Index/Writing

Trauma-Informed Practices for Students with Disabilities

Defining trauma

When considering the ways in which trauma-informed practices currently and could exist to support students with disabilities, it is necessary to first delineate what both “trauma” and “trauma-informed” practices mean in relation to present research. In their literature review (which will be discussed further in terms of critiques of present models of trauma-informed practices), Stacy Gherardi, Ryan Flinn, and Violeta Blanca Jaure (2020) identify the way in which schools’ definition of trauma is often broader than the American Psychiatric Association’s. This is due in large part to schools’ use of adverse childhood experiences (ACEs) as a foundation for said definition. According to the research of Katrina Cummings, Samantha Addante, Jami Swindell, and Hedda Meadan (2017) (based on qualitative interviews with 14 community-based service providers), then, “[a]bout 1 in 4 children experience potentially traumatic events before their third birthday […] [and,] by age nine, 13% of children will have experienced 4 or more traumatic events;” however, “teachers might not readily connect children’s behaviors and emotions to trauma” (both Cummings et al., 2017, p. 2728). That is to say, challenging behaviors that present as a response to trauma—and that pose a significant risk of students re-experiencing the traumatic event and being hyperaroused—could be interpreted in myriad ways, not least of all as the label of “emotional disturbance” (Cummings et al., 2017). Tied to this point, Deserai Miller and Rosa Milagros Santos (2020) state that “children are 4 times more likely to receive special education services if they have experienced abuse and neglect” (Miller & Santos, 2020, p. 216) and that “almost half of the children who have been abused or neglected also [qualify] to receive special education services” (Miller & Santos, 2020, p. 222).

This duality speaks to a simultaneous truth pointed to by Gherardi et al. and another salient critique offered by Noah Golden (2020)—of the way in which trauma “disproportionately impact[s] people of color, people living in poverty, and people with other marginalized identities” (Gherardi et al., 2020, p. 498)—and the way in which the current framework pathologizes students (Golden, 2020). Given this and that “children who have experienced abuse and neglect and do not receive appropriate support, are more likely to have greater cognitive, communication, and social-emotional delays […] [and] to experience school failure, mental health concerns, substance abuse, and suicidal behavior” (Miller & Santos, 2020, p. 216), they identify an urgency for special educators in particular to receive training in such supports and the environmental barriers that lead to them being minimally-available. Similarly to Cummings et al., in compiling data across numerous studies, Miller and Santos found that training is overall insufficient in quality, length, or amount, thereby speaking to a general deprioritization of it as an initiative, and the way in which that runs counter to school professionals’ own values (Miller & Santos, 2020). They extend Cummings et al.’s point to explicitly state that most school staff had “limited understanding related to the connection between abuse and disability” (Miller & Santos, 2020, p. 221).

Trauma-informed practice across settings

Given the cited prevalence of trauma, based on the way in which trauma can “‘include both large-scale, collectively felt events…and small-scale, personal experiences—of loss, violence, displacement, and oppression’” (Golden, 2020, p. 71) and the subsequent import of trauma-informed practices generally (and specifically for students with disabilities), it is unsurprising that research has been conducted in a multiplicity of settings and with regard to specific populations of students. Patricia Buxton (2018), Skip Kumm et al. (2020), Sarah Dababnah et al. (2019), Cheryl Holmes et al. (2015), and Anna Berardi and Brenda Morton (2017) all offer such framings that, when taken together, inform an understanding of intersectional trauma-informed approaches (or, at least, generate questions in that space).

