Universal Supports for Trauma-Informed Schools

In Tier 1, the school district will first create a safe and supportive learning environment for all children.  This includes evaluating school systems to determine high expectations, reinforcement for expectations, systems of response to appropriate behavior as well as systems of response for inappropriate behavior.  This can then lead to universal screening for behavior for all students to determine if they are demonstrating internalizing or externalizing behavior and then, for some students, screening for trauma to determine if students require specific targeted interventions or wrap-around services.  Eklund and Rossen (2016, p. 9)1 note the core components of universal supports for trauma in schools use a framework that includes the following:

Step One:  Evaluate school discipline policies, expectations, reinforcement systems, as well as positive behavior supports.

Step Two:  Creating and sustaining a safe and supportive school environment.  South Dakota can find specific advice at the SD Department of Education.

  • Building and sustaining student resilience and coping.
  • Building and sustaining staff capacity to understand trauma, effective prevention systems, effective response systems, as well as strategies to support students struggling with the effects of trauma.

Step Three:  Consider implementing the following strategies:

Step Four:  Review the Universal Behavior and Trauma Screening recommendations for schools

Understanding the Role of Trauma for Student Outcomes

Research has demonstrated that presence of Adverse Childhood Experiences (ACEs) can lead to poor academic and/or behavioral outcomes for children. Because of this relation, it is vital to understand the landscape of trauma for some students in schools. However, research also indicates that some students that experience adverse experiences have enough protective factors in place that they do not have poor outcomes. It is important for schools to understand that the presence or lack of ACEs for children does not necessarily guarantee negative outcomes and/or trauma for students 1. Because of this important distinction, school professionals must be thoughtful of the approach to screening for trauma symptoms in children.

Behavior and Trauma Screening in Schools

Systematic screening has increased in popularity in public schools over the last decade. Most commonly, public schools will screen for vision, hearing, reading, math, and/or speech problems. These are often conducted to determine which students need targeted interventions. Less common in schools is screening for social, emotional, and/or trauma symptoms.2 It isn’t clear exactly why schools do not engage in screening procedures, but researchers have noted that many schools have concerns about how to obtain parental consent for screening procedures, as well as lack of content knowledge about how to effectively engage in systematic social/emotional screening 3. Many schools also have concerns about capacity to intervene if a significant number of students are identified as having significant mental health needs. Because of these concerns, as well as professional knowledge regarding the impact of trauma on student’s mental health, a thoughtful and logical approach is needed. It is important to note that ACEs is a training, not a screening tool for schools.

 

Universally Screening for Internalizing, Externalizing, and Adaptive Behaviors

As trauma symptoms do not always lead to negative behavioral manifestations, schools must first universally screen students to identify which students are demonstrating internalizing, externalizing, and/or adaptive skill deficits. Internalizing problems are negative problems turned inward. These problems can be most clearly articulated as students struggling with anxious and/or depressed behaviors. Externalizing behaviors are negative behaviors turned outward. Problems that are identified as external are problems that others can easily see, such as hyperactivity, impulsivity, oppositional problems, as well as conduct problems. Adaptive behaviors are behaviors required to meet the everyday demands of the school environment. These can be thoughts of as practical, social, and/or conceptual skills. Identifying which students are struggling with specific social, emotional, and/or coping skills can help schools to effectively target student intervention. Screening measures are to be brief in length and help to identify which students have little to no risk, which students have some risk, and which students are at-risk for social-emotional problems.

 

Parent Consent

When considering the use of universal screening for trauma, it is critical to evaluate the need for active parental consent.  Two constructs that are important to understand are active consent and passive consent.  Active consent is explicit permission, signed by parents, that explains the scope of the assessment, the risks associated with the assessment, as well as information about what will be done with the assessment results.  This is the highest form of informed consent.  Passive consent, on the other hand, is when information is shared with parents regarding the scope of the assessment, the risk associated with the assessment, and information about what will be done with the assessment, but instead of having parents give written consent, a school district tells parents that they can “opt out” of the assessment if they so choose in writing.  This increases participation as it is easier to have higher participation with passive consent.  Eklund and Rossen (2016)1 highlight that although passive consent may be permissible for some screening measures, the inherent nature of trauma screening brings concerns for those parents who may have English as a second language or who may not understand the concept of “opting out” of participation.  Therefore, best practices for trauma screening recommend active parental consent.

 

The links below provide examples of the parent consent:

 

 

Appropriateness of Self-report

Young children are particularly susceptible to response bias patterns on self-report instruments.  Due to our understanding of the developmental nature of children, it is not recommended to administer a self-report measure to children younger than age 11.  This may be problematic when navigating trauma screening.  Students can quickly and easily be rating for behavioral problems via teacher report (see table above), but no trauma screening measure exists that ask for teacher responses.  Parent reports may be used for children younger than age 11, but it is important to note that often parent and child ratings do not match on measures of adversity and trauma 4.

 

Time

The time needed to administer a behavior or trauma screener can range from 5-25 minutes (Gonzales et al., 2016).  It is important to consider the time needed for professionals to administer universal screening and targeted trauma screening to students in schools.  Additionally, considerations need to be made for the time it may take professionals to score and analyze the data following the administration.  For example, paper-pencil screening assessments may cost less in terms of administration costs but may cost more in professional time for scoring and interpretation.  This consideration needs to be made as school districts navigate the screening process.

References

1Eklund, K. & Rossen, E. (2016). Guidance for Trauma Screening in Schools:  A product of the defending childhood state policy initiative. Delmar, NY: The National Center for Mental Health and Juvenile Justice
2Bruhn, A., Woods-Groves, S., & Huddle, S. (2014). A preliminary investigation of emotional and behavioral screening practices in K-12 schools. Education and Treatment of Children 37(4), 611-634. doi:10.1353/etc.2014.0039.
3Chafouleas, S. M., Kilgus, S. P., & Wallach, N. (2010). Ethical Dilemmas in School-Based Behavioral Screening. Assessment for Effective Intervention, 35(4), 245–252. https://doi.org/10.1177/1534508410379002
4Shemesh, E., Newcorn, J. H., Rockmore, L., Shneider, B. L., Emre, S., Gelb, B. D., & Yehuda, R. (2005). Comparison of parent and child reports of emotional trauma symptoms in pediatric outpatient settings. Pediatrics, 115, e582–e589. doi:10.1542/peds.2004-2201