Where we goin'? Outta here!!!!
Back to Class for Frequent Fliers
Why, oh why, are you in the office again???
Sheila V. Rose, MS
Psychologist
Youth Health Services, Inc.
Where are they?
You know who we are talking about – the students
who are never where they are supposed to be. If
someone comes to pick them up, no one can find
them. So where are they? Legitimately,

In the Secretary's office

In the Principal's office

In the Guidance Counselor's office

In the School Nurse's office
Where are they?
And often illegitimately,

In the bathroom

In the hall

In the gym/library

At their lockers

In the band room/theater/auditorium

In another teacher's room
And why do they say they are there?

To get make up work

To get a band-aid or medicine or cough drop.....

To call mom about practice, field trip...

To use the phone for some other reason

To talk about a bully

To ask a question – it's private

To get a pad/tampon
And why do they say they are there?

To get my book, homework, ruler, calculator.....

To talk to _____ - it was important!

To ask about After-School Tutoring.

To change clothes

To calm down – I don't want to hurt anybody....

To find out where to go after school

I GOT KICKED OUT OF CLASS!!!!
But why are they really here????
Because they don't know how to be anywhere else!
So many times, these kids are told to get back to class,
and “I better not see you in here again!”
But they have not been taught the skills they need to
cope.
So what are they trying to cope with – it can't be that
bad, can it? Yes, it can....
But why are they really here????
Standard school issues that are tough for kids to deal
with include, but are not limited to:


Bullying
Learning disabilities, diagnosed or not...
perhaps due to frequent changes in schools that
leave embarrassing knowledge gaps

Sexual harassment

Peer conflict
But why are they really here????

Substance abuse

Dating violence

Self-harm

Issues related to family in the military

Family problems

Boredom (are the classes too long or not challenging
enough? Undiagnosed gifted?)
But why are they really here????
And my two areas of interest:

Mental illness

Trauma drama
Both of these areas can be caused by some of the
former reasons for leaving the classroom, and both
can be exacerbated by such normal school issues.
Sometimes, it's impossible to know whether the
school issues caused the mental illness/trauma, or if
the mental illness/trauma caused the school issues!
Mental Illness
What mental illnesses contribute to poor school
performance? Many children have been diagnosed,
and many more suffer but are not diagnosed, with
mental illnesses. Children can be diagnosed with
many of the same mental illnesses as adults, as well
as some specific to children. Major categories
include the following:
Mood and Anxiety Disorders

Major depressive disorder/Dysthymia

Bipolar disorder

Generalized anxiety

Separation anxiety

Posttraumatic stress disorder

Obsessive-compulsive disorder

Social or specific phobias
Behavior Disorders and Other Common
Childhood/Adolescence Diagnoses

Attention-Deficit Hyperactivity Disorder

Oppositional Defiant Disorder/Conduct Disorder

Eating Disorders

Substance Abuse Disorders

Pervasive Developmental Disorders

Tic Disorders

Reactive Attachment Disorder
And, Childhood Trauma
I call it TRAUMA DRAMA.
It is what happens to kids who experience awful
things, things you would never imagine. It has a
huge impact on their psychological health, and is
probably quite often responsible for the mental
illnesses and behavior problems you see in schoolchildren.
Childhood Trauma
Sadly, children can be traumatized even before they
are born. Studies have shown that being exposed to
domestic violence in the womb can alter the
development of neural pathways. And we all know
what prenatal exposure to drugs, alcohol, and
cigarettes can do to children. Many of your frequent
fliers have been exposed to such prenatal trauma.
And, many have also been exposed to trauma
vicariously, through television or even through
family stories passed down.
Childhood Trauma
Examples of trauma
include but are not
limited to:
Death of someone – either
known or unknown to
the child

Physical or sexual abuse Deployment of parent

Car wrecks/house fires

Medical procedures

Domestic violence
Natural disaster – flood,
tornado, hurricane....
Man-made disaster –
bomb, shooting, war...
How do you get them back to class?
So, you know who they are and why they are in the
office. Now what? Get them back to class!!!
Three steps:

Calm them

Problem solve

Teach skills
And be sure to document your interaction!
Calming techniques
Relaxation techniques:

Belly breathing, visualization.
Cognitive grounding techniques:

Name everything you see; count backwards by 3s.
Sensory grounding techniques:

