A National Education
Talk Radio Interview (Free Link Included) Puts it All into Perspective
Dear Colleagues,
Introduction
Given the wide range of family, community,
school, peer, virtual, and personal interactions experienced by children and
adolescents, the potential impact of trauma on their learning, behavior, and
emotional status has become an important topic in the popular press and across
diverse psycho-educational circles.
However, I believe that:
- Some educators have become over-sensitized to this issue—for example, incorrectly attributing some students’ emotional or behavioral issues to “trauma” when they are due to other factors;
- Some schools do not understand and are misusing the Adverse Childhood Experiences (ACEs) scale and research; and
- Some districts—with all good intents—have adopted “trauma sensitive” programs and protocols that are either not needed or not advisable.
Indeed, relative to this latter point, some
districts are adopting “trauma sensitive” programs, protocols, and practices
that are NOT scientifically-based, NOT field-tested, NOT validated using
objective and methodologically-sound approaches, NOT applicable to their
students and needs, and NOT implemented along a multi-tiered continuum.
And while I understand the “public pressure”
and the “good intentions” of needing to response to the school-apparent effects
of students’ trauma, the results of implementing the wrong or unsuccessful
programs or interventions are that:
- Staff and student time, resources, efforts, and expectations are wasted;
- Some students are not provided the correct services or supports that they need right now—which delays the social, emotional, or behavioral change process (and may actually make their “problems” worse or more resistant to change in the future); and
- Students and staff mistakenly conclude that the “problem is worse than we thought,” or they believe that more intensive, community-base “solutions” are needed when their (incorrect or misapplied strategies) do not work.
Below, I will expand on this Introduction by
summarizing the most critical points from a recent Blog that I published in
August.
The reason for returning to this topic so
quickly is because of a national radio broadcast that I did on this subject a
week ago. Below, I will provide a free link
to this interview so you can share it with your colleagues.
In the end, I hope that state departments of
education, districts and schools, and community-based organizations and
practitioners (a) will evaluate what they are doing to address all students’
social, emotional, and behavioral development and challenges, and (b) will
re-position themselves if they have fallen into the identified “trauma traps”
by adopting a trauma sensitive program for the wrong reasons and/or with the
wrong developer.
_ _ _ _ _ _ _ _ _ _
Evaluating the Essential
Trauma-Sensitive School Issues
I extensively addressed the status and my concerns
with some trauma-sensitive school approaches in an August 17th Blog message:
Aren’t
Schools with Positive, Safe Climates Already Trauma Sensitive? Unmasking
the ACEs, and Helping Students Manage their Emotions in School
[CLICK
HERE for Full August 17th Blog message]
While I will summarize the essential issues
below, below is the link to a
national radio broadcast interview that I did on this subject with Larry
Jacobs, the host of Education Talk Radio—on October 4, 2019.
_ _ _ _ _ _ _ _ _ _
Issue #1: Do
Practitioners Understand the Original ACEs Research, Its Strengths, and Its
Limitations to School-Based Practice?
The original ACEs
Study was conducted by the Kaiser Permanente Health Maintenance Organization
(HMO) in Southern California from 1995 to 1997 with two waves of data collection.
As they were receiving physical exams, over
17,000 HMO members completed confidential surveys regarding their childhood
experiences and their current health status and behaviors. Significantly, beyond the fact that the
sample was from a limited geographic area, the participants were primarily
white and from the middle class.
While more recent
research has been published to update the original ACEs outcomes, the fact of
the matter is that, when used by schools to identify specific students, the
ACEs Survey is a screening tool.
And, as with any
screening tool, practitioners need to (a) analyze the data for false-positive
and false-negative student results, (b) determine the clinical
meaningfulness of any “red-flag, statistically significant” student
results, and (c) perform additional diagnostic assessments with
identified students to determine the depth, breadth, intensity, and impact of
the traumatic events embedded in the ACEs on their (school) lives.
In order to
understand the limitations of the ACEs survey, it is important to read and
understand the actual ACEs Study Questions, and then consider students’
experiences and responses in a late 20th Century world versus a now-21st
Century world—a generation later.
