Two decades ago, Vincent Felitti, then director of Kaiser Permanente’s weight-loss program, noticed a troubling pattern among his patients. Many were losing weight—upwards of 100 pounds. Yet several kept dropping out of the program, including some who were losing the most weight. A poignant example was Ella, a middle-aged woman who started at 295 pounds and slimmed down to 150 before announcing she was quitting to avoid losing any more weight. After some counseling, the truth emerged. Ella had been molested as a child, married in her teens, and was now in an abusive marriage with only one escape from her husband’s jealous suspicions: being overweight (Szalavitz, 2010).
Felitti heard Ella’s story of adverse childhood experiences reflected in the lives of many other patients. He decided to conduct a study of nearly 10,000 people in the San Diego area. The study found that nearly half of the adults surveyed had endured at least one “adverse childhood experience” (ACE), such as being verbally, physically, or sexually abused; seeing their mother treated violently; or having parents who abused drugs or alcohol, had a mental illness, or were incarcerated. A quarter had endured two or more (Felitti et al., 1998).
Scars that Run Deep
Felitti and colleagues uncovered another stark finding: People who experienced four or more ACEs were much more likely to abuse alcohol or drugs, suffer from depression, and attempt suicide. They were also far more likely to smoke cigarettes, have had 50 or more sexual partners, contract sexually transmitted diseases, be severely obese, and experience related health problems. This ground-breaking study sparked recognition among health care providers that mental and physical health problems are often scars resulting from the psychological wounds of negative childhood experiences.
More recently, researchers at Johns Hopkins and UCLA (Bethell et al., 2014) examined data for nearly 100,000 U.S. children and discovered a similar pattern. Forty-eight percent of children under age 17 have endured at least one adverse childhood experience (including exposure to violence; emotional, physical, or sexual abuse; deprivation, neglect, or social discrimination; or family discord or divorce, among other painful experiences). Twenty-three percent had experienced more than one such experience. For children 12 years or older, this last figure was even higher, at 30 percent. Sadly, children with exposure to two or more adverse experiences were nearly three times more likely to repeat a grade, four times more likely to engage in bullying behavior, and eight times more likely to have behavior problems in school.
Psychological Trauma and the Brain
Chronic stress—like that associated with ACEs—appears to have lasting effects on the brain. Neuroscience studies (Bremner, 2006) have found that people with post-traumatic stress disorder, for example, have a smaller hippocampus—the region of the brain responsible for converting short-term memories to long-term ones. People suffering with PTSD also register increased activity in their amygdala, which triggers fight-or-flight responses, and decreased activity in their medial pre-frontal cortex, the part of the brain that helps tamp down anxiety.
In short, exposure to the chronic stress of psychological trauma appears to leave students in a constant state of high alert that makes it difficult for them to concentrate; it also appears to contribute to deficits in verbal declarative memory—the very stuff of academic learning. It’s not surprising, then, that students with adverse childhood experiences can be irritable, distractible, and struggle to retain new knowledge (Streeck-Fischer & van der Kolk, 2000).
What Helps?
So what can educators do to help the many students who’ve experienced trauma? For starters, it’s worth noting that in the Johns Hopkins / UCLA study of 100,000 students, those exposed to two or more adverse experiences were far less likely to demonstrate emotional resilience than those with no adverse experiences (55 versus 72 percent) (Bethell et al., 2014). However, among students with two-plus ACEs, those who did demonstrate resilience were one and a half times more likely to be engaged in school than students with two-plus ACEs who didn’t show resilience.1 This prompted researchers to conclude that helping students develop self-regulation skills may be one of the most important things we can do to counteract the effects of trauma. For example, one group-therapy program that taught elementary students coping techniques like relaxation, social problem-solving, and conflict resolution showed promise in relieving PTSD symptoms (Langley et al., 2015).
Other research suggests that one solution for counteracting the effects of trauma already exists inside our schools. Consider the following:
- A meta-analysis of 11 studies of music therapy interventions for children facing trauma—such as teaching students to listen thoughtfully to music and discuss how it makes them feel—found that the interventions had significant effects on cognitive development, behavior, and self-concept (Gold, Voracek, & Wigram, 2004).
- A small-scale study of teenagers in New York with PTSD found that 16 weekly, one-hour art therapy sessions significantly reduced PTSD symptoms for teens in the program (Lyshak-Stelzer et al., 2007).
- A meta-analysis of 73 studies (Ahn & Fedewa, 2011) concluded that increased physical activity improved various mental health outcomes for children, with the strongest effects related to improving psychological distress and PTSD.
Music, art, and exercise—the school “specials”—all seem to address the wounds of psychological trauma. Schools around the country, in fact, are beginning to see the benefits of using music therapy (Valdillez, 2017), art therapy (Durham, 2016), and physical activity to help students in psychological distress. Reframed thoughtfully, schools’ specials might offer therapeutic benefits for students facing trauma. That would be truly special.
1 Although resilience is usually seen as a larger construct, these researchers defined resilience as “staying calm and in control when faced with a challenge.”
