HARTFORD, Conn. (CBSNewYork/AP) -- A stunning new report on Friday said the troubled man who shot 26 people dead in Newtown, Connecticut went untreated for years before the shooting.
The State of Connecticut report said the school system unwittingly enabled Adam Lanza's mother in her preference to "accommodate and appease'' him as he became more withdrawn socially in the time before the Dec. 14, 2012 massacre at Sandy Hook Elementary School.
The Office of the Child Advocate identified missed opportunities to provide more appropriate treatment for Lanza, whose social isolation and obsession with mass killings have been detailed by police reports that found the motive for the shooting may never be known.
WEB EXTRA: Read The Full Report (pdf)
A thread running through the 114-page report, which refers to Lanza as "AL,'' is the effort on the part of his parents to accommodate his disabilities, rather than adhering to specialists' recommendations for extensive special education support.
Sandy Hook Elementary School Shooter's History Reviewed In New Report
"Both AL's mother and his educational team shared a goal of managing and accommodating, rather than securing treatment for, AL's disabilities, and likely this approach was fueled by a lack of critical information and guidance,'' the report said.
In the three months before the massacre, Lanza had not left his room in his mother's spacious colonial-style house, where he lived surrounded by an arsenal of weapons and spent long hours playing violent video games. His parents were divorced, and Lanza had not seen his father for two years.
The report found that Lanza appeared to have "early developmental challenges consistent with a form of autism," and may have had additional mental health issues, such as "anxiety disorder, Obsessive Compulsive Disorder, and suicidal ideation."
There is also evidence of primitive anger and preoccupation with violence, but the authors of the report wrote that they "cannot know the source of such preoccupation."
"There is no way to adequately explain why AL was obsessed with mass shootings and how or why he came to act on this obsession," the report read.
The report said Lanza's severe and deteriorating mental health problems, combined with a preoccupation with violence and access to deadly weapons, "proved a recipe for mass murder."
The report said further that in the time he was isolating himself before the massacre, the 6-foot tall Lanza had wasted away only to 112 pounds. Mental health experts said that alone should have been a red flag.
"If you see someone who is 6 feet tall -- especially a male -- and he weighs 112 pounds, wouldn't you have a problem with that?" said Dr. Harris Straytner of the Mount Sinai School of Medicine. "I mean, I wouldn't even threaten him. I would say, 'I want you to see your internist.'"
The report also said Lanza's mother did not follow recommendations to make sure her son took medication, instead complaining about possible side effects.
"There's no question -- mom enabled him," Straytner said. "I mean, why would a mother go out and get guns, take her kid for target practice, have him play all kinds of games which were violent?"
The report provocatively asks whether a family that was not white or as affluent as the Lanzas would have been given the same leeway to manage treatment for their troubled child.
"Is the community more reluctant to intervene and more likely to provide deference to the parental judgment and decision-making of white, affluent parents than those caregivers who are poor or minority?'' the report said.
But mental health experts said such is not always true.
"I think sometimes, the poor are mistreated, and I think the wealthy are mistreated because they can get away with things; they can buy their way out of things," Straytner said. "I think it goes both ways."
Stratyer said he feels most parents genuinely think they are doing the right thing.
The advocate's office investigates all child deaths in the state for lessons on prevention. The authors of the Newtown report said it aims to reinforce the importance of effective mental health treatment and communication among professionals charged with the care for children.
The report noted that recommendations by specialists for extensive special education support and expert consultations largely went unheeded.
"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,'' the authors wrote.
The authors said they could not say whether more effective treatment could have prevented the tragedy.
"This report raises, but cannot definitively answer, the question as to whether better access to effective mental health and educational services would have prevented the tragic events at Sandy Hook,'' they wrote.
Some highlights from Friday's 114-page report from the Connecticut Office of Child Advocate that looked into the history of Newtown school shooter Adam Lanza:
-- Lanza's mother and his educational team both had a goal to manage and accommodate his disabilities, rather than treat them.
-- Lanza's parents and the school thought of him as intellectually gifted. But psychological testing showed his cognitive abilities were average.
-- Lanza and his parents did not appear to seek or participate in any mental health treatment after 2008. There also was no sustained input from any mental health provider documented in Lanza's educational record or medical record after 2006.
-- Lanza's "severe and deteriorating internalized mental health problems" were combined with a preoccupation with violence. With access to deadly weapons, this "proved a recipe for mass murder," the report concludes.
-- Lanza's communications suggest depression and suicidal thoughts, but not psychosis. Autism spectrum disorder neither caused nor led to the shooting.
-- Lanza's weight relative to his height made him anorexic, to the point of malnutrition and resultant brain damage.
-- The authors said they recognized the "significant role" that assault weapons and high capacity ammunition magazines played and said Lanza's easy access to them "cannot be ignored as a critical factor in this tragedy." The ready availability of assault weapons in the U.S. is a critical public health issue, they said.
"Nothing can mitigate or fully explain those actions," the report reads. "This report cannot offer solace or answers for the indescribable pain and trauma inflicted by AL."
"In the end, only he, and he alone, bears responsibility for this monstrous act," the report concluded.
Lanza killed his mother then shot his way into the Newtown school on Dec. 14, 2012, and gunned down 20 children and six educators before committing suicide.
A portrait of the shooter and his fascination with mass killings has emerged in thousands of pages of police documents: Authorities found violence-laced writings and an arsenal of weapons in the Newtown home where he lived his mother and spent long hours playing shooter video games.
The police investigation into the massacre concluded more than a year ago with prosecutors saying in a summary report that a motive might never be known. It said Lanza was afflicted with mental health problems, but despite his dark interests, he did not display aggressive or threatening tendencies.
Documents released by police in December 2013 included descriptions of sporadic treatment for his mental health troubles. At one point, experts at the Yale Child Studies Center prescribed antidepressant/anti-anxiety medication, but his mother, Nancy Lanza, discontinued the treatment after her son was unable to raise his arm after taking the medicine and never scheduled follow-up visits, police reports said.
A Connecticut judge last year ordered Newtown school officials to give Lanza's records the Office of Child Advocate for its investigation. The governor's Sandy Hook Advisory Commission has been waiting for the office's report, which is being issued Friday, before releasing its recommendations on what the state can do to prevent and respond to future incidents.
Child Advocate Sarah H. Eagan already has met with the families of the victims and Newtown school officials to discuss the findings.
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