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Triaging for Trauma During COVID-19
Getty + Laura Baker/Education Week

To say educators should expect rough emotional weather this fall is an understatement.

Regardless of whether they return online or in-person, students will start school this fall amid a perfect storm of ongoing trauma: a nationwide pandemic, economic instability, and racial unrest over police killings, as well as months of anxiety and isolation caused by school and community shutdowns.

Before the pandemic, federal data suggested nearly half of all U.S. children had been exposed to at least one traumatic event, and more than 20 percent had been exposed to several. Studies from across health and education fields have found that students who experience sustained traumatic stress, known as "adverse childhood experiences," are more likely to have academic and behavioral problems in school and cognitive and emotional difficulties outside of it.

District and school leaders are confronting difficult, high-stakes decisions as they plan for how to reopen schools amid a global pandemic. Through eight installments, Education Week journalists explore the big challenges education leaders must address, including running a socially distanced school, rethinking how to get students to and from school, and making up for learning losses. We present a broad spectrum of options endorsed by public health officials, explain strategies that some districts will adopt, and provide estimated costs.

Part 1: The Socially Distanced School Day
Part 2: Scheduling the School Year
Part 3: Tackling the Transportation Problem
Part 4: How to Make Remote Learning Work
Part 5: Teaching and Learning
Part 6: Overcoming Learning Loss
Part 7: Teaching Social-Emotional Skills
Up next: Equity Access
Full Report: How We Go Back to School

By this summer, more than 3 in 4 school social workers in a national survey reported that a majority of students at their schools needed serious mental health supports in the wake of the pandemic and school closures.

"We've been told if we do basic [social-emotional learning] for these kids, everything's going to be fine. While that may be enough for upper-middle and upper-class schools, it's not going to be true for these schools with major capacity issues," said study co-author Ron Avi Astor, a professor and chair of social welfare at the University of California Los Angeles's graduate school of education. "Everything we do there may not be effective if you don't organize and build capacity, not in a crisis mode ..., but for the long-term, like you would in a war."

Traditional aspects of trauma-sensitive instruction-such as using a whole-child approach, rethinking student discipline and other policies, and promoting a sense of belonging for students-had already started to gain traction among schools before the pandemic. But the new and disparate contexts for learning this fall will make it both more challenging and more critical for teachers to identify and support the students struggling with toxic stress.

Here are a few ways schools can address student trauma as schools reopen.

1. Expect distress, but don't pathologize students

"I think there's a danger that schools will pathologize kids. I think teachers are going to see a lot more extreme behaviors, but that's not necessarily kids experiencing [post-traumatic stress syndrome]," said Mary Walsh, a professor of counseling and developmental psychology at Boston College. "We know all kids are being affected by the pandemic, this fluid, traumatic event, but only about a third of kids who experience trauma develop serious issues that can become PTSD. If we put the right protective factors in place, kids have enormous resilience."

Walsh advised teachers to work this fall with each other and school counselors and social workers to review the academic, social-emotional, behavioral, and health status of each student in their incoming class.

Online classes may even offer new opportunities to get a read on students. Some schools are asking counselors to sit in on academic subject classes, such as math, to check students' engagement and emotional temperature while the teacher focuses on instruction.

Downloadable Guide: Identifying Stress and Trauma

Colleen Perry, coordinator of City Connects, a student support program, at Pottenger Elementary in Springfield, Mass., said she and other school counselors held weekly video conferences for K-5 students in the spring in which they could sing and play games with classmates. They plan to continue this fall.

"It was really nice because we interacted with students that we normally wouldn't have interacted with because we never knew that they really needed as much interaction," she said. "In school, they were the quiet ones, ones that really weren't seen as high-needs kids just because they didn't act out in their behavior."

2. Coordinate holistic supports to remove sources of toxic stress

The toxic stress that hinders learning and long-term outcomes often comes not from a one-off trauma, but from deep, ongoing instability, particularly relating to a child's home and family. In Astor's survey from earlier this summer, more than 60 percent of the school social workers also reported that more than half of students at their school had "profound, immediate, urgent needs" related to health problems, food instability, and individualized student tutoring.