Cheryl Holmes, Michelle Levy, Avis Smith, Susan Pinne, and Paula Neese explore a partnership (Head Start Trauma Smart) between early education and mental health systems in supporting children ages 3-5, insofar as existing systems at that time primarily served older students. This particular program integrated three modalities—the Attachment, Self Regulation, and Competency (ARC) framework, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), and Early Childhood Mental Health Consultation—to attempt to decrease stress associated with chronic trauma, promote social and cognitive development, and create a supportive environment. The tenets of the program involved training, intensive individual trauma-focused intervention, classroom consultation, and peer based mentoring. The discussion pointed to the need for interventions that are flexible—that extend across natural environments—and that have “multiple points of intervention [so as to allow] […] the child to receive a consistent, repetitive message from the therapist, teacher, and parent so it can then be internalized” (Holmes et al., 2015, p. 1657); to that end, the community aspect of the intervention is of particular import. They also point to the fact that, while this study was conducted in an urban setting, trauma occurs everywhere—a point that Miller and Santos similarly illuminate when debunking some teachers’ perspectives (that trauma is not as urgent in rural and affluent communities).

Skip Kumm, Sarup Mathur, Michelle Cassavaugh, and Erin Butts examine another system of behavioral interventions—a facility-wide positive behavioral intervention and support (FW-PBIS) within the context of juvenile “justice” facilities (quotations mine), given the fact that “up to 70% of youth in juvenile justice facilities meet the requirement to be diagnosed with a mental health disorder as compared to 20% of youth in the general population […] [and that, of this group], 25% of them may experience mental health disorders so severe that it significantly impairs their ability to function” (Kumm et al., 2020, p. 80). They cite the way that “[t]he term mental health consists of many multifaceted components and is broadly defined in the research literature to provide an inclusive definition that illustrates the relationship between mental, behavioral, and social health […] [and how] [y]outh with mental health needs manifest their needs through behaviors that include aggression, hyperactivity, impulsivity, withdrawal, or behaviors that are not age appropriate” (Kumm et al., 2020, p. 80). They identify the challenges of this approach—the logistical complications and the collaboration necessary in particular—but they point to the ways in which incarcerated youth experience extremely complex needs based on valences of trauma. The implications for educators and mental health professionals hinge on that tiered system—of more targeted approaches based on data in the service of supporting students. It is not dissimilar to forms of PBIS seen in other educational settings, then, but includes more facets to acknowledge the complicated and multifaceted needs of incarcerated youth.

Sarah Dababnah, Serene Habayeb, Benjamin Bear, and Dana Hussein conducted a study specifically with Syrian refugees living in Turkey, looking at a trauma-informed parent-teacher cooperative training program to support autistic children based on the understanding that “family functioning post-trauma is associated with child mental health outcomes” (Dababnah et al., 2019, p. 1301). Environmental challenges related to an attempted government coup interrupted the study, but salient points emerged that both relate to working with refugee populations and to engendering more support for families across settings; namely, involving community stakeholders, expanding access to services (by using virtual platforms and by expanding reach outside of urban centers), and conducting more rigorous training.

Anna Berardi and Brenda Morton, then, conducted a study on maximizing academic success for students in the foster care system by utilizing a trauma-informed approach. They cite the particular vulnerability of children in foster care to trauma and the disproportionate referral of such students to special education; in a study mentioned, it was found that “44% of foster care children were enrolled in special education, of which 30% were placed in the most restrictive environment[, as compared to] 10% to 11.4% of the general school population” (Berardi & Morton, 2017, p. 10). This, they say, is perhaps a low estimate given the way in which students in the foster care system may move school districts frequently. The trauma-informed approach for which they advocate hinges on “an integration of neurobiology and development, traumatology, and attachment theory” (Berardi & Morton, 2017, p. 12) and upon an expanded understanding of the unique challenges students in the foster care system face. Given this, they echo other studies in their advocacy for a restructuring of school culture in conjunction with partnering with community groups (specifically, trauma-informed advocacy groups), family-based collaborations, and increased training for all school staff.

