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Approximately 25% of children in the U.S. will experience at least one traumatic event by the age of 16 (The National Child Traumatic Stress Network, n.d.). Traumatic events include, but are not limited to, exposure to: (1) sexual, verbal, or physical abuse; (2) having a parent who suffers from mental illness, alcoholism, or drug abuse; (3) having a parent who is a domestic violence victim; (4) having an incarcerated family member; and (5) losing a parent through divorce, death, or abandonment (Mullaney, 2018). When children are exposed to a traumatic event, each responds differently. For example, some experience no behavioral changes; others, however, may develop debilitating mental and physical symptoms that may eventually develop into post-traumatic stress disorder (PTSD). This article details the significance of students with PTSD, summarizes the relevant federal law, and provides recommendations for school leaders.

Significance of Students With PTSD

Because everyone reacts differently to traumatic events, not everyone exposed to trauma will develop PTSD. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) outlines the necessary criteria for an individual to receive a PTSD diagnosis. According to the DSM-5 (American Psychiatric Association, 2022), after experiencing a traumatic event, an individual must exhibit symptoms in each of four categories:

  1. Intrusion symptoms (reliving the event, having repeated dreams of the event, etc.);
  2. Stimuli avoidance (avoiding the people, places, or things that remind them of the event);
  3. Negative alterations in cognition and mood (persistent negative beliefs, feelings of detachment, etc.); and
  4. Alterations in arousal and reactivity (irritable behavior, concentration issues, hypervigilance, etc.).

These symptoms must be present for at least one month, cause a significant impairment in functioning, and be unrelated to medication, substance use, or another diagnosis (U.S. Department of Veteran Affairs, 2022).

While the above symptoms must be present for an official diagnosis, children may present with slightly different symptoms. The U.S. Department of Veteran Affairs (2022) has explained that children ages seven to 11 with PTSD may act out traumatic events through drawings or stories; become irritable or aggressive; avoid school; and have trouble with schoolwork and friends. Students ages 12 to 18 may exhibit anxiety or depression or engage in reckless activities such as abusing substances or
running away.

School-aged children who are diagnosed with PTSD face significant challenges that can hinder their ability to succeed socially and academically. These children may struggle to listen and process information, experience uncontrollable emotions and reactions, and have diminished cognitive control and emotional reasoning (Association of California School Administrators, 2024).

Relevant Law

Because PTSD can impact a child’s ability to learn and participate in school, it is crucial to understand how federal laws might protect them. The Individuals with Disabilities Education Act (IDEA) stipulates that eligible children are entitled to receive special education and related services that would enable them to receive a free appropriate public education (FAPE). A child with PTSD may be eligible for special education under IDEA if their symptoms present as a serious emotional disturbance, which is one of the 13 disability classifications recognized by IDEA (Shaver & Decker, 2017).

According to the Association of California School Administrators (2024), students with PTSD may have an emotional disturbance, which could entitle them to special education under IDEA, if they have:

  1. An inability to learn that is not explained by intellectual, sensory, or other health issues.
  2. An inability to build or maintain interpersonal relationships with peers or teachers.
  3. Inappropriate behaviors, including unhappiness or depression.
  4. A general pervasive mood of unhappiness or depression.
  5. A tendency to develop physical symptoms or fears associated with personal or school problems.

Because a child’s symptoms may not present as an emotional disturbance, they may not qualify for services under IDEA. Similarly, just because a child’s symptoms manifest as an emotional disturbance, that does not mean that the child will require special education and related services. Students who do not qualify for services under IDEA may still be protected by Section 504 of the Rehabilitation Act of 1973 (Section 504) or the Americans with Disabilities Act (ADA). These two civil rights laws prohibit discrimination based on a physical or mental impairment that substantially limits one or more “major life activities,” such as walking, breathing, thinking, concentrating, and learning. Section 504 applies to programs that receive federal financial assistance, which includes public schools, and Title II of the ADA applies to the private sector, which includes private schools. Students who qualify for services under Section 504 are entitled to meaningful access to educational programs comparable to those offered to their peers (Shaver & Decker, 2017). Therefore, schools may need to consider providing reasonable accommodations to students with PTSD (e.g., optional breaks).