"To do a trauma-informed-care school where everybody's focused on great interactions, but 80 percent of your kids are hungry, doesn't make sense," Astor said.

Schools can help to buffer students from these stressors by coordinating with other agencies and community groups to provide a multi-tiered system of academic, social, and basic living supports. Districts from Bucksport, Maine, to Los Angeles, Calif., are connecting students to online mental health and sometimes school clinic services.

In Salem, Mass., where a majority of students are students of color or those from low-income families, school and city agencies have been working to create more substantive supports for vulnerable students. The shutdowns this spring "exacerbated all the barriers that existed before for a lot of our kids who have experienced systematic oppression and injustice," said Ellen Wingard, the director of student and family support at Salem public schools, leaving teachers and staff concerned about students and families who were struggling.

The pandemic provided the incentive to get a long-planned interagency initiative off the ground. The school district, mayor's office, local health, housing and social service agencies, and community organizations launched a website and initiative called Salem Together to provide wraparound supports to children and their families.

"We were able to pretty quickly put into place a protocol for all teachers to reach out to their kids and ask a few simple questions-Are you OK? Do you need food? What's going on with your family?-and the system could report back to support staff and all our partners and coordinate a ton of volunteers ready to help," Wingard said.

Beyond streamlining help to students, Wingard said the initiative has also provided an outlet for teachers and the community who wanted to support each other. "It gave us a way to know what was going on so we didn't feel completely helpless," she said.

The district is bracing for rising unemployment and housing instability this fall in addition to the pandemic, and the district's leadership team, principals, assistant principals, and special education coordinators have been receiving additional training on trauma-sensitive instruction in the runup to school restarting in mid-September.

3. Consider unintended consequences of school policies

Protests this spring and summer for racial justice following police killings of black people have reignited concerns about disproportionate discipline practices in schools, as well. A new Education Trust study on equity issues in social-emotional development found students and families of color strongly valued social-emotional development in schools but considered school policies and services to be focused on "fixing" them rather than supporting them.

Some students of color have already been subject to harsh discipline for not fully participating in remote learning during the school shutdown this spring. A 15-year-old Michigan student was jailed for not completing remote homework when a judge found that violated her probation. Education Trust researcher Nancy Duchesneau, an author of the Education Trust study, said that while students are less likely to experience overt exclusionary discipline like suspensions in an online classroom, teachers may more easily exclude students they consider disruptive or overlook those who are not actively reaching out online.

As school leaders develop policies and norms for new remote and socially distanced classrooms, it is important to build in ways to help students and families feel safe and respected. For example, Duchesneau recommended limiting the use of dress codes for home learning, and suggested allowing students to attend without broadcasting video, or teaching students how to set up a virtual screen behind them that can protect their privacy if they feel uncomfortable allowing others to see them or their home environments.

4. Promote a sense of belonging

Finding ways to identify and leverage students' strengths rather than deficits can bolster their resilience to stress.

"Students-and especially students of color and students from low-income households-have been stepping up in many ways during this time: taking on caretaking duties, becoming more active in protests against police brutality and racial injustice," said Duchesneau of Education Trust. "Adults in schools really need to understand that these skills may not present in a very particular way. If you have a student who has a lot of caretaking duties at home and comes into school every day, but may miss a homework assignment here or there, instead of seeing that student as deficient in their self-management skills, educators should be recognizing that strength."

To ease anxiety, particularly among students who are unable to see their peers outside of school, teachers can build in time during remote classes for students to talk to each other or to share concerns about their lives in and out of school.

Koslouski worked with Massachusetts elementary teachers last year to create professional development curriculum and training in trauma-informed instruction and with administrators to review school discipline and other policies. Teachers now are using both online class meetings and parent-only online meetings to provide strategies on how parents could recognize signs of trauma and manage their own and their children's stress.

"I think we need to be really clear that what happens now with regard to our relationships and social connections can change the brain and build in resilience for kids," said Wingard of Salem public schools. "We're in a place where we need to empower and acknowledge the incredible strengths of our kids, even the kids who have experienced trauma."

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