This week, students at Marjory Stoneman Douglas High School returned to class for the first time since 17 people died during a school shooting there.

The students’ strength and resilience has already been recognized across the nation, but we want to pause and recognize their courage once again. It will undoubtedly take time and effort for students and school staff to heal from their trauma and feel safe in school.

However, trauma doesn’t have to take place at school for school to not feel safe.  Over 2/3 of young people have experienced at least one traumatic event (though certainly not everyone who’s experienced trauma has the same reaction to it). Instead of concentrating on learning and building relationships with friends and mentors, many young trauma survivors find that their brain’s reaction to trauma, combined with the challenges of adolescence and schools’ zero tolerance policies, make it incredibly difficult to succeed. Trauma is a significant contributor to the school-to-prison pipeline and the school pushout of young girls of color.

Most traumas do not make the news. Trauma is any emotionally overwhelming or distressing experience which overwhelms a person’s ability to cope. It includes abuse, the death of a loved one, homelessness and witnessing violence, and affects every part of a person’s life: sleep, mood, brain development, cholesterol levels, cancer risk, relationships, memory, organization, and much more. This is one of the reasons we’ve called it the nation’s hidden public health crisis.

Research shows chronic trauma affects students’ school performance, attendance and behavior. Some schools have begun to train their teachers and staff in trauma-informed responses, with amazing results. Unfortunately, this is still rare. My hope is that more educators will understand the effects that trauma has on young people’s brains and lives. If they did, I believe most would approach them with empathy and understanding, and ask, “what happened to you and how can I help?” rather than, “what is wrong with you?”

Here are 4 common ways that trauma affects young people in school.

1. Relationships are unpredictable.

Children who have been abused or neglected often have trouble trusting adults or authority figures. This is because they’ve been betrayed or hurt before, and understandably question the reliability, predictability and safety of their relationships. Students can become hyperaware of their own safety, asking themselves, “Who can I trust? What does this person want?” Because their own relationships have been unpredictable, they tend to push others away, withdraw into themselves, or act out. To educators and administrators, it may seem like the student is being rude or dismissive, or just isn’t trying. As a result, school staff may think these students are too hard to invest their limited time and energy in, leaving some of the most vulnerable young people unsupported.

2. Danger is everywhere.

Within the classroom, trauma survivors might seem jumpy, easily startled, or impulsive. This is because their fight, flight or freeze response has been activated so many times that their brain will “slip” into danger response mode much more quickly than a non-traumatized brain. Behaviors that seem out of control are usually a result of their exaggerated startle response.

This means that it can seem like young trauma survivors are easily overwhelmed, suspicious or emotional. This isn’t because they’re “weak,” but because their brain is registering neutral events as threats. This can cause adults to see young trauma survivors as volatile or oversensitive. It can be easy for school staff to respond to “oppositional behaviors” by punishing their students and withdrawing attention and support. However, approaching them empathetically using de-escalation strategies (like helping them to identify their emotions and giving them space and time to collect themselves) can be much more effective.

3. Negative thinking is the norm.

Young trauma survivors often blame themselves for what happened. They may expect to fail, see themselves as inherently “bad,” and think that people are not going to like them or treat them well. They may also feel like everyone is out to get them. Because of this, neutral statements like “sit down” or, “take out your notebook,” can sound like criticism, and lead them to act out or withdraw. School staff can help students identify these thought patterns.  They can also help by recognizing and praising students when they act in a way that benefits the classroom environment.

4. Planning ahead is hard and necessary.

Because young trauma survivors’ lives can feel so out of control, structure and predictable routines can really help them with concentration and emotion regulation. At the same time, chronic trauma affects children’s memory and attention skills, and their ability to plan ahead and think through problems. Not knowing what is coming in the future can be really unsettling and create additional emotional distress. Switching seat assignments, changing class schedules, having a substitute teacher and other changes to routine can therefore make them feel very uncomfortable. Teachers can help by establishing a routine and giving the class advance warning about changes to the routine whenever possible.

While children who have experienced trauma are at risk for mental and physical health problems, seeking additional support has proven to help. At the Mount Sinai Adolescent Health Center, I work with young trauma survivors on skills they can use to heal and ultimately thrive. I am continually amazed at the resilience of young people.

Creating a trauma-informed classroom is easier said than done, especially since so many teachers are working with limited resources to begin with. As a starting point, I hope that just a basic overview of the effects of trauma can help educators approach students with increased understanding.

For more information on creating trauma sensitive classrooms, I recommend the Trauma and Learning Policy Initiative, the National Child Traumatic Stress Network and the Attachment & Trauma Network’s resources for educators.

Melissa Klosk, PsyD is a Postdoctoral Fellow at Mount Sinai Adolescent Health Center and holds a doctoral degree in School and Clinical Child Psychology. Her research explores the intersections between neurodevelopmental delays and severe psychopathology in children and adolescents. She aims to use her unique background in both school and clinical psychology to help the families she works with navigate the special education system. Her additional clinical interests include: learning disorders, intellectual disabilities, Attention Deficit Hyperactivity Disorders, Posttraumatic Stress Disorder, anxiety disorders, and depressive disorders.

The Mount Sinai Adolescent Health Center is located in New York City. It provides comprehensive, confidential, judgment free health care at no charge to over 10,000 young people every year. This column is not intended to provide medical advice, professional diagnosis, opinion, treatment or services to you or to any other individual, only general information for education purposes only.