For
one young student – let’s call him Martin — the 2012-2013 school year
at El Dorado Elementary in the Visitacion Valley neighborhood of San
Francisco was a tough one, recalls Joyce Dorado, director of UCSF
HEARTS — Healthy Environments and Response to Trauma in Schools.
“He
was hurting himself in the classroom, kicking the teacher, just blowing
out of class many times a week.” There was good reason. The
five-year-old was exposed to chronic violence and suffered traumatic
losses. His explosions were normal reactions to events that overwhelmed
him.
This year, Martin’s doing better. That’s because he spent months working with a HEARTS therapist, and that therapist worked
with his teachers and other school staff to create a more safe and
supportive learning environment. Still, on days when he feels extremely
anxious, Martin sometimes asks to visit the school’s Wellness Center, a
small, bright room stocked with comforting places to sit, headphones to
listen to music, and soft and squishy toys.
“If a student starts
to lose it, the teacher can give the kid a pass to go to the Wellness
Center,” says Dorado. “The kid signs in, circles emotions on a
‘feelings’ chart (to help the person who staffs the center understand
how to help the child). The staff member starts a timer. The kid gets
five to 10 minutes. The kid can sit on the couch with a blanket, listen
to music, squeeze rubber balls to relieve tension and anger, or talk to
the staff member. Kids who use the room calm down so that they can go
back to class. It’s not a punishment room. It’s not a time-out room.
It’s not an in-school suspension room. It’s a room where you feel better
going out than when you went in.”
One day this year, as school
staff members are meeting in the Wellness Center, Martin bursts in. “I
need to borrow something,” he tells them. “Somebody needs my help.
”
They
are stunned. He has had such a difficult time learning to manage his
own feelings, that they’re shocked that he’s helping another child work
through her distress. You go right ahead, they tell him. Martin picks up
a couple of squeeze balls and takes them to a girl on the playground
who’s crying. He shows her how to use them. Then he brings her to the
Wellness Center and helps her use some of the other tools. Seeing that
she’s in a safe place and in safe hands, he says, “I’m going back to
class now.”
“Obviously,” says Dorado, a psychologist who’s also an
associate clinical professor in the University of California San
Francisco Department of Psychiatry, Child and Adolescent Services,
“we’re going to work with him to build that strength.”
In
most schools in the U.S., it’s likely that Martin would have been
suspended, expelled, or shunted into special education classes. In fact,
during the 2010-2011 school year 150,349 out of 3,042,670 – nearly five
percent — of elementary school students were suspended or expelled in
California.
Instead, because El Dorado Elementary has integrated
HEARTS, Martin’s life is on a completely different trajectory than it
was a year ago.
So are the lives of many of its other 275
students. The numbers tell the story: In 2008-2009, the year before
HEARTS was introduced at El Dorado, there were 674 referrals – students
sent to the principal’s office for fighting, yelling, or some other
inappropriate behavior.
During the last school year – 2012-2013, there was a 74% drop, to only 175. This year, only 50 referrals have occurred.
There
were 80 suspensions in 2008-2009. And although suspensions increased
for four years to 150 in 2011-2012, last year they dropped 89%, to only
17. So far this year, only three students have been suspended.
As
El Dorado Elementary School Principal Silvia Cordero thought when she
first heard about trauma-informed practices: “Why don’t all schools have
this?”
Kids who throw chairs in class – that’s a public health issue
“Childhood
trauma is a public health issue,” says Dorado as we sit in a coffee
shop in Berkeley, CA, late one afternoon to talk about the HEARTS
program. “It’s really common, and the way kids react to it gets them
into trouble in school.”
In fact, serious and chronic
childhood trauma is so common that most people in the U.S. have experienced at least one type out of ten measured by the
CDC’s Adverse Childhood Experiences Study.
These include physical, sexual or verbal abuse; physical or emotional
neglect; and five types of family dysfunction — family violence, living
with alcoholic (or other drug-addicted) or mentally ill parents, losing a
parent to divorce or abandonment, or a family member who’s in prison.
