Experts: No link between Asperger's, violence

NEW YORK (AP) — While an official has said that the 20-year-old gunman in the Connecticut school shooting had Asperger's syndrome, experts say there is no connection between the disorder and violence.

Asperger's is a mild form of autism often characterized by social awkwardness.

"There really is no clear association between Asperger's and violent behavior," said psychologist Elizabeth Laugeson, an assistant clinical professor at the University of California, Los Angeles.

Little is known about Adam Lanza, identified by police as the shooter in the Friday massacre at a Newtown, Conn., elementary school. He fatally shot his mother before going to the school and killing 20 young children, six adults and himself, authorities said.

A law enforcement official, speaking on condition of anonymity because the person was not authorized to discuss the unfolding investigation, said Lanza had been diagnosed with Asperger's.

High school classmates and others have described him as bright but painfully shy, anxious and a loner. Those kinds of symptoms are consistent with Asperger's, said psychologist Eric Butter of Nationwide Children's Hospital in Columbus, Ohio, who treats autism, including Asperger's, but has no knowledge of Lanza's case.

Research suggests people with autism do have a higher rate of aggressive behavior — outbursts, shoving or pushing or angry shouting — than the general population, he said.

"But we are not talking about the kind of planned and intentional type of violence we have seen at Newtown," he said in an email.

"These types of tragedies have occurred at the hands of individuals with many different types of personalities and psychological profiles," he added.

Autism is a developmental disorder that can range from mild to severe. Asperger's generally is thought of as a mild form. Both autism and Asperger's can be characterized by poor social skills, repetitive behavior or interests and problems communicating. Unlike classic autism, Asperger's does not typically involve delays in mental development or speech.

Experts say those with autism and related disorders are sometimes diagnosed with other mental health problems, such as depression, anxiety, bipolar disorder or obsessive-compulsive disorder.

"I think it's far more likely that what happened may have more to do with some other kind of mental health condition like depression or anxiety rather than Asperger's," Laugeson said.

She said those with Asperger's tend to focus on rules and be very law-abiding.

"There's something more to this," she said. "We just don't know what that is yet."

After much debate, the term Asperger's is being dropped from the diagnostic manual used by the nation's psychiatrists. In changes approved earlier this month, Asperger's will be incorporated under the umbrella term "autism spectrum disorder" for all the ranges of autism.

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AP Writer Matt Apuzzo contributed to this report.

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Online:

Asperger's information: http://1.usa.gov/3tGSp5

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As school resumes, security increases in schools across the nation

Teachers and students across America are confronting the issue of safety and security in the classroom today after a weekend of grappling with the deadly massacre at a grade school in Newtown, Conn.

"It's very important that we address their concerns [about safety]," teacher Lauren Marrocco of New Jersey said. "I think my students will have a lot of questions and, as adults, we don't have answers to those questions."

Near Newtown, one teacher's weekend homework for students was simple: Go home and hug your loved ones. In California, another educator wrote, "I'll be locking my [classroom] door this week to make my students feel safer."

For many, this morning's school drop-off will be a difficult but necessary start to the day.

"I'm not too worried about her, I'm more worried about how I feel and how I'm going to let go of her hand when she gets on the bus," a parent told ABC News.

In Fairfax County, Va., schools sent notice that they would be upping security, not for any specific threat but to alleviate anxiety.

Dr. Steven Marans, head of the National Center of Children Exposed to Violence at Yale University's Child Study Center, said that falling into normal routines can provide comfort.

"One of the ways of demonstrating that their lives are secure and reliable is to have them disrupted as little as possible," he said.

Marans says it is also important not to avoid discussing Friday's events, where 20 children and seven adults were killed before Adam Lanza took his own life.

"We need to acknowledge that we all have big feelings," he said. "This is very sad. This is an opportunity for kids to put into words what their thinking about."

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Nationalist Shinzo Abe is likely Japan's next PM

WAKO, Japan (AP) — The Liberal Democratic Party's victory in Japan's parliamentary election virtually ensures that Shinzo Abe, who resigned as prime minister for health reasons in 2007 after just a year in office, will get a second chance to try to lead Japan out of its economic slump.

In Abe's political resurrection, the Japanese are confiding their hopes for a national comeback, backing Liberal Democrat pledges to restore the good times of the 1980s and 90s, before the financial bubble went bust and the economy slid into a 20-year funk.

Abe epitomizes the LDP brand of conservatism and nationalism that kept the party in power for most of the post-World War II era, until it was ousted by the Democratic Party of Japan in 2009.

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A children's choir opens 'SNL' with 'Silent Night'

NEW YORK (AP) — "Saturday Night Live" made a rare departure from its comedic opening to pay tribute to the children and adults killed at a Connecticut elementary school.

Not known for treating anything seriously or tenderly, the show made a fitting exception during the first moments of its show Saturday. Rather than the usual comedic sketch, a children's choir appeared on camera and angelically sang "Silent Night," with the touching refrain, "Sleep in heavenly peace."

