34. Emergency

Summer 2005

36 Yogananda — Sandy Hook, Connecticut

Nancy did the laundry. Adam would leave his dirty clothes in a basket in the upstairs bathroom, under the counter, for her to pick up on her way downstairs. That bathroom was really his, ever since his older brother moved down to the basement; Nancy had her own, in the master bedroom at the other end of the hall.

Over the summer, Nancy noticed something: the baskets of Adam’s laundry were filling up faster and faster. She was picking one up every day, sometimes two or three. And it wasn’t like Adam was changing for fashion’s sake — he had taken to wearing the same polo-and-khakis outfit every day (a holdover from his uniform at St. Rose that he “wanted to keep wearing,” despite the circumstances of his exit). It was more that he always stayed inside, fully dressed, wearing his long pants and socks, no matter how hot it got that summer. But with his OCD, he couldn’t stand the possibility that anything touching him was unclean, and so his sweaty clothes would feel “dirty” within hours, and then he would have to change into a new set. His feet were the worst; he was going through twenty pairs of socks a day.

Each time Nancy hauled a basket of socks, khakis and identical shirts down to the basement laundry room, she passed through Ryan’s section 36 Yogananda: a bed at the bottom of the steps, and a bedroom that led to into the rec area. She didn’t have to worry about intruding on Ryan’s privacy much; her older son was usually out of the house, being seventeen and about to start his senior year at Newtown High School. Nancy and Peter had been talking about his plans for the future; with his grades, and his father’s salary, Ryan could pursue just about any career he wanted. Ultimately, he would choose much the same path his father had taken: a Bachelor of Science degree in Accounting, followed by a job at Ernst & Young. Adulthood was in sight, and all was going according to plan.

The contrast between him and his younger brother was, by this point, very stark. It had been easier to attribute their differences to the four-year age gap when they were growing up, but as the years went by and milestones passed, friends of the family noticed Adam wasn’t keeping up. Then, after one year of middle school for Adam, it was like they were not even traveling on the same path anymore.

Part of the reason they had drifted apart during Ryan’s high school years may have been the typical younger-brother syndrome; an event with his friends from the Tech Club wasn’t as fun for Ryan when he had to watch out for his fragile, timid kid brother. But Nancy insisted that Adam tag along now and then; the Tech Club meetings had been one of the few reliable ways to get him to leave 36 Yogananda. He wasn’t just becoming detached from his older brother, he was drifting away from the whole outside world.

* * *

Home was the safest place. Adam wasn’t afraid there. The biggest problem he had with the house, during the warm months, were the windows: too many of them. He didn’t like the heat, but more than that, he hated the light coming through the blinds.

Still, two months of liberation from the school’s bells would have been just what he wanted. He didn’t have to talk to anybody, or be anywhere. He could just stay inside and play video games, and read, and watch movies. If he stayed up late enough, and slept in, he could even miss the next day’s sun entirely.

He started to develop a peculiar taste in film. Alone in his bedroom, he would put on old vintage VHS tapes, running them through an analog TV-VCR combo unit. His favorite cinematic find was Killer Klowns from Outer Space: a campy schlock-scifi horror movie about alien clowns who land on earth and begin killing humans, transforming their victims’ bodies into cotton candy. Best of all, it had an infectious pop-punk theme song, performed by the group The Dickies. Adam loved the tune, and eventually would track down the CD.

Adam got his own computer, and frequently used it to play Counter-Strike — a tactical first-person shooter that was revolutionary at the time for its realism and fast action. In older games like DOOM, an enemy could absorb hundreds of bullets before falling, but in Counter-Strike, one well-placed shot to the head, and they were done. It even took place in modern day, using real guns. And the enemies weren’t a computer program, but other players, somewhere out there online.

But more and more, Adam was on his PC just to browse the internet. He googled, and googled. It provided a nearly perfect remedy for the anxiety he had carried home from Newtown Middle School: he sought isolation, information, and escapism, and all three were abundant in the burgeoning broadband era, and all at his own chosen pace. His bedroom became a custom learning environment, with curriculum tailored exclusively to his idiosyncrasies and interests. He could stay inside for days at a time, if his mom let him.