And almost
half the nation’s children have experienced at least one or more types of serious childhood traumas, as measured by a recent
survey on adverse childhood experiences by the
National Survey of Children’s Health
(NHCS). This translates into an estimated 35 million children
nationwide. (Since parents responded to the survey, questions about
physical, sexual and verbal abuse were excluded, since it was unlikely
those would be answered accurately. Hence, 35 million children suffering
childhood trauma is on the low side.)
It’s a public health issue,
explains Dorado, because the toxic stress caused by chronic trauma can
harm children’s brains. Toxic stress alters the brain’s structure and
functioning, so that a child is hyper-vigilant. With their trigger reset
on “red alert”, they can flip into “fight, fight, or freeze” mode even
when they aren’t in real danger. As a result, they can have trouble
concentrating, learning, or sitting still. They can erupt into rages,
lash out at others or hurt themselves. Or they can withdraw in fear and
not participate in anything that’s going on around them. None of this
behavior is intentional, says Dorado.
Many teachers and principals
think kids’ “bad” behavior is deliberate, and that the kids can control
it. But it’s often not and they can’t – not without help, says Dorado.
Their behaviors are a normal response to stresses they’re not equipped
to deal with. Throwing a punch makes sense if they’re jumping in to
defend their mother from an alcoholic raging father; screaming in fury
is a normal reaction to a bully who continuously harasses them. But when
the raised voice of a teacher or a counselor who’s criticizing them
inadvertently triggers the same response, these behaviors look
“abnormal, rude, or inappropriate,” says Dorado. “So, they’re getting
kicked out of class and disengage from school. That puts our kids at
incredible risk for later problems, including imprisonment.”
“We’re
trying to change the school culture,” by teaching educators about the
underlying neurobiology of trauma, she explains. “When we see
aggravating behavior in a kid and ask the question, ‘What has happened
to you?’ instead of ‘What’s wrong with you?’, that’s the fundamental
reframe. This reframe helps give the behavior a context, engenders
compassion, and helps us respond more effectively.”
The good news
is that kids’ brains are plastic. If they develop a trusted relationship
with a caring adult, if they’re taught how to calm themselves, if they
spend more time in a resilience-building environment than a traumatic
environment, their brains will heal and they will become happy and
eternally curious learning sponges — i.e., their natural state of being.
Keeping everybody’s riders on their horses = happy teachers and kids
In 2007, after San Francisco Chronicle reporter Jill Tucker did a story about the
overwhelming number of San Francisco schoolchildren who had PTSD,
the San Francisco Unified School District (SFUSD) asked Dorado and
Miriam Martinez, then director of the Division of Infant, Child, and
Adolescent Psychiatry at UCSF-San Francisco General Hospital, if
anything could be done about it.
UCSF was providing therapy to some students, but “we weren’t addressing the larger school culture,” says Dorado.
“We
could bring kids into our offices, process their trauma, teach them how
to be calm, and send them back into their classrooms, where they’d
inadvertently be triggered again, because teachers weren’t aware of what
complex trauma does to kids’ behavior in school.”
Borrowing from the book,
Helping Traumatized Children Learn, and the trauma-informed “flexible framework” practices that Susan Cole, Ann Eisner and Joe Ristuccia at the
Trauma and Learning Policy Initiative had developed for schools in Massachusetts, Dorado and Martinez developed HEARTS. The Metta Fund
and
the John and Lisa Pritzker Family Fund provided most of the support for
the project. The search for schools to pilot the program began in 2009.
El Dorado Elementary School is located in the Visitacion Valley neighborhood in San Francisco
“We
were looking for schools that understood the whole school mental health
approach to trauma, and that understood that this approach was going to
help improve their academic achievement,” explains Dorado. They invited
five schools to apply and selected three to work with in the 2009-10
school year: El Dorado Elementary, Bret Harte Elementary and Paul Revere
PreK-8 School.
Tai Schoeman was principal of El Dorado at the
time. The training that Dorado provided “really shifted my thinking
about why kids were acting the way they were,” he recalls. “It’s amazing
information that I didn’t have access to before that. It completely
transformed my understanding about why kids were getting in fights,
throwing chairs, and struggling academically.”