Then the members of the New York City Children's Chorus shouted out the NBC show's time-honored introduction: "Live from New York, it's 'Saturday Night!'"

It was the night's sole reference to the tragedy and struck just the right tone.

Later, the chorus returned to join musical guest Paul McCartney in a rendition of his "Wonderful Christmas Time."

Appearing in a sketch in an unbilled cameo, actor Samuel L. Jackson made a distinctive contribution of his own.

Pretending to be miffed at getting interrupted as a guest on the mock talk show "What Up with That?" Jackson said what sounded very much like an F-bomb, followed by the term sometimes shortened to "B.S."

Playing the host of "What Up with That?" Kenan Thompson looked startled by Jackson's vulgarities but kept going.

"C'mon, Sam. That costs money!" he quipped, cracking up the studio audience.

Moments after the show ended, Jackson tried to explain in a Twitter posting.

"I only said FUH," he insisted, adding that Thompson was supposed to cut him off with his second eruption, but "blew it!!"

Jackson's tweet was accompanied by a photo of himself looking mortified.

Besides Jackson, some of the stars dropping by for this special Christmas "SNL" included Alec Baldwin, Tom Hanks, Kristen Wiig, Jimmy Fallon and Tina Fey. The guest host was Martin Short.

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Online: www.nbc.com

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Experts: No link between Asperger's, violence

NEW YORK (AP) — While an official has said that the 20-year-old gunman in the Connecticut school shooting had Asperger's syndrome, experts say there is no connection between the disorder and violence.

Asperger's is a mild form of autism often characterized by social awkwardness.

"There really is no clear association between Asperger's and violent behavior," said psychologist Elizabeth Laugeson, an assistant clinical professor at the University of California, Los Angeles.

Little is known about Adam Lanza, identified by police as the shooter in the Friday massacre at a Newtown, Conn., elementary school. He fatally shot his mother before going to the school and killing 20 young children, six adults and himself, authorities said.

A law enforcement official, speaking on condition of anonymity because the person was not authorized to discuss the unfolding investigation, said Lanza had been diagnosed with Asperger's.

High school classmates and others have described him as bright but painfully shy, anxious and a loner. Those kinds of symptoms are consistent with Asperger's, said psychologist Eric Butter of Nationwide Children's Hospital in Columbus, Ohio, who treats autism, including Asperger's, but has no knowledge of Lanza's case.

Research suggests people with autism do have a higher rate of aggressive behavior — outbursts, shoving or pushing or angry shouting — than the general population, he said.

"But we are not talking about the kind of planned and intentional type of violence we have seen at Newtown," he said in an email.

"These types of tragedies have occurred at the hands of individuals with many different types of personalities and psychological profiles," he added.

Autism is a developmental disorder that can range from mild to severe. Asperger's generally is thought of as a mild form. Both autism and Asperger's can be characterized by poor social skills, repetitive behavior or interests and problems communicating. Unlike classic autism, Asperger's does not typically involve delays in mental development or speech.

Experts say those with autism and related disorders are sometimes diagnosed with other mental health problems, such as depression, anxiety, bipolar disorder or obsessive-compulsive disorder.

"I think it's far more likely that what happened may have more to do with some other kind of mental health condition like depression or anxiety rather than Asperger's," Laugeson said.

She said those with Asperger's tend to focus on rules and be very law-abiding.

"There's something more to this," she said. "We just don't know what that is yet."

After much debate, the term Asperger's is being dropped from the diagnostic manual used by the nation's psychiatrists. In changes approved earlier this month, Asperger's will be incorporated under the umbrella term "autism spectrum disorder" for all the ranges of autism.

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AP Writer Matt Apuzzo contributed to this report.

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Online:

Asperger's information: http://1.usa.gov/3tGSp5

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Portraits of Conn. victims show lives at their very start, ended in gunfire

Most died at the very start of their young lives, tiny victims taken in a way not fit for anyone regardless of age. Others found their life's work in sheltering little ones, teaching them, caring for them, treating them as their own. After the gunfire ended Friday at Sandy Hook Elementary School, the trail of loss was more than many could bear: 20 children and six adults at the school, the gunman's mother at home, and the gunman himself.

A glimpse of some of those who died:

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Charlotte Bacon, 6, student

They were supposed to be for the holidays, but finally on Friday, after hearing much begging, Charlotte Bacon's mother relented and let her wear the new pink dress and boots to school.

It was the last outfit the outgoing redhead would ever pick out. Charlotte's older brother, Guy, was also in the school but was not shot.

Her parents, JoAnn and Joel, had lived in Newtown for four or five years, JoAnn's brother John Hagen, of Nisswa, Minn., told Newsday.

"She was going to go some places in this world," Hagen told the newspaper. "This little girl could light up the room for anyone."

