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Bob Stewart knew that some students were frequently missing class or dropping out of the Gladstone School District in Gladstone, Ore (14.6% Latino).
But he didn’t know why.
Stewart came to realize his students face trauma─neglect, mental illness, poverty, foster care, divorced or jailed parents, and other adverse childhood experiences─that affect their school attendance and long-term social, emotional, mental, and physical health.
He wanted to help. He started mental health services in his district.
Stewart wanted to go bigger.
Could he achieve his goal of starting a statewide learning collaborative to educate other school districts how to support students who have adverse childhood experiences?
Absenteeism: A Symptom of a Larger Problem
Stewart, who started as Superintendent of Gladstone School District in 1999, knew all schools across the country deal with some level of chronic absenteeism and dropouts.
But he didn’t realize how bad it was in Oregon.
Oregon had one of the nation’s highest rates of chronic absenteeism (missing 10% of more of enrolled school days).
Nearly 1 in 4 Oregon students were chronically absent in 2009-2010, according to a study.
Low-income children and children of color are disproportionately affected by chronic absenteeism and the consequences of chronic absenteeism.
When kids are absent, they miss learning time, fall behind, and are more likely to drop out.
More than 1 in 3 Oregon students didn’t graduate high school within four years, data show.
Stewart wanted to find out why.
So they asked students.
Connecting Absenteeism to Childhood Trauma
In 2010, Stewart’s district interviewed 52 dropouts to ask why they did not finish school.
Stewart learned that most dropouts were dealing with home issues like neglect, mental illness, poverty, foster care, and homelessness, as well as parental divorce, incarceration, and domestic abuse.
“In most cases, there was something else that got in the kid’s way that wasn’t school,” Stewart said. “Did we miss something earlier, in 4th or 5th grade?”
These “something else” issues are called adverse childhood experiences (ACEs), or childhood trauma.
Students facing ACEs are also more likely to be chronically absent.
For example, U.S. children living in poverty are two to three times more likely to be chronically absent, and Latino children are more likely to live in poverty than their white peers.
In 2011, more than a quarter of Oregon adults (26.4%) reported three or more adverse experiences from their childhoods, according to the Oregon Behavioral Risk Factor Surveillance System (BRFSS).
Next door to Oregon in Washington, elementary school students with three or more ACEs are five times more likely to have severe attendance problems, according to a 2010 study.
Trauma and absenteeism can combine to derail a child’s education, health, and life.
Absenteeism can lead to lower academic achievement and higher risk for misbehavior in school, dropping out of high school, substance abuse, involvement in the juvenile and criminal justice system, chronic disease, and overall diminished health.
Stewart was beginning to make the trauma/absenteeism connection.
Stewart started meeting health professionals, hearing here and there about ACEs. He was part of a project to transform an abandoned grocery store into a center for healthcare and family services, the Gladstone Center for Children and Families, and he served as a member of the Board of Directors for CareOregon.
But one event truly opened his eyes.
Stewart’s Lightbulb Moment
Stewart was invited to a symposium on ACEs featuring Dr. Vincent Felitti, one of the lead investigators of the ACEs Study, and Dr. Chris Blodgett, director of the CLEAR Trauma Center in the Child and Family Research Unit at Washington State University.
This symposium was Stewart’s light bulb.
“The presentation about ACEs crystallized what we were already seeing,” Stewart said.
“We knew the stuff Dr. Felitti was talking about was getting in the way of kids to learn, but we did not know the long-term implications.”
Stewart was inspired to address ACEs among his students.
He searched for other districts that had worked to support children of trauma.
“We gotta see who is doing something on this,” Stewart said.
His search yielded very little.
“We found skeleton things,” he said.
A First Step: Mental Health Support in 3rd Grade
Stewart, through his partnership with CareOregon, got an $80,000 grant a year later to bring in psychologists to address mental health among third-graders in crisis at John Wetten Elementary in Gladstone, Ore.
The principal, Wendy Wilson, expressed support because she understands that childhood trauma makes it difficult for a student to succeed in the classroom.
“We call them ‘red zone kids,’ kids at the tip of pyramid,” Stewart said of students in crisis.
Through the year, they brought in psychologists, but felt like they were missing other kids in need.
Some children facing trauma go unnoticed.
“Children are impacted by toxic stress in different ways. Some have difficulty regulating emotions, while others show lack of attention, impulsivity, or extreme passivity,” said Wilson, according to the Gladstone website. “For these children to develop in healthy ways, they need connections to caring mentors and strategies to self-regulate their emotions, behaviors, and attention.”
