Parkland school shooter’s death penalty trial: Experts mention mental health terms during testimony

Defense attorneys introduced this photo of the Cruz family into evidence on Aug. 23. Lynda and Roger pose with their adoptive sons, Nikolas and Zachary. Roger Cruz died on Aug. 11, 2014, and Lynda Cruz died on Nov. 1, 2017. (For The Washington Post)

FORT LAUDERDALE, Fla. – The public defenders who are trying to save the Parkland school shooter’s life are focusing their case on his childhood development and mental health before the 2018 Valentine’s Day massacre at Marjory Stoneman Douglas High School.

Assistant Public Defender Melisa McNeill asked Carolyn Deakins and Danielle Woodard, Cruz’s biological maternal half-sister, to testify about Cruz’s biological mother’s addiction to crack cocaine, alcohol, and cigarettes and her use during pregnancy.

McNeill also asked other witnesses — including a school counselor, a therapist, and a psychologist — who met Cruz as a child in kindergarten and elementary school to describe the challenges that he and his adoptive mother faced.

Here is a list of some of the terminology experts have referred to or mentioned during their testimony:

Prenatal exposure

Researchers are still studying the long-term impacts that the exposures and experiences during pregnancy could have on the developing brain. Scientists have established the brain starts to develop during the third week of gestation and does not finish developing and maturing until the mid to late 20s, according to the National Institutes of Health.

Deakins and Woodard testified Cruz’s biological mother, Brenda Woodard, used cocaine, marijuana, alcohol, and cigarettes while pregnant with Cruz.

  • Cannabis: A study shows it affects attention scores in early childhood. Other studies show the effects include disturbances in memory and verbal development, sustained attention, increased impulsivity, and hyperactivity.
  • Cocaine: Studies show it had “significant negative associations” with sustained attention and behavioral self-regulation.
  • Alcohol: Fetal alcohol spectrum disorders, or FASDs, can include physical problems and problems with behavior and learning, according to the U.S. Centers for Disease Control and Prevention.
  • Tobacco: Smoking during pregnancy can cause tissue damage in the brain, according to the CDC. Also, studies show the use is associated with negative behavioral and cognitive outcomes in childhood.

Developmental delay

Pediatricians evaluate basic developmental progress by focusing on the changes in motor, cognitive, social, and emotional skills from conception through birth. When the progress is consistently slow, physicians recommend therapeutic interventions such as speech therapy, and a special education plan, according to Yale Medicine experts.

Susan Hendler-Lubar, Anne Marie Fischer, and John Newnham testified meeting Cruz as a student in pre-kindergarten, kindergarten, or elementary school and reported that he had a special education plan due to developmental delays.

“He was delayed in independence skills, he was delayed in language, he was delayed in gross motor, fine motor,” said Fischer, the former director of the Young Minds Learning Center where Cruz was a pre-school student.

Attention-deficit/hyperactivity disorder (ADHD)

Frederick M. Kravitz, a clinical psychologist, said he agreed with Cruz’s ADHD diagnosis, which caused him to have trouble paying attention and controlling impulsive behaviors. The common disorder can cause difficulty at school and can be treated with a combination of behavior therapy and medication, according to the CDC.

“ADHD kids tend to be impulsive,” said Dr. Laurie Karpf, a psychiatrist who treated Cruz from 2008 to 2011.

Oppositional defiance disorder (ODD)

Kravitz said Cruz was diagnosed with ODD, a behavior disorder characteristic of defiance and hostility toward authority figures. ADHD makes it more likely for children to have ODD, according to researchers at Johns Hopkins University.

  • “His acting out, tantrums, anger outbursts, low frustration tolerance, refusing to do things, running away at times,” Kravitz said listing Cruz’s ODD symptoms.
  • “He had a pretty active bad imagination,” Kravitz said.

Obsessive-compulsive disorder (OCD)

Kravitz said Cruz displayed some symptoms of OCD. The common anxiety disorder causes irrational thoughts, fears, or worries that some manage through rituals or compulsions that help stop or ease the obsessive thoughts, according to researchers at Johns Hopkins University.

  • “He repeats questions three or four times ... he did have some obsessive qualities ... he would cross out writing that he did if it wasn’t perfect,” Kravitz said adding Cruz had to “always eat eight chicken nuggets ... not seven, not nine, eight.”
  • “In the beginning, his fears were excessive, affecting his daily life,” said Caridad Harvey, a licensed mental health counselor who treated Cruz at his home when he was in first grade.

Autism spectrum disorder (ASD)

Kravitz said he didn’t diagnose him with ASD, but observed “autistic tendencies” such as withdrawal, isolation, and delayed language skills. According to the CDC, patients often have problems with social communication and interaction and restricted or repetitive behaviors or interests that make life challenging.

Anti-social personality disorder (ASPD)

Patients with ASPD, also known as psychopathic personality, do not show regard for right or wrong and ignore the rights and feelings of others without guilt or remorse. According to the American Psychological Association, its manifestations include repeated violations of the law, exploitation of others, deceitfulness, impulsivity, aggressiveness, and a reckless disregard for the safety of self and others. It’s also known as dyssocial personality and sociopathic personality.

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The Emmy Award-winning journalist joined the Local 10 News team in 2013. She wrote for the Miami Herald for more than 9 years and won a Green Eyeshade Award.