Brendan Depa’s Mother (Occupational Therapist Leanne Depa) Tells Her Son’s Story

Reprinted from Flagerlive.com June 25 2023
Written by Leanne Depa

It saddens us when things in our schools don’t always go right or as planned. Our family is filled with concern for Ms. Joan Naydich, and we continue to pray for her swift recovery. Our whole family was horrified by what she endured. Nobody deserves this. We are sincerely sorry for our son’s actions. We support the needs of students, educators, and staff to feel secure in their school environment.

By sharing Brendan’s story, we aim to shed light on who he is to us and how a system has let all of us down, resulting in the tragic incident on Feb. 21.

Brendan, who is now 17 years old, joined our family through foster care when he was just an infant. As a baby, Brendan was quite fussy, and he struggled in a school setting from the age of 2. Despite our attempts to enroll him in daycare and public schools, the busy and noisy environments proved too overwhelming for him, leading to environmentally induced meltdowns.

He was easily upset by flies, stickers, and discarded bandages.  He was terrified of things other children enjoyed. However, we found that he thrived in smaller and more structured environments, which is why we chose to homeschool him for the most part. To ensure that Brendan had opportunities for socialization, we enrolled him in co-op classes and introduced him to other homeschoolers. We also went camping frequently with other homeschool families and friends, which he loved.

Brendan loved to read and frequently studied the dictionary.  He astounded others with his vocabulary while at the same time had difficulty applying his knowledge to real-life situations, as he is a level 3, the most severe on the autism scale, which requires substantial support to manage.

Brendan loves most people. He is a big hugger, hugging everyone he meets, even hugging strangers like the pizza delivery guy. Once when we were at Walmart, he was so excited by something his grandmother was buying him that he lifted her up off the ground and swung her around. That made quite the picture. I wasn’t sure whether to laugh or be worried about what the image looked like to other shoppers.

The Diagnoses – While Brendan loves people, he has difficulty with friendships because he is fixated on only what interests him. He struggles with being reciprocal, which affects the way people view him. But he has a big heart. As much as he loves food, he always asked to give his food to any homeless person we passed. If we were in a shopping center, he would ask to buy something and then would walk it over to them. During this time, before the spring of 2017, Brendan was managing in the community by receiving the support he needed through therapies and constant supervision.

While under the care of specialists, Brendan was diagnosed with Autism, ADHD, Oppositional Defiant Disorder (ODD), Intermittent Explosive Disorder, Mood Dysregulation Disorder, Post Traumatic Stress Disorder (PTSD), and Anxiety. From a young age, Brendan has struggled with hypersensitivity to sounds and textures, poor frustration tolerance, poor emotional regulation, rigidity in his thought processes, and frequent demonstrations of magical thinking causing difficulty with focusing. Often it seemed like he viewed characters in his video games as real. For example he had severe fears of a mural at Tijuana Flats, a restaurant that I loved. The mural advertised the restaurant’s very hot sauces by showing a boy standing in a fire, looking over his shoulder with tears running down his face. It terrified Brendan, who thought it represented Hell. He was similarly terrified of our museum’s Disasterville. He wouldn’t get near it, or near a shark statue. It was as if everything came to life for him.  He thought throwing toilet paper at a police officer would make her go away.

Even now, Brendan’s therapist reports that he has the emotional maturity of a 4 to 6-year-old. These symptoms are all part of the autism spectrum (ASD). Brendan was first prescribed antipsychotic medications, among others, in 2018 to control his heightened aggression during a time that our family was going through tremendous stress. At that time multiple close family members were experiencing life-threatening conditions, including his grandmother pictured above, who had pancreatic cancer. Another family member required an emergency craniotomy.

Baker Acts – Unfortunately, the medications did little to improve Brendan’s condition and had onerous side effects: he gained over 100 pounds in a year, making it challenging for us to manage him. Following guidance from healthcare professionals, I reached out to our local police to have Brendan placed under a Baker Act whenever his aggression resurfaced and we could no longer physically calm him down as we once could when he was smaller, by wrapping our arms around him.

Whenever the police came to our house, I never knew what response to expect. Some officers would talk to him and help him calm down. Others would take him to the emergency room for a Baker Act or even arrest him, as was twice the case, even though that’s not what we were seeking. Whenever he was hospitalized under the Baker Act, I would plead with the hospital staff to consult with his treating psychiatrist on medication changes. Astoundingly, they never did. As a result, his psychiatrist would often change his medications once he left the hospital, which became a frequent occurrence, again with unintended, at times onerous consequences.

At one point in 2019 his neurologist took him off the mood stabilizer that his psychiatrist had prescribed, and he soon began to spiral downward. During that time, he initially was able to ignore a couple of neighborhood kids that were bullying him by calling him racial slurs. The bullying continued. One day one of the children attempted to trick him into drinking urine, then rub a tennis ball on his genitals prior to throwing it at him. He got into a confrontation and was arrested. The other individual was not disciplined.

