Health Treatment & Crisis Prevention and Intervention
Question Description
Crisis Prevention and Intervention
Examine the recommended findings on pages 80–94 of the State of Connecticut’s Office of Child Advocate report, “Shooting at Sandy Hook Elementary School.” Include the following in your post:
Identify the recommendations you believe are most pertinent.Health Treatment & Crisis Prevention and Intervention
Theorize about what might have been missed with the gunman, Adam Lanza, that could have prevented this tragedy.
Evaluate the role the current school systems play in preventing tragedies such as this, based on the recommendations
Evaluate how coordination of care between the family, school, and community was lacking.
Create a plan outlining how coordination of care between the family, school, and community could help prevent tragedies such as this one in the future.
Provide validation and support for assertions by including relevant examples and supporting evidence.
ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT: Capella University Health Treatment & Crisis Prevention and Intervention HW Assignment
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SHOOTING AT SANDY HOOK ELEMENTARY SCHOOL
REPORT OF THE OFFICE OF THE CHILD ADVOCATE
November 21, 2014
DEDICATION
The authors of this report submit this work with acknowledgement of the 27 individuals murdered
on December 14, 2012, and the terrible and incalculable loss suffered by all victims. Authors convey
condolences for these losses and the grief that continues to be felt by the victims, families, and the
community. We acknowledge and honor the lives of the twenty first graders who died at Sandy Hook
Elementary School; they have been the sole reason for this report.Health Treatment & Crisis Prevention and Intervention
Avielle
Ana
Allison
Benjamin
Caroline
Catherine
Charlotte
Chase
Daniel
Dylan
Emilie
Grace
Jack
Jesse
Josephine
Jessica
James
Madeleine
Noah
Olivia
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STATEMENT FROM THE AUTHORS
In January, 2013, the Office of the Child Advocate was directed by the Connecticut Child Fatality Review
Panel to prepare a report that would focus on Adam Lanza (hereinafter referred to as AL), and include a
review of the circumstances that pre-dated his commission of mass murder at Sandy Hook Elementary
School. The charge was to develop any recommendations for public health system improvement that
emanated from the review. Authors of this report focused on AL’s developmental, educational, and
mental health profile over time, the services he received from various community providers, and
ultimately his condition prior to his actions on December 14, 2012.
Authors looked for any warning signs, red flags, or other lessons that could be learned from a review of
AL’s life. It was not the primary purpose of this investigation to explicitly examine the role of guns in the
Sandy Hook shootings. However, the conclusion cannot be avoided that access to guns is relevant to an
examination of ways to improve the public health. Access to assault weapons with high capacity
magazines did play a major role in this and other mass shootings in recent history. Our emphasis on AL’s
developmental trajectory and issues of mental illness should not be understood to mean that these issues
were considered more important than access to these weapons or that we do not consider such access to
be a critical public health issue.
It is important to state at the outset that this report is crafted with recognition of the lives lost on
December 14, and authors have a deep sense of compassion for the families of the children and adults
who were murdered by AL. To honor the terrible loss of life, authors strove to create a comprehensive
and candid report that we hope will inform approaches to making other children, families, and
communities safer in the future.
This report will identify missed opportunities in the life of AL. Authors underscore however that only
AL was responsible for his murderous actions at Sandy Hook. There can be no direct line drawn
between one entity or person’s actions and a mass murder. This report cannot and does not answer
the question of “why” AL committed murder. This report focuses on how to identify and assess youth
from a very young age, the importance of effective mental health and educational service delivery, and
the necessity of cross-system communication amongst professionals charged with the care of children.
Additionally, because the work of this report tracks AL from birth to the mass shooting the authors
described AL in what appear to be human terms. Authors acknowledge that the telling of AL’s story may
be painful for some readers, especially those irrevocably harmed by his terrible actions. However, the
report required a review of AL’s life to address interventions and services that could have and should
have been delivered over the course of his life. This report does not seek to draw any link between mental
illness and violence, or between persons with autism and violence. As stated later in the report, there are
millions of individuals with mental illness or developmental challenges in this country and worldwide,
and a very small percentage of these individuals will engage in any act of violence, much less violence on
a horrific scale. AL was an individual with mental illness and he was an individual who was diagnosed as
having Autism Spectrum Disorder. This report outlines this story and makes recommendations
accordingly. It is vital to note that AL was completely untreated in the years before the shooting and did
not receive sustained, effective services during critical periods of his life, and it is this story that the report
seeks to tell. .
