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Should Complex Trauma Qualify as a Disability?

From Phi Delta Kappan's Learning on the Edge: http://pdkintl.org/blogs/uncat...ify-as-a-disability/

Should complex trauma qualify as a disability?

09.18.15 

By Eric Rossen

 

A lawsuit against Compton Unified School District (Calif.) will address whether youth experiencing complex trauma should qualify for special education services as students with a disability. The outcome of this lawsuit has the potential to shift how schools operate, particularly those in communities with high student exposure to stress and adversity.

 

Considering students with complex trauma as eligible for special education services offers potential benefits. It could increase awareness of the effect of stress and adversity on a child’s educational, behavioral, social and emotional outcomes, and prompt schools to engage in efforts to identify students at increased risk of trauma. We could see more dedicated investment in creating trauma-sensitive schools. And perhaps most importantly, it could compel schools to provide individualized supports and interventions to help those students most affected by trauma.

 

This move, however, could lead to unintended consequences. First, given that trauma refers to the individual effect of stressful or adverse experiences (difficult to measure) rather than measuring the occurrence of those adverse experiences (easier to measure), we’d see inconsistency in its identification from school to school. Similarly, due to low disclosure rates of adverse experiences from families and students, schools may be held accountable for misidentification despite not having relevant information to warrant further evaluation. With the potential for added stigma associated with special education, some families may be less likely to disclose, ultimately leading to kids not receiving the services and supports they need to learn and thrive.

 

Above all, most concerning is the implication that supporting students experiencing stress, adversity, and trauma is a special education issue rather than a general education issue. Consider the child whose parent was recently arrested at home in front of the child, incarcerated, and is preparing for the first visitation; or the child whose deployed parent recently returned home permanently disabled, or worse, killed in action; or the adolescent who witnessed a stabbing on the way home from school. All of these students present with potential barriers to learning, yet should not require identification as a student with a disability in order for them to receive support services in school. Special education is not designed to support the nearly 50% of students who have at least one childhood adverse experience, or the students who may be experiencing a temporary stressor and a developmentally appropriate response to that stressor.

 

The data are increasingly clear that many of our students regularly experience stress, and for many, this stress begins early in life. The degree of effect of those experiences ranges widely due to many factors. Suggesting that trauma-focused interventions are available only to those with severe trauma symptoms is a complete contradiction to best practices in supporting student learning. Instead, schools should embrace multi-tiered system of supports (MTSS), anapproach to supporting students that has trauma-sensitive schools embedded within its framework. This suggests implementation of a range of increasingly intensive services based on need; implementing policies that promote connectedness, supportive environments, positive discipline, and physical and psychological safety; and ensuring that the school positions itself to meet those needs with school-employed mental health professionals that help enable teachers to teach and students to learn.

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Chart: Trauma Hospitals Fail to Screen for Civilian PTSD

A growing body of research shows injured civilians, particularly those injured as a result of violence, are developing PTSD at rates comparable to veterans of war. But many hospitals are doing little to address the problem. We asked 21 top-level trauma centers in cities with the nation's highest murder rates whether they screen injured patients for signs of PTSD. | Related Story »

<label class="sort-label">Sort Trauma Centers</label> <button class="button button-left" data-sort-value="loc" id="ptsd-sort-city">By City</button><button class="active button button-mid" data-sort-value="rank" id="ptsd-sort-rank">By City Murder Rate</button><button class=" button button-right" data-sort-value="rating" id="ptsd-sort-rating">By PTSD Screening Status</button>

Hurley Medical Center

Flint, Mich.
1st in 2012 national murder rate
62 murdered per 100,000 people

I recently came across a radio show group discussion, which may be germane to this discussion:

"PTSD In Inner-City Neighborhoods" at: 

http://thekojonnamdishow.org/s...r-city-neighborhoods

 

I'd previously heard one of the presenters, Thomas Mellman, M.D., then at Dartmouth-when I heard him speak. The others are: Lois Beckett, a reporter for ProPublica; Penelope Griffith-Exec. Dir. of Columbia Heights/Shaw Family Support Collaborative; and Maxwell Manning-a social worker & CEO of The Institute for Human and Business Development, and New Life Counseling Center.

Eric and Melissa, in 1999/2000, I attended "Grand Rounds" continuing medical education presentations at Dartmouth (Geisel) Medical School, and one Epidemiological presentation involved Detroit Metropolitan Area Schoolchildren. It was noted that 52% of them met the then DSM-4 criteria for PTSD. I would say your argument for Regular School trauma-informed programming, rather than "Special Education", makes a lot of sense, considering that more recently similar [Epidemiological] findings have been reported in Philadelphia and Baltimore. I hope the Public Advocate Law Firm in California can utilize this, if they weren't already aware of it, and those other Public Interest Law practices, especially any remnants of the OEO Legal Services programs around the country. While I was a VISTA Volunteer paralegal at one of those OEO Legal Services programs, it was not unusual to represent a [High] School student[s] in school Disciplinary/school Suspension hearings. The Robert F. Kennedy Memorial foundation was one philanthropic supporter of that, at the time.

Great points, Melissa. Neither direction is an "absolute" as far as benefits or unintended consequences. Certainly, the case itself suggests increased recognition and awareness of the many complex factors that contribute to student wellness and readiness to learn in school. If nothing else, it helps keep the impact of stress, adversity, and trauma in the dialogue.

 

Thanks for reading

Well said Eric.  I too am concerned about childhood trauma being seen as a special education issue.  It's public health issue.  Perhaps if/when we get a diagnosis in DSM that adequately describes the characteristics of Complex or Developmental trauma, we can use it as a guide.

It helps, too, to remember that there are children with Dyslexia who do not need special education classification.  I have known children with Cerebral Palsy who were not receiving special services.  Just because you have a diagnosis doesn't mean you need services.

On the other hand, the problem parents across the country are facing is that when they meet with an evaluation team in their child's school to discuss possible services, often the team isn't aware that developmental/complex trauma is a thing that can impact behavior or learning.

If the Compton case forces special education evaluators to, at the very least, know that there is a trauma lens, then it has improved the situation.

After that, we need to do what we should be doing for all special education cases, treating each child as an individual and not a label.

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