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Olivia Engel, 6, student

The images of Olivia Engel will live far beyond her short lifetime. There she is, visiting with Santa Claus, or feasting on a slice of birthday cake. There's the one of her swinging a pink baseball bat, and another posing on a boat. In some, she models a pretty white dress; in others, she makes a silly face.

Dan Merton, a longtime friend of the girl's family, says he could never forget the child, and he has much to say when he thinks of her.

"She loved attention," he said. "She had perfect manners, perfect table manners. She was the teacher's pet, the line leader."

On Friday, Merton said, she was simply excited to go to school and then return home and make a gingerbread house.

"Her only crime," he said, "is being a wiggly, smiley 6-year-old."

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Dawn Hochsprung, 47, principal

Dawn Hochsprung's pride in Sandy Hook Elementary was clear. She regularly tweeted photos from her time as principal there, giving indelible glimpses of life at a place now known for tragedy. Just this week, it was an image of fourth-graders rehearsing for their winter concert; days before that, the tiny hands of kindergartners exchanging play money at their makeshift grocery store.

She viewed her school as a model, telling The Newtown Bee in 2010 that "I don't think you could find a more positive place to bring students to every day." She had worked to make Sandy Hook a place of safety, too, and in October, the 47-year-old Hochsprung shared a picture of the school's evacuation drill with the message "safety first." When the unthinkable came, she was ready to defend.

Officials said she died while lunging at the gunman in an attempt to overtake him.

"She had an extremely likable style about her," said Gerald Stomski, first selectman of Woodbury, where Hochsprung lived and had taught. "She was an extremely charismatic principal while she was here."

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Madeleine Hsu, 6, student

Dr. Matthew Velsmid was at Madeleine's house on Saturday, tending to her stricken family. He said the family did not want to comment.

Velsmid said that after hearing of the shooting, he went to the triage area to provide medical assistance but there were no injuries to treat.

"We were waiting for casualties to come out, and there was nothing. There was no need, unfortunately," he said. "This is the darkest thing I've ever walked into, by far."

Velsmid's daughter, who attends another school, lost three of her friends.

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Catherine Hubbard, 6, student

A family friend turned reporters away from the house, but Catherine's parents released a statement expressing gratitude to emergency responders and for the support of the community.

"We are greatly saddened by the loss of our beautiful daughter, Catherine Violet and our thoughts and prayers are with the other families who have been affected by this tragedy," Jennifer and Matthew Hubbard said. "We ask that you continue to pray for us and the other families who have experienced loss in this tragedy."

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Chase Kowalski, 7, student

Chase Kowalski was always outside, playing in the backyard, riding his bicycle. Just last week, he was visiting neighbour Kevin Grimes, telling him about completing — and winning — his first mini-triathlon.

"You couldn't think of a better child," Grimes said.

Grimes' own five children all attended Sandy Hook, too. Cars lined up outside the Kowalskis' ranch home Saturday, and a state trooper's car idled in the driveway. Grimes spoke of the boy only in the present tense.

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Nancy Lanza, 52, gunman's mother

She once was known simply for the game nights she hosted and the holiday decorations she put up at her house. Now Nancy Lanza is known as her son's first victim.

Authorities say her 20-year-old son Adam gunned her down before killing 26 others at Sandy Hook. The two shared a home in a well-to-do Newtown neighbourhood, but details were slow to emerge of who she was and what might have led her son to carry out such horror.

Kingston, N.H., Police Chief Donald Briggs Jr. said Nancy Lanza once lived in the community and was a kind, considerate and loving person. The former stockbroker at John Hancock in Boston was well-respected, Briggs said.

Court records show Lanza and her ex-husband, Peter Lanza, filed for divorce in 2008. He lives in Stamford and is a tax director at General Electric. A neighbour, Rhonda Cullens, said she knew Nancy Lanza from get-togethers she had hosted to play Bunco, a dice game. She said her neighbour had enjoyed gardening.

"She was a very nice lady," Cullens said. "She was just like all the rest of us in the neighbourhood, just a regular person."

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Jesse Lewis, 6, student

Six-year-old Jesse Lewis had hot chocolate with his favourite breakfast sandwich — sausage, egg and cheese — at the neighbourhood deli before going to school Friday morning.

Jesse and his parents were regulars at the Misty Vale Deli in Sandy Hook, Conn., owner Angel Salazar told The Wall Street Journal.

"He was always friendly; he always liked to talk," Salazar said.

Jesse's family has a collection of animals he enjoyed playing with, and he was learning to ride horseback.

Family friend Barbara McSperrin told the Journal that Jesse was "a typical 6-year-old little boy, full of life."

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Ana Marquez-Greene, 6, student

A year ago, 6-year-old Ana Marquez-Greene was reveling in holiday celebrations with her extended family on her first trip to Puerto Rico. This year will be heartbreakingly different.

The girl's grandmother, Elba Marquez, said the family moved to Connecticut just two months ago, drawn from Canada, in part, by Sandy Hook's sterling reputation. The grandmother's brother, Jorge Marquez, is mayor of a Puerto Rican town and said the child's 9-year-old brother also was at the school but escaped safely.

