A safe haven in a world of uncertainty

4th January 2019 at 00:00
Schools are becoming increasingly aware of their responsibility to support children who have suffered trauma, amid growing evidence that small changes in the school environment can make a big difference to these pupils’ lives. Helen Ward visited one school in the US that pioneered the ‘trauma-informed’ approach to education to find out how institutions on this side of the Atlantic can better prepare themselves to deal with ‘adverse childhood experiences’

It will be at least 18 years before Thabiti Brown, headteacher of Codman Academy Charter Public School in Boston, US, is confident that the children who are now in his kindergarten are doing well.

“It’s fine to have a really transformative experience from kindergarten to grade 12 [Year 13 in the UK],” he says. “But if the only thing you have once you leave Codman is a high-school diploma, your odds of stumbling on to a career that’s going to be sustainable for the course of your life are really low.”

And to check whether his “transformative” approach has paid off, Brown keeps track of his graduates for four years after they leave his care. His work has not only inspired parents and pupils, but also one of the most powerful couples in the US – a couple who have now set up their own headline-generating school.

But Codman is no star-studded institution – a public (state) school in the Dorchester area of Boston, it is open to all pupils who want to apply for its lottery-based admissions.

For those who get in, who mostly live in one of the toughest areas of the city, the odds are already stacked against them. So Brown is determined that his students not only have the academic knowledge needed to go on to higher education or training but also the social and emotional resilience to succeed once they are there.

More than four in five pupils at Codman are economically deprived, all are pupils of colour and a high proportion have experienced traumatic events within their families, including deaths, violence and substance abuse, commonly known as adverse childhood experiences (ACE) (see box, page 36). Such traumatic experiences can trigger stress reactions, ranging from anxiety and nightmares to difficulties controlling behaviour or paying attention – reactions which, from a school’s point of view, lead to lower academic achievement and can have a lifelong impact.

And so Codman has a “trauma-informed” approach to education in order to support its pupils through school and beyond.

The term “trauma-informed” has its origins in the growing understanding of post-traumatic stress disorder after the Vietnam War, but it has evolved over the past 30 years beyond mental health care into many more settings, including schools. A trauma-informed school is a school that puts in place systems that support all children and staff who may be suffering from the stress induced by trauma. The approach is only just starting to be introduced in mainstream schools in the UK – although interest is growing, with separate projects beginning this year to offer training to all schools in Wales and all schools in Cornwall.

Codman, with many years of experience, already has the type of whole-school approach that such training aims to embed.

The impact of childhood trauma

All teachers at Codman, for example, are trained in the research into childhood trauma. Teachers work with coaches to ensure what they are teaching and how they teach takes account of this. There are clear, written schedules in each classroom, and changes are kept to a minimum, to create a safe, predictable environment for all pupils. But there is also a recognition that flexibility is essential. So while children are expected to sit at their desks to work, there are also “cosy caves”, little den areas in each of the lower grade classrooms where overwhelmed children can escape for a few minutes.

For children who, despite this, still have difficulties with school work or behaviour there is one-to-one counselling available – and for pupils who are experiencing more serious mental health difficulties, the school contacts outside specialists for help.

Margot Sunderland, a UK child mental health expert, says the approaches used at Codman are absolutely what she wants to see here. She says that while there has been a growing awareness of ACE in the UK, the idea of embedding support for pupils into school procedures, policies and practices is still very new. And she fears that currently schools are not only failing to help, they also could actually be making the problem worse.

“Some schools are unwittingly traumatising children through Victorian-style principles,” she says. “By being trauma-aware, firstly we make sure we are not traumatising children in school and secondly we are supporting them if they do have trauma already.

“Some schools still use Victorian principles like isolation rooms. If a traumatised child has been shoved in a room and not talked to for three days by their parents, then putting them in there is going to retraumatise them.”