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Table of Contents
ACKNOWLEDGEMENTS ………………………………………………………………..5
EXECUTIVE SUMMARY ………………………………………………………………..6
INTRODUCTION ………………………………………………………………12
ADAM LANZA’S EDUCATION, MENTAL HEALTH, AND DEVELOPMENT
Early Years ………………………………………………………………………………….15
Summary and Recommendations …………………………………………………………….21
Elementary School……………………………………………………………………………24
Summary and Recommendations…………………………………………………………….31
Middle School…………………………………………………………………………………36
Summary and Recommendations……………………………………………………………..44
High School ………………………………………………………………………………….48
Summary and Recommendations……………………………………………………………..80
2010 to 2012………………………………………………………………………………….96
FINAL STATEMENT……………………………………………………………………..106
APPENDIX………………………………………………………………………………..109
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ACKNOWLEDGEMENTS
Many individuals contributed to the development of this report.
Primary Authors Include
Sarah Healy Eagan, J.D., Child Advocate State of Connecticut, Office of the Child Advocate
Faith VosWinkel, M.S.W., Assistant Child Advocate, Office of the Child Advocate
Julian D. Ford, Ph.D, Dept. of Psychiatry, Center for Trauma Recovery and Juvenile Justice
University of Connecticut Health Center
Christopher Lyddy, L.C.S.W., C.O.O., Advanced Trauma Solutions, Inc.
Harold I. Schwartz, M.D., Psychiatrist-in-chief, Institute of Living, Hartford Hospital, Connecticut
Andrea Spencer, Ph.D., Dean, School of Education, Pace University
Additional Contributors Include
Kirsten Bechtel, M.D., Yale New Haven Hospital
Kathleen Costello, MSW Candidate, University of Connecticut School of Social Work
Jeffrey Goldberg, Copy Editor
James W. Loomis, Ph.D., The Center for Children with Special Needs, Glastonbury, CT
Felicia McGinniss, Law Student, University of Connecticut School of Law
Michael D. Powers, Psy.D., Director, CCSN: The Center for Children with Special Needs & The
Center for Independence, Glastonbury, CT
Colleen Shaddox, Communications consultant
Paul Weigle, M.D., Child and Adolescent Psychiatrist, Natchaug Hospital
Additional Acknowledgements
The Office of the Child Advocate would also like to extend thanks to the following individuals and
organizations for assisting with the development of this report:
Connecticut State Police
Federal Bureau of Investigation
Members of the State Child Fatality Review Panel
Nina Rovinelli Heller, Ph.D., Professor, University of Connecticut School of Social Work
Patricia Llodra, First Selectwoman, Town of Newtown
State’s Attorney’s Office, Judicial District of Danbury
U.S. Attorney’s Office, District of Connecticut
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EXECUTIVE SUMMARY
On Friday, December 14, 2012, our state and nation were stunned by the overwhelming tragedy at
Sandy Hook Elementary School where twenty children and six educators were shot in their school.
AL, who had already shot his mother in their home, also shot himself.
In the immediate aftermath of this terrible event, state and federal law enforcement agencies began
investigating the circumstances leading up to the shooting. On January 30, 2013, the State Child
Fatality Review Panel (CFRP)–charged with reviewing the sudden and unexpected death of childrendirected the state Office of the Child Advocate (OCA) to investigate the circumstances leading to the
death of the children at Sandy Hook, with a focus on any public health recommendations that may
emanate from a review of the shooter’s personal history. The Office of the Child Advocate, with the
assistance of co-authors and consultants, reviewed numerous subjects pertinent to the charge from
the CFRP, including:
• The mental health, developmental and social history of AL from his birth to the days
before the shootings at Sandy Hook Elementary School.