Below are the
actual ACEs Study Questions. Each “Yes”
response by a student receives one point toward the “final score.” Once again, read these items relative to today’s
students’ lives. Think about how many of
your students are likely to have experienced four or more of these events so
far in their lives (and why).
Here are the ten
ACEs Study Questions—which still are used today:
While you were growing up, during your first 18 years
of life:
1. Emotional Abuse. Did a parent or other adult
in the household often or very often… Swear at you, insult you, put you down,
or humiliate you? or Act in a way that made you afraid that you might be
physically hurt?
2. Physical Abuse. Did a parent or other adult
in the household often or very often… Push, grab, slap, or throw something at
you? or Ever hit you so hard that you had marks or were
injured?
3. Sexual Abuse. Did an adult or person at
least 5 years older than you ever… Touch or fondle you or have you touch their body in a
sexual way? or Attempt or actually have oral, anal, or vaginal
intercourse with you?
4. Emotional Neglect. Did you often or very often feel that … No
one in your family loved you or thought you were important or special? or Your family didn’t look out for each other, feel close
to each other, or support each other?
5. Physical Neglect. Did you often or very
often feel that … You didn’t have enough to eat, had to wear dirty clothes, and
had no one to protect you? or Your parents were too drunk or high to take care of
you or take you to the doctor if you needed it?
6. Parental Separation or Divorce. Were your
parents ever separated or divorced?
7. Mother Treated Violently. Was your mother or stepmother: Often or very often pushed, grabbed, slapped,
or had something thrown at her? or Sometimes, often, or very often kicked, bitten, hit
with a fist, or hit with something hard? or Ever repeatedly hit at least a few minutes or
threatened with a gun or knife?
8. Household Substance Abuse. Did you live with anyone who was a problem
drinker or alcoholic or who used street drugs?
9. Household Mental Illness. Was a household
member depressed or mentally ill, or did a household member attempt suicide?
10. Incarcerated Household Member. Did a household member go to prison?
_ _ _ _ _
Clearly, all
of these questions relate to a student’s home life and family experiences. Not a single question relates to a student’s
peer relationships, academic status, or school interactions. Thus, three embedded assumptions within the ACEs
are:
- A specific number of the ACEs home “traumas” creates a strong potential that a student will experience significant social, emotional, or behavioral problems;
- The intensity or pervasiveness of these problems will most likely affect a student—academically, socially, or behaviorally—in school; and
- Students who are “emotionally at-risk” due to their ACEs Survey results need some kind of “early intervention.”
In some ways, I
have no issues with these assumptions.
I do,
however, have significant concerns when schools do not correctly use (if they
are going to use it at all) the ACEs Survey as a screening tool (see
above), and act on these three assumptions—without the recommended follow-up
assessments—as if they are true.
_ _ _ _ _
But, beyond this, some other critical
concerns with the ACEs Survey questions— especially for educators and
relative to predicting students’ school behavior—are:
- They do not discriminate between “finite” events (e.g., having a household member incarcerated) and events that can occur over time or in a repeated way;
- Thus, they do not quantify many of the events (e.g., how long was the separation, how many times was your mother physically threatened);
- They do not identify the age (or age range) when the child or adolescent experienced each event;
- They do not ask for a rating of the intensity of each event (e.g., along a Mild-Moderate-Severe continuum);
- They do not get a rating of the emotional impact of each event at the time that it occurred (e.g., along a None-Low-Mild-Moderate-Significant-Life Changing continuum); and
- They do not get a rating of the current (assuming an event occurred in the past) and/or continuing emotional impact of each event.
_ _ _ _ _
Given the
absence of the critical contextual and functional assessment information
underlying a student’s responses on the ACEs Survey. . .
When a student scores above the ACEs
“cut-off” (representing a concern), we do not really know the cumulative depth,
breadth, intensity, or impact of that individual’s traumatic history. Indeed, we may just simply know how many
events an individual may have experienced.
Beyond this, relative to students, staff, and
schools, another critical issue is that there is no well-established and
validated science-to-practice connection to group or individual ACEs results and
effective approaches to trauma awareness, programming, or interventions in
schools.
The closest we get
to this is an October, 2018 report by the American Institutes for Research
(AIR), Trauma and Learning Policy Initiative (TLPI): Trauma-Sensitive
Schools Descriptive Study. This
Report is discussed in greater depth in my August 17th Blog message.
_ _ _ _ _ _ _ _ _ _
Issue #2. Are Schools Implementing Specialized “Trauma
Sensitive” Programs When They Should be Implementing More Comprehensive
(Pervasive and Preventative) Positive School Climate Practices?
Quite honestly, we do not need—in 2019—the
ACEs study to tell us that some students come to school having experienced
significant emotional traumas in their lives, or that all schools need to
create and sustain safe school climates and positive, supportive
classrooms. Moreover, to a large degree,
the neuro-physiological and neuro-psychological pathways and impact of trauma
have been known for many years.
But, to their credit, what the ACEs and
follow-up research studies have done is to crystallize the discussion
and information, and put it directly in the hands of different
educators—helping them to better understand some of the social, emotional, and
behavioral interactions of our children and adolescents.
But, as noted above, we may have gone too
far, too fast in suggesting that schools move to the “specialized” level
represented by many trauma sensitive school programs.”
Indeed, in the first paragraph of the
Executive Summary of AIR’s Trauma-Sensitive Schools Descriptive Study
referenced above, the authors state:
Background and Introduction:
School Climate and Culture and School Improvement
For decades, educators and policymakers have grappled
with the issue of school improvement—or how to create systemic changes that
lead to better and sustained student academic outcomes. A growing body of evidence
suggests that school improvement efforts cannot happen without considering the
impact of school climate and culture. Research demonstrates that a positive
school climate (which includes factors such as safety, a sense of connectedness
and belonging, social and emotional competencies, and the physical environment)
is associated with positive student outcomes (Kraft, Marinell, & Yee, 2016;
Kwong & Davis, 2015). Specifically, a positive school climate is associated
with higher student achievement, improved psychological well-being, decreased
absenteeism, and lower rates of suspension.
It also has been found that improving safety and
school climate can help reduce bullying and aggression (Bradshaw, Mitchell,
& Leaf, 2010; MacNeil, Prater, & Busch, 2009; Ross & Horner, 2009;
Thapa, Cohen, Guffey, & Higgins-D’Alessandro, 2013). In addition, research
indicates that the perception of a positive school climate, though beneficial
for all students, may be even more useful for students at risk for negative
outcomes (Loukas, 2007). The latter finding is particularly important given the
prevalence of trauma among students in schools.
While the remainder of the 118-page report
focused on the qualitative impact of trauma in only five schools—because
AIR was being paid to produce this report for a trauma-focused educational
organization—the paragraph above reflects the appropriate mindset that all
educators must have when even considering a trauma-sensitive program.
That mindset should be:
Focus on establishing and
sustaining prosocial and safe school climates, and positive and supportive
classrooms interactions.
As part of this school
discipline, classroom management, and student self-management process, identify
how trauma—and other critical factors—are affecting students’ social,
emotional, and behavioral readiness for and interactions in school, and
integrate prevention and early-response services, supports, and strategies to
address high-hit circumstances or needs.
For students with significant
social, emotional, behavioral, or mental health needs (whether trauma-based or
not), schools need a multi-disciplinary team of diverse experts who can analyze
the root causes of the problems, and link the assessment results to effective,
research-based multi-tiered services, supports, strategies, and interventions.
In other words,
educators should be establishing comprehensive, evidence-based, multi-tiered
school discipline (or positive behavioral support/social-emotional learning)
systems that integrate trauma as but one factor affecting students’
behavior, interactions, and academic readiness and engagement.
Moreover, this
suggests that schools should not implement a dedicated Trauma-Sensitive
Program as its core (or even secondary) system relative to school safety
and discipline, classroom climate and management, and student self-management
and academic engagement.
This is because:
- A Trauma-Sensitive Program may be too specialized for the typical school, and it may miss many of the non-trauma factors that contribute to school safety and climate;
- The Trauma-Sensitive Program may not be needed (thus, saving time, training, money, and motivation) if trauma-related information and practices are integrated into the core system;
- Most Trauma-Sensitive Programs are not even close to addressing the (Tier II and Tier III) strategic or intensive multi-tiered needs to specific students; and
- We still do not have a sound research-to-practice foundation (as discussed above) to know which trauma-sensitive practices and interventions provide the best services and supports to students, and the best return-on-investment to schools.
_ _ _ _ _ _ _ _ _ _
Issue #3.
Do Schools (Have the Time to) Evaluate the Integrity and Utility of
their Trauma Sensitive Programs Prior to Implementation, and How Many
Schools Choose their Programs Due to Cost and Not Outcomes?
One problem created by the Adverse Childhood
Experiences (ACEs) study is that it has spawned a “cottage industry” of
“experts and consultants” who have generated their own (what they call)
“research-based trauma programs.”
Unfortunately, many of these programs have
never been fully and objectively field-tested (if at all). . . in multiple
settings, under multiple conditions, and with students who have experienced
different types and intensities of trauma.
Said a different way: While many of these programs cite research
that explains why they have included certain components or activities, they
have not—themselves—been researched.
In fact, even from a research perspective,
many of these programs are not psychologically and neuropsychologically
grounded. That is, they do not use the
“deep science” of trauma—including the clinical, multi-tiered psychoeducational
elements needed for student and staff success.
Moreover, many of these programs are “stand
alone” programs. They do not integrate
their approaches into the school’s existing discipline, behavior management,
and student self-management systems, and they often are seen by staff as a
disconnected thread of information that represents “another thing to do” . . .
in an already impossibly busy day, week, and month.
Finally, too many of these programs
recommend global and generic components and activities that are not
strategically-chosen or sustainable. The
programs present a fixed package. . . rather than presenting sound strategies
on how to identify and then analyze the root causes of students’ trauma— so
that the assessment results can be strategically linked to needed services,
supports, and interventions.
Part of this latter problem exists because,
as discussed above, many educators do not fully understand the history and
limitations of the original ACEs research, and they do not have the
psychological understanding to discriminate potentially effective from
ineffective trauma-sensitive practices.
Indeed, some educators are focused more on
“program or package” implementation, rather than on implementing effective and
strategically-selected trauma-responsive practices.
_ _ _ _ _ _ _ _ _ _
Issue #4.
Do Schools Understand the Science-to-Practice Components that Facilitate
Students’ Emotional Self-Management—The Key Preventative “Skill” Needed by All
Students?
One of the ultimate
goals of a comprehensive, multi-tiered school discipline (Positive
Behavioral Support/Social-Emotional Learning, PBSS/SEL) system is to teach and
motivate students to learn, master, and independently apply social, emotional,
and behavioral self-management skills.
Emotional self-management skills, which some call “emotional
self-regulation” or even “emotional intelligence,” involves instruction in emotional
awareness, emotional control, and emotional coping skills.
In the August 17th Blog
Message, we describe these three components and their characteristics from a
psychological and neuropsychological science-to-practice perspective—a
perspective that often is missing in many “trauma-sensitive” programs.
[CLICK HERE for the August
17th Blog Message]
When schools implement effective approaches
within these three components—from preschool through high school—their students
are more able to handle the emotional triggers in their lives. Critically, the anchor to the entire process
is an evidence-based social, emotional, and behavioral skills program that is
taught in the general education classroom by students’ classroom teachers—like
the evidence-based Stop & Think Social Skills Program.
This social skills
program literally teaches students—at their specific developmental
level—emotional control, attributional and attitude control, and behavioral
execution skills.
For students who
need small group or individual instruction—due to their social, emotional,
behavioral, or mental health challenges, the school’s mental health and related
service professionals (e.g., school psychologists, counselors, and social
workers) need to be directly involved.
This is because some of these students need more clinical intervention,
and these mental health professionals are the best-trained and skilled people
to deliver them.
Indeed, some of the
clinical interventions that may needed at this deeper multi-tiered level
include:
- Progressive Muscle Relaxation Therapy and Stress Management
- Emotional Self-Management (Self-awareness, Self-instruction, Self-monitoring, Self-evaluation, and Self-reinforcement) Training
- Emotional/Anger Control and Management Therapy
- Self-Talk and Attribution (Re)Training
- Thought Stopping approaches
- Systematic Desensitization
- Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
- Cognitive-Behavioral Intervention for Trauma in Schools (CBITS)
- Structured Psychotherapy for Adolescents Responding to Chronic Stress (SPARCS)
- Trauma Systems Therapy (TST)
The Question is: Do schools’ related service professionals
have the skills to clinically deliver (as needed—based on student-centered
assessments) some or all of these strategies or therapies. . . or, are they
available from mental health professionals who are practicing in your community?
_ _ _ _ _
Developmental Differences and Students’ Emotional
Triggers
Part of the
emotional control training also involves a recognition of the developmental
differences of students from preschool through high school. Another part involves an understanding of
students’ shared and individual emotional triggers.
Relative to the
former area, there are significant developmental and emotional differences
between students at the preschool to Grade 2, Grades 3 to 5, and Grades 6 and
above levels. Teachers need to factor
these differences into their classroom self-management discussions and
instruction—both as they plan and as they implement the social skills
curriculum.
At the preschool to
Grade 2 level, students are concrete, sequential, and egocentric in their
thinking. Early on, they don’t even have
an emotional vocabulary to help them identify or express their feelings. Later on, they are egocentrically focused more
on their own—than others’—feelings, and their insight is limited relative to
the social complexities of many interpersonal situations. Given all of this, then, teachers at these
grade levels will need to be both their students’ social, emotional, and
behavioral guides, as well as their emotional control prompters and compasses.
At the Grade 3 to 5
level, students are beginning to develop higher-ordered thinking skills (both
academically and behaviorally), they have more self-insight, and they are more
able to predict and understand how others are feeling. . . and why they are
reacting in different social situations.
At these grade levels, however, teachers still need to teach their
students about their own and others’ feelings, and how to analyze and solve
common social situations. In other
words, while students here are more developmentally ready to solve more complex
social situations and dilemmas, they still need the instruction.
An academic
parallel here is when Grade 4 students are more cognitively ready to handle
abstract and multi-level comprehension questions in literacy or science, but
they still need the instruction in how to do this.
At the Grade 6 and above
level, students’ emotional situations are compounded by their desire for more
independence, physiological and sexual changes, enhanced academic and organizational
demands, the impact and influence of different peer groups, and their less
restricted exposure to social media, internet-driven, and news or entertainment
broadcasts and events that touch on sensitive issues or ones they have yet to
experience.
Here, teachers need to
recognize that, while they often “sound” mature, these students still need
training and guidance in (a) how to handle these complex or sensitive social
situations; (b) how to communicate in or respond to highly emotional personal,
peer, or adult situations; (c) how to understand and navigate their virtual,
social media-driven worlds; and (d) how to integrate moral and ethical
decision-making into these social dilemmas and deliberations.
Critically, this
requires a blend of advanced skill instruction, group discussion and
processing, social problem-solving simulations, and personal reflection and
self-evaluation.
_ _ _ _ _
Relative to the
latter area, students’ emotions are triggered in many different ways.
While they are a good
start, the issues embedded in the ACEs questions (revisit them above) need to
be expanded, as relevant, to community, school, and peer experiences and
interactions. To reflect this, the August
17th Blog Message provides a table with the original ten ACEs areas, with X’s
in the boxes where these traumas could also occur in non-familial settings or
with individuals who are not family members.
[CLICK HERE for the August
17th Blog Message and this Table]
The point here is
that: These events or issues are no
longer limited to our students’ familial experiences, and our trauma-related
assessments need to include these multiple settings. Said a different way: “Trauma is not setting-specific. It is event-dependent.” Traumas obviously can be experienced outside
of the “family home,” and be just as emotionally debilitating.
But beyond the trauma
areas in the ACEs research, other areas that trigger students’ emotionality include:
- Academic Frustration
- Test/Homework/Work Completion Anxiety
- Peer (including Girlfriend/Boyfriend) Conflicts/Rejection
- Teasing and Bullying—Direct, Indirect, Social, and Social Media
- Gender Status or Discrimination
- Racial or Multi-Cultural Status or Discrimination
- Sexual Identification or Orientation Discrimination
- Socio-economic Status or Discrimination
- Circumstances Related to Poverty/Parental Income
- Family Moves/Housing Mobility/Homelessness
- Competition/Losing
- Physical or Other Limitations or Disabilities
On a situational level,
these triggers can product emotional reactions that are just as quick and
intense as those that are trauma-related, and these need to be consciously
factored into a school climate, discipline, and classroom management system.
Moreover, as in the
trauma research, please remember that student emotionality can be manifested
along a “fight, flight, or freeze” continuum.
The Take-Aways here,
once again, include the following:
- There are multiple circumstances or events that trigger students’ emotionality in school. Many of them are not specifically (or by definition) traumatic events and, thus, schools that are using trauma-sensitive programs may easily miss them.
- Schools need to assess and identify the emotional triggers that are most prevalent across their student bodies, and the emotional triggers (if different) that are most often present for the students presenting with the most frequent, significant, or severe social, emotional, and behavioral challenges.
For the former group, these triggers
need to be integrated into the social skills curriculum at the prevention and
early response levels.
For the latter group, these triggers
need to frame the strategic or intensive interventions or therapies that
related services personnel need to be prepared to deliver.
- Finally, schools and districts need to be prepared to deliver the full multi-tiered continuum of services, supports, strategies, and interventions. This includes the necessary training, resources, and personnel both in general, and as needed on a year-to-year basis.
_ _ _ _ _ _ _ _ _ _
Summary
While I encourage everyone to pass this Blog
message on to other interested colleagues, feel free to start by forwarding the
link (once again) to the national
radio broadcast interview that I did on Trauma Sensitive School Programs with
Larry Jacobs, the host of Education Talk Radio—on October 4, 2019.
_ _ _ _ _ _ _ _ _ _
In addition, check out the following
additional free Project ACHIEVE monograph that more comprehensively describes
the evidence-based components and specific multi-tiered services, support,
strategies, and programs needed for a core positive school climate,
social-emotional learning system:
Project ACHIEVE’s School Improvement and Positive
Behavioral Support System/Social-Emotional Learning Overview
[CLICK
HERE and Find at the Bottom of the Page]
. . . and consider
its companion resource, A Multi-Tiered Service and Support Implementation
Guidebook for Schools: Closing
the Achievement Gap
[CLICK HERE and Find at the
Top of the Page]
_ _ _ _ _
Even when they are needed, most trauma
sensitive school programs are still in their infancy, most have not been
field-tested nor independently proven to be effective in multiple settings and
under multiple conditions, and—if implemented—most of these programs will not address
the comprehensive emotional needs of most students as there are many emotional
triggers that are not trauma-related.
We encourage districts and schools to
evaluate their current programs or approaches in light of the points discussed
in this Blog—summarized below:
Schools need to focus on establishing and sustaining
prosocial and safe school climates, and positive and supportive classrooms
interactions.
As part of this school discipline, classroom
management, and student self-management process, they need to identify how
trauma—and other critical factors—are affecting students’ social, emotional,
and behavioral readiness for and interactions in school, and integrate
prevention and early-response services, supports, and strategies to address high-hit
circumstances or needs.
For students with significant social, emotional,
behavioral, or mental health needs (whether trauma-based or not), schools need
a multi-disciplinary team of diverse experts who can analyze the root causes of
the problems, and link the assessment results to effective, research-based
multi-tiered services, supports, strategies, and interventions.
And so, all of this suggests that schools should
not implement a dedicated Trauma-Sensitive Program as its core (or even
secondary) system relative to school safety and discipline, classroom climate
and management, and student self-management and academic engagement.
Schools need to most effectively address the
social, emotional, and behavioral needs of all students—with a focus on their
emotional self-management. When students
have emotional self-management skills, and the support around them to
facilitate emotional control and coping, issues related to trauma and emotional
triggers become less evident, because the students have the capacity to handle
them.
_ _ _ _ _
As always, I look forward to your thoughts
and comments.
As the school year continues, know that I am
always available to provide a free hour of telephone consultation to those who
want to discuss their own students, school, or district needs. Feel free to contact me at any time if there
is anything that I can do to support your work.
Best,
Howie