El Dorado
Elementary, which has 275 students from kindergarten through fifth grade
— is a high-needs school, says Schoeman, who was its principal for
seven years. Its students, mostly African-American and Latino, live in
some of the poorest and most violent neighborhoods in San Francisco.
Most students’ families live just above, at or below poverty level.
“There’s
already a negative connotation about why these kids are behaving a
certain way, especially the boys,” says Schoeman. “What you hear
educators saying is: ‘You know how they are.’ They don’t understand that
their behavior – fight-flight, confusion of cognition — comes from
being exposed to clinical trauma. When you start to see that, then you
begin to see that the kids aren’t doing it on purpose. “
The
teachers learned what happens to a child’s brain when it’s faced with
overwhelming stress. “You can think of the two main parts of the brain
that come into play as a horse (“the survival/emotional brain,” AKA the
limbic system) and the rider (“the learning/thinking brain”, AKA the
prefrontal cortex),” says Dorado. “When something happens that reminds
the child of their traumatic experiences, the rider falls off the horse.
You’re left with a really terrified horse.
“No amount of star
charts, reasoning with or demanding explanations from or yelling at that
terrified horse will make a difference. It will just make the horse
more terrified. That’s because you’re not talking to that child’s
thinking brain.
You’re talking to a terrified horse. The first thing to do is to get
the rider back on the horse by helping the child to feel safe and a
little bit in control. Only then can you talk about what happened.
That
can take minutes, hours or days, depending on how stressful the
triggering event was, if the child was on edge to begin with, or if the
child trusts you.” And, she added, sometimes adults’ riders get knocked
off their horses too, which can make situations worse if they aren’t
aware of it.
The overwhelming response from the teachers was: Wow — this explains a lot of what we see in front of us.
“I
was very careful not to tell teachers how to do their jobs,” says
Dorado. “I just helped them understand how trauma might affect kids, and
to use that information to think through strategies to deal with them.”
Over
that first year in 2009-10 – with the teachers’ new awareness, the
skills and tools Dorado taught them to help children learn how to calm
themselves, and more counseling available for students with the most
severe problems — the school climate began to shift.
“After a
year, the kids who were throwing chairs and running out of class at the
start of school were staying in class, and the reduction in fights was
dramatic,” says Schoeman. Before the school began integrating
trauma-informed practices, 40 to 50 kids – one-fifth of the school’s
students — were erupting into rages or running away every day, and each
classroom had four or five students who had serious problems.
Dorado
also spent a great deal of time focusing on how stress and trauma
affects teachers. “Taking care of our teachers is central to this work,”
she says. “We don’t want to lose these incredible educators.”
“We
explained how stress and trauma affect us as human beings,” recalls
Dorado. “And then we showed what it does to teachers and other school
staff. As I named some of the symptoms of burnout, many teachers said,
‘I’m NOT crazy.’ and ‘They don’t teach us this in school.’ The things
they experience are why they burn out and leave the teaching
profession.”
She offered teacher wellness groups at each of the
three schools, and the teachers chose how they wanted to structure the
meetings. The El Dorado teachers decided to take walks in the park.
Physical exercise (and its accompanying deep breathing), social
connections, and being in nature have all been shown to reduce stress,
says Dorado.
Dorado says that by helping the teachers, all three
schools kept teachers who might otherwise have quit. “One new teacher
was so stressed out that she was ready to leave,” she recalls. “Nobody
had taught her how to manage a classroom with so many stressed out kids.
She’s now one of our best trauma-informed teachers, and enjoys teaching
again.”
During 2010-2011, the school integrated another tool —
restorative practices. These work well with trauma-informed practices,
says Dorado – because they hold students accountable for their actions,
teach empathy and focus on the importance of relationships. But
restorative practices aren’t as effective without a trauma-informed
approach.
“Chronic stress and trauma can get in the way of
restorative practices,” she explains. “Restorative practices don’t work
if you’re asking a kid who’s crying right after an incident to
participate. But it’s useful after somebody’s recovered, after the
rider’s back on the horse.”