Elba Marquez had just visited the new home over Thanksgiving and is perplexed by what happened. "What happened does not match up with the place where they live," she said.

A video spreading across the Internet shows a confident Ana hitting every note as she sings "Come, Thou Almighty King." She flashes a big grin and waves to the camera when she's done.

Jorge Marquez confirmed the girl's father is saxophonist Jimmy Greene, who wrote on Facebook that he was trying to "work through this nightmare."

"As much as she's needed here and missed by her mother, brother and me, Ana beat us all to paradise," he wrote. "I love you sweetie girl."

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James Mattioli, 6, student

The upstate New York town of Sherrill is thinking of Cindy Mattioli, who grew up there and lost her son James in the school shooting in Connecticut.

"It's a terrible tragedy, and we're a tight community," Mayor William Vineall told the Utica Observer-Dispatch. "Everybody will be there for them, and our thoughts and prayers are there for them."

James' grandparents, Jack and Kathy Radley, still live in the city, the newspaper reported.

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Anne Marie Murphy, 52, teacher

A happy soul. A good mother, wife and daughter. Artistic, fun-loving, witty and hardworking.

Remembering their daughter, Anne Marie Murphy, her parents had no shortage of adjectives to offer Newsday. When news of the shooting broke, Hugh and Alice McGowan waited for word of their daughter as hours ticked by. And then it came.

Authorities told the couple their daughter was a hero who helped shield some of her students from the rain of bullets. As the grim news arrived, the victim's mother reached for her rosary.

"You don't expect your daughter to be murdered," her father told the newspaper. "It happens on TV. It happens elsewhere."

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Emilie Parker, 6, student

Quick to cheer up those in need of a smile, Emilie Parker never missed a chance to draw a picture or make a card.

Her father, Robbie Parker, fought back tears as he described the beautiful, blond, always-smiling girl who loved to try new things, except foods.

Parker, one of the first parents to publicly talk about his loss, expressed no animosity for the gunman, even as he struggled to explain the death to his other two children, ages 3 and 4. He's sustained by the fact that the world is better for having had Emilie in it.

"I'm so blessed to be her dad," he said.

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Noah Pozner, 6, student

The way Noah Pozner's parents saw it, no schools in New York could compare with those in Newtown, a relative told Newsday. So they moved their family — Noah, his twin sister and his 8-year-old sister.

"At this stage, two out of three survived. ... That's sad," said Noah's uncle Arthur Pozner, of New York City's Brooklyn borough. "The reason they moved to that area is because they did not consider any school in New York state on the same level. That's one of the reasons they moved, for safety and education."

Noah's siblings were also students there but were not hurt. Noah's uncle recalled him as "extremely mature."

"When I was his age, I was not like him," Pozner told the newspaper. "Very well brought up. Extremely bright. Extremely bright."

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Lauren Gabrielle Rousseau, 30, teacher

Lauren Rousseau had spent years working as a substitute teacher and doing other jobs. So she was thrilled when she finally realized her goal this fall to become a full-time teacher at Sandy Hook.

Her mother, Teresa Rousseau, a copy editor at the Danbury News-Times, released a statement Saturday that said state police told them just after midnight that she was among the victims.

"Lauren wanted to be a teacher from before she even went to kindergarten," she said. "We will miss her terribly and will take comfort knowing that she had achieved that dream."

Her mother said she was thrilled to get the job.

"It was the best year of her life," she told the newspaper.

Rousseau has been called gentle, spirited and active. She had planned to see "The Hobbit" with her boyfriend Friday and had baked cupcakes for a party they were to attend afterward. She was born in Danbury, and attended Danbury High, college at the University of Connecticut and graduate school at the University of Bridgeport.

She was a lover of music, dance and theatre.

"I'm used to having people die who are older," her mother said, "not the person whose room is up over the kitchen."

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Mary Sherlach, 56, school psychologist

When the shots rang out, Mary Sherlach threw herself into the danger.

Janet Robinson, the superintendent of Newtown Public Schools, said Sherlach and the school's principal ran toward the shooter. They lost their own lives, rushing toward him.

Even as Sherlach neared retirement, her job at Sandy Hook was one she loved. Those who knew her called her a wonderful neighbour, a beautiful person, a dedicated educator.

Her son-in-law, Eric Schwartz, told the South Jersey Times that Sherlach rooted on the Miami Dolphins, enjoyed visiting the Finger Lakes, relished helping children overcome their problems. She had planned to leave work early on Friday, he said, but never had the chance. In a news conference Saturday, he told reporters the loss was devastating, but that Sherlach was doing what she loved.

"Mary felt like she was doing God's work," he said, "working with the children."

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Victoria Soto, 27, teacher

She beams in snapshots. Her enthusiasm and cheer was evident. She was doing, those who knew her say, what she loved.

And now, Victoria Soto is being called a hero.

