Traumatized students represent a major challenge in inclusion. So far there is a lack of evidence-based concepts for diagnostics and supportin this context. In the TRAILS research project, an integrated system of methods for trauma-sensitive diagnostics and support for children and adolescents with a refugee background in inclusive schools (TRAILS system) is being implemented and its effectiveness evaluated.
Psychological trauma results from events and/or circumstances that are experienced by an individual as physically or emotionally harmful and potentially life-threatening, and that have a lasting impact on core areas of functioning as well as mental, physical, social, emotional, or spiritual well-being (Carter & Blanch, 2019, p. 50). Accordingly, children and adolescents who are exposed to war and flight show an increased risk of trauma (Pine, Costello & Masten, 2005).
More about the initial situation
Almost 166,000 asylum applications were made in Germany in 2019, 50.5% of them from children and young people up to the age of 18 (BAMF, 2019). The entries came from crisis and war zones, so that these children and young people are at high risk for traumatization, e.g. due to human trafficking, criminal or sexual exploitation and forced military recruitment (Schröder, Zok & Faulbaum, 2018).
The negative impact of traumatic experiences on the mental development of children and adolescents with refugee experience is well documented (Fazel et al., 2012; Liming & Grube, 2018; Pine, Costello & Masten, 2005). The risk for traumatized children and adolescents to develop a mental disorder depends largely on their individual ability to regulate emotions as well as on social support in the host country (Demir et al., 2020; Pine, Costello & Masten, 2005). For such stressed children and adolescents, school can hold a trauma-sensitive life context, since the personal, material, and social prerequisites for emotional-social competence promotion are available there and the students experience social support through positive friendships with classmates or by supportive teachers (e.g., Casale et al., 2018).
An inclusive school that rejects “labels and classifies, [ablehnt]takes as its starting point the rights of vulnerable and marginalized people, [nimmt]advocates for their participation in all areas of life [plädiert] and aims for structural changes in regular institutions [zielt]in order to do justice to the diversity of the preconditions and needs of all users” (Biewer, 2009, p.193), holds particularly great potential for burdened students with a refugee background to be able to enter into an intensive, satisfying social coexistence of their own choosing and on a lasting basis (cf. Grosche, 2015).
Multi-Tiered systems of support (MTSS) are a promising way to implement a trauma-sensitive school concept in inclusion and have been established and positively tested in the United States for years. MTSS are preventive in nature and organize supports for students at different levels with increasing intensity and individualization of methods (Casale et al., 2018). TRAILS responds to the fact that in Germany there are no methods of this kind for diagnosing and supporting students with trauma-specific problem behavior
Such a link between diagnostics and support could support the trauma-sensitive efforts of an inclusive school, promote the cognitive emotion regulation and social support of the affected students, and thus also prevent the development of mental disorders.
Literature
Biewer, G. (2009). Grundlagen der Heilpädagogik und Inklusiven Pädagogik. Stuttgart: Kohlhammer.
Bundesamt für Migration und Flüchtlinge (BAMF) (Hrsg.) (2019). Current numbers Edition: December 2019. https://www.bamf.de/SharedDocs/Anlagen/DE/Statistik/AsylinZahlen/aktuelle-zahlen-dezember-2019.pdf?__blob=publicationFile&v=4. Zugegriffen: 27. Februar 2020.
Carter, P. & Blanch, A. (2019). A Trauma Lens for Systems Change. Stanford Social Innovation Review, 17, S. 48–54
Casale, G., Hövel, D., Hennemann, T. & Hillenbrand, C. (2018). Prevention and school health promotion. In B. Röhrle, J. Anding, D. Ebert & H. Christiansen (Hrsg.). Prevention and school health promotion Bd. VI. To improve the effectiveness (S.245-285). Tübingen: DGVT-Verlag
Demir, Z., Böge, K., Fan, Y., Hartling, C., Harb, M. R., Hahn, E., Seybold, J. & Bajbouj, M. (2020). The role of emotion regulation as a mediator between early life stress and posttraumatic stress disorder, depression and anxiety in Syrian refugees. Translational Psychiatry, 10, S. 371. https://doi.org/10.1038/s41398-020-01062-3
Fazel, M., Reed, R. V., Panter-Brick, C. & Stein, A. (2012). Mental health of displaced and refugee children resettled in high- income countries: Risk and protective factors. The Lancet, 379, S. 266–282.
Grosche, M. (2015). What is inclusion? Ein Diskussions- und Positionsartikel zur Definition von Inklusion aus Sicht der empirischen Bildungsforschung. In P. Kuhl, P. Stanat, B. Lütje-Klose, C. Gresch, H. A. Pant & M. Prenzel (Hrsg.), Inklusion von Schülerinnen und Schülern mit sonderpädagogischem Förderbedarf in Schuleistungserhebungen (S. 17–39). Wiesbaden: Springer VS.
