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At a Montana school, a fifth-grader threatened to strike his teacher with a chair. In many schools, the child would be suspended, expelled, or arrested, leading to missed school, further alienation, and possibly a criminal record. But that’s not what happens here.

But this student is in one of Montana’s 10 Wraparound program schools. So instead, the student and his teacher at this school that serves mostly Native American kids, met with Stephanie Iron Shooter, director of the Montana Office of Public Instruction’s SAMHSA grant for trauma-informed care, to look for alternative solutions. “[The student] was able to tell the teacher that there were times when he felt he was going to get really angry and throw something,” says Iron Shooter. “He said that at those times, ‘I just want to go sit in a corner for a minute, then I’ll come back to the group.’” The teacher, with a new understanding of why the child acted out, was willing to accommodate his strategy for regaining self-control, and the student returned to class.

This meeting was part of an approach developed by the National Council for Behavioral Health, SAMHSA’s National Center for Trauma-Informed Care and Alternatives to Seclusion and Restraint, and other organizations to address the psychological and educational consequences of trauma.  

Schools like these are using trauma-sensitive practices to address children’s mental health, behavioral, and academic issues. The goal is to create schools where adults—from the principal to the lunch room personnel—consistently respond to children with empathy and compassion.

According to the , trauma-sensitive schools create safety—physical, social, and emotional—for students who may have experienced trauma. In a trauma-sensitive school, as defined by the NASP, all school personnel are trained to recognize and respond to the impacts of trauma. Discipline is a positive and productive process. The schools have access to mental health professionals and a wide range of services. And they recognize that helping traumatized children thrive is a community-wide challenge and responsibility. The village, in this case, extends well beyond the building and playground.

Vulnerable populations—in particular, kids exposed to poverty and other adverse childhood experiences—especially need this kind of care, according to Iron Shooter, though it benefits all students.

The effects of childhood trauma

According to , childhood trauma affects health and well-being later in life. In the 1998 study on the topic, ACEs were defined as “psychological, physical, or sexual abuse; violence against mother; or living with household members who were substance abusers, mentally ill or suicidal, or ever imprisoned.” Children who experienced four or more ACEs had increased risks for alcoholism, drug abuse, depression, and suicide, as well as increased rates of smoking, sexually transmitted diseases, and severe obesity.

Since that study, other causes of childhood trauma have been identified by researchers at SAMHSA, , and the , among others. These include war, natural disasters, poverty, divorce, separation of children from their families, terrorism, living in a violent neighborhood, racial discrimination—and historical trauma, where the physiological effects of trauma have been passed from generation to generation, first recognized among Holocaust and since recognized in and other communities of color.

Native American children are particularly vulnerable to trauma. According to Jacqueline Pata, executive director of the National Congress of American Indians, they are 2.5 times . They are also subject to historical trauma resulting from genocide and the boarding school experience of their parents and grandparents, she says. Historical trauma is implicated in high rates of suicide, homicide, violence, child abuse, and alcoholism in Native American communities, according to the .

“Children with brains affected [by trauma] are often in survival mode in schools.” 

In addition to affecting health, childhood trauma also affects learning ability. “We know that trauma is widespread, and we know that it impacts how people learn. It changes the chemistry of the brain. It changes the structure of the brain in young children, even children up to the age of 18,” says Karen Johnson, director of the National Council for Behavioral Health.

Bessel van der Kolk, a neuroscientist with the Trauma Center at Justice Resource Institute and former professor of psychiatry at Boston University School of Medicine, describes . These include the ability to focus and filter out irrelevant information, regulate emotions, and form healthy relationships. Children coming to school with these challenges have trouble learning.

“Science tells us that children with brains affected [by trauma] are often in survival mode in schools,” Johnson says. “Instead of being able to learn, process and respond, they feel unsafe and often default to a survival mode, which interrupts any kind of learning that can happen in a school. We need to understand this dynamic and how to create safe, nurturing environments in which children who have been impacted by trauma can learn.”

Trauma-informed schools give kids whose life experiences have impaired their ability to learn a second chance, she says.

Developing trauma-sensitive practices

The trauma-informed initiative in Montana Public Schools began back in 2009, when the state’s Office of Public Instruction received a U.S. Department of Education grant to assist the neediest schools in the state, Iron Shooter explains. OPI chose the five lowest-performing schools and set about improving them in the area of mental health, among others. A grant for a statewide Wraparound program came in 2011. Montana’s program is based on the .