* * *

Newtown’s 2005-2006 school year was set to start on August 30, and Newtown Middle School was expecting 905 students to be reporting for the eighth grade. To what was surely a profound shock to the sense of safety he had settled into over the summer break, Adam Lanza learned that he was going to be one of them; Nancy was sending him back into the lion’s den.

Her decision to return her son to the school that fall is puzzling, and nothing in Nancy’s or the school district’s files has been found to shed any light on her reasoning. If Adam’s sudden exit from St. Rose of Lima at the end of the previous school year had indeed stemmed from his stance on religion — as he and Nancy claimed — then that conflict was apparently even more insurmountable than the acute anxiety Adam had already displayed when he first had to navigate the halls of Newtown’s much, much larger public middle school.

Given the events that would unfold soon after this decision, it is evident that what Nancy had been planning over the summer would require a paper trail that documented Adam’s inability to attend any school, and so perhaps sending Adam back to NMS was just a step down that path. Or perhaps, for Nancy, the line between real and imagined health issues was starting to blur.

Robert Anthony’s Hair Salon — Newtown, Connecticut

Every four weeks, Adam would get in the car, and Nancy would drive him down the hill for a haircut. Starting in his early teens, the salon they went to was on Church Hill Road, across the street from St. Rose of Lima. The stylist, almost always the same young woman named Jackie, would groom the boy to Nancy’s specifications. Jackie cut Ryan’s hair too, sometimes in the same trip, but the strange thing was, she never saw the brothers actually talk to each other. They seemed to exist in the same orbit — and never intersect.

The more Jackie thought about it, the less she was surprised. The two brothers were just so different. She knew Ryan; he was seventeen, and was into some of the same music that she was into, so every once in awhile they’d run into each other at a show. He’d always be friendly. “He was a nice, sweet, intelligent shy guy,” she would say of Adam’s brother.

But with Adam, it was like talking to an empty room. When his turn came in the barber’s chair, he would walk across the hair salon with that awkward gait of his, his over-sized shirt billowing like a tent, and he’d desperately avoid eye contact with her or anyone else in the room. Upon taking his seat, he would immediately look straight down, and place his hands in his lap.

Nancy gave Jackie special instructions to follow whenever cutting Adam’s hair: don’t shampoo him in the sink, like most clients. Use a spray bottle to wet him down, and keep him seated. Her instructions on how to style Adam’s hair were always the same — what Jackie summarizes as “take an inch to 1/2 inch off and leave the bangs a certain length, more in his face.” Sometimes, Nancy made corrections: “I don’t like it. Cut it shorter, trim his sideburns.” Jackie would do as Nancy said, but when selecting from her barber’s tools, she knew the loud electric clippers were pretty much out of the question; whenever she turned them on, Adam would literally cower in fear.

At some point, Ryan (or it may have been Nancy; the hairdresser isn’t sure) explained to her how to talk to Adam. “He’s very intelligent,” they told her, so Jackie should just “talk to him normal.” The only thing was, don’t expect much of a conversation in return. For him, that’s normal.

Indeed, when Jackie followed the advice and started talking to Adam while snipping his locks, he remained near-silent. “He would never return [the conversation] with anything other than one-word answers,” she remembers, and he would dip his head down when he spoke; “The answer would be in a soft whisper, not a completed word, but enough that I could understand what he would say.”

After the haircut, when Jackie asked Adam if he was happy with his appearance, Nancy would step in to answer on his behalf. If she was happy with Jackie’s work, her son would rise from the barber’s chair, and rigidly walk back to the front door, where he would wait for Nancy. He can not wait to leave, Jackie would remember thinking. But his mom wanted him to be presentable.

September 19, 2005

Pediatrician’s Office, Fairfield County

Adam went for a doctor’s visit. Nancy told the pediatrician that she was concerned her son wasn’t sleeping well, and as a result was “sleeping a lot during the day,” and she noticed he wasn’t eating well, either. He had been back at Newtown Middle School for less than a month.

Adam stepped onto a scale: 98 pounds. The nurse measured his height at 5 feet and 8 inches, and this corresponded to a Body Mass Index (BMI) of 14.9; Adam wasn’t just a skinny kid, anymore. At age 13, he fell in the lowest single BMI percentile of boys his age. And as he continued to grow taller, his already-meager flesh would be thinned even more.