Sunderland is the co-director of Trauma Informed Schools UK, a non-profit-making organisation which offers training to teachers and school leaders on how to support children who have suffered trauma, abuse or neglect. She hopes that the government’s £300 million mental health plan, Transforming Children and Young People’s Mental Health Provision, which was given the go-ahead in July, will prompt a culture change. It points out that research has found that appropriately-trained teachers and teaching assistants can be as effective as trained therapists for pupils with mild to moderate mental health issues.

“An emotionally available adult is a protective factor against ACE,” Sunderland says. “These are people who are trained to listen well, to understand, to empathise.” She says that the training offered – which is currently being rolled out in all schools in Cornwall – is not about training teachers or teaching assistants to become psychotherapists.

“We are replicating what happens in good parenting. There is good listening, good understanding, summarising, empathy; these will all bring toxic stress levels down to tolerable stress levels. We have a moral duty to do this in English schools,” she adds. “We have health and safety for bodies, we need to have health and safety for minds and brains.”

While supporting children who have these difficulties may be the right thing to do, why should it be something that schools have to do?

The approach at Codman grew out of its “whole-child” philosophy, which has been in place since it was set up 17 years ago, initially catering for pupils aged 12 to 18 within a health centre.

Integrating health and education is about setting up a virtuous cycle in which children thrive. “We want to remove any impediments and any barriers that are standing in children’s way to being successful academically: if it’s counselling, if it’s healthy eating, if it’s physical fitness, if it’s support for families, if it’s grants to college kids so they can pay for their books,” says Brown.

The school’s approach has even inspired Priscilla Chan, who did part of her training as a paediatrician at Codman, and her husband Mark Zuckerberg, founder of Facebook, to set up a similar school in California two years’ ago called The Primary School, which is also partnered with a health centre.

Back in Boston, the popularity of the approach is clear. In the past few years, Codman has grown to take in pupils from age 4. It now has 345 pupils – and almost 3,000 on the waiting list. Under its charter, the school has to disseminate good practice – its 2017-18 annual report shows that visitors have been keen to learn about trauma-informed practices, trauma-sensitive design and social and emotional learning.

Trauma seems to be, almost by definition, something unusual, something extraordinary, something that most children will not experience. But there is a growing awareness that for those children who have experienced trauma, small changes in schools can make a real, positive difference to their lives. Schools will not replace the need for clinical counselling or, in some cases, social services intervention. But they can provide a haven, a welcome and, of course, the education that will ensure that children feel able to overcome obstacles rather than being overwhelmed by them. But if things do go wrong, being trauma-informed means that there are already relationships and procedures in place.

Children growing up in the US live in a country with one of the highest rates of gun deaths in the developed world – and last year, some of those deaths were in Boston. Raika Nasirullah, Codman’s full-time social worker, is a key figure in dealing with such situations when they affect the school. She is responsible for referrals to outside agencies and building relationships with those agencies – so that, when there is a crisis, the school can respond to minimise trauma.

“There was a shooting at a high school basketball game last year, where a lot of our students were present,” she says. “A teenager was killed and two were injured.”

It was Nasirullah who had the job of organising the school’s response when it became clear that students would be arriving the next day having witnessed such violence.

She ensured that there was a designated space for those children to go to for that day. “We had clinicians come in and do a group session with our students – to provide an outlet for those students,” she says. “Those clinicians could then follow up and offer additional services for students who wanted them.”

Such events are extreme. But many people – across the world and across all income groups – have experienced some extremely stressful events during childhood. In a 2017 survey of 2,500 adults by Public Health Wales, 50 per cent had experienced at least one ACE.

Marc Bush, chief policy adviser at mental health charity YoungMinds, warns against seeing trauma-informed practice as something only relevant to inner-city schools.

“Research shows that ACE and trauma transcends socioeconomic or class,” he says. “Although financial stress can be an exacerbating factor.” And he points out that behaviour problems are not a clear-cut indicator that a pupil has suffered trauma – while traumatised children may behave by acting out, some may “act in”.

“It could be that the child who is always at the front of the class, always putting their hand up, always worried about getting the question right, could be showing a trauma response,” he says. “They have such a sense that getting anything wrong threatens the core of who they are.”