Most of the schools involved in the Montana program are small and rural, and at this point most of the students are Native American, she says.

Another school offering trauma-sensitive care for its students is Wasilla Middle School in Alaska, where 12 percent of students self-identify as Alaska Native or American Indian. Over 50 percent of the students in the school qualify for free and reduced lunches. Wendy Degraffenried, a school nurse, is the team lead for the district’s trauma-informed care program.

Becoming a trauma-informed school was a multistep, community-wide process that began with training, she explains. Personnel from the regional Mat-su Health Foundation were the first to be trained by the National Council for Behavioral Health. They brought what they learned back to five Alaska schools, including Wasilla Middle School, to develop trauma-informed services and trainings for schools. The program is funded by the Health Foundation, the community, and a grant from SAMHSA.

Degraffenried says it’s an effort to reduce disruptive behavior, increase attendance, and improve the high school graduation rate.

“Instead of identifying students who have experienced trauma,” Degraffenried says, “we act as if all students have experienced trauma. … All teachers are trained in how to respond to behaviors by asking questions such as, ‘I wonder what happened to them,’ versus ‘Why are they acting this way?’”

It was the death of Freddie Gray in police custody in 2015 that sent the Baltimore City Public Schools scrambling for strategies to help students cope with trauma. Jim Padden is the director of related services for BCPS, the office responsible for keeping special needs kids in the regular classroom whenever possible. He says that schools were closed for the day, and when they reopened, the district and mental health partners, including the University of Maryland and Johns Hopkins, had put between one and five mental health clinicians into all of the approximately 200 schools.

After a week and a half, it was clear that having mental health clinicians in the schools was helpful, he says, so BCPS looked for ways to have those people and other resources available to students every day. Baltimore received over $2 million from a U.S. Department of Education grant to fund the program.

Padden says the program has created an environment where children who might otherwise be removed from the classroom—or the school—are better integrated into the school community. Instead of dealing with behavioral issues with discipline, he says, they try to make the student feel connected by asking, “‘Hey, what’s going on? You haven’t been able to be on time for the last four days. Is everything OK? Is there anything I can do to help you?’”

Next steps

Two main barriers stand in the way of putting trauma-sensitive programs in all schools. The first is funding. There is no one source for funding many of the resources—educational, psychological, physical, and social—that go into creating an effective program. And the schools that most need trauma-sensitive practices—the schools that serve vulnerable populations—are often the schools with the least amount of financial resources to draw from.

Though Native American children are particularly vulnerable to trauma, the schools they attend have some of the least adequate financial resources. The federal government, for example, has produced showing that Bureau of Indian Education schools, which are responsible for educating 41,000 children, use only about half of their funding for instruction—the rest goes to trying to maintain dilapidated buildings and other costs, such as buses, needed to educate children in remote settings. And many schools on reservations, because they are on federal land, do not receive support from property taxes, but must rely largely on federal impact aid, which has not been fully funded since 1969, according to the of Brent Gish, executive director of the National Indian Impacted Schools Association before the Senate Committee on Indian Affairs.

Awareness of children’s mental health needs is increasing.

This could change. In a landmark last March, a federal district court allowed to go forward with a case brought by Havasupai parents and several civil rights organizations that alleges, in part, that the personal and historical trauma suffered by Native American children are adequate reasons for requiring the Bureau of Indian Affairs to provide special education services.

The second barrier, Degraffenried says, is that these programs must be initiated by someone in the community, be it a health care entity, a school board, a principal, or even a single teacher. “First there’s got to be buy-in, whether it’s an individual teacher or an administrator, or a school district,” she says. And that can be difficult when the program deals with kids who are traditionally viewed as being disruptive in class, she says.

Still, awareness of children’s mental health needs is increasing. In a recent put out by the National Association of Elementary School Principals, for the first time children’s emotional problems topped the list of concerns expressed by principals. If the plaintiffs prevail in the Havasupai lawsuit, trauma-sensitive care could become the law in schools that serve Native American children. In the meantime, on-the-ground educators and staff like Degraffenried and Padden are taking initiative to fill the gap.