Impairments.” Given his diagnoses which may or may not have been shared with the school system (for example, the commissioners noted that the Yale Child Study evaluation was neither referenced in the educational record, nor did it appear in his file) this seems entirely inappropriate on so many accounts. Although it should be pointed out that an IEP is not driven by a classification but rather should be crafted from the child’s listed strengths and needs in the evaluation, a classification does often signal to staff a level of intervention. Clearly, given the information in the commission’s report, Lanza could have been classified both as a student with Autism and Emotional Disturbance. Doing so would have given a clear signal to the school that a significant level of intervention was necessary.

Throughout his life apparently, Mrs. Lanza sought to insulate Adam from the “slings and arrows” of daily life, which had the damaging effect of isolating him from the outside world–and permitted him to indulge in his worst proclivities. As time wagged on, she also tended to treat him as a confidant. As the report notes, it was a dynamic of mutual dependency. Mrs. Lanza’s hypervigilance and micromanaging of his life coupled with the rejection of the psychiatric advice of the Yale Child Study Center had the effect of unwittingly sabotaging opportunities for her son to get better.

Other red flags lay in Lanza’s growing obsession with violence, as exemplified by his writings in middle school. One project, called the Big Book of Granny, chronicled the adventures of a homicidal shotgun toting grandma––who at one point says “lets hurt children”––while at the same time abuses her son and cohort. In the end, the son shoots Granny in the head with a shotgun. In seventh grade, Lanza’s teacher at the private school where he was placed for a year observed that his writings were so graphically violent that “they could not be shared.” Indeed, Lanza returned to public school upon mutual agreement that he withdraw from the private school setting.

Finally, one must wonder what on earth Mrs. Lanza’s thought process was to continue to allow her son access to high powered weaponry. (Apparently, “firearms and target shooting were a pastime for the Lanza family.”) Despite his deteriorating condition and virtual complete withdrawal to his “lair” in the basement with blacked out windows, Lanza had unfettered access to the guns, which included the Bushmaster XM-15, capable of sustained bursts of fire of 45 rounds per minute. After having found a compliant psychiatrist who, contrary to the advice of the Yale Child Study, recommended homebound services, Lanza consumed his days with online gaming (“Call of Duty” seems to have been a favorite as well as “School Shooter”) as well as participating in chatrooms dealing with mass murder.

Completely unaddressed was also Lanza’s Anorexia Nervosa. At the time of his death, at six feet tall, he weighed 112 pounds and was “aneorexic to the point of malnutrition and resultant brain damage.” It seems that even in this Mrs. Lanza was oddly compliant. Pediatric well visits had ceased in late adolescence, shortly after the termination of services with the Yale Center. It would appear that in catering to his disabilities as opposed to obtaining treatment for them, Lanza spent his days indulging his whims, spiraling ever downward into the rage that exploded in the only place (Sandyhook Elementary) he had ever been marginally happy.

For some years now in my practice as a school psychologist, when encountering students with serious behavioral issues, including depression, one question I routinely ask the parents is whether or not they have weapons in the house. In Lanza’s instance I would have immediately thought, given the depression, of the possibility of suicide. As the drama unfolded, not only did he engage in a hideous school shooting, but began his rampage with matricide, also a fairly rare occurrence. And had he at that point, turned the weapon on himself, we would have never heard of him. Lamentably, he only resorted to this eventuality after having decimated 20 first-graders and their teachers. That Nancy Lanza not only allowed but promoted Lanza’s access to military style weapons (or, frankly any weapons) is, in a phrase, an appalling lack of judgment.

The OCA report rightly points out the missed opportunities in this case. To say that there were “red flags” here seemed to me a gross understatement.

Among the documents investigators discovered in the Lanza home, one speaks saliently to this issue. In what possibly was her last act in life, Nancy Lanza had written a check to Adam––a Christmas gift––for the purchase of a handgun. Blind to the last.

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