Patricia Buxton’s study attempts to examine behavioral responses cited in IEPs of students identified with the label “emotional disturbance.” She cites the way in which “cognitive delays and neurobiological deficits […] [can be] a direct result of maltreatment” (Buxton, 2018, p. 31). This study identifies four “behavioral responses evident in IEPs of ED children are indicative of: (a) difficulty learning; (b) impaired relationships; (c) behavior or feelings that differ significantly from expectations given the child’s development, and (d) align with three out of four functional core domains in which students may show possible trauma-related difficulties in school” (Buxton, 2018, p. 44). In truth, this study is less useful for actual teaching implications—insofar as it relies on a small sample size and for its problematic perspectives on emotional disturbance—as it is for exemplifying many of the salient critiques of the field.

Critiques of the dominant model

To that end, within this framework of understanding present research on trauma-informed practices for students with disabilities, it is necessary to simultaneously hold the critiques of said framework. Noah Golden (2020) and Clio Stearns (2020) in particular deliver similar critiques, predicated on the ways in which “[t]he dominant framing of trauma-informed pedagogy uses a reductive biomedical model that suggests that trauma is the locus of unequal outcomes” (Golden, 2020, p. 71) and how it can constitute “an extension of neoliberal demands that children’s lives be surveilled and managed” (Stearns, 2020, p. 23).

Golden’s research and argument is based on observation of a specific “second-chance” program, Conexiónes, in the Dolores Huerta Alternative Learning Complex, and on interviewing small groups of adolescent scholars. The students were “primarily Mexican-American, mostly working class or experiencing poverty, and either second-generation or generation 1.5 […] immigrants” (Golden, 2020, p. 74), who came to the school from their prior ones for a range of reasons. Stearns’s observational data comes from a single third grade classroom in an “urban public school with a high level of poverty” (Stearns, 2020, p. 26) with quite a bit of staff turnover. Both, in the course of their research, identify the classroom as a potential site for trauma and for healing, depending in large part on whether the approach hinges on the individual or the collective level.

That is to say, Golden articulates the way in which the dominant biological framework emphasizes regulation and relational abilities, thereby “overwhelmingly locat[ing] the problem in the students and pathologiz[ing] them and assum[ing] a static, culture-free, and ahistorical understanding of normative behavior” (Golden, 2020, p. 72). This pathologizing, according to Golden, leads to a deficit-based framework, in which the school ignores its potential as a historical and present site of trauma. Thus, it is necessary to ground an understanding of trauma-informed practice in “environmental issues and sociocultural understandings of trauma, its causes, and its effects” (Golden, 2020, p. 72). This manifests as a focus on making meaning—on narratives that allow for students to process and verbalize their experiences. Doing so would shift the focus away from individual interventions—and labeling of students as “bad,” or, as Golden neglects to name, with specific behavior disorders. Stearns similarly focuses on the way the present framework “works within very specific boundaries for behavior, thought, and emotion, and encourages the development of these phenomena in children—by the teacher, who is assumed to be absent of trauma and to understand and expertly embody disparate skills associated with social and emotional life” (Stearns, 2020, p. 26). These boundaries, according to Stearns, constitute a type of wedge between students and teachers—in which both are surveilled, and the potential for empathy is lost in the enforced calmness of the teacher. What is also lost, according to Stearns, is an understanding of “anger and its expression […] as a performative representation of what is ultimately a political experience” (Stearns, 2020, p. 29). That is to say, forms of protest—against rigid constructs of what it means to be “normal” or “disordered”—are pushing back against sociocultural constructs of behavior that teachers and students alike create based on their intersectional identities. Again, Stearns does not explicitly mention race or disability, but it is almost impossible not to think of the disproportionate referral of Black male students for disabilities related to behavior when considering that subjective lens or frame that creates that wedge.