I vividly recall during one emergency room trip a doctor telling me to expect the teen years for someone with ASD to be tough, because of the added component of hormone changes.  He told me it would all start to calm down after he made it through puberty. It did not.

Medicating the Impossible – Frequently new medications were added, until he was taking a cocktail of medications, which left us with no clue as to what was helping and what was causing more harm. It is not always clear how different combinations of medication will affect an individual. Unfortunately, it can often be a process of trial and error. As you can imagine, when you’re trying to help a child with a unique nervous system, experimenting with various mind-altering medications can lead to unpredictable, at times uncontrollable and unintended outcomes.

Changes in medication cocktails were not the only problem.  Studies have shown that individuals with autism have a stress system that operates differently than those who are neurotypical. The nervous system in its various states does not function as intended, and when combined with hormonal changes during adolescence, can have lasting effects on the stress response system. Individuals with ASD quickly perceive threats and overreact to negative situations, leading to constant feelings of insecurity, heightened emotions and poorer decision-making compared to typical teenagers going through puberty.

Although it was clear that long-term hospitalization was necessary to properly adjust Brendan’s medications, you will not be surprised to know that the insurance company created numerous lengthy obstacles. That’s not unique to Brendan, but it is yet one more factor that interfered with and delayed with care, with consequences we cannot readily measure. We eventually were approved by our insurance for an autism residential treatment center in South Carolina. We visited Brendan once a month, but due to the Covid pandemic, these visits had to be halted.

At the end of September 2020, my husband experienced a massive heart attack involving 100 percent blockage (known as a widow-maker), but thankfully survived. Brendan had to hear about it from hospital staff. He was extremely worried about his father.

The hospital environment was chaotic, noisy, and dealing with Covid challenges. Under normal circumstances, we would have made arrangements for Brendan to spend weekends with us in a hotel as part of his discharge process and reintegration into our family. Covid precautions and my husband’s health made that impossible. Brendan ended up staying at the facility for a year with only a few family visits. He did not receive the medication wash that we advocated for and had anticipated–a process that involves discontinuing all medications and starting anew in a controlled setting.

Group Home and Matanzas High School –Despite continuing to exhibit aggressive behavior in the hospital, the insurance company forced his discharge. It was out of our control. We were able to secure acceptance into the Agency for Persons with Disabilities (APD) and eventually found an intensive behavioral group home for him in November of 2020–the East Coast Habilitation Options (ECHO) group home in Palm Coast. It was two and a half hours away from our own home near the West Coast. There were no closer options available: That, too, is one of the challenges of a labyrinthine system with limitations at every turn.  My husband and I took turns visiting him every two weeks, taking him on outings and arranging for brief stays away from the group home even as Covid-related strictures stressed even our little time together.

From the beginning of his time at ECHO, I expressed my reservations about Brendan being placed in the public school system. I was told by ECHO that Brendan had to attend a public school because the Agency for Persons with Disabilities only covered day programs for clients who had graduated high school or turned 22. I was assured by the group home that they place all their clients in the public schools and that a crisis team was only ten minutes away. It took a few months for the school to complete testing and for the Individual Education Program (IEP) meeting to occur.

An IEP is a legally binding agreement that ensures a student’s disability is accommodated in his or her education. For those with behavioral challenges, there’s also a Behavior Support Plan in place to help reduce negative behaviors. IEP teams meet at least annually to review progress towards specific goals and set new ones.  If any concerns arise, the team can call an additional meeting to make necessary changes to the IEP.  Our IEP team included his ESE teacher, behavioral analysts, school staffing specialist, district behavior specialist, school counselor, ESE director, mental health counselor, behavior interventionist, his private therapist, ECHO staff, his APD coordinator, and me.

IEP Directives

During the IEP meeting, everyone was told that removal of his electronics was a trigger that often resulted in him having to be restrained.  It was also documented in his IEP that he can become overwhelmed and escalate quickly when he is frustrated or feels threatened.

Here are direct citations from his approved IEP:
Brendan’s behavior can affect his ability to succeed in the classroom. Brendan can become overwhelmed if he is given a task that he does not understand immediately, and can shut down when he becomes frustrated or anxious. When a directive is not explained to Brendan, he can become argumentative with teachers and refuse to comply. If he begins to escalate he can become verbally and physically aggressive towards his peers and staff. Brendan does not do well with competition, and losing a game can make Brendan extremely upset and can lead to severe aggression. Once Brendan has escalated it can be very difficult to bring him back to base level behavior.

Even more relevant, here’s what the IEP documents, regarding the Nintendo Switch that was the trigger for the assault:

Echo said that he plays games at home from 5-7 and 8-10. Removing a game is definitely a trigger; if Brendan is playing a game and the house needs to take it away, they will call the crisis team before they ask for the game, because there will be an incident requiring a restraint. [The ESE administrator] said that this information would definitely be useful to know so that MHS was aware of that problem.

