Many more students than usual will return to school this fall having experienced trauma. Some will have witnessed loved ones struggle with a frightening and unpredictable illness and some will even have lost family or friends to COVID-19. Others will have suffered from sudden food and housing insecurity as a result of the swift and deep pandemic-caused recession. Still others will have experienced the killings of George Floyd and others at the hands of police as a trauma or have been affected by destruction in their communities following protests against police violence and racism.
Research gives us some reliable ideas about which children are most likely to be traumatized by these recent events, how to identify them, and how schools can respond. Children who were thriving prior to these events and whose families escaped largely unscathed will likely be fine, research suggests. Children who were already experiencing emotional or behavioral difficulties or whose family and community were hit hard by COVID-19 and racial injustice may not be so fortunate.
Some background: Children affected by what's called "adverse childhood events"-often enumerated as abuse, neglect, household dysfunction, being victimized by crime, or witnessing violence-can develop emotional or behavioral difficulties from trauma-related stress. Addressing childhood trauma has come onto schools' radar in the past few years, in part because of the large number of children-up to two-thirds-who experience at least one adverse event.
Traumatized children are more likely than others to end up in conflict with peers and teachers, to be absent from school, and to encounter academic difficulty. Children subject to large-scale traumatic events, like natural weather disasters or political violence, may show similar symptoms, at least in the short term.
Research on childhood trauma suggests two concrete actions for schools and districts. First, districts can screen for trauma when school restarts, either in person or online, in the fall. Then, in places where the events of this year have showed up as trauma, schools can implement programs that promote child coping skills and support teachers in their work helping mitigate students' trauma symptoms.
School-based screening instruments focus first on a child's exposure to traumatic events, for instance, job loss or a death in the family. Next, the instrument seeks to uncover emotional or behavioral symptoms related to that exposure.
Several screening tools are available, including one specifically for COVID-19 trauma. Researchers at the University of California, Los Angeles, have adapted the PTSD Reaction Index, which is itself a well-researched instrument. The COVID-19 version is short, containing fewer than 20 items for most children. Because of its brevity, the tool may not cover all the ways children can be affected by the pandemic, and schools may want to augment the UCLA list with other stressors common in their local community.
Schools in communities affected by police violence and its aftermath may want a more comprehensive screener. These include:
*the Structured Trauma-Related Experiences and Symptoms Screener (STRESS)
*the Child and Adolescent Trauma Screen (CATS), and
*the Child Reaction to Traumatic Events (CRTES).
This essay is the tenth in a series that aims to put the pieces of research together so that education decisionmakers can evaluate which policies and practices to implement.
The conveners of this project-Susanna Loeb, the director of Brown University's Annenberg Institute for School Reform, and Harvard education professor Heather Hill-have received grant support from the Annenberg Institute for this series.
To suggest other topics for this series or join in the conversation, use #EdResearchtoPractice on Twitter.
Most useful from these instruments will be the portion that screens for trauma symptoms. Again, schools may need to adapt the exposure sections of the instruments by writing items related to either or both of this spring's health and social upheavals.
All of the above tools are available for download for free and can be completed by children themselves. Schools that wish to have teachers report on children's trauma can use the Social, Academic, and Emotional Behavior Risk Screener-Teacher Rating Scale (SAEBRS-TRS), another well-researched instrument.
Researchers note that these screening instruments are not diagnostic. Not all children who experience traumatic events show emotional and behavioral symptoms and not all children who report those symptoms require treatment. Further screening may be needed, possibly by mental-health clinicians within schools.
Then, if screening or observation suggest students are suffering from trauma, schools and districts can adopt programs that give students tools to cope. In a review, University of Notre Dame researchers Kaitlin Fondren, Kristin Valentino, and colleagues point to several such programs with proven track records.
Some programs are designed to be used by students' classroom teachers. ERASE-Stress, an Israeli program that has addressed children's mental health in natural disasters and in regions with political violence, reduced children's post-traumatic stress symptoms, improved their functioning, and gave students more hope. Training is available from the program developer, Rony Berger.
Other programs target only children severely affected by trauma, using school-based mental-health staff to deliver the program. The best-studied such program listed in Fondren's review is Bounce Back for elementary children. A companion program, Cognitive Behavioral Intervention for Trauma in Schools, is aimed at adolescents. Both programs have been tested with ethnically diverse student populations and offer free online training for mental-health practitioners at schools.
Many other programs in Fondren's review were piloted on a small scale or internationally and do not appear accessible to U.S. schools. As a consequence, schools may wish to create their own. Fondren's review shows that effective programs typically rely on cognitive behavioral therapy, often paired with other approaches like mindfulness, meditation, or art therapy. Cognitive behavioral therapy gives users concrete strategies to put fears in perspective and improve emotional regulation. It is a popular treatment method among mental-health clinicians with substantial research evidence supporting its use.
Researchers note that it is important to support teachers charged with helping students overcome trauma. This is particularly important now because teachers themselves may have been traumatized this spring and summer. A study following the Christchurch Earthquake in New Zealand found that teachers implementing the ERASE-Stress program experienced fewer post-traumatic stress symptoms and reported more efficacy in working with students to alleviate their stress. Another program, STAT (Support for Teachers Affected by Trauma), is based on principles that are effective in other stress-reduction programs, but it has not yet been evaluated in a study that compared effects between groups randomly assigned to either participate in the program or not.
Districts may also want to invest in practices meant to promote positive teacher-student relationships. Student-teacher bonds are a protective factor when students experience trauma, as I'll discuss in a future essay. Whatever may come this summer and through the new school year, it's useful to know that some programs have been shown to help students, schools, and teachers through very dark days.
Heather C. Hill is a professor of education at the Harvard Graduate School of Education and studies teacher quality, teacher professional learning, and instructional improvement. Her broader interests include educational policy and social inequality.