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Wednesday, August 15, 2018

Don’t Be in Any Doubt – ADHD is an Illness and It Must Be Treated

From The Guardian (U.K.)

By Ann Robinson
August 13, 2018

Britain is right to take a more cautious approach than the U.S., but we should be prepared to fund a range of treatments.

 There is no doubt that rates of prescription for ADHD in the U.K. have risen
significantly since the 1990s.’ Photograph: Murdo Macleod for the Guardian

Imagine a neurological condition that affects one in 20 under-18s. It starts early, causes significant distress and pain to the child, damages families and limits the chances of leading a fulfilled life as an adult. One in 20 children are affected but only half of these will get a diagnosis and a fifth will receive treatment. If those stats related to a familiar and well-understood illness, such as asthma, there would be little debate about the need to improve intervention rates.

But this is attention deficit hyperactivity disorder (ADHD), and the outcry is muted. If anything, we hear warnings that too many children are being labelled this way, and too many given prescriptions.

In the United States, ADHD is diagnosed at more than twice the incidence in Britain. The true prevalence is likely to be the same on both sides of the Atlantic. So what’s the story? Is the U.S. too gung-ho, or is the U.K. dragging its heels? Are American doctors too quick to medicate children, or British doctors too slow?

Ritalin-type drugs best to treat ADHD in children, shows study.

Emily Simonoff, co-author of a new meta-analysis in the journal the Lancet Psychiatry, says the problem in the U.K. is “predominantly about undermedication and underdiagnosis”. Her study examined a range of drug treatments compared to placebo, and it shows that methylphenidate (better known by under the brand name Ritalin) works best for children and amphetamines for adults.

It can seem counterintuitive that stimulants work for ADHD. In fact, both treatments are thought to increase the activity of the chemicals dopamine and noradrenaline in the brain, neurotransmitters that play a role in executive functions such as learning, planning and exerting control over our behaviour and thoughts. The side-effects such as agitation, weight loss, sweating, sleep disturbance and high blood pressure can occur whether you take the drugs for ADHD or recreationally.

The difference is that people with ADHD are more likely to benefit, and prescribed doses are carefully controlled and monitored. As an NHS G.P., I can only prescribe these drugs using a special protocol that lays down follow-up arrangements. The idea that we dole them out in a cavalier manner is just not true.

ADHD isn’t some sort of catch-all term for bad behaviour, but a clearly identifiable set of symptoms (including inattention, impulsivity and hyperactivity), with strict diagnostic criteria and evidence-based treatment options. People with neurodevelopmental disorders such as ADHD, autism, dyslexia, dyspraxia and dyscalculia have brains that are structurally and functionally different to those of neurotypical people.

It’s a widespread misconception that ADHD equates to disruption in classrooms; a more common presentation is anxiety and difficulty with learning. “A kid with ADHD may be well-behaved and academically able,” says Tony Lloyd of the ADHD Foundation. Identifying that there is a problem and providing the right support is critical.

Treatment doesn't always or only mean medication. Nice recommends a multimodal approach.

So where does the scepticism about ADHD come from? Perhaps it’s an understandable reluctance to label kids while they are still developing, or a wariness about medicalising normal variation in behaviour.

Oftsted’s chief inspector, Amanda Spielman, speaks for many when she voices concerns that the drugs used in the treatment of ADHD are a “chemical cosh”, are overprescribed and disguise bad behaviour that should be managed in other ways.

There is no doubt that rates of prescription for ADHD in the U.K. have risen significantly since the 1990s. The prospect of a U.S.-style situation in which one in 10 children aged two to 17 (rising to one in five boys aged 14 to 18) are diagnosed with ADHD, and two-thirds of those diagnosed are on medication, raises justifiable questions.

But this scenario is a long way from the reality in the U.K., where the NHS imposes vigorous diagnostic guidelines and, crucially, there are no financial incentives for NHS doctors to write prescriptions.

Caution about the action of psychoactive drugs on developing brains is entirely appropriate. The short-term safety data we have is reassuring, though more research is needed into long-term effects. But this caution has to be weighed against the harms, if other treatments aren’t suitable or effective, of doing nothing.

Without diagnosis and treatment, children become prone to anxiety, self-harm and school failure. Around a third will continue to have problems into adulthood and some people will only be diagnosed once they are adults.

U.K. children with ADHD wait up to two years for diagnosis, say experts.

