Why the nation should screen all students for trauma like California does

As the first person to hold the new role of Surgeon General of California, Dr. Nadine Burke Harris is pushing an unprecedented plan to implement universal screenings for childhood trauma^[1] within the state’s schools.

Childhood trauma is defined^[2] by the National Institute of Mental Health as an “emotionally painful or distressful” event that “often results in lasting mental and physical effects.”

Burke Harris’ plan is already more than a dream: In June, Gov. Gavin Newsom approved a budget that provides roughly $45 million^[3] for trauma screenings and another $50 million to cover training for those who will administer the screenings. Burke Harris’ vision of universal screening for trauma in children may be a massive undertaking, but it’s also already under way.

Well-intentioned critics might question the cost of Burke Harris’ project or schools’ capacity to handle it. As a social work professor^[5] whose research^[6] has long focused on childhood traumatic experiences and addiction, I believe such a program is needed nationwide.

If all the country’s children could undergo developmentally appropriate screenings for what we in the medical and social work communities call adverse childhood experiences, I suggest, based on my research, millions of tax dollars could be saved every year, premature deaths and diseases could be prevented^[7] and schools would be healthier, happier places for students and teachers. A quiet but urgent public health crisis could finally be seriously addressed. Here’s why:

1. Untreated childhood trauma can cause permanent biological damage

Recent biological evidence^[8] confirms what many child development experts have long suspected: When kids experience certain types of childhood trauma, the impacts are not necessarily temporary. It can fundamentally change their brain development and other aspects of physical development.

One example of this: It appears that for some children who face adverse childhood experiences, the brain and body changes the way it responds to future stress^[9]. Many of the changes affect the prefrontal cortex, which plays a key role in the regulation of emotions. A possible consequence: Some children with unresolved traumas are not sufficiently able to understand their own or their peers’ emotions^[10]. Perhaps unsurprisingly, this disconnect can lead to various behavioral problems in schools^[11].

2. Early detection can largely resolve the impacts of trauma

A traumatic experience itself cannot be undone. However, adults often underestimate just how resilient^[12] children can be in the face of even the most serious adverse childhood experiences. And when adverse experiences are detected early^[13], trained professionals can help sufferers resolve lingering effects of trauma through therapy before they turn into much bigger behavioral problems.

Efforts, then, should focus on ensuring early detection of traumatic experiences. They should also focus on fostering habits that strengthen children’s resilience. That includes getting enough sleep and exercise, opportunities for mindfulness practice, and the support of a nurturing community.

3. Screenings can help educators better understand their students

When teachers better understand what might lie behind violent, stubborn or erratic behavior, it can help them be less punitive^[14] and respond in ways that get closer to the root cause. In other words, teachers can spend more time proactively addressing the bigger potential issues rather than simply reacting to what has already happened. For example, if a teacher knows a child has been exposed to domestic violence, the teacher may have the school nurse check regularly whether the child is having any biological reactions. And school social workers and psychologists can talk to the child about whenever the student reacts negatively to something that took place in class.

4. Universal screenings remove the stigma of “at-risk” kids

The school system is the right place for universal screening for trauma, because every child is required to go to school. That means it’s not just kids coming from certain ZIP codes who are labeled as more “at risk” and more likely to undergo the screenings. Unfortunately, our society has a history of using these types of screenings for discriminatory purposes. For an example, look no further than this country’s history with mandatory genetic screening programs^[15].

What’s next after universal trauma screenings?

Once we’re screening for trauma across the board, educators and school systems will have no choice but to develop a language and practice around trauma-sensitive and trauma-informed education. This can only be a good thing for our schools, our children, and our society.

I think of trauma screenings as being similar in some ways to an X-ray: Even the most advanced machines cannot heal the bone. In order to heal the fracture, what you need is treatment that often involves resetting the bones and immobilizing it with a cast or splint. We will have to stress: What will we do with these results? How can we help our systems get to the point where they’re more than ready to handle the next step?

Implementing universal trauma screenings in the nation’s schools is an understandably daunting proposition. It would be highly costly and require intense logistical planning. School systems will also need to anticipate what they’ll do with the results if universal trauma screenings become a reality. The benefits of such screenings, however, far outweigh the logistical and financial costs. In my view, not implementing schoolwide screenings for childhood trauma should be more worrisome than the challenges associated with the implementation. Too many modern societal problems, such as chronic disease and addictive behaviors, originate from ignorance around childhood trauma. But with a trauma screening plan like the one in California, schools could better work toward massively beneficial solutions.

[ You’re smart and curious about the world. So are The Conversation’s authors and editors. You can get our highlights each weekend.^[16]. ]

References

1. ^{^} implement universal screenings for childhood trauma (www.nbcnews.com)
2. ^{^} defined (www.isbe.net)
3. ^{^} roughly $45 million (cpehn.org)
4. ^{^} California Governor's Office (www.gov.ca.gov)
5. ^{^} social work professor (socialwork.vcu.edu)
6. ^{^} research (rampages.us)
7. ^{^} premature deaths and diseases could be prevented (rampages.us)
8. ^{^} biological evidence (acestoohigh.com)
9. ^{^} changes the way it responds to future stress (www.ncbi.nlm.nih.gov)
10. ^{^} not sufficiently able to understand their own or their peers’ emotions (www.sciencedirect.com)
11. ^{^} behavioral problems in schools (rampages.us)
12. ^{^} resilient (www.child-encyclopedia.com)
13. ^{^} early (www.ncbi.nlm.nih.gov)
14. ^{^} less punitive (www.sciencedirect.com)
15. ^{^} history with mandatory genetic screening programs (biotech.law.lsu.edu)
16. ^{^} You can get our highlights each weekend. (theconversation.com)