Stand up and shake it out; splash water on your face;
eat a mint or cinnamon candy; worry stone.
Problem Solving
The STAR Method - Encourage students to be a
STAR:
Stop: When you first notice you are upset, BREATHE!
Think: Whose problem is it? Mine or not?????? If
mine, generate and evaluate possible solutions.
Act Responsibly: Pick one that will most likely give
positive results, and go for it!
Then, look back and decide: Did it work?
Teach and/or review skills
Teach the child several tools to use when the thought
first comes into their head to leave the classroom:

Impulse control skills
Traffic light, Write it down, Big deal/little deal

Calming skills
Breathing, grounding as used earlier
Document the Visit
Create a log-in sheet for all students to complete when
they come to your office. It should include name,
day, date, time, and the teacher's and student's best
memory of what was happening in the classroom at
the time. If possible, have the student complete it
himself. Once completed, the log should be filed in
that student's folder.
*Note: A calming activity may be for a student to
personalize and decorate a manila folder in which to
file the log sheets.
Now What?
If a student has a pattern of leaving the classroom
repeatedly, then someone needs to step up and be
responsible for finding out why! So, whose job is it?
Ideally, the School Counselor's. However, many
school counselors are overwhelmed by the extensive
problems in students' lives today and the burden of
administrative tasks they are required to carry out.
So, Expanded School Mental Health has been
created. The ESMH provider would be the next
logical choice, if available.
Now What?
A Student Assistance Team, the School Nurse, or an
Administrator would also be appropriate choices. A
SAT would definitely be necessary during the
process of developing and implementing a plan to
address the problem behavior.

The classroom teacher is the one most likely to
notice the pattern in elementary children who stay in
one class. For middle/high school, the secretary is
more likely to notice.
How do you keep them in class?
Six steps

Identify triggers

Make a plan

Pass it on

Obtain the necessary tools

Put it in action

Assess effectiveness
Identify triggers
What started it? Review your folder and log sheets to
check for patterns of repeat visitors. Review with
the student to point out the frequency of visits.

Look for patterns!!!! May include leaving at a
certain time of day, if a substitute teacher, if a
certain student is present, if a test, if did not
complete homework...
Note: This step is crucial and may require help from
mental health professionals, school counselors, etc.!
Make a plan
Once you have identified a pattern, develop a system
to cope with the triggering events.


Find ways to prevent the triggers from occurring.
Find ways to help the student cope with them when
they do occur.
Make a plan - Prevention
Examples of prevention steps:

Moving a student away from a peer

Not using certain words that trigger reactions

Removing a certain picture or sound from the room

Not wearing a certain perfume/cologne

Changing the surface of the chair/desk

Eliminating a certain color from the room
Make a Plan - Coping
Develop a specialized plan to deal with triggers that
cannot be removed. The teacher may need to
remind the student to use them. Examples include:



Allowing the student to put their head down after
signaling the teacher that class is too loud.
Have teacher calmly state “You are safe” when
student appears frightened.
Keep a list of cognitive coping and relaxation skills
posted.
Pass it on
Make sure that all parties
involved get a copy of
the coping plan:



Parents
Student
All teachers, including
those on duties where
issues may come up
Principal
Secretary
School counselor
Nurse
Bus driver
Mental health
professionals involved
Obtain the necessary tools
Does the student's plan involve any materials that need
to be made available? Examples include:

Copies of the coping skills sheets and of plan

Stress ball

Headphones/music

Silly putty or play-doh

Sketch book or journal

Mints/cinnamon candy
Put it in action
Make sure everyone knows the date of
implementation. A SAT meeting is ideal to assure all
parties involved get the information they need to
help the student succeed. However, make sure you
do not leave out the “first responders,” such as
secretaries and bus drivers. These personnel are a
critical piece of the plan.
Assess effectiveness


Monitor the effectiveness of the plan by tracking the
number of times the student leaves the classroom.
Check in with the staff, student, and family
separately to see what each think about the plan. Is
it too hard to implement, or are the coping skills not
working?
Questions and Answers
Feel free to contact me by email at:

srose796@yahoo.com
Additional Resources

National Child Traumatic Stress Network
http://www.nctsn.org/

Positive Behavioral Interventions and Supports
www.pbis.org

Association for Positive Behavior Support
www.apbs.org/
Additional Resources

Center on the Social and Emotional Foundations for
Early Learning
http://csefel.vanderbilt.edu/

What Works Clearinghouse
http://ies.ed.gov/ncee/wwc/

National Association for School Psychologists
http://www.nasponline.org/