Earlier this year a Demos report highlighted the social and economic cost to society of adult ADHD, as impulsivity, poor concentration and risk-taking behaviour interfere with work and relationships. The inability to regulate emotions and tendency to become overloaded by external stimuli has been described as “like driving a Ferrari with bicycle brakes”.

Treatment for ADHD doesn’t always or only mean medication; the National Institute for Health and Care Excellence’s guidelines recommend a multimodal approach including support for parents, cognitive behavioural therapy (CBT) and stress-reduction strategies. Lloyd says the Nice guidelines are great but mostly aren’t being followed.

My experience as a G.P. would certainly back that up. Children tend to be seen quicker than adults, but often the only treatment given is medication, with other interventions such as parenting support and CBT failing to materialise.

The cautious U.K. approach to ADHD may be preferable to the more enthusiastic U.S. one. But it would be a shame to let scepticism get in the way of good medicine. And that means casting aside any doubt that ADHD is a medical condition, and demanding funding for a range of treatments, including but not limited to drugs. Unfortunately, it seems that is still a long way off.

Ann Robinson is a G.P.

Why Italy's U-Turn on Mandatory Vaccination Shocks the Scientific Community

From CNN

By Gianluca Mezzofiore
August 7, 2018

An amendment from Italy's anti-establishment government that removes mandatory vaccination for schoolchildren is sending shock waves through the country's scientific and medical community.

It suspends for a year a law that requires parents to provide proof of 10 routine vaccinations when enrolling their children in nurseries or preschools. The amendment was approved by Italy's upper house of parliament on Friday by 148 to 110 votes and still has to pass the lower house.

The law had originally been introduced by the Democratic Party in July, 2017 amid an ongoing outbreak of measles that saw 5,004 cases reported in 2017 -- the second-highest figure in Europe after Romania -- according to the European Centre for Disease Prevention and Control (ECDC).

Italy accounted for 34% of all measles cases reported by countries in the European Economic Area, the center said.

Italy's Five Star movement and its coalition partner, the far-right League, both voiced their opposition to compulsory vaccinations, claiming they discourage school inclusion.

League leader and Interior Minister Matteo Salvini said in June that the 10 obligatory vaccinations, which include measles, tetanus and polio, "are useless and in many cases dangerous, if not harmful," according to ANSA news agency.

"I confirm the commitment to allow all children to go to school," he added. "The priority is that they don't get expelled from the classes."

Health Minister Giulia Grillo, a Five Star member, said the government wants to "spur school inclusion and simplify rules for parents."

Why It's Dangerous

Doctors and experts have warned that the amendment might invert a positive trend that saw Italy's inoculation coverage rising after spending years lagging behind the World Health Organization's recommended 95% coverage level to ensure "herd immunity."

"Italy's measles vaccine coverage was par with Namibia, lower than Ghana," said Roberto Burioni, a professor of microbiology and virology at San Raffaele University in Milan. "But the law was working, the coverage was improving. We should strengthen it, not weaken it. Now, children who are not vaccinated will endanger other children at school who are too small for vaccines or cannot be vaccinated because they suffer from immunosuppressive diseases."

Measles tripled in Europe in 2017, European CDC reports

In 2015, child immunization rates in Italy for the first dose of the measles vaccine was 85%, according to World Health Organization figures. The second dose was 83%.

Italians' trust in the efficacy and safety of vaccinations was affected by an infamous ruling in 2012 from a Rimini court that established a link between autism and the combined measles, mumps and rubella vaccination, experts say. While the ruling was overturned three years later, it helped anti-vaccination theories to spread in Italy -- and globally.

"Italy is part of a global trend of distrust in mediators -- doctors and scientists -- who can interpret and explain data," said Andrea Grignolio, who teaches the history of medicine and bioethics at La Sapienza University of Rome.

"With the advent of the Internet, people have the illusion they can access and read data by themselves, removing the need for technical and scientific knowledge."

While European countries behave differently as far as mandatory vaccinations are concerned, and the actual efficiency of forcing parents to inoculate their children is disputed, Grignolio and Burioni agree that, in the case of Italy, the law was having the desired effect.

By 2017, child immunization rates for the first dose of the measles vaccine had increased to 92%, though the second dose remained low at 86%.

The majority -- 89% -- of measles cases in Italy in 2017 were among unvaccinated people, and 6% of infections affected people who received only one dose of vaccine, according to a report from the ECDC.

Distrust in Institutions

Others maintain that the skepticism about vaccines is in line with a more general lack of trust in Italy's institutions, a sentiment that the populist Five Star Movement was able to channel in its political agenda, winning support at the latest general elections.

"Distrust in vaccines is one of the symptoms of a more general distrust in institutions," says Riccardo Saporiti, a data journalist and contributor to Wired Italy who has written about vaccine coverage in Italy.

Saporiti argues that distrust in Italian institutions started in Italy with what was called Tangentopoli (Bribesville), a corruption scandal that shattered the postwar political establishment in the 1990s.

"It destroyed Italians' trust in politics, and then it spread to anyone with a specific expertise," he said. "Five Star's slogan at the 2013 elections was 'One is worth one,' which is the denial to any concept of competence and merit."

In a data analysis for Wired, Saporiti uncovered that in some areas in Italy, one in two children born in 2013 did not get the MMR vaccination.

However, the future is not all dark, according to Grignolio, who says 10% of Italians who are somewhat hesitant about vaccinations that can be convinced to inoculate their children.

"When there's an obligation, they will comply. But the newly approved self-certification is a joke," he said.

Children Return to Schools Without Promised Water Filters to Screen Lead

From The Lens

By Marta Jewson
August 14, 2018

Children are returning to Orleans Parish public schools this month without the water filters to screen lead from drinking water that school officials promised to install last year.

“The lack of urgency is appalling,” said Gail Fendley, executive director of Lead Safe Louisiana.

Thousands of students have passed through school district-owned buildings in the two years since officials first promised to test school water for lead, she said.

No one knows whether New Orleans schools have high lead levels in their water systems. Orleans Parish schools tested for lead in drinking fountains in 1989, shortly after the federal Lead Contamination Control Act became law. But it’s not clear if they’ve been tested since.

Last year, asked when the district last tested its water for lead, a school district spokeswoman said, “We have no records associated with the Orleans Parish School Board conducting testing of that nature.”

“The lack of urgency is appalling.”
— Gail Fendley, Lead Safe Louisiana

The Sewerage and Water Board of New Orleans must check its water system for lead, and those tests have shown it is in compliance with federal guidelines. But lead levels can spike when underground pipes are shaken during road construction or when nearby lead service lines are replaced. The water agency has been criticized for failing to inform residents when nearby projects pose that risk.

On the heels of Flint, Michigan’s lead-in-water scandal, the state-run Recovery School District and Orleans Parish public schools announced in 2016 that they would test school drinking water for lead. A few months later, they decided to forego it.

Instead, the districts decided to install filters on drinking fountains and kitchen taps, which they concluded was a safer move. But that hasn’t happened yet either.

The Orleans Parish school district appeared to be making progress last fall, when it allotted money for filters and put the project out to bid. But problems with the winning contractor’s qualifications sent the project back out to bid.

The district selected a contractor early this year, but they still have not signed a contract.

The delay concerned Fendley.

“Parents should take the initiative and insist on safe drinking water, bottled if necessary,” she said. “All children should be tested.”

A Switch from Testing to Filters

The process started in July 2016. Local officials teamed up to announce they would test school water for lead.

School officials commissioned a plan to test 10 schools for $24,336. If any positive results were returned, then they would test like-schools and fixtures.

Then-superintendent of the Recovery School District, Patrick Dobard, shared the plans with the Sewerage and Water Board of New Orleans in August 2016.

According to emails and documents reviewed by The Lens, the water agency wanted school district administrators to allow more lead in the water before taking a fixture out of service.

“We have no records associated with the Orleans Parish School Board conducting testing of that nature.”
—Dominique Ellis, spokeswoman, Orleans Parish Schools

The water system uses a threshold of 15 parts per billion. The U.S. Environmental Protection Agency recommends taking a school drinking fountain out of service if it shows more than 20 parts per billion of lead.

But there is no safe level of lead, and children are especially susceptible to lead poisoning.

The schools initially set a threshold of 10 parts per billion. After the Sewerage and Water Board questioned their reasoning, it was raised to 15.

Both levels are substantially higher than the American Academy of Pediatrics’ recommendation to shut off any school water fountain with a lead level higher than one part per billion.

The Sewerage & Water Board wanted to take its own samples, causing the schools’ testing consultant to wonder if they would end up with dueling test results.

But school officials decided to scrap the plan altogether and go with what experts said was the safest and most cost-effective option — water filters.

Officials Said Filters Would Be Installed Last Year

The day after The Lens reported on the aborted plan to test water, officials from the RSD and the Orleans Parish school district told school leaders that filters would be installed in the fall of 2017.

The filters appeared to be on track. In September, the Orleans Parish school district selected a filter company — EcoWater Systems — and made plans to test the water after installation to ensure the filters were working. In October, the school board allotted $800,000 to install them in all district-owned buildings.

But the bidding had to start over because the district decided the filters offered by the companies weren’t properly certified — not for lead, but for microbes that could enter pipes during a citywide boil-water alert.

The district wanted to protect against the microbes to prevent school closures during the advisories.

The district re-bid the project and again awarded the bid to EcoWater in February.

But the contract still has not been signed, Orleans schools spokeswoman Dominique Ellis told The Lens last week.

Once it’s inked, water filter installation should begin within weeks, Ellis said.

Fendley just wants to see the district take action.

“If they do want to go the most conservative route, that’s OK,” Fendley said, referring to filter installation. “But let’s do it.”

Marta Jewson covers education in New Orleans for The Lens. She began her reporting career covering charter schools for The Lens and helped found the hyperlocal news site Mid-City Messenger. Jewson returned to New Orleans in the fall of 2014 after covering education for the St. Cloud Times in Minnesota. She graduated from the University of Wisconsin-Madison with majors in journalism and social welfare and a concentration in educational policy studies.

Tuesday, August 14, 2018

Tips to Help Kids with Back-To-School Anxiety

From KQED's Blog "Mind/Shift"
How we will learn.

By Elissa Nadworny
August 29, 2017

The start of the school year can be rough on some kids. It's a big shift from summer's freedom and lack of structure to the measured routines of school. And sometimes that can build up into tears, losing sleep, outbursts and other classic signs of anxiety.

"Going back to school is a transition for everyone," says Lynn Bufka, a practicing psychologist who also works at the American Psychological Association. "No matter the age of the child, or if they've been to school before."

In the vast majority of cases, this is pretty standard stuff. It doesn't mean it's not painful — for you and your kids. Just watch this viral video -- (Andrew is now in first grade and doing fine).

"If you see that in your kids, don't panic," says John Kelly, a school psychologist in Long Island, N.Y. "For most kids, there's gonna be some level of anxiety."

And, if you think back on it, you can probably remember feeling that way, too.

We talked to some experts about what parents can do to ease the transition — plus, what to watch out for if there's a more serious problem.

Here's their list of tips:

Listen to your kid.

Be available, says Lynn Bufka. If children have questions about school, or, once school starts, something exciting happens during the day, parents should make time to listen. Sharing the excitement can help ease concerns.

Tune into what your kids are talking about. "Emotionally, parents are the safe place for children to experience emotions and to help them develop the language around expressing emotions," says Bufka.

Be specific.

Beyond listening in general, drill down to the specifics. "It's important for parents to explore with their kids what they're feeling anxious about," says Bufka.

If parents know what, exactly, is making students nervous — friends, classes, a new teacher — they can help problem-solve.

Let kids be the experts.

Eleanor Mackey, a psychologist with Children's National Health System in Washington, D.C., suggests asking kids what might make them feel better.

"Let them generate solutions," she says, "Ask them what helps them feel better in other scary situations."

If they need help coming up with ideas, parents can help them role-play tough situations or come up with strategies they can use in situations that make them worried.

Positive messaging.

Create a positive expectation. Talk about things your kids can look forward to in school, past experiences they've enjoyed. Friends or field trips are good examples.

Talk through previous triumphs.

Many kids have been nervous or anxious before, so reminding them of their own successes with similar situations can help.

Try: "Remember last year, when you were feeling this way? You got through it."

Reassuring kids that they have the tools to get through the challenge ahead, because they've overcome their fears in the past, can go a long way, says Lynn Bufka.

Eleanor Mackey says parents may be unsure what to say in situations like this. She offers a template:

"I understand you are scared – that's just fine. I also know that you can manage this. Remember last year when you were so nervous but you did it and made it through and ... made a great new friend, did well in Spanish, etc..."

Reach out to the teacher.

"I'm surprised at how reluctant parents are to talk to the teacher," says Mackey. "They don't want to be that parent, or they don't want to label their kid with issues."

And yet, she says, teachers have consistently told her they like hearing from parents.

Educators spend a lot of time trying to figure each kid out, she explains, so if you can save them the time, why not share? Parents are, after all, the experts on their kids.

Maybe your child is scared to answer questions in front of class, or has anxiety about being put on the spot — let the teacher know. She (or he) can use that information to help design the class, or maybe there can be more small-group work instead.

Parents can also tell their kids they've talked to the teacher, which can lower anxiety and send the message that the adults are on their side.

Start the routine early.

"It's always helpful to practice your routines before things start," says Bufka.

Find (and clean!) backpacks, lunch boxes, folders and other supplies. Plan ahead and get the child involved in the planning process — have them get their belongs ready, etc.

"That gives the child a sense of mastery over the situation," Bufka explains. "Getting your child engaged about the new thing will help them feel like it's more under their control."

Often, families try and squeeze in a last fun adventure right at the end, but that can make things worse. Don't wait for the night before, says John Kelly, who is also the president of the National Association of School Psychologists. "You really need to start that adjustment early."

That means getting up earlier — and going to bed earlier too.

It's kind of a no-brainer that sleep is essential, Mackey points out, but patterns can't be adjusted (literally) overnight.

"Kids really get out of rhythm in the summer," she says, and this has a bigger impact than adults realize.

"When we're tired, we're moody, and little things can feel really big," Mackey explains. "Anxiety is much worse if sleep is bad. Make sure you have a good quiet routine and early enough bedtime that your child can get sufficient sleep."

Oh, and turn off that tablet or smartphone before bed, too.

Do a dry run.

If it's a new school or a new neighborhood, introduce students to that situation before the big day. Visiting the school, or walking to and from the bus stop, can go a long way, says Mackey. You may have to do this more than once to make it seem familiar, she says. "Just once may lead to more anxiety."

A dry run can help even if it's not a new school. Kelly calls it: Say Hello To the School Again.

It's a great way to remind anxious kids they've been here before. Many schools are open the week before Day 1, often teachers are around too. If the school has an orientation, don't miss it.

Social connections.

When kids can make social connections before they start school, that's a really helpful step, says Kelly. Many kids have anxiety around friends, 'Who's going to be in my class? Who can I sit with at lunch? Ride the bus with?'

Especially for older students, comparing schedules with friends can help.

Don't ignore clothing anxiety.

Parents may not think that what you wear on the first day matters, but for kids it can be huge. Especially, John Kelly says, in the middle and high school years.

Read some books.

Kelly recommends School's First Day of School, by Adam Rex. It's about how nervous the school itself is. First Day Jitters by Julie Danneberg is helpful for kids starting new schools.

And, Kelly says, for really young kids try Nancy Carlson's Look Out Kindergarten, Here I Come. Carlson's book also has a Spanish version: Preparate, kindergarten! Alla voy!

Chill out after school.

Give kids a break after school, says Mackey. They don't need a lot of time, 5 to 10 minutes is just fine. Kids, she explains, need this after a hectic day when their brains are in overdrive.

Try doing it with them. A few minutes of quiet or light conversation can be great for the whole family — and it's another opportunity to connect with your kids.

Remember: Easing anxiety can take time.

Not everyone is going to adjust to a new situation on the first day. Be patient. Each day can bring new challenges. This is especially true for older students, who are navigating new classes, different teachers and changing schedules.

It's very normal for kids to have trouble for a week or two weeks into the school year. "It's all new," says Kelly. "They're re-starting routines, or starting routines for the first time, and that can take a while."

Parents have anxiety, too.

"It's important for parents to realize that schools are filled with professionals who work with children all the time," says Bufka. Remember, Kelly adds, kids are going to pick up cues from parents, so making sure you're comfortable too is an important piece.

Signs that it's not normal.

There are some warning signs that your child may need some extra help. Kelly ticks off a few: If you really see your child struggling, having a really difficult time just getting to school or feeling increasingly anxious at night time.

Lynn Bufka says as a parent, you're in the best position to observe changes in their behavior.

"If the child is refusing to do things that they've normally done, or that they've not had difficulty doing before," she says, "that's a sign that something isn't going right."

Maybe it's a bully, or your child is really overwhelmed and they need some extra work with a psychologist.

Bufka says that in some cases anxiety around school can develop into school refusal, where kids flat out refuse to go. And that's definitely the time to reach out to a professional.