Gherardi et al. (2020), then, offer another critique that, as mentioned at the outset of this paper, explicitly names the way in which trauma affects marginalized communities. They disrupt present narratives by engaging in a literature review and by pointing out the ways in which “specific models for trauma-sensitive schools and existing evidence documenting their outcomes do not reflect inherent attention to the intersections of trauma and social justice” (Gherardi et al., 2020, p. 483), even as trauma-sensitive schools’ theoretical frameworks are based upon the ecological model of trauma-informed care. That is to say, while trauma-informed care is based upon safety; trustworthiness and transparency; peer support; empowerment, voice and choice; and cultural, historical and gender issues, Gherardi et al. find that “trustworthiness/transparency, peer support, and empowerment/voice/choice are absent or only minimally addressed” (Gherardi et al., 2020, p. 486). Given special education’s principles of self-determination and agency, this is significant in that space in particular. The shift, they argue, must come as schools move from asking what’s wrong with students, to what has happened to them, to “why these experiences happen to particular groups of students, interrogating the intersections of trauma and identity as a critical step in addressing the root causes of trauma and preventing re-traumatization” (Gherardi et al., 2020, p. 492).

Open questions

All of these articles, but in particular the critiques of current methodologies, leave space for a number of abstract and concrete questions. Many of the studies could be characterized as race evasive, and many mention disability only briefly. None explore the intersection of race and disability in relation to trauma, and so immediately my mind goes to that question—if students with disabilities and students of color both disproportionately experience trauma (not to even speak to the disproportionate referral of students of color to special education and the intersection therein), what would that disproportionality look like when examined at the intersection of the two? How might, as Gherardi et al. suggest, educational equity be measured in relation to trauma-informed schooling for students of color with disabilities? Given, as Golden and Stearns point to, both the urgency and the challenges of constructing narratives after trauma, how can teachers best support students in doing so? Given the way in which that question in large part depends upon the specific dynamic of the classroom, how can schools prepare and support teachers in doing so?

References

  • Berardi, A., & Morton, B.M. (2017). Maximizing Academic Success for Foster Care Students: A Trauma-Informed Approach. The Journal of At-Risk Issues, 20(1), 10-16.
  • Buxton, P.S. (2018). Viewing the Behavioral Responses of ED Children from a Trauma-Informed Perspective. Educational Research Quarterly, 41(4), 30-49.
  • Cummings, K.P., Addante, S., Swindell, J., & Meadan, H. (2017). Creating Supportive Environments for Children Who have had Exposure to Traumatic Events. Journal of Child & Family Studies, 26, 2728-2741. doi: 10.1007/s10826-017-0774-9
  • Dababnah, S., Habayeb, S., Bear, B.J., & Hussein, D. (2019). Feasibility of a trauma-informed parent-teacher cooperative training program for Syrian refugee children with autism. Autism, 23(5), 1300-1310. doi: 10.1177/1362361318805368
  • Gherardi, S.A., Flinn, R.E., & Jaure, V.B. (2020). Trauma-Sensitive Schools and Social Justice: A Critical Analysis. The Urban Review, 52, 482-504. doi: 10.1007/s11256-020-00553-3
  • Golden, N.A. (2020). Importance of Narrative: Moving Towards Sociocultural Understandings of Trauma-Informed Praxis. In Possibilities and Problems in Trauma-Based and Social Emotional Learning Programs (71-78). Bank Street College of Education.
  • Holmes, C., Levy, M., Smith, A., Pinne, S., & Neese, P. (2015). A Model for Creating a Supportive Trauma-Informed Culture for Children in Preschool Settings. Journal of Child & Family Studies, 24, 1650-1659. doi: 10.1007/s10826-014-9968-6
  • Kumm, S., Mathur, S.R., Cassavaugh, M., & Butts, E. (2020). Using the PBIS Framework to Meet the Mental Health Needs of Youth in Juvenile Justice Facilities. Remedial and Special Education, 41(2), 80-87. doi: 10.1177/0741932519880336
  • Miller, D., & Santos, R.M. (2020). The Characteristics Among Maltreatment, Special Education Service Delivery, and Personnel Preparation. The Journal of Special Education, 53(4), 215-225. doi: 10.1177/0022466919836278
  • Stearns, C. (2020). Let Them Get Mad: Using the Psychoanalytic Frame to Rethink SEL and Trauma-Informed Practice. In Possibilities and Problems in Trauma-Based and Social Emotional Learning Programs (23-32). Bank Street College of Education.