Nancy’s son’s appearance made him stand out, a bad setup for someone who was terrified of attention. His eyes would bug out when he was frightened — and so groups of people would inevitably notice him, as the boy with the bugged-out eyes. Meanwhile, his rotating wardrobe of identical blue polo shirts, and grey hoodies, just seemed to get baggier.

His day-to-day behavior was noticeably peculiar, too: he carried a box of tissues with him at school, using them to cover doorknobs or other metal objects he didn’t like to touch. If he ran out of tissues, he would pull the baggy sleeve of his hoodie over his hand. And if he heard someone on the other side of a door, Adam would wait until he heard the unidentified person go away before he entered the room — just to avoid another social interaction.

Danbury Hospital — Emergency Room

It was on a school day, somewhere between the 21st and the 30th of September that year, when it all finally fell apart. The fear engulfed Adam and he would not, or perhaps could not, go to school even one more day. Nancy took him to the emergency room at Danbury Hospital instead.

The ER doctors took in what they observed to be a very agitated 13-year-old boy, “anxious,” “withdrawn,” and “hesitant to be touched.” Their assessment further recorded that Nancy’s son “presented as agitated, hyper-vigilant, and overwhelmed with fear,” and that he had been admitted by his mother because of the anxiety episodes he was experiencing. She said he was “having trouble in school, trouble in groups, and [was] exhibiting repetitive behaviors which had gotten worse in recent days.”

The hospital staff asked Nancy a standard set of questions about her son.

Was Adam taking any drugs? “No.”

Did she believe that her son was homicidal? “No.”

Did she believe that her son was suicidal? “No.”

Had Adam been diagnosed with any disorders? Nancy told the doctors that Adam had at one time shown signs of “borderline autism,” but for years she had believed that her son had “outgrown” the disorder. Now, she again feared “the beginning of possible autism.”

The ER doctor listened, and scrawled a presumed diagnosis and course of action on the intake form: “Anxiety Disorder, [Not Otherwise Specified]; Rule out Asperger Syndrome; Rule out Autistic Disorder.”

First, the doctors suggested that they perform an extensive medical work-up on Adam. Nancy declined, knowing the intensely negative reaction her son would have to being interviewed and touched by a group of hurried strangers — not to mention the needles.

She told them that Adam was “already scheduled to see a psychiatrist in three weeks,” and that the only reason she had even come to the hospital that day was to “obtain medical permission to allow [Adam] to stay home from school indefinitely.”

The hospital’s crisis team told Nancy about the options available for child therapy. They especially recommended a “therapeutic educational placement” at the nearby Center for Child and Adolescent Treatment Services, which offered an “intensive outpatient” program. They even offered to conduct a full psychiatric evaluation of Adam, then and there, confident that it would expedite his admission to the therapy-focused program.

Nancy declined this offer, too; she insisted that Adam would be “better off” at home than staying at the hospital any longer. All the prodding and commotion was causing her son even more anxiety than the halls of Newtown Middle School had in the first place. She said that she could “manage” Adam at 36 Yogananda, and that she just needed the doctor’s note, to keep Newtown Schools off her back about attendance for those three weeks. By then, she would have it all taken care of.

Danbury Hospital did agree to write a note for Adam — but it was only to keep him home for three more days, the expectation being that a Planning and Placement Team would be assembled by then, and would schedule an emergency meeting to address the situation. After more than three years without one, her son needed an IEP.

The Danbury staff had Nancy sign a written promise to bring Adam back to the ER if his anxiety symptoms increased, and, with three-day note in hand, Nancy and Adam rushed out of Danbury Hospital just as suddenly as they had arrived. Nancy didn’t get quite what she wanted that day, but she did not give up. In the meantime, Adam was going to stay home, no matter what anyone said.

Newtown Middle School

An administrator with the school district remembers being in their office one day that fall, when they were notified that a parent of a student was there to see them. In walked Nancy Lanza, age 45, who told the administrator that she wanted to “home school” her youngest son.

Her son didn’t even have an IEP, so this was quite a dramatic request. The administrator started asking questions, and Nancy explained that it was for Adam’s sake: he couldn’t handle being at school. She had already taken him to the emergency room in Danbury, but the environment at the hospital caused her son so much anxiety that she felt it was “abusive” to him to keep him there any longer. She wouldn’t need to keep him home “sick” anymore, if she could just home-school him.