Though details of the 27-year-old teacher's death remained fuzzy, her name has been invoked again and again as a portrait of selflessness and humanity among unfathomable evil. Those who knew her said they weren't surprised by reports she shielded her first-graders from danger.

"She put those children first. That's all she ever talked about," said a friend, Andrea Crowell. "She wanted to do her best for them, to teach them something new every day."

Photos of Soto show her always with a wide smile, in pictures of her at her college graduation and in mundane daily life. She looks so young, barely an adult herself. Her goal was simply to be a teacher.

"You have a teacher who cared more about her students than herself," said Mayor John Harkins of Stratford, the town Soto hailed from and where more than 300 people gathered for a memorial service Saturday night. "That speaks volumes to her character, and her commitment and dedication."

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Associated Press writers Denise Lavoie, Mark Scolforo, Allen Breed and Danica Coto contributed to this report.

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Schools and students are targets worldwide

BEIJING (AP) — A half-day before a young gunman committed one of the deadliest school attacks in U.S. history, a Chinese farmer took a kitchen knife and hacked at more than 20 children as they entered their rural elementary school.

Though the outcomes are different — 28 dead in Connecticut, and 23 injured in China — the Friday attacks show how disturbingly frequent rampages against children and schools are. Attackers often seek out the vulnerable, hoping to amplify their outrage before they themselves often commit suicide. News of one mass killing often serves as inspiration and blueprint to other potential mass killers.

"It's these disaffected people who are angry at the world, who plan to take out as many people as they can, and there's some element there of notoriety," said forensic psychologist James Ogloff of Monash University in Melbourne, Australia. "It's a way of becoming infamous."

Mass killings, when an individual tries to kill as many people at one time as possible, have occurred in places as far away as Switzerland, where 14 people died in a shooting spree by an unemployed man who then killed himself in 2001, to South Korea, where a police officer killed 56 people before he blew himself up in 1982. Distinct from acts of terror that have political or collective aims, other mass killers act out of personal grievances.

Attacks against schools are a bleak subset, offering easy targets for taking down large numbers of victims. Shootings at schools have periodically occurred in Finland and Germany as well as the U.S., though the American attacks have been more frequent.

China has seen more than a half-dozen school attacks in less than three years, though the death tolls have been mostly in single digits, largely because knives have been the most-used weapon. China largely prohibits private ownership of guns.

"They choose to attack school students who are weak in defending themselves and are easily assaulted," said Zhu Zhuohong, an associate researcher in psychology at the Chinese Academy of Sciences.

Ogloff, the forensic psychologist who has studied both spree and serial killers in the U.S., Canada and Australia, said that a break-down in a relationship or a humiliating experience often acts as a triggering event for mass shooters. After Thomas Hamilton killed 16 kindergarteners and a teacher at an elementary school in Dunblane, Scotland, in 1996, reports said that he had been suspected of inappropriate behavior with boys he oversaw in a youth group and that letters he wrote talked of persecution by police and authorities for forcing him from taking part in boys clubs and for causing a business he ran to fail.

While police in Connecticut and in China have so far not given motives for Friday's attacks, both began with single assaults. Twenty-year-old Adam Lanza first shot his mother in their home in the New England town of Newtown before driving to the nearby Sandy Hook Elementary School; armed with two handguns, he shot into two classrooms, killing 20 people and six adults and then apparently shooting himself.

Min Yingjun, a 36-year-old resident of Guangshan, an area of tea and rice farms in central China, burst into the home of an elderly woman and stabbed her with a kitchen knife, the government's Xinhua News Agency reported. Min then went to the Chenpeng Village Primary School, slashing at 22 students, ages 6 to 12, as they arrived for class. Seven of the students, some with severed fingers and ears, required hospitalization, Xinhua said.

Though Min did not die — he was grabbed by police at the scene and is under arrest — Zhu, the psychologist, said many mass attacks should be seen as "expanded suicide." The attackers, often in a state of depression, believe society is malicious or unsafe and wants others to die with them, said Zhu.

Police described Min as possibly being "mentally ill," Xinhua said, and a law enforcement official briefed on the Connecticut shooting told The Associated Press that Lanza was believed to suffer from a personality disorder. But overall, said Ogloff, very few mass shooters are mentally ill.

Most perpetrators are young men, and their common traits — an interest in the military or violence — are so widespread as to make it impossible to identify potential killers, said Ogloff. Spree shootings, he said, are increasing and becoming deadlier because each killing leaves a blueprint for others to follow.

"Imagine you're a kid and you're 20 years old, and you're angry at the world and you're fascinated with the military and you're in a situation where you want to end your life. ... You're influenced by all the ones who've gone before you," said Ogloff, who has overseen the treatment of Martin Bryant, who shot 35 people at Port Arthur, a former penal colony and tourist site, in Tasmania in 1996.