In fact, it’s important for trauma-informed practices to be paired with any program or framework, including
PBIS (Positive Behavioral Interventions & Supports) and
Safe &Civil Schools,
she says. Without that trauma lens, “we miss components about what
makes these approaches work or not work.” For example, knowing that
toxic stress affects children in different ways helps kids who are often
labeled as “lazy”, “slow learners”, or “unmotivated”. These children
slip through the PBIS and restorative practices nets because they sit
quietly at their desks and aren’t acting out. But they fall behind, just
as those who are suspended and expelled do, and are just as likely to
eventually drop out of school.
What
also helped Schoeman and the staff change the school climate was
developing a data system to identify the location and time of referrals –
students who are sent to the principal’s office for behavior issues.
Instead of the entire school being considered a disaster, the staff
could get a better grip on identifying which students were having the
most trouble, why they were being sent to office, and which teachers
were sending them.
“By the time I left (in June 2012),” says
Schoeman, “there were only 10 or 15 kids who we were dealing with on a
daily basis, and, in each class, only one or two had serious problems.”
Everybody needs a beanbag chair and a peace corner
Each
classroom at El Dorado Elementary has a “peace corner” where kids can
take a break if they need to. Beanbag chairs, books, squeeze toys,
blankets, stuffed animals, windmills to blow into, pencils, crayons and
paper crowd the peace corners at El Dorado.
“When teachers invite a
student to use the corner, it’s not a reprimand,” says Principal
Cordero. “It’s a space where kids can pull themselves together. It
doesn’t mean they’re in trouble; there are no consequences. Kids spend
no more than five minutes there.”
Students who feel an internal
volcano brewing, as some of their drawings about toxic stress on the
classroom walls show, also have the option of spending a few minutes in a
buddy classroom with another teacher with whom they have a
relationship. They can stay there five to 10 minutes, and return,
without consequences.
This year, the school added the Wellness
Center. If a child still can’t calm himself after time in a peace corner
or in a buddy classroom, the teacher can send him to the Wellness
Center, says Jen Caldwell, the school’s social worker. And if a
student’s behavior escalates to a point where a teacher thinks a
consequence will help, the student is sent to the Wellness Center to
de-escalate, and then to another teacher’s classroom to spend 30 minutes
up to the remainder of the day. The consequence is that the child is
not participating in learning with his classmates.
The Wellness
Center is also where restorative practices take place. “It’s where they
may talk with the people they harmed, if they did, to learn how to
repair the relationship,” says Caldwell.
If
there’s an extreme situation – a physical fight, extreme verbal
aggression (think “I’m going to take these scissors and stab your eyes
out!”), or being sexually inappropriate – the child could be suspended.
There are several reasons behind the stunning drop in referrals and suspensions this year, say Cordero and Caldwell:
- The
kindergarteners of 2008-2009 are now fifth graders, so most students
have been living in the trauma-informed environment for six years. This
pre-empts blowouts. “They have the language and are implementing
cool-down practices that can get them back on track,” notes Cordero.
“I’m referring to the peace corner in the classroom, mindfulness
(breathing/meditation), the buddy classroom, and restorative
conversations.”
- The addition of the Wellness Center this year
provides an additional place where students go to “reset themselves,
where they feel safe and supported to get back on track,” Cordero
explains. “These visits to the Wellness Center are not considered
referrals to the office. Students with conflicts are sent here too; not
the office. The ‘wellness team’ made up of our school social worker,
school social worker intern, HEARTS post doc, and behavior coach all
staff this room throughout the day.”
- Teachers and staff have
been trained to recognize when a child is triggered, and have the skills
to intervene early, so that kids don’t escalate their behavior.
- “Every
student has a positive relationship with at least one grownup in the
building,” says Caldwell. “A teacher, a secretary, the behavior coach, a
custodian, me…any adult. Having a trusted adult is really important.
For some kids, the school staff members are the only consistent adults
in their lives.”