Trauma Can Make It Hard for Kids to Learn. Here’s How Teachers Learn to Deal with That.

From Chalkbeat
Education news. In context.

By Adeshina Emmanuel
August 1, 2018

Childhood trauma can make it hard for students to focus or behave in classrooms.

There’s no debating that childhood trauma seriously impacts how students learn. Researchers have tied stressful events such as divorces, deportations, neglect, sexual abuse and gun violence to behavioral problems, lower math and reading scores, and poor health.

The latest research, from the University of Wisconsin-Madison, finds that children who endure severe stress are more likely to suffer heart attacks and mental health disorders.

So, we know trauma affects kids, but how do we teach educators to confront it? That’s where Dr. Colleen Cicchetti comes in.

Dr. Colleen Cicchetti
A child psychologist at Lurie Children’s Hospital and an assistant professor at Northwestern University’s medical school, she helps lead the hospital’s efforts to improve how local schools handle trauma. The goal: to train teachers to spot and respond to warning signs in kids.

Last Tuesday and Wednesday, about 150 aspiring teachers with Golden Apple’s scholars program attended day-long training sessions.

It’s not the job of a teacher to become a mental health provider, said Cicchetti, who earlier this year was named Public Educator of the Year by the National Alliance on Mental Illness. “It’s really their job to try to understand what barriers are making it hard for them to do their job.”

Chalkbeat Chicago interviewed Cicchetti about training teachers, the cost of childhood trauma in Chicago communities, how it takes a toll on classrooms, and what teachers can do to promote healing in schools.

What are some examples of the different types of trauma Chicago children might be dealing with?

Seeing someone shot, seeing someone stabbed. It could be sexual abuse, it could be physical abuse. It could be parents incarcerated, divorced, separation, death. It can be someone that you know being killed, someone you know in a car accident.

What are some ways that trauma finds its way into the classroom?

Flashbacks, difficult sleeping, difficulty eating, choosing not to — or being unable to — enjoy the things you used to enjoy. Being hyperalert where you are scanning the space because you don’t feel safe, which impacts your learning. There’s that hopelessness and sense that the world is dangerous. They might be getting in fights. Another thing we sometimes see is frequent absences.

We see some kids who are spending a lot of time in the nurse’s offices, complaining of stomachaches and headaches — their biology is triggered.

We often see it manifest in difficulty negotiating relationships with other people. Some days they can be really engaged with the teacher, the next day they’re really angry and throwing temper tantrums.

How do you teach teachers to recognize trauma?

We do these trainings called Trauma 101. We show them pictures of brains and which areas of the brain are impacted by that flight-or-fight response being triggered all the time. We talk about the ACES studies.

(Many studies on Adverse Childhood Experiences, or ACES, have linked childhood trauma with the development of diseases like diabetes and heart disease, behavioral problems, substance-abuse disorders in adults, and self-harm. But chronic trauma also can disrupt brain development, impair learning, and make it hard to cope with emotions.)

We look at the symptoms you would see [of PTSD] and what that would look like in a classroom. For example, a kid having flashbacks: You might see a kid who is distracted or looking out the window, or they’re having nightmares so they’re coming into class and putting their head on their desks and they’re sleeping during class because the classroom feels safe and they can’t sleep at night.

We sort of try to walk between the clinical symptoms and the manifestations you may see in the classroom.

How do you teach teachers what to do once they see signs of trauma? What are they supposed to do?

The first level is to be aware of kids you think are likely to be experiencing trauma in your classroom. What do you do to create a sense of safety, and do that self-regulation and peer building in your classroom? But if you have kids who are sort of experiencing more challenges and those things aren’t working, in Chicago Public Schools we have something called a request for assistance.

Teachers can fill out a form and submit it to their social worker or their behavioral health team. Somebody in the school will do a more in-depth assessment or screening. Those kids are then linked to services, either provided by the school or, in some cases, there’s community providers.

There are few — if any — jobs harder than teaching. What are the limits to what teachers can really do?

In a lot of schools, it’s not very safe for a teacher to say ‘I’m struggling with this student.’ But when teachers feel very isolated, and then feel bad and get angry at themselves and at the student, that’s where burnout comes in.

What we’re trying to create is a culture within a school, not just the teachers, but from the administration to all the adults in the buildings, that says it’s our job to take care of the whole child here. If a child is struggling, it’s not a bad teacher, it’s a situation we need to modify.