The spate of school attacks in China — six in a seven-month period in 2010 — have raised concerns about copycats. News media in China, all of which are state-controlled, gave wide coverage to the Connecticut attack. But they ran the same brief Xinhua report about Friday's knifings in Guangshan, and local officials refused to provide more information, signs that authorities want to restrict the news either to prevent encouraging others or to play down the crime to keep blame off the government.

If identifying possible perpetrators is difficult, providing better access to mental health services and restricting the availability of firearms are key to reducing the numbers of victims, experts said.

"It's interesting that you have two individuals entering schools but because of the means of their attacks — one with firearms, one with a knife — there's an extreme disparity in the casualties," said Christian Chan, a professor of psychology at Hong Kong University. "It's the means that we can control, not necessarily the psychology of people. Throughout history there will always be people who might lose it."

Tight controls mean that gun crimes are rare in China and make knives and sometimes explosives the weapons used in mass attacks in China. Even so, violence is on the rise as people grow frustrated with a corrupt and often indifferent officialdom and seek other means to address grievances.

"The social environment is a factor behind attacks in China," said Ku Jianhui, a lawyer with the Beijing Xindong law firm. "A person who chooses extreme acts to voice his or her grievances usually believes that his or her cases were unable to be handled fairly through normal channels or legal procedures."

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Associated Press reporter Kristen Gelineau in Sydney, Australia, and researcher Henry Hou in Beijing contributed to this report.

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School shooting postpones Cruise premiere in Pa.

NEW YORK (AP) — The U.S. premiere of the Tom Cruise action movie "Jack Reacher" is being postponed following the deadly Connecticut school shooting.

Paramount Pictures says "out of honor and respect for the families of the victims" the premiere won't take place Saturday in Pittsburgh, where "Jack Reacher" was filmed.

The premiere would've been Cruise's first U.S. media appearance since his split from Katie Holmes over the summer. It was to be more contained with select outlets covering and a location away from Hollywood or New York.

A proclamation ceremony for Cruise had been planned with Pennsylvania Gov. Tom Corbett and Pittsburgh Mayor Luke Ravenstahl.

No new date for the premiere has been set. The movie opens Dec. 21.

Friday's massacre at a Newtown, Conn., elementary school killed 20 children and several adults.

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Fewer health care options for illegal immigrants

ALAMO, Texas (AP) — For years, Sonia Limas would drag her daughters to the emergency room whenever they fell sick. As an illegal immigrant, she had no health insurance, and the only place she knew to seek treatment was the hospital — the most expensive setting for those covering the cost.

The family's options improved somewhat a decade ago with the expansion of community health clinics, which offered free or low-cost care with help from the federal government. But President Barack Obama's health care overhaul threatens to roll back some of those services if clinics and hospitals are overwhelmed with newly insured patients and can't afford to care for as many poor families.

To be clear, Obama's law was never intended to help Limas and an estimated 11 million illegal immigrants like her. Instead, it envisions that 32 million uninsured Americans will get access to coverage by 2019. Because that should mean fewer uninsured patients showing up at hospitals, the Obama program slashed the federal reimbursement for uncompensated care.

But in states with large illegal immigrant populations, the math may not work, especially if lawmakers don't expand Medicaid, the joint state-federal health program for the poor and disabled.

When the reform has been fully implemented, illegal immigrants will make up the nation's second-largest population of uninsured, or about 25 percent. The only larger group will be people who qualify for insurance but fail to enroll, according to a 2012 study by the Washington-based Urban Institute.

And since about two-thirds of illegal immigrants live in just eight states, those areas will have a disproportionate share of the uninsured to care for.

In communities "where the number of undocumented immigrants is greatest, the strain has reached the breaking point," Rich Umbdenstock, president of the American Hospital Association, wrote last year in a letter to Obama, asking him to keep in mind the uncompensated care hospitals gave to that group. "In response, many hospitals have had to curtail services, delay implementing services, or close beds."

The federal government has offered to expand Medicaid, but states must decide whether to take the deal. And in some of those eight states — including Texas, Florida and New Jersey — hospitals are scrambling to determine whether they will still have enough money to treat the remaining uninsured.

Without a Medicaid expansion, the influx of new patients and the looming cuts in federal funding could inflict "a double whammy" in Texas, said David Lopez, CEO of the Harris Health System in Houston, which spends 10 to 15 percent of its $1.2 billion annual budget to care for illegal immigrants.

Realistically, taxpayers are already paying for some of the treatment provided to illegal immigrants because hospitals are required by law to stabilize and treat any patients that arrive in an emergency room, regardless of their ability to pay. The money to cover the costs typically comes from federal, state and local taxes.

A solid accounting of money spent treating illegal immigrants is elusive because most hospitals do not ask for immigration status. But some states have tried.

California, which is home to the nation's largest population of illegal immigrants, spent an estimated $1.2 billion last year through Medicaid to care for 822,500 illegal immigrants.

The New Jersey Hospital Association in 2010 estimated that it cost between $600 million and $650 million annually to treat 550,000 illegal immigrants.