- A before- and after-school program gives kids a
safe place to be from 7:30 a.m. until 6 p.m.. Martha Merchant, one of
the UCSF HEARTS post-doctoral fellows who works with the children with
the highest trauma levels, as well as some of their families, used to be
a marriage and family therapist before getting her doctorate. Before
she began working in the HEARTS program at El Dorado, she didn’t believe
that it was possible to help children without involving their families.
But some families don’t have the time, resources or ability to
participate in the counseling. Nevertheless, she’s seen children make
great strides. Many are at the school most of their waking hours, and
that’s enough time in a safe and supportive environment to counteract
the time spent in a family environment where caregivers’ suffering may
get in the way of them being able to provide a healthy family
environment, she believes.
Dorado, Cordero and Caldwell
agree that it’s likely – and the data are beginning to show this – that
from now on, most referrals and suspensions will come from two places:
new students, most of whom are in kindergarten and the first grade; and
the classrooms of new teachers who aren’t experienced in the “El Dorado
way”. And the best way to decrease those suspensions and referrals is to
help the kids and the teachers.
“You
can’t punish behavior out of a kid,” says Caldwell. “The old-school
model of discipline expects kids to listen to you just because you’re a
grown-up. But they won’t, especially when they’re being raised in an
environment where grownups are not trustworthy or safe. You have to
understand where the students are coming from, develop a relationship
with them so that they will trust you, teach them empathy. That’s what’s
going to make a successful community.”
Schools can’t do this alone
At
the end of the 2012 school year, the original three-year grant for
HEARTS ran out. Despite many requests by other schools for the program,
Dorado’s goal to expand HEARTS to other schools looked as if it was dead
in the water.
But 2013 seemed to be a turning point in the school
discipline debate in California. With more research showing that
zero-tolerance policies were damaging, especially to minorities, and
more pressure across the state and the nation to change the approach to
school discipline, the Los Angeles Unified School District – the largest
in the state — ended suspensions for “willful defiance”. Some schools
in California eliminated suspensions altogether.
SFUSD, which is
also considering ending suspensions for willful defiance, revived a
restorative practices program that it had let lapse and funded the
HEARTS program for one more year at El Dorado and Bret Harte Elementary.
So,
after a year of uncertainty, Dorado is partnering with the restorative
practices team as well as infusing trauma-informed practices into a
district-wide effort to help change school environments that includes
PBIS and social-emotional learning. “We’re learning from them; they’re
learning from us,” she says. “It’s a good match.” With her colleague,
Lynn Dolce, she’s also creating a curriculum for SFUSD mental and
medical health staff who will train other schools how to integrate
trauma-informed practices.
Tai Schoeman, who’s now assistant
principal at A.P. Giannini Middle School, hopes that trauma-informed
practices spread to all schools. But he makes this point: “Asking
schools to carry out this work in isolation of the rest of society is
challenging. In Visitacion Valley there are big barriers to a school
having success with this model. The nearest big grocery store is two
miles away. There’s only one bus line and the bus comes only once an
hour. There’s limited access to medical care. There’s extreme poverty in
an isolated community that has gang issues and continuing violence,
with criminalization of young men.’
In fact, in the communities
where schools are becoming trauma-informed, there’s a growing
recognition that schools can’t do this alone. If a community really
wants to become healthy, i.e, to reduce crime and health care costs, all
the sectors of a community – police, housing, employment,
transportation, medical services, economic development, etc. – need to
implement trauma-informed practices.
“The American myth is that
you can lift yourself up with your bootstraps,” continues Schoeman, “and
if you fail, the myth says it’s because you didn’t work hard enough.
But we now know through research and data that there are plenty of
reasons to debunk this archetype.
“It gives you pause about how poorly kids are treated in this society in so many ways.”
______________________________
This
is part of an investigative series into “right doing” – how some
schools, mostly in California, are moving from a punitive to a
trauma-informed approach to school discipline. The series includes
profiles of schools in Le Grand, Fresno, Concord, Reedley, Los Angeles, Vallejo, and San Diego, CA; and Spokane, WA, and Brockton, MA. The series is funded by the California Endowment.
