A recent study from the Massachusetts Department of Public Health and the CDC analyzing data from the 2009 Massachusetts Youth Health Survey found that students who were either victims of bullying or perpetrators were four times more likely to have been physically hurt by a family member compared to those students who said they were neither a victim nor a bully. Harm to children is far more common than most imagine, and its traumatic impact on the broader community is far more pervasive than we would like to think.

As a child psychiatrist who for more than 20 years has consulted to schools and treated students in a school-based health center, I frequently see the psychological trauma resulting from domestic violence play out in the classroom. I am often called in to evaluate students who are considered "aggressive." The tragedy is that I am usually intervening too late. Frequently, students have had underlying traumatic experiences that have destabilized their sense of safety. They have woken up next to an overdosed mother or watched helplessly as a loved one is hit. In these cases students' aggression (kicking, biting, swearing, incessant teasing) is the only way they know how to signal their terror. That fear becomes anger, which is often misdirected at peers and adults alike. I remember one young child telling me he was beaten with a belt every day after school. His teacher saw the impact in the classroom where he was filled with explosive rage.

Most of these children look to the adults at their school for stability. Some teachers may sense that a child is frightened and will comfort him, but many children mask their true feelings. It takes time for a teacher to gain a student's trust, and for a student to open up rather than hide behind defiance or apathy. Schools and families may not make the connection between a child's current behavior and past experience of overwhelming adversity.

Despite the attention to traumatic experiences given in the recent report, it is important to note that trauma does not always result in aggressive behaviors and, by far, most traumatized students never bully or hurt anyone. We may not even be aware of what may be going on in the life of a child who appears to be successful in a school setting despite inner turmoil.

This makes it critical that schools provide a sanctuary for all children - those who may act out, those who may suffer in silence - and their classmates. Schools can offer a place for children to communicate their distress without either being victimized further or victimizing others. Addressing the role that trauma is playing at school requires a broad-based approach woven into every aspect of the curriculum. The Massachusetts Advocates for Children's (MAC) report, "Helping Traumatized Children Learn" provides a good starting place, outlining how schools can create safe, environments and establish the infrastructure needed to support all children, regardless of whether they have been traumatized.

Unfortunately, recent budget cuts have wiped out the Department of Elementary and Secondary Education's Trauma Sensitive Schools Program, which is based on the MAC report. Fortunately the House restored the line item. Hopefully the Senate will do the same. The program gives schools resources to develop environments that reinforce children's sense of safety by building skills among staff. This helps educators connect with students who may find it difficult to trust, provide guidance to students to form positive relationships with peers, and offer expanded strategies to help frightened children feel more comfortable in the classroom and focus on learning. The program also has enabled staff to develop the skills to welcome and support vulnerable families so that they can better nurture and keep their children safe at home.

We know schools can help. All students who have been exposed to traumatic experiences deserve a survival kit to reinforce their sense of safety. This requires us to take the time and provide the resources to help them heal. Our sustained effort could fortify children to behave appropriately and learn at their highest levels at school.
Printed as Guest Commentary in Cambridge Chronicle 5-3-2011

About the Author

Nancy Rappaport

Nancy Rappaport is associate professor of psychiatry at Harvard Medical School.

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