• The educational record of AL, including documentation of needs and services provided.
• The medical history of AL from childhood to adulthood.
• Relevant laws regarding special education and confidentiality of records and how these
laws implicate professional obligations and practices.
OCA began a comprehensive collection and review of records related to the life of AL—including
his medical, mental health and education records, as well as un-redacted state police and law
enforcement records. OCA reviewed thousands of pages of documents, consulted with law
enforcement and members of the Child Fatality Review Panel, conducted interviews, and
incorporated extensive research to develop the report’s findings and recommendations.
Key Findings
1. AL presented with significant developmental challenges from earliest childhood, including
communication and sensory difficulties, socialization delays, and repetitive behaviors. He
was seen by the New Hampshire “Birth to Three” intervention program when he was almost
three years old and referred for special education preschool services.
2. The Newtown Public Schools also provided some special education services to AL when he
was in elementary school, but services were limited and providers did not identify any
communication or social-emotional deficits
3. AL’s social-emotional challenges increased after fourth grade.
4. There were early indications of AL’s preoccupation with violence, depicted by extremely
graphic writings that appeared to have been largely unaddressed by schools and possibly by
parents.
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5. AL’s anxiety began to further impact his ability to attend school and in 8th grade he was
placed on “homebound” status through his education plan—a placement for children that
are too disabled, even with supports and accommodations, to attend school.
6. AL had several sessions with a community psychiatrist between age 13 and 15, though there
are no medical records regarding this physician’s treatment. Through brief correspondence
with the school the psychiatrist supported Mrs. Lanza’s desire to withdraw AL from the
school setting in 8th grade.
7. The district provided little surveillance of AL’s homebound status, which lasted an entire
school year.
8. Recommendations from the Yale Child Study Center, where AL was evaluated at age 14
(AL’s 9th grade year), offered prescient observations that withdrawal from school and a
strategy of accommodating AL, rather than addressing his underlying needs, would lead to a
deteriorating life of dysfunction and isolation.
9. Medical and education records reflect repeated reference to AL’s diagnosis of Autism
Spectrum Disorder, Anxiety, and Obsessive Compulsive Disorder.
10. Records indicate that Mr. Lanza made efforts after the Yale Child Study evaluation to seek
treatment, appropriate care coordination, and education planning for AL.
11. Yale’s recommendations for extensive special education supports, ongoing expert
consultation, and rigorous therapeutic supports embedded into AL’s daily life went largely
unheeded.
12. AL’s resistance to medication recommended for treatment of his Anxiety and Obsessive
Compulsive Disorders appeared to be reinforced by his mother. According to records, AL
disagreed with his Asperger’s diagnosis and may not have understood the benefit of
individual therapy.
13. Once AL was diagnosed, AL’s education plan did not appropriately classify his disabilities
and did not adhere to applicable guidelines regarding education for students with either
Autism Spectrum Disorders or Emotional Disturbance.
14. Though AL showed initial progress in 10th grade with the school’s plan to incrementally
return him to the school environment, his progress was short-lived. By the spring of that
year, AL had again withdrawn from most of his classes and had reverted to working on his
own or with tutors.
15. AL’s parents (and the school) appeared to conceptualize him as intellectually gifted, and
much of AL’s high school experience catered to his curricular needs. In actuality,
psychological testing performed by the school district in high school indicated AL’s
cognitive abilities were average.
16. AL completed high school through a combination of independent study, tutoring, and
classes at a local college.
17. Records indicate that the school system cared about AL’s success but also unwittingly
enabled Mrs. Lanza’s preference to accommodate and appease AL through the educational
plan’s lack of attention to social-emotional support, failure to provide related services, and
agreement to AL’s plan of independent study and early graduation at age 17.
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18. AL and his parents did not appear to seek or participate in any mental health treatment after
2008. No sustained input from any mental health provider is documented in AL’s
educational record or medical record after 2006.
19. Though AL was profoundly impaired by anxiety and Obsessive Compulsive Disorder, his
parents may not have understood the depth or implications of his disabilities, including his
need for ongoing support.Health Treatment & Crisis Prevention and Intervention