But as word has spread about the “ACE-aware” movement, some have expressed caution. There are fears about the potential to oversimplify the realities of day-to-day trauma-informed practice.

In Scotland late last year, thousands flocked to a conference about trauma and how to heal it. And writing for Tes earlier this year, Whitney Barrett, principal psychologist at Clackmannanshire Educational Psychology Service, pointed out that “knowing your ACE score as an adult or counting up the ACE scores of any children you know is foolhardy at best, and downright dangerous at worst … the ACE questionnaire was not designed to ask children to report on the number of traumatic events they have experienced but instead asks adults to retrospectively reflect on their childhood experience.”

And she adds that it is not the traumatic event but the impact of the event which is crucial is knowing how to support a family. The wide range of what can be traumatic for children and the differing emotional responses and behaviours triggered – sometimes long after the event – is one reason Codman does not explicitly assess ACE scores. The school avoids labelling children as “traumatised” and is even moving away from the term “trauma-informed”. Brown and his team prefer the term “pro social-emotional learning” when talking to parents about the school’s approach.

“We know in our community there is a higher rate of challenge,” Brown says. “We are very, very committed to this idea of growing young people to be established, successful, amazing members of our community. The tests matter – you have got to do the reading, writing and arithmetic. But being a good human being also requires knowing yourself well enough to know how to manage your own shit, for want of a better word.”

The school’s design incorporates cues that it is a safe space, with slightly curved corridors; an emphasis on neutral, calming colours; bookcases that can be covered with cloths in order to minimise visual distraction, as well as “cosy caves” – little dens – in the classrooms for younger children.

In terms of teaching practice, the challenge is to balance routine with flexibility – for example, Codman has special passes that children can use to leave the classroom when they are feeling overwhelmed. And the school is always experimenting with new ideas – this year mindfulness sessions have been introduced for younger children. But a trial of silent hallways was dropped, when the teachers realised they were spending so much time telling children to be quiet that the hallways were not silent at all. Now, children are expected to move sensibly and speak quietly.

Brown points out that it is not just children who can be misjudged through labels – the same stereotyping can happen to communities. While not wanting to downplay the difficulties that his pupils face, he points out that Dorchester is more nuanced than detractors may acknowledge. Just 10 minutes’ walk from Codman, homes sell for $1 million (£780,000). And Dorchester – the first place in Massachusetts to support public schools through taxation – is also home to Boston’s mayor.

The work being done at Codman doesn’t just take the long view towards improving its own students’ lives, it also takes the wide view. The school has ambitions not just for its students but for their families, friends, neighbours and the generation yet to come, which go beyond the immediate need to help them to deal with trauma.

“A lot of this is really about how to build a community of amazing human beings who will help one another to grow – that is what all this support is about,” Brown says. “The reality of increased violence in these communities is real.

“But if we can have an impact on young people and encourage them to make different choices, that can ripple out and impact on other people in the community. Test scores matter, but I’m not here just for test scores. I’m here to help the next generation of educators and students to change the world for the better.”

Helen Ward is a Tes reporter. She tweets @teshelen


What is an adverse childhood experience?

The Adverse Childhood Experiences Study was a research study conducted by Kaiser Permanente, an US health organisation, and the US government’s Centers for Disease Control and Prevention. The study took place from 1995-97. It found that ACE are linked to a higher risk of long-term physical and mental health difficulties, including depression, heart disease and alcoholism.

There is no universally agreed definition for ACE, but studies do use similar sets of experiences. A typical list of ACE was used by Public Health Wales in a 2017 survey of 2,500 adults; it found that 50 per cent of those surveyed had had at least one ACE.

The experiences were:

* Verbal abuse

* Physical abuse

* Sexual abuse

* Physical neglect

* Emotional neglect

* Parental separation

* Household mental illness

* Household domestic violence

* Household alcohol abuse

* Household drug abuse

* Incarceration of a family member

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