Changing the School Environment across the District
Stewart wanted to do more to change the whole school environment.
He wanted to make sure teachers and school personnel respond effectively to students who behave in challenging ways due to childhood trauma and ACEs.
“If one child is having a hard day, it causes a long-term impact on each child in that classroom by creating distractions and delays that interrupt learning,” Stewart said.
So, with additional funding from CareOregon, Stewart started “Culture of Care” at John Wetten Elementary School and then across the entire district.
Culture of Care trains school staff on children’s social/emotional development, student interventions, and calming strategies to build resiliency and coping skills.
The training focuses on relationships and school discipline in a new way, using empathy and listening, known as “first connect, then correct.”
“Kids with high ACE scores have their radar up all the time. It doesn’t take much to flip their lid,” Stewart said. “Kids with high ACE scores also have an ability to see things that are not sincere. It had to be real.”
The efforts paid off.
Attendance improved. the district’s third, fourth, and fifth graders made gains of 10% to 14% in English Language Arts and 8%-14% in math, as well as fewer behavioral referrals in 2016.
February 2019 UPDATE: Read more about building a Culture of Care at John Wetten Elementary from the Children’s Institute.
Engaging Multiple Districts to Support Students of Trauma
Stewart still wanted to do more.
“To build a school system with a 100% graduation rate, we need more staff than we had before,” Stewart wrote in a commentary. “Teachers. Counselors. Social workers. Truancy officers. Psychologists. Intervention specialists. Summer school staff. Tutors. Mentors. We need adults to serve the full spectrum of student needs.”
But he was increasingly frustrated with how the state was doing business.
“We were not as politically smart as we should be because, as educators, we are supposed to play nice in the sandbox,” Stewart said. “We have to stop playing nice. We have to think about policy and think more globally.”
Prior to starting Culture of Care, Stewart ran for and was voted in as president of the Oregon Association of School Executives (OASE), one of four departments of the Confederation of Oregon School Administrators (COSA), a membership organization of more than 2,000 school administrators, managers and executives.
COSA gives Oregon’s education leaders a united voice in helping to shape public policy, advocate for schools and speak on behalf of students.
Stewart would facilitate OASE meetings, among other tasks.
He used this opportunity to discuss ACEs. He would include a slide about ACEs in his presentation, then watch the room and mentally note members who perked up or expressed interest.
Stewart used this short list to start a statewide learning collaborative.
The year-long “ACEs Learning Collaborative” united seven school district leaders to develop a broader understanding of how schools and communities experience and address issues related to childhood trauma. Funding came from CareOregon and Moda Health.
“Teams had to commit to attend monthly meetings for an entire year, and they had to bring a team of eight to 12 community members,” Stewart said.
Teams took part in seven five-hour sessions from November 2015 to May 2016.
The first two sessions introduced the science of ACEs. The other five provided reflection on what they had learned and discussion about local and national efforts related to ACEs intervention strategies and trauma-informed practices.
Teams also participated in monthly calls, and quarterly meetings in the second year.
The learning collaborative was successful.
“Participants described the collaborative experience as engaging and rewarding, valuable both for their own professional development and for their districts’ abilities to respond to student needs,” according to the ACE Intervention Learning Collaborative Interview Project Report.
“At the end of that year, every single school district said the information they received and the implications of what it means will lead to systemic changes in the way they do business,” Stewart said, which is a big deal because almost nothing in education careers causes systemic change; it’s usually just initiatives.
This got Stewart and other members of OASE thinking even bigger.
Developing Childhood Trauma Priorities for the State
Stewart and the OASE wanted to take what they knew to the state legislature to influence public policy.
“Every citizen in Oregon lives in a school district and school districts are held in high regard in their communities,” Stewart said. “If we were smart, we could leverage that.”
In September 2017, COSA convened a two-day retreat for Oregon school districts to collaborate with other partners in creating policy targets to forward into legislation.
Nearly 40 of 197 school districts participated, representing about 75% of kids in Oregon.
State agencies and healthcare organizations attended, too. This included Oregon Mental Health Services, Oregon Health Authority, Chalkboard Project, Latino Network, REED College, NAMI, Children First for Oregon, Oregon Community Foundation, Oregon Education Association Foundation, CareOregon, Moda Health, AllCare Health, Providence Health and Services, Northwest Education Association, and others.
The large group brainstormed major issues they were facing in their school districts.
