Wednesday, December 04, 2013


By Jane Meredith Adams, EdSource Today |

Joyce Dorado, director of UCSF's Healthy Environments and Response to Trauma in Schools program. Credit: EdSource Today: Jane Meredith Adams

Joyce Dorado is director of UCSF’s Healthy Environments and Response to Trauma in Schools program. Credit: Jane Meredith Adams, EdSource Today

December 2nd, 2013   ::  Backed by brain research, California schools are beginning to address the effect of severe trauma on the health and achievement of their students.

In districts including Humboldt, Richmond, Santa Cruz, Aptos and San Francisco, groups of teachers are being trained to recognize that students’ explosive anger, classroom outbursts, habitual withdrawal and self-injurious behaviors could be symptoms of traumatic stress, the result of repeated exposure to violence, abuse and neglect.

But while other initiatives focus on providing counseling services to youth, these trainings aim to provide teachers with the science and skills to better manage traumatized students in the classroom, an approach known as “trauma-informed” or “trauma-sensitive” teaching. The trainings ask teachers and staff to look at how their tone may contribute, knowingly or unknowingly, to combative interactions with traumatized youth.

“You understand that something’s going on with this kid who’s disengaged, with his head on the desk, or bouncing off the walls,” said Robert McDuff, a math teacher at De Anza High School in Richmond who took part in teacher trainings about trauma hosted by the school’s health center. “You don’t take it personally.”

Students under stress

Schools are responding to an enormous body of research about how children’s brains adapt to complex trauma, defined as multiple traumas including physical or sexual abuse, abandonment, and domestic and neighborhood violence.

In the brains of traumatized youth, neural pathways associated with fear and survival responses are strongly developed, leaving some children in a state of hyperarousal that causes them to overreact to incidents other children would find nonthreatening, the research shows. Consumed by fear, they find it difficult to achieve a state of calmness that would allow them to process verbal instructions and learn, according to the Child Welfare Information Gateway of the U.S. Department of Health and Human Services.

And many children are experiencing chronic stress, according to data. In 2012, California child welfare agencies received 487,000 reports of child abuse and neglect. Nationally, an estimated 1 in 4 children has witnessed a violent act and 1 in 10 has seen one family member assault another, according to the federal National Survey of Children’s Exposure to Violence, sponsored by the Office of Juvenile Justice Prevention and Delinquency Prevention and the Centers for Disease Control.

The link between childhood trauma and trouble at school is strong, according to a 2011 study of 701 children from the Bayview Child Health Center in San Francisco. In that study, pediatrician Dr. Nadine Burke Harris found that a child with four or more “adverse childhood experiences” was 32 times more likely to be labeled with a learning or behavior problem than a child with no adverse childhood experiences. The categories of adversity include having a household member who is chronically depressed; having an incarcerated household member; living in a household with one or no parents; and living in a household with an alcohol and/or drug abuser.

In the classroom, the quick-trigger behavior can be difficult for everyone to handle.

“What is wrong with him?” Joyce Dorado, director of UCSF’s Healthy Environments and Response to Trauma in Schools program and one of the leaders in the field of trauma-sensitive schools, asked a group of teachers and staff at a trauma training at Ida B. Wells Continuation High School in San Francisco in November. She described a hypothetical student who arrived late to class, put his head on the desk and refused to answer questions from the teacher. Ultimately he pushed a classmate, cursed the teacher and a received a five-day suspension.

“Does this sound like something that might happen here?” Dorado asked. A few teachers nodded.

Teachers at a trauma training at Ida B. Wells Continuation High School in San Francisco. Credit: EdSource Today, Jane Meredith Adams

Teachers at a trauma training at Ida B. Wells Continuation High School in San Francisco. Credit: Jane Meredith Adams, EdSource Today

“And what’s wrong with her?” Dorado asked, referring to the hypothetical teacher. Dorado noted that some people might say the teacher didn’t handle the situation well.

The backstory provided an explanation of what was going on, emotionally, at the start of the school day. The scenario was hypothetical, but Richard Duber, principal of Ida B. Wells Continuation High School, said it represented life for many students at the school. For the student, the night before had been a scene of domestic violence at home, with his father taken away by the police. That morning, his mother would not get out of bed, so the student took his siblings to school, which made him late. His thoughts in the classroom, Dorado speculated, included, “I can never do anything right,” “My teacher hates me” and “I am in danger here.”

For the teacher, she had been through a school lock-down the week before and was facing the start of testing the next day. Her thoughts included, “I can’t take one more thing,” “I am in danger here” and “I hate that student.”

“Actually,” Dorado said, “she cares about the student very much, when she’s in a calmer state.”

“We know from the research that unaddressed trauma is associated with dropping out,” Dorado said. But she added, “Does that mean (a student) gets to curse at his teacher? Of course not.”

But stress hormones block clear thinking in all of us, Dorado said. “If you take one thing away from the training today,” she told teachers, “it’s to change the question from ‘What’s wrong with him?’ to ‘What happened to him?’”

Building safe spaces

Classroom strategies for managing traumatized students align with the evidence-based social and emotional programs that are part of a system known as Positive Behaviorial Interventions and Supports, a program of school interventions that is recommended by the U.S. Department of Education and used in 600 California schools.

Those interventions, which include curricula such as Best Behavior and Time to Teach, involve teaching students how to self-regulate and calm down by taking a break, taking a deep breath and becoming aware of their surroundings. The programs, and others like them, also instruct teachers to build rapport with students by praising progress and speaking kindly. All of the interventions, including trauma-informed teaching, are meant to improve school culture and provide a new approach to school discipline.

Trauma is about the lack of safety, so effective interventions focus on restoring safety, said Gabriella Grant, director of the California Center of Excellence for Trauma Informed Care, who has conducted trauma trainings for teachers and assistant principals in Santa Cruz and Aptos. “We understand unsafe behavior as an expression of how unsafe this person feels, so we work to increase physical and emotional safety.”

The move to create trauma-sensitive schools is part of a broader effort to bring an understanding of trauma to all systems that deal with youth, including juvenile justice, foster care, mental health and education. This week in Anaheim, California Supreme Court Chief Justice Tani Cantil-Sakauye and State Superintendent of Public Instruction Tom Torlakson are to convene a summit for juvenile court workers, educators and others to examine how trauma, truancy and school discipline affect children, and how to build resilience.

“Having a better understanding of the meaning behind the behavior is really helpful,” said Meg Walkley, children and family support specialist at the Humboldt County Office of Education, which is now hosting a five-week series of trauma trainings for early childhood teachers, school counselors and mental health workers.

Walkley, co-author of “Building Trauma-Informed Schools and Communities,” published in Children and Schools, a journal of the National Association of Social Workers, directs The 0 to 8 Mental Health Collaborative in the county and trains Head Start teachers and preschool teachers to identify and address trauma in very young children, before trauma has a chance to affect their neurological development.

“We are trying to be as far upstream as we can be,” Walkley said. “If you can make a difference then, when the brain is rapidly developing, that’s the goal.”

Going deeper

“Response to Intervention for Behavior” by Jeffrey R. Sprague, Institute of Violence and Destructive Behavior, University of Oregon

“Preventing Children’s Exposure to Violence: The Defending Childhood Initiative” by Sarah B. Berson, Jolene Hernon and Beth Pearsall, National Institute of Justice Journal, June 2012

The National Child Traumatic Stress Network, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services

“Trauma and Resilience, An Adolescent Provider Toolkit,” by Alicia St. Andrews, Adolescent Health Working Group, 2013

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