We try to only go into schools and have these conversations when we’re invited in at the systems level, where the administrators are talking about understanding professional development and reflective learning practices for new teachers, and mentoring, so they can understand why this work is crossing over into their home lives, why they’re coming home grumpy, or overeating or drinking, and don’t want to go back to work.

It’s hard, but we can teach you what you can do to set your classroom up to be successful, and also make sure you have the right kind of supports, so if you’re seeing a kid who’s struggling — and you’re struggling — that you can reach out to other adults in the building.

What does a safe classroom look like in practice for a kid who has experienced trauma, maybe multiple forms of trauma in their lives?

It’s predictable. [Students] know what expectations are, what they need to do to be successful. There’re different parts of the day where it may be getting hard for them to focus, but then they get breaks.

If you didn’t get your homework done it’s not super punitive. We want to hold people accountable and help them be successful, but let’s say maybe they took three buses to get to school and they were babysitting their siblings last night, so they don’t have enough time for an assignment. Are you going to get a zero or will you be coming in during your recess or lunch break to get this done?

It’s an environment that says, I believe you can be successful, and I’m going to stack the deck for your success. I’m going to provide both physical safety and emotional safety. We’re going to have rules around respecting differences and how we talk to one another. We’re going to have restorative conversations and practices around discipline, so we can not be so reactive. And we’re going to foster relationships both with kids and between each other.

Monday, August 13, 2018

Students’ Math Scores Drop for Years After Using a Private School Voucher in Country’s Largest Program

From Chalkbeat
Education news. In context.

By Matt Barnum
August 10, 2018

Low-income students who use a voucher to attend private school in Indiana see their math scores drop for several years as a result, according to a new study.

Ft. Wayne, IN: Students walk past "The Road to Success" sign displayed in
the hallway at Horizon Christian Academy in Ft. Wayne, Indiana. Horizon
Christian Academy is one of more than 300 schools that accepts vouchers
in Indiana, which has the largest statewide voucher program in the nation.

The findings are a blow to the argument that poor students benefit from the choice to attend a private school, a policy championed by U.S. Secretary of Education Betsy DeVos.

“Our results do not provide robust support that the [voucher program] has been successful to date at improving student achievement for low-income students who use a voucher to switch from a public to a private school,” conclude the researchers, Mark Berends of Notre Dame and Joseph Waddington of the University of Kentucky.

The paper, focuses on the initial rollout of what has become the largest school voucher program in the country. In the most recent school year, over 35,000 students were enrolled in the initiative.

The study examines a few thousand low-income students who switched from public to private school using a voucher starting in the 2011-12 school year.

Notably, the authors show that low-income students who used a voucher had slightly higher starting test scores than low-income kids who stayed in public schools. This gives credence to fears that a voucher program could concentrate the most disadvantaged students in the public school system.

The authors attempt to control for these and other factors to isolate the effect of attending a private school. (Unlike some voucher studies, this paper is not able to compare students who randomly won or lost a chance to attend private school — a stronger method.)

In math, the results, which focus on grades five through eight, are consistently negative. Even four years into the program, students who use a voucher had lower scores than public school students.

In English, there were no clear effects. Here, there was some evidence that voucher students improved over time, though there were no statistically significant positive effects after four years.

The results were generally consistent for students of different races, genders, and locations. The findings, though, might not hold for more affluent students or the increasing numbers of participating students who never attended a public school to begin with. Neither group is accounted for in this study.

The results, published this week in the peer-reviewed Journal of Policy Analysis and Management, are largely in line with an earlier version of the same study — with a key exception. The first paper suggested that declines in math disappeared for students who used a voucher for multiple years. The latest version finds that the negative effects seem to persist for at least four years.

The results, then, undermine the argument that recent studies showing drops in voucher students’ test scores just represent students adjusting to private school. A recent study in Washington, D.C. showed substantial drops in math achievement persisted into a second year. Negative results also were consistent in an Ohio voucher study.

In Louisiana, math and reading test scores bounced back according to one method but not another after three years; drops were consistent in social studies.

Voucher advocates have responded by arguing that tests should not be the sole judge of these programs’ success, pointing to more favorable research looking at high school graduation and college enrollment. Despite test score declines, a recent study showed that Louisiana’s program had no effect or somewhat positive effects on college enrollment.

“Although academic achievement outcomes are important for researchers, policymakers, and practitioners to consider, parents make schooling decisions for their children based on a multitude of factors, including academics, location, safety, and religion,” Waddington and Berends write. “Therefore, researchers need to examine outcomes beyond test scores.”

Critics might also point to other concerns not captured in the study: A Chalkbeat investigation in 2017 found that about one in 10 Indiana private schools that accepted a voucher had policies that explicitly discriminated against LGBT students.

That’s perfectly legal under Indiana’s system, as well as the vast majority of publicly funded private school choice programs.

Trauma Doesn't Have to Define New Orleans Children

From The New Orleans Times Picayune/

By The Times-Picayune Editorial Board
August 12, 2018

Trauma counseling is only available to a fraction of the children in New Orleans who need it, and services have been shrinking.

But the New Orleans City Council took an important step Thursday toward changing that dynamic. The council unanimously passed a resolution calling for the New Orleans Children and Youth Planning Board to develop a comprehensive approach for prevention and treatment of violence-induced trauma in the city.

The planning board's work must be done by August 1, 2019, and must include recommendations for new or expanded services for children exposed to violence, potential revenue to pay for those services and any changes needed in state law or city policy.

This is a vital mission. The well-being of thousands of children and families and of the city as a whole depend on the work of the planning board.

The City Council's action grew out of a | Times-Picayune series published in June on "The Children of Central City," which follows the lives of the 9- and 10-year-old A.L. Davis Park Panthers football team. These children have witnessed murders and lost family members to violence.

Between 2003 and 2017, 28 former members of the Panthers were killed.

Panthers coach Edgarson Shawn Scott told the council audience Thursday why he took over the team. "I lost my brother, I lost my friends, I lost my cousin, all to gun violence. That played a big part in my life," Mr. Scott said. "I was scared to go to school. ... I was really afraid. I know what trauma is."

He doesn't want his players to suffer that way. "I started this coaching to give the kids an opportunity ... to give love back to them because I knew in the streets there is no love," he said. He and his wife have been subsidizing the team but have started a GoFundMe account to raise money for uniforms for the players and cheerleaders.

Without counseling and other services, traumatized children can end up getting kicked out of school or even locked up for misbehavior. That has happened to generations of children in New Orleans, perpetuating a cycle of violence and heartache. We can't let that continue.

The Children and Youth Planning Board seems perfect for this mission. The Legislature established youth planning boards in 2004 to help reduce the state's juvenile jail population. The City Council created the New Orleans board that year. Essentially every group that deals with youngsters is represented on it.

The planning board is headed by Paulette Carter, executive director of the Children's Bureau of New Orleans, which provides trauma counseling in the city. It includes members from the Metropolitan Human Services District, Families and Friends of Louisiana's Incarcerated Children, United Way of Southeast Louisiana, the state Department of Children and Family Services, the state Office of Juvenile Justice, the Orleans Parish School Board, the District Attorney's Office, Juvenile Court, the New Orleans Recreation Development Commission, the New Orleans Police Department and the City Council, among others.

Ms. Carter said Thursday that her agency provided treatment to 1,000 children in the past year. In 2017, the Metropolitan Human Services District treated 849 children in its clinics, with an additional 1,200 youngsters treated by contractors they pay.

But that is not nearly enough.

Surveys by the Institute of Women and Ethnic Studies have found high rates of mental health disorders, PTSD and depression among New Orleans children. One in five children surveyed in and around Central City since 2016 had witnessed a murder.

City Council members deserve credit for making trauma counseling services a priority. The council approved a resolution two weeks ago urging all city schools to adopt the trauma-informed methods being used by 11 city schools. The emphasis is on helping traumatized children cope with anxiety, so they can function in school, rather than suspending or expelling them.

"This council is going to keep talking about trauma until it is front of mind for every single person in this community, because it is going to create a different 300 years," Councilman Jason Williams said Thursday.

The council chambers were full of people there to support children who've been traumatized by violence. "Oftentimes, when we talk about children's issues in this chamber it is completely empty," Williams said. "This is very impressive. It is very hopeful for the children of this city."

It is a hopeful moment, but it will take all of us to truly bring about change.

"I'm their guardian for the few hours they're with me," Coach Scott said at Thursday's council meeting.

We should all look at the city's children as if we are their guardians. And we should be ready to do everything we can to keep violence from derailing their lives.