To illustrate how these laws could apply to students with PTSD, consider the following court case. In 2015, a group of students and teachers (plaintiffs) filed a lawsuit against the Compton School District in California (defendants), alleging that the district had failed to address the trauma that students experienced in their community (P.P. v. Compton Unified Sch. Dist., 2015). The plaintiffs claimed that various traumatic events in their community (violence, racism, homelessness, abuse, etc.) had impacted their ability to learn and teach and that, by failing to provide adequate accommodations, the defendants had violated Section 504 and the ADA. The plaintiffs also argued that trauma should be recognized as a disability, and that the defendants’ failure to implement trauma-informed practices and provide mental health services was detrimental to the students. The teachers claimed that they suffered from secondary stress and burnout, which only further destabilized their community. Though the court ultimately denied the plaintiffs’ claims, the U.S. District Court for the Central District of California acknowledged “the allegations that exposure to traumatic events might cause physical or mental impairments that could be cognizable as disabilities under [Section 504 and the ADA]” (P.P. v. Compton Unified Sch. Dist., 2015, p. 1126). This case not only demonstrates how Section 504 and the ADA may offer future protection to students with PTSD, but also highlights the need for schools to adopt trauma-informed policies and practices.

Recommendations for School Leaders

Because approximately one in four children will be exposed to at least one traumatic event by the age of 16, school officials will likely encounter students who suffer from PTSD. Given the prevalence of trauma and the impact it has on learning, it is essential to promote a supportive and inclusive environment. School leaders must not only understand how the law applies, but they must also focus on developing trauma-sensitive practices to create a holistic and enriching environment.

Children with PTSD require various supports and accommodations to succeed socially and academically. Because PTSD manifests differently in different people, school leaders must ensure that a student’s accommodations are individualized to fit their unique needs. It is imperative to foster strong, positive relationships with students to build trust and create a safe learning environment. Students with PTSD often feel out of control, so involving them in the process of creating a safe and predictable environment may provide them with the sense of control needed for optimal learning. Educators should consider allowing students to make choices, such as selecting their seats in the classroom, to give them a sense of control. Other accommodations might include providing regular breaks to manage stress, offering sensory tools to help alleviate anxiety, and implementing flexible attendance and homework policies to accommodate times when they are unable to attend school. By adopting these practices, educators can support the emotional and academic growth of students with PTSD, ensuring they feel safe and supported in the classroom.

The Trauma and Learning Policy Initiative (TLPI) suggests that schools begin to create trauma-sensitive practices by engaging in an inquiry-based exercise that asks staff members to consider the following four questions:

  1. Why do we feel an urgency to become a trauma-sensitive school?
  2. How do we know we are ready to create a trauma-sensitive action plan?
  3. What actions will address staff priorities and help us become a trauma-sensitive school?
  4. How do we know whether we are becoming a trauma-sensitive school? (Jones et al., 2018)

This process empowers teachers and leaders to build practices that positively impact everyone by creating a culture of change, accountability, flexibility, and collaboration.

By gaining knowledge and a better understanding of the legal landscape and trauma-sensitive practices, school leaders should be better equipped to address the challenges of educating children with PTSD and ensure that they have the necessary tools and skills to support their educational journey.

Dena N. Klineline, MBA, MSN, RN, CNOR, is a clinical assistant professor of nursing at Indiana University and an EdD student studying higher education and student affairs with a minor in education law. Janet R. Decker, JD, PhD, is an associate professor of education law at Indiana University and a co-author of Legal Rights of School Leaders, Teachers, and Students.

References

American Psychiatric Association. (2022). What is posttraumatic stress disorder (PTSD)? psychiatry.org/patients-families/ptsd/what-is-ptsd

Association of California School Administrators (2018, January 16). Trauma series part 2: IDEA eligibility. content.acsa.org/part-2-idea-eligibility/

Hamblen, J., & Barnett, E. (2022, October 6). PTSD in children and adolescents. U.S. Department of Veterans Affairs. ptsd.va.gov/professional/treat/specific/ptsd_child_teens.asp

Jones, W., Berg, J., & Osher, D. (2018, October). Trauma and learning policy initiative (TLPI): Trauma-sensitive schools descriptive study. American Institutes for Research. traumasensitiveschools.org/wp-content/uploads/2019/02/TLPI-Final-Report_Full-Report-002-2-1.pdf

Mullaney, T. N. (2018). Litigating trauma as a disability in American schools. Northwestern Journal of Law & Social Policy, 13(4), 451−468. scholarlycommons.law.northwestern.edu/cgi/viewcontent.cgi?article=1175&context=njlsp

P.P. v. Compton Unified Sch. Dist., 135 F. Supp. 3d 1126 (C.D. Cal. 2015).

Shaver, E. A., & Decker, J. R. (Eds.). (2017). A guide to special education law. Education Law Association.                       

The National Child Traumatic Stress Network. (n.d.). School personnel. nctsn.org/audiences/school-personnel