This sparked five months of ongoing conversations with more than 300 people, which eventually landed on three major issue areas to prioritize during the 2019 legislative session:
- early learning
- the education workforce
- social and emotional well-being of children
COSA convened three workgroups to develop plans to address challenges in the three major issue areas and continued to invite partner organizations to attend.
Stewart chairs the Social and Emotional Determinants of Health and Education Workgroup.
“Students experiencing trauma walk into Oregon classrooms every single day, and our schools lack the resources and infrastructure necessary to support them, leaving thousands of kids without adequate tools and strategies to deal with their experiences in a healthy and productive way,” Stewart’s workgroup says.
Stewart’s workgroup had to generate policy proposal(s) to encourage healthcare organizations, coordinated care organizations (CCOs), county health programs, and health-focused nonprofits to partner with school districts to meet the social, emotional, mental and physical health needs of Oregon students and families.
Did we miss something along the way that would have told us this kid was in jeopardy? Was there something earlier, in 4th or 5th grade?Bob Stewart
Superintendent of Gladstone Schools
“We never had a meeting with less than 60 people,” Stewart said.
One superintendent, who previously didn’t know about ACEs until he got involved, went on to be appointed by the governor to serve as the State Superintendent of Public Instruction.
The workgroups met one final time, in August 2018, to present their proposed policy goals.
Stewart says the policy goals aim to give schools flexibility to address social and emotional learning.
“If everybody wanted to hire mental health therapists for schools, there would not be enough for all schools,” Stewart said. “It needs to be a mixed bag.”
Advocating at the State Legislature for Students and Schools
In September 2018, the COSA Workgroup chairs were invited to present findings of their workgroup to the Joint Interim Committee on Student Success.
In October 2018, the COSA Workgroups released the Preliminary Report to the Joint Interim Committee on Student Success.
In the 2019 legislative session, Oregon will improve student outcomes by supporting the social, emotional, mental, and physical health needs of underserved students by investing $85 million in a Student Social and Emotional Health and Development Fund in the 2019-2021 biennium. The fund will be used to:
- Hire and/or contract youth/student and family support professionals to work directly with students and their families to serve their health needs, including social and emotional health and well-being;
- Facilitate the implementation of hiqh-quality professional development and training on social and emotional learning (SEL), mental health, and trauma-informed care (TIC) that is culturally responsive; develop recommendations for and state adoption of high quality SEL and mental health curriculum and standards; and implement other programs and initiatives that support student social and emotional development;
- Form partnerships and build infrastructure between school districts and healthcare organizations, including state agencies, Coordinated Care Organizations (CCOs), county government, and community nonprofits for co-location or coordination of health services; and
- Create a statewide Data Sharing Implementation Team that will eliminate barriers between healthcare and education service providers.
“We try not to be too prescriptive with schools because we don’t know what they need,” Stewart said. “We wanted to leave the door open for schools to craft in a way that is most useful for their district.”
With the recommendations complete and the bill soon to be drafted, COSA is developing advocacy strategies to support upcoming legislation.
“We’ve changed our hat,” Stewart said. “Up until August was about developing policy, now it is about advocating for policy.”
In the meantime, Stewart is concerned about opportunists attempting to profit off the trauma-informed approach.
“I believe this belongs in the public domain, and that all the information and knowledge need to be free,” he said. “It’s too important.”
What Can You Do?
Over 65 cities have started Handle With Care.
You can get Handle With Care started in your community, too!
Download the free Salud America! “Handle With Care Action Pack” to start a Handle With Care program, in which police notify schools when they encounter children at a traumatic scene, so schools can provide support right away.
The Action Pack, which contains materials and technical assistance to help school and police leaders everywhere plan their own Handle With Care program, was created by Dr. Amelie G. Ramirez, director of the Salud America! Latino health equity program at UT Health San Antonio, with help from the West Virginia Center for Children’s Justice, which started the Handle With Care program in 2013.
By The Numbers
This success story was produced by Salud America! with support from the Robert Wood Johnson Foundation.
The stories are intended for educational and informative purposes. References to specific policymakers, individuals, schools, policies, or companies have been included solely to advance these purposes and do not constitute an endorsement, sponsorship, or recommendation. Stories are based on and told by real community members and are the opinions and views of the individuals whose stories are told. Organization and activities described were not supported by Salud America! or the Robert Wood Johnson Foundation and do not necessarily represent the views of Salud America! or the Robert Wood Johnson Foundation.