Liming, K. W. & Grube, W. A. (2018). Wellbeing outcomes for children exposed to multiple adverse experiences in early childhood: A systematic review. Child & Adolescent Social Work Journal, 35, S. 317–335. https://doi.org/10.1007/s10560-018-0532-x
Pine, D. S., Costello, J. & Masten, A. (2005). Trauma, proximity, and developmental psychopathology: the effects of war and terrorism on children. Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology, 30, S. 1781–1792. https://doi.org/10.1038/sj.npp.1300814
Objectives
In TRAILS, an integrated and multi-level system for trauma-sensitive diagnostics and support in inclusive schools (TRAILS system) is to be developed, implemented and evaluated with regard to its effectiveness in a demand-oriented and participatory manner with the systematic involvement of teachers, students and parents.
The methods developed in the project will finally be made available to teachers and students free of charge as an Open Educational Resource (OER).
Target group
The primary target group of this project are students in grades 5 to 8 at inclusive secondary schools and comprehensive schools who have an increased risk of mental disorders due to traumatic experiences of flight, as well as their teachers and parents.
Figure: Three-tiered RTI approach in academic and behavior domains.
source: Grosche, M., & Volpe, R. J. (2013). Response-to-intervention (RTI) as a model to facilitate inclusion for students with learning and behaviour problems. European Journal of Special Needs Education, 28(3), 254-269.
Diagnostic and support methods that include the target groups in their development from the very beginning can be better accepted by teachers and accordingly better implemented in school practice. We expect that our participatively developed support system will be perceived positively by teachers and students and be implemented with high quality in everyday school life.
The assessment scale developed in TRAILS is to be used as a screening tool. We test it´s psychometric properties by including appropriate and correspondingly large samples. The process oriented diagnostic is based on the method of Direct Behavior Rating (DBR), whose test goodness can be assessed primarily by its reliability under different measurement conditions. We test this in generalizability and reliability studies.
More about the research plan
The TRAILS methods are specifically designed to promote emotion regulation and social support. Accordingly, we expect an improvement in emotion regulation and thus also an effect on the psychological development of the students. At the same time, we assume that the TRAILS methods are more effective in school classes with high social support.
The needs and previous experiences of teachers and parents with regard to trauma-sensitive diagnostics and support will be recorded participatively via sequential focus group interviews.
Individual interviews will also address students’ prior experiences and needs regarding trauma-related school support.
Psychometric validation and efficacy testing of TRAILS methods will be conducted in a quasi-experimental wait-list control group design with pre-, post-, and follow-up measurement with randomization at class level.
In this study we test a) the psychometric quality of the diagnostic assessment scales, b) the effectiveness in reducing psychological problems, c) the build-up of cognitive emotion regulation, and d) the moderating impact of social support in the classroom.
We are investigating the following five questions:
Phase 01 – Development and planning
In a first step, the needs and previous experiences of teachers, students and parents with regard to trauma-sensitive diagnostics and support are recorded in a participatory manner via sequential focus group and individual interviews and used for the further work phases – for example, in the design of the screening and the items for the process oriented diagnostics with trauma-related behaviors in school.
Next is the design of the support concept and the development of therapeutic materials supported by the participation of teachers (regular school teachers, teachers for special needs education) and our US-American Critical Friends from the University of Massachusetts, Amherst, USA.
In addition, this website was developed to support the acquisition of the schools and to be used as an information and communication platform and for the exchange of materials. At the end of the research project, the materials will be made available as OER on the website free of charge for further use.
Phase 02 – Implementation and Evaluation
Initial data collection will assess child-related trauma-specific behavioral problems in the classroom, skills in cognitive emotion regulation, and classroom climate.
In addition in-service training for teachers will be conducted in the last quarter of 2023. Support for the children will begin after the fall vacations in the 2023/2024 school year over a period of ten weeks. The teachers will receive accompanying coaching from a professional trauma educator.
In parallel and afterwards, data will be collected to assess the quality of implementation and the practical usefulness of the diagnostic procedures and support methods – supplemented by a follow-up survey in May/June 2024.
Phase 03 – Transfer and dissemination
Finally the results of the research project are made publicly available. This will happen at national and international scientific conferences and via publications of research results in professional journals.
Based on the results, the methods for diagnostics and support will be revised and prepared for the website in such a way that they are publicly available to interested users as an Open Educational Resource (OER).
This project is funded by the German Federal Ministry of Education and Research under the funding code 01NV2128. The responsibility for the content of this homepage lies with the authors.