And in Texas, a 2010 analysis by the Health and Human Services Commission found that the agency had provided $96 million in benefits to illegal immigrants, up from $81 million two years earlier. The state's public hospital districts spent an additional $717 million in uncompensated care to treat that population.

If large states such as Florida and Texas make good on their intention to forgo federal money to expand Medicaid, the decision "basically eviscerates" the effects of the health care overhaul in those areas because of "who lives there and what they're eligible for," said Lisa Clemans-Cope, a senior researcher at the Urban Institute.

Seeking to curb expenses, hospitals might change what qualifies as an emergency or cap the number of uninsured patients they treat. And although it's believed states with the most illegal immigrants will face a smaller cut, they will still lose money.

The potential impacts of reform are a hot topic at MD Anderson Cancer Center in Houston. In addition to offering its own charity care, some MD Anderson oncologists volunteer at a county-funded clinic at Lyndon B. Johnson General Hospital that largely treats the uninsured.

"In a sense we've been in the worst-case scenario in Texas for a long time," said Lewis Foxhall, MD Anderson's vice president of health policy in Houston. "The large number of uninsured and the large low-income population creates a very difficult problem for us."

Community clinics are a key part of the reform plan and were supposed to take up some of the slack for hospitals. Clinics received $11 billion in new funding over five years so they could expand to help care for a swell of newly insured who might otherwise overwhelm doctors' offices. But in the first year, $600 million was cut from the centers' usual allocation, leaving many to use the money to fill gaps rather than expand.

There is concern that clinics could themselves be inundated with newly insured patients, forcing many illegal immigrants back to emergency rooms.

Limas, 44, moved to the border town of Alamo 13 years ago with her husband and three daughters. Now single, she supports the family by teaching a citizenship class in Spanish at the local community center and selling cookies and cakes she whips up in her trailer. Soon, she hopes to seek a work permit of her own.

For now, the clinic helps with basic health care needs. If necessary, Limas will return to the emergency room, where the attendants help her fill out paperwork to ensure the government covers the bills she cannot afford.

"They always attended to me," she said, "even though it's slow."

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Sherman can be followed on Twitter at https://twitter.com/chrisshermanAP .

Plushnick-Masti can be followed on Twitter at https://twitter.com/RamitMastiAP .

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Police, world wonder about Conn. shooting motive

NEWTOWN, Conn. (AP) — The massacre of 26 children and adults at a Connecticut elementary school elicited horror and soul-searching around the world even as it raised more basic questions about why the gunman, a 20-year-old described as brilliant but remote, would have been driven to such a crime and how he chose his victims.

Investigators were trying to learn more about the gunman, Adam Lanza, and questioned his older brother, who is not believed to have been involved in the rampage at Sandy Hook Elementary. Police shed no light on the motive for the nation's second-deadliest school shooting.

In tight-knit Newtown on Friday night, hundreds of people packed St. Rose of Lima church and stood outside in a vigil for the 28 dead — 20 children and six adults at the school, the gunman's mother at home, and the gunman himself, who committed suicide. People held hands, lit candles and sang "Silent Night."

"These 20 children were just beautiful, beautiful children," Monsignor Robert Weiss said. "These 20 children lit up this community better than all these Christmas lights we have. ... There are a lot brighter stars up there tonight because of these kids."

Lanza is believed to have suffered from a personality disorder and lived with his mother, said a law enforcement official who was briefed on the investigation.

Lanza shot his mother, Nancy Lanza, drove to the school in her car with at least three guns, including a high-powered rifle that he apparently left in the back of the vehicle, and shot up two classrooms around 9:30 a.m. Friday, law enforcement officials said, speaking on condition of anonymity.

A custodian ran through the halls, warning of a gunman, and someone switched on the intercom, perhaps saving many lives by letting them hear the chaos in the school office, a teacher said. Teachers locked their doors and ordered children to huddle in a corner or hide in closets as shots echoed through the building.

The well-liked principal, Dawn Hochsprung, was believed to be among the dead. A woman who worked at the school was wounded. An update on victims' identities was planned Saturday morning.

A law enforcement official speaking on condition of anonymity said investigators believe Lanza attended the school several years ago but appeared to have no recent connection to it.

At least one parent said Lanza's mother was a substitute teacher there. But her name did not appear on a staff list. And the official said investigators were unable to establish any connection so far between her and the school.

Lanza's older brother, 24-year-old Ryan Lanza, of Hoboken, N.J., was questioned, but a law enforcement official said he was not believed to have had a role in the rampage. Investigators were searching his computers and phone records, but he told law enforcement he had not been in touch with his brother since about 2010.

The officials spoke on the condition of anonymity because they were not authorized to discuss the unfolding investigation.

At one point, a law enforcement official mistakenly identified the gunman as Ryan Lanza. Brett Wilshe, a friend of Ryan Lanza's, said Lanza told him the gunman may have had his identification. Ryan Lanza apparently posted Facebook page updates Friday afternoon that read, "It wasn't me" and "I was at work."

