Students carry their outside worlds into school like raindrops on a coat. And if what they carry are symptoms of trauma, cognitive and emotional problems can follow.
Left unrecognized and unaddressed, students suffering from trauma can be misdiagnosed and improperly medicated. Trauma emerges when a student's life is raked by abuse, an accident or extreme poverty; or it can be communitywide, such as when flooding destroys homes and businesses, or the local water supply is contaminated by toxins.
The need to understand the effect of trauma on students — and to create effective responses based on resiliency — is so pressing, NYSUT provided workshops on trauma awareness this spring at its Health and Safety Conference and at its annual Professionals Issues Forum on Health Care. The sessions delved into the effects of acute and complex trauma on students and best practices for developing trauma-informed schools.
Acute trauma is a single troubling event, such as a death of a parent or an injury. Complex trauma comes from chronic experiences such as long-term illness, homelessness, neglect, an incarcerated family member, prolonged exposure to violence, cyberbullying or family substance abuse. Both kinds of trauma are identified as ACEs, or Adverse Childhood Experiences, and can lead to impaired development and medical problems.
Trauma-informed schools are built on safety and trust. Teachers, health care professionals and School-Related Professionals are trained to respond in similar ways. It can start with flipping the standard question from "What's wrong with you?" to "What is happening to you?" says Colleen Condolora, a special education teaching assistant and member of the Capital Region BOCES Faculty Association. She is also a member of NYSUT's Health and Safety Committee.
"I have had a great deal of success with many students who have experienced ACEs," she said. "It all begins with name recognition, saying hello each morning, and sharing your own vulnerabilities ... I try very hard to build their self-esteem and resiliency."
Trauma can manifest quickly and spread wildly. Winsome Brown-Cooke, a social worker and member of Hempstead Classroom Teachers Association, said students and their families in her Latino-majority district were on edge when President Trump issued a travel ban on immigrants.
Adam Piasecki, president of the Ithaca TA, attended the NYSUT workshop with several ITA social workers because he believes an increasing number of students "are having more characteristics of trauma in their lives."
Students affected by ACEs can have issues with trust, memory and organization-sensory processing, self-regulation, social skills and comprehension. They may overreact to people, loud noises and smells. They may have temper tantrums, or cut themselves.
Assessing a troubled student needs to include taking a trauma history. Without that information, "you run a great risk of leading to the wrong clinical and diagnostic mental health treatment plan," said David Wallace, LCSW, of LaSalle School in Albany, who presented at the NYSUT health care forum. The trauma history needs to be shared with everyone who comes in contact with the student each day at school, he said, so responses are uniform.
Wallace is a fierce advocate for music and art, necessities, he says, for a student's emotional health. "They develop the right side of the brain. To read, to create, for emotional regulation and problem-solving ... you need both sides of the brain developed."
To help build resiliency, Wallace suggests "little interventions," such as inviting students to help decorate classrooms, using weighted blankets instead of restraints for students who act out, letting fidgety children snap rubber bands placed between the front legs of their chair.
"The most effective approach is not to think of this as mental health problems, but as organizational and core training problems," he said. Punishment or using loud voices to reprimand is "a failed intervention. It can further aggravate neurodevelopment."
Overmedicating can also exacerbate the issues, Wallace cautioned, explaining how some traumatized children and young adults are treated with heavy medications, such as antipsychotics.
"The traumatized brain is already hyper-aroused. We're pouring (stimulants) over them," Wallace said, pointing out there are no studies on the value of using polypharmacy — the simultaneous use of multiple drugs to treat a single ailment or condition — in children.
Resiliency, he said, is stimulated by vigorous physical play, social support, healthy nutrition, sleep hygiene, help with managing stress and meaningful new learning. Transforming a school to help students with trauma begins by appointing a leader who can get trained and then train other staff, from social workers to bus drivers.
"It's a game changer," Wallace said.
13 resources ... and why
The Netflix series "13 Reasons Why" — about a teen who professes 13 reasons for committing suicide — should not be watched by "vulnerable youth, especially those who have any degree of suicidal ideation. Its powerful storytelling may lead impressionable viewers to romanticize the choices made by the characters and/or develop revenge fantasies," the National Association of School Psychologists said.
Here are 13 resources for school health professionals made available through the New York Association of School Psychologists,www.nyasp.org, all NYSUT members:
1. Reinforce that school-employed mental health professionals are available to help.
2. Youth who do view the series might need supportive adults to process it. Take the opportunity to prevent the risk of harm, and to identify ongoing social and behavior problems.
3. Take warning signs of suicide seriously; never promise to keep them secret.
4. Establish a confidential reporting mechanism for students.
5. Try to ensure that all student spaces are monitored and that school is truly safe, supportive and free of bullying.
6. Help students articulate their perceptions when viewing controversial content in shows such as this.
7. Take adolescents' concerns seriously.
8. Make sure parents, teachers and students are aware of suicide risk warning signs.
9. Avoid statements that might be perceived as minimizing a student's emotional pain (i.e., "You need to move on." "You should get over it.")
10. Reinforce resiliency factors and help the student build on them, including family support, peer support, school and community connections, a sense of purpose.
11. Help the student build easy access to effective medical and mental health resources.
12. Focus concern on the student's well-being and avoid being accusatory.
13. Schools should not glorify or accentuate a student death from suicide; promote a memorial that benefits others (i.e., donations for a suicide prevention program) and positive actions.