Once he reaches this point, it can be challenging to bring him back to a calm state. An example of this occurred over Thanksgiving last year. We stayed in an Airbnb. Brendan came in off the porch crying. When I asked him what was wrong, he first stated that there wasn’t any sun before melting into a heart wrenching wail. It took over 30 minutes of him splashing water on his face and putting his face into the cold air of the freezer to calm his crying. It may not have been about the sun, particularly. He said he hadn’t been home in over three years, and that he missed being with his family. He just wanted to come home.

Previously he’d resisted our attempts to bring him closer to home because he had been insisting on wanting to graduate from Matanzas High School. According to the IEP team, Brendan frequently talked about graduating and going to college, but still lacked the ability to understand the concept of accountability. Magical thinking led him to believe that he would always pass his classes with good grades, even when he wasn’t completing the work. Living with contradictions is part of the challenge as the mother of a child with ASD. I was left with the feeling that Brendan temporarily seeing his home on the West Coast yet not being able to remain was too difficult for him. He remained at ECHO.

Then came that horrific day.

Brendan as an ESE Student – At the time of the incident at Matanzas, he was on six psychiatric medications, all of which can have devastating side effects. Bupropion HCL XL: irritability, false beliefs that cannot be changed by facts, having extreme distrust of people, seeing, hearing, or feeling things that are not there, trouble concentration. Clonidine HCL: anxiety, holding false beliefs that cannot be changed by facts, irritability, mental depression, seeing or hearing things that are not there. Ziprasidone HCL: agitation, irritability, abnormal behavior. Lamotrigine: agitation, irritability, other abnormal behaviors. Topamax: memory problems, nervousness, trouble concentration, unusual tiredness, aggression, agitation, discouragement, feeling sad or empty, irritability.  Propranolol: anxiety, nervousness.

These are just one of the combinations of trials and errors he has been on over the years. While each of these medications are meant to improve psychiatric conditions, they can make them worse.

Brendan was in an Exceptional Student Education classroom and had a paraprofessional. ESE classrooms are unique and require more specialized training than the average classroom. It is a thankless job that is not compensated nearly as adequately as it should be for teachers or paraprofessionals, considering what is expected.

The demands on staffers are grueling. It’s crucial for the staff to have a deep understanding of every child in the classroom–their unique needs, what sets them off, and how to keep them motivated. This can be quite a challenge, as they often must take on the roles of both investigator and counselor. The teachers must have a thorough understanding of extremely detailed documents for each student with an IEP and a behavioral plan. The IEP team is the one who works diligently on these documents for the best outcome.

Although I was hesitant about Brendan attending a public school due to his triggers, I was partially reassured by the IEP process. What I didn’t realize was that while the Behavioral Plan looked good on paper, it would prove very difficult to follow in practice.

There was a reward system in place for students to manage their behavior. The team’s IEP plan consisted of using a token economy. This allowed the students to purchase items out of the closet after delaying gratification, by building up the number of tokens.

But somehow the reward system shifted from the approved plan to utilizing or perhaps misapplying one of Brendan’s known triggers. This year’s teacher changed the overall reward system to allow students to access their electronics once they were done with their work. Most likely not realizing that his teacher was going against Brendan’s IEP, the teacher requested that Brendan’s Nintendo Switch be sent into school daily.

The group home’s behavioral analyst reluctantly and prematurely went along with this request. It was premature, because the IEP team had not been consulted. The teacher stipulated that the game was kept locked up and only given to Brendan at the end of the day, during an empty period.

The Assault – We have lived with the unintended consequences of small and various factors that at times snowball into devastating results for many years. It is never malice or even negligence, but an accumulation of seemingly minor and even reasonable and well-intended acts that somehow reach a critical mass no one would have expected. This is what appears to have happened.

Somehow there was a failure in communication, and the teacher increasingly utilized electronics as rewards over time. On the day of the incident, Brendan was permitted to have his game in the lunchroom and bring it to his non-ESE class. During the manifestation meeting following the incident, it was revealed that he was reminded twice by his paraprofessional to put away his game during that class. Brendan reported he believed he was allowed to use it because the other students were on their phones.

Upon returning to the ESE classroom, Brendan’s paraprofessional explained the situation to his teacher and a discussion took place as to whether he should be allowed to continue to use his game in that setting. Brendan often gets upset when he doesn’t fully comprehend things, and he was convinced that his paraprofessional was not conveying what he thought should be conveyed about what happened in the non-ESE classroom. This led to his emotions becoming heightened and his behavior escalating. You have seen and heard the rest.

“Manifestation Meeting”

His behavioral plan had some strategies in place that were meant to prevent negative behaviors. Here are three of them: