Thursday, March 9, 2017


It is not always easy to predict when a person is going to become violent, but is also true that in some cases there are clear warnings. In the case of the Virginia Tech massacre, the warnings were there, yet Virginia Tech’s response and treatment were not. Seung Hui Cho’s medical history at the university was largely one of institutional inaction, pervasive ignorance of the law, individual incompetence, and bureaucratic indifference.

Cho was born in Korea on January 18, 1984. He was the second child of Sung-Tae Cho and Hyang Im Cho. Their daughter, Sun Kyung, was born three years earlier. As a child, Cho was frail. He developed whooping cough and then pneumonia when he was nine months old. When he was three, doctors diagnosed him with a hole in his heart; some medical records refer to it as a heart murmur.  At age five doctors conducted cardiac tests to examine the heart. Those tests may have included an echocardiograph or cardiac catherization and apparently had a traumatic effect on the child.  From that point on he did not like to be touched. His parents describe him as being sick a great deal of the time while growing up.

In 1992 when the Cho family emigrated from South Korea to the United States none of the family spoke English and the transition to their new life was not easy. It took the Cho children approximately two years to learn to speak, read, and write English. During that time both were teased, but Cho’s sister said she took it in stride. There apparently is no record as to Cho’s reaction to this teasing.

Cho’s parents indicate that he was quiet and gentle; they do not recall tantrums or angry outbursts. As a youngster he took Tae Kwon Do, watched TV, and played video games. He reportedly liked basketball and collected both figurines and remote controlled cars. Cho was a very shy child and did not communicate much with his parents but when he did talk he avoided discussing his feelings. Cho remained introspective and the fact that he talked little with family members became an increasing concern to his parents. His mother and sister worried that he was being bullied at school, but he never mentioned it. According to the Review Panel Report, when interviewed, Cho’s sister did know that when he walked down the hall a few students would sometimes taunt him.

Throughout Cho’s elementary school years, his lack of communication became more and more of a concern for the family. Mrs. Cho, in particular, tried to socialize him by encouraging him to go to church, but to no avail. In the end they decided to “let him be the way he is.”

In mid-1997, the Chos sought therapy for their son at the Center for Multicultural Human Services (CMHS), a mental health facility offering treatment and psychological evaluations to low-income, immigrant families. His first counselor was not a good fit (the Review Panel Report does not explain this point), so Cho began working with a specialist trained in art therapy. Art therapy is used with young people who do not have sufficient language or cognitive skills to utilize traditional spoken therapy.

Cho also saw a psychiatrist who diagnosed him with social anxiety disorder. He continued to work with the mental health specialists, but made next to no improvement.

Then came the Columbine shootings in April 1999. After that tragedy, Cho wrote a disturbing paper for his English class in which he expressed thoughts of suicide and homicide and indicated he wanted to repeat Columbine. The school contacted Cho’s parents and urged psychiatric care.

Again, Cho was evaluated by the CMHS. The psychiatric intern who evaluated him was an experienced child psychiatrist and family counselor. (As good as the intern may have been, he or she--the Review Panel Report does not specify whether the intern was a male or female--was not an expert. An intern, by definition, works under someone’s supervision.) The Cho family explained that they were facing something of a crisis, as their daughter, the one person with whom Cho would communicate, was getting ready to go away to college.

The doctor diagnosed Cho with selective mutism* and major depression: single episode. He prescribed the antidepressant Paroxetine 20 mg, which Cho took from June 1999 to July 2000. He did so well that the doctor stopped the medication, feeling he was so improved that he no longer needed the antidepressant.

* The Addendum, The Governor’s Review Panel Report, defines selective mutism as an anxiety disorder characterized by a constant failure to speak. The unwillingness to speak is based on painful shyness. Children with selective mutism are usually inhibited, withdrawn, and have an obsessive fear of hearing their own voices. They may show passive-aggressive, stubborn, and controlling traits. Doctors are not clear about the relationship between autism and this disorder. Major treatment for depression and selective mutism include psychotherapy and anti-anxiety agents such as Selective Reuptake Inhibitors.

Cho entered high school in the Fall of 1999. The teachers noted that he was shy, not verbally active, and that there was practically no communication between Cho and his peers or teachers. The Review Panel Report does not indicate how much, if any, communication there was about Cho between his elementary school, middle school, and high school. When Cho talked, he could barely be heard.

Furthermore, he did not speak in complete sentences, but his grades were high and he was always punctual. The school apparently noted no other unusual traits or behaviors. When a teacher asked him if he would like help in communicating he reportedly nodded his head yes.
In high school Cho met with a guidance counselor who asked him if he had ever received mental health care or special education assistance at his previous schools. He reportedly indicated he had not.

Cho was brought to the attention of the high school’s Screening Committee in October of 2000. Federal law requires that children with learning disabilities be given the opportunity to learn in the least restrictive environment and to be mainstreamed in classrooms. Cho was then given a series of tests to diagnose his problems and to guide the school in preparing an Individualized Education Plan (IEP).   

School representatives met with Cho’s parents to learn more about their son. Mrs. Cho, in what was an ominous glimpse of what was to come, expressed concern about her son’s future and how he would fare in college given his poor social skills.

The Screening Committee decided that Cho was eligible for the Special Education Program for Emotional Disabilities and Speech and Language. The school developed an IEP for Cho that included curriculum and classroom modifications: First, a modification for oral presentations, and second, a modification for grading based on oral and group participation. It was recommended that Cho receive language therapy, and he did. Other modifications included allowing Cho to eat lunch alone and to provide verbal responses in private rather than in front of the class where his manner of speech and accent drew derogatory comments from his fellow students.  Cho’s grades were excellent.

In the eleventh grade, Cho’s weekly counseling sessions at the mental health care center ended. He resisted further sessions. Despite evidence of slight improvement and while his parents were not happy over the termination, Cho was turning 18 and legally they could not make him continue.

Cho’s high school grades were very high, he finished school with a 3.52 in an honors program and his SAT scores were very good. On that basis, he was accepted to Virginia Tech. His guidance counselor, however, in talks with Cho and his family, strongly recommended that he go to a smaller school where the transition to college life would be easier. But Cho’s goal was Tech.

The counselor was apparently so concerned about Cho that she made sure he had the name and contact information of a school district resource that he could call if he encountered problems in Blacksburg. There is no record that Cho ever sought this help while at Virginia Tech. (To be continued)

No comments: