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 psychoeducational 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 respond 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 mis-applied 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.
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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.
[CLICK HERE for this 28-minute Education Talk Radio Interview]
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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?
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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.
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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.
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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.
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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 neurophysiological and neuropsychological 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 schoolsafety 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.
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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.
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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?
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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.
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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.
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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.
[CLICK HERE for this 28-minute Education Talk Radio Interview]
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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]
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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.
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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,