For about two hours late Friday and early Saturday, clergy members and emergency vehicles moved steadily to and from the school. The state medical examiner's office said bodies of the victims would be taken there eventually for autopsies.

The shooter took three guns into the school — a Glock and a Sig Sauer, both pistols, and a .223-caliber Bushmaster rifle, according to an official who was not authorized to discuss information with reporters and spoke on the condition of anonymity. The weapons were registered to his slain mother.

Adam Lanza and his mother lived in a well-to-do part of prosperous Newtown, about 60 miles northeast of New York City, where neighbors are doctors or hold white-collar positions at companies such as General Electric, Pepsi and IBM.

Lanza's parents filed for divorce in 2008, according to court records. His father, Peter Lanza, lives in Stamford, Conn., and works as a tax director for General Electric.

The gunman's aunt Marsha Lanza, of Crystal Lake, Ill., said her nephew was raised by kind, nurturing parents who would not have hesitated to seek mental help for him if he needed it.

"Nancy wasn't one to deny reality," Marsha Lanza said, adding her husband had seen Adam as recently as June and recalled nothing out of the ordinary.

Catherine Urso, of Newtown, said her college-age son knew the killer and remembered him for his alternative style. "He just said he was very thin, very remote and was one of the goths," she said.

Adam Lanza attended Newtown High School, and several news clippings from recent years mention his name among the honor roll students.

Joshua Milas, who graduated from Newtown High in 2009 and belonged to the school technology club with him, said Adam Lanza was generally a happy person but that he hadn't seen him in a few years.

"We would hang out, and he was a good kid. He was smart," Joshua Milas said. "He was probably one of the smartest kids I know. He was probably a genius."

An official who spoke on condition of anonymity said it was not clear that Adam Lanza had a job, and there was no indication of law enforcement interviews or search warrants at a place of business.

The mass shooting is one of the deadliest in U.S. history, and among school attacks is second in victims only to the 2007 Virginia Tech massacre, which left 33 people dead, including the gunman. Reaction was swift and emotional in Newtown, a picturesque New England community of 27,000 people, as well as across the country and around the world.

"It has to stop, these senseless deaths," said Frank DeAngelis, principal of Colorado's Columbine High School, where a massacre in 1999 killed 15 people.

In Washington, the Coalition to Stop Gun Violence organized a vigil at the White House, with some protesters chanting, "Today IS the day" to take steps to curb gun violence. In New York's Times Square, a few dozen people held tea lights in plastic cups, with one woman holding a sign that read: "Take a moment and candle to remember the victims of the Newtown shooting."

President Barack Obama's comments on the tragedy amounted to one of the most outwardly emotional moments of his presidency.

"The majority of those who died were children — beautiful little kids between the ages of 5 and 10 years old," Obama said at a White House news briefing. He paused for several seconds to keep his composure as he teared up and wiped an eye. Nearby, two aides cried and held hands.

Australian Prime Minister Julia Gillard described the attack as a "senseless and incomprehensible act of evil."

"Like President Obama and his fellow Americans, our hearts too are broken," Gillard said in a statement.

In Japan, where guns are severely restricted and there are extremely few gun-related crimes, the attack led the news two days before nationwide parliamentary elections. In China, which has seen several knife rampages at schools in recent years, the attack quickly consumed public discussion.

At the Newtown vigil, Anthony Bloss, whose three daughters survived, said they are doing better than he. "I'm numb. I'm completely numb," he said.

The gunman entered the school through its front door, and authorities are looking into the possibility that he shattered glass next to it to get in, said Newtown Police Lt. George Sinko.

Panicked parents looking for their children raced to Sandy Hook, a kindergarten-through-fourth-grade school where police told youngsters to close their eyes as they were led from the building so that they wouldn't see the blood and broken glass.

Schoolchildren — some crying, many looking frightened — were escorted through a parking lot in a line, hands on one another's shoulders.

Robert Licata said his 6-year-old son was in class when the gunman burst in and shot the teacher. "That's when my son grabbed a bunch of his friends and ran out the door," he said. "He was very brave. He waited for his friends."

He said the shooter didn't utter a word.

Kaitlin Roig, a teacher at the school, said she implored her students to be quiet.

"I told them we had to be absolutely quiet. Because I was just so afraid if he did come in, then he would hear us and just start shooting the door. I said we have to be absolutely quiet. And I said there are bad guys out there now and we need to wait for the good guys to come get us out," Roig told ABC News.

"If they started crying, I would take their face and say it's going to be OK. Show me your smile," she said. "They said, we want to go home for Christmas. Yes, yeah. I just want to hug my mom, things like that, that were just heartbreaking."

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Contributing to this report were Associated Press writers Pat Eaton-Robb and Matt Apuzzo and videographer Robert Ray in Newtown; Bridget Murphy in Boston; Samantha Henry in Newark, N.J.; Pete Yost in Washington; Michael Melia in Hartford; and the AP News Research Center in New York.

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