The administrator from Newtown Schools was unpersuaded, and told Nancy that they didn’t agree that homeschooling would be appropriate in Adam’s case. Instead, they proposed that “the family and school work together to try and meet Adam’s needs, even in unconventional ways if necessary.”

Nancy could see that the homeschooling approach wasn’t going to work, but she still wasn’t about to give up.

There were essentially two ways for a student to stay home from school long-term in Connecticut: the first, and most common, was to be home schooled. The second way was to be placed in “homebound” status. For that, you need a doctor.

October 18, 2005

Office of Dr. Paul Fox, MD — Brookfield, Connecticut

Dr. Paul Lewis Fox came from New York. He interned at Benedictine Hospital, and then was a resident at Westchester County Medical Center in Valhalla, until he married an archaeologist from Stamford in 1988. Shortly after, they relocated to Connecticut, and he opened his private practice, in a sycamore-shaded white-brick office building in Brookfield (a town adjoining Danbury and Newtown) where he specialized in adolescent psychology.

Nancy Lanza’s quest to liberate her son from Newtown Middle School ultimately led her to Dr. Fox’s door — but nobody seems to know exactly how their paths crossed. It’s unlikely that Danbury Hospital referred her there, since she had told the Emergency Room staff during the September visit that Adam was “already scheduled to see a psychiatrist in three weeks.” On the other hand, one unidentified administrator for the Newtown School District claims that they were the one who referred Nancy to Dr. Fox; this would seem to settle the issue, except that this administrator also claims that this conversation with Nancy happened after the ER visit. The confusion could be attributed to memory fading over the years, or possibly to Nancy telling the doctors different things than she was telling the school district; whatever the case, it seems that one day in the late summer or early fall of 2005, Nancy Lanza and Paul Fox suddenly knew each other. And for some reason, Nancy — who for years now had been notoriously protective of her son, particularly when it came to doctors — almost immediately trusted this particular doctor with Adam like she trusted herself.

The “three weeks” time frame that Nancy asked the ER to excuse Adam for was likely an indication that she was trying to document his condition to fulfill a set of requirements established by the Connecticut State Board of Education, which state that “homebound or hospitalized instruction shall be provided when a child’s condition will cause an absence of at least three weeks’ duration.”

Immediately after Adam’s second evaluation with Dr. Fox on October 18 — three weeks removed from the emergency room visit — Fox sent a letter to Newtown administrators asserting that Adam “should not attend school” because of the “the lack of an appropriate placement” for him in Newtown’s facilities, where he had been experiencing “mounting and overwhelming anxiety.”

That there was no “appropriate placement” for Adam was an extraordinary claim for Dr. Fox to have made at this time, especially after just one or two evaluations. In doing so, Fox was not only claiming that attendance at Newtown Middle School (which provided both “mainstream” and special-education classes) would be inappropriate for his patient, but was also dismissing the possibility of placement at any alternative school, as well as any sort of hospitalized or institutionalized setting. In other words, any arrangement that would require Adam to leave the confines of 36 Yogananda was totally out of the question.

Demanding this of any school district would be a tall order. Federal regulations required Newtown to place their student in the “least restrictive environment” that his education plan could be implemented in, and homebound status was the most restrictive kind of placement, as well Dr. Fox knew. So, in the same note to Newtown, Dr. Fox — likely anticipating that the school district would propose a less drastic measure for Adam’s IEP — ruled out any alternative. “Adam has agreed to achieve competency in all academic subjects at home,” Fox wrote. “At this point tutoring is not needed and could be viewed as counter-productive both academically and emotionally.”

* * *

In an undated note, later found in Nancy’s IEP files from this period, Adam’s handwriting lists the reasons he couldn’t tolerate Newtown Middle School, underneath a doodle of a sad-face shedding a tear, and the word “School.” The list is extensive:

* People

* Unsanitary

* Not enough time in the overcrowded hallways

* Teachers being disappointed in me

* I always seem to miss hearing homework being assigned (or implied…)

* Lunch is too short to be enjoyable

* I have to wake early for just disappointment

* Bus

* I learn too slowly, they teach to the slowest children

* I can’t learn the way that school teaches

* * *

Dr. Fox’s October 18 note bought the Lanzas more time, but there was still work to do. Generally, Connecticut’s “necessary conditions” for determining homebound status required an “expected date the child will be able to return to the school,” but Dr. Fox was recommending indefinite homebound placement — only permitted if “the child has a handicap so severe that it prevents the child from learning in a school setting, or the child’s presence in school endangers the health, safety or welfare of the child or others.” Homebound status would also require a specific diagnosis of a disability, one recognized under the IDEA act: a 13-category list, ranging from speech and language impairments, to deafness, blindness and traumatic brain injuries.

The “overwhelming anxiety” that Dr. Fox had cited was not a disability recognized on the IDEA list, and so it would not be enough to get the Lanzas what they wanted. However, the Child Advocate would determine in 2014 that, given the observations Dr. Fox reported to Newtown, “consideration of the criteria for emotional disturbance would have been appropriate.”

Emotional disturbance is a recognized category of disability that is diagnosed after a student exhibits one or more characteristics “over a long period of time and to a marked degree that adversely affects a child’s educational performance,” of which there are five:

* An inability to learn that cannot be explained by intellectual, sensory, or health factors

* An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.

* Inappropriate types of behavior or feelings under normal circumstances.

* A general pervasive mood of unhappiness or depression.

* A tendency to develop physical symptoms or fears associated with personal or school problems.

Adam had exhibited at least the last four of these traits while in Newtown schools over the years (Nancy had long attributed his learning delays to sensory issues.) But there is no record that a diagnosis of emotional disturbance was even considered. Apparently, Nancy and Dr. Fox saw something else in him.

Fox had one more meeting with Adam, and then he granted Nancy’s wish.

November 15, 2005

Newtown Schools got a letter from Dr. Fox. After years with the boy as their student, this was their first detailed insight into just what might be wrong with Adam Lanza — and finally, a doctor had identified his primary disability:

Adam is a 13 year old boy who I have evaluated on 9/30/05, 10/18/05, and 11/15/05. He meets the DSM IV criteria for Asperger’s Disorder.

Adam presents with a significant social impairment including lack of peer relationships, avoidance of eye-to-eye gaze, lack of understanding of how to play or interact with peers. He avoids peer interaction and is very anxious around strangers. He lacks empathy and tends to employ a very rigid systematic thought process.

He demonstrates intense emotional rage when his systematic world is threatened due to his extreme need for routine.

He tends to take a very literal interpretation of written and verbal material. Concepts like metaphor, symbolism and intangible references are exceedingly difficult for him and can cause significant distress.

He tends to have an overly precise quality of speech and tends to not comprehend emotional expression in others.

The note went on to document a shift in the atmosphere within 36 Yogananda, a marked departure from the loving mother-son relationship that Marvin Lafontaine had witnessed in Adam’s preschool years — when the boy was already averse to touch, but could at least tolerate Nancy’s; as Dr. Fox reported, Adam was now “phobic [of] physical contact, even with his own mother who has been his most constant and consistent individual in his life.”

Dr. Fox then went about proposing a new educational environment that was based on accommodating Adam’s emotional vulnerabilities, along with a curriculum that was to be conducted entirely at home:

Due to his extreme anxiety and emotional discord due to minor changes in routines and/or his expectations, he is unable to attend school.

Due to his need for systematic precision and logic there needs to be modifications in the school curriculum. For example, the English curriculum should focus on the grammar and writing in a clear precise way. Literary choices should tend to be more literal and less figurative. It would be constructive for Adam to have an accelerated program in Math and Science by allowing him to take honor classes in the high school.

At this point I am strongly recommending that Adam not be compelled to attend school. He has clearly demonstrated that the experience of the school setting which has an intolerable level of noise and unpredictable elements would promote extreme anxiety and discomfort.

If you have any questions please do not hesitate to call.

It was just what Nancy had been chasing for the last two months: an indefinite excuse to keep Adam home, with a qualifying disability and a doctor’s signature. Her victory in place, she was finally ready to schedule a meeting of Adam’s IEP team, three months after the Danbury ER doctors had advised her to.