The state of Ohio is one of the bloodiest battlefields in the national war on opioids.
By 2017, Ohio was second to West Virginia in rates of overdose deaths — 5,111. State district attorneys are battling with the makers of prescription opioids, and the settlements will someday help pay for programs to help addicts.
But one school district in Ohio isn’t waiting. The rural township of Minford in southern Ohio started a program for children of parents and grandparents who are dealing with addiction. These kids are suffering emotional, behavioral and physical consequences of being raised by someone who suffers from addiction, says Marin Applegate, the district’s school psychologist.
“A lot of the behaviors that we’re seeing, traditional things don’t work,” she says. “Or we see kids that just completely shut down. I mean, completely shut down — no affect, no response, not taking in information.”
When a child is living with a parent who is addicted to drugs, they are likely experiencing a lot of emotional, or even physical, trauma and stress, says Kendra Cram, who was hired by the Minford school district last year to teach elementary school kids about trauma.
“When that’s happening, they’re not able to access their prefrontal cortex, which allows them to retain information and gain new information. So they’re not able to learn math or reading or writing during that school day,” Cram says. “They’re thinking about survival skills and getting enough food to eat or having their basic needs met. So the trauma is affecting their academic outcomes and their development.”
Part of the program includes a 45-minute social-emotional learning class each week that every student is required to attend — not just those directly impacted by the opioid crisis.
“By the time that our children go into fifth grade, they have had 135 hours of conversations on social-emotional topics, such as regulating their emotions and behaviors, self-control, perseverance, grit, resiliency, conflict resolution, growth mindset,” Cram says. “So that’s 135 hours of talking about how to be happy and productive and to live a happy life, and just really working on mental health and well-being.”
As a result of this program, Applegate says she has observed more students asking for help because they now have the language to communicate their needs.
“Kendra is using the language with them — self-regulation and zones of regulation — and we’re hearing those kids use that language,” Applegate says. “Now it’s becoming part of their everyday vocabulary and using that language to reach out and ask for help.”
Interview Highlights
On behaviors kids impacted by opioid crisis exhibit at school
Applegate: “We see a lot of transiency in kids, so we have a lot of kids that are here with us for a minute, moving somewhere else, somewhere else and then back to us. I just worked through one student’s records who has attended almost, we have 13 school districts in our county, and she’s attended almost every single one of those districts within a year. As well as truancy. We see a lot of missing school, being late to school, parents not showing up to pick up, things like that. Kids’ behaviors, you know, we see some real limited eye contact, lots of disconnection from kind of the world around them and what’s happening in the classroom setting, not showing a lot of empathy or care for peers or understanding that peers have feelings and emotions. We’ve seen a lot of [tantrums] or meltdowns and you know, those things look like kicking, screaming, hitting, throwing. And these kids are extremely hard to de-escalate. So [with] traditional kids, we use our strategies and we’re able to de-escalate very quickly and get back into the classroom setting.”
Cram: “We’ve had a lot of kids that have been affected by the opioid crisis here in our county and in our school district, and even had a child that came to school and got off the bus, went to breakfast, came to me and said, ‘You know, my mom died this morning.’ And it was true. Her mother had passed away earlier that morning, and she had gotten herself on the bus and gotten herself to school. And just saying very matter of factly, ‘My mom overdosed this morning.’ As a very young child having to cope with that kind of emotional trauma and stress, and that’s what we’re seeing a lot of this is that our kids are dealing with a lot of trauma. And what we know from research is that children who are dealing with trauma are in that survival part of their brain, that downstairs part of their brain.”
On the use of a sensory room to help kids dealing with emotional issues
Applegate: “We have a sensory room in our elementary building, and we have a variety of things to calm kids as well as things to stimulate their senses. So we have kids that go in there that may spend five to 10 minutes on the trampoline just jumping to get out every bit of energy that they have, or maybe they’re jumping to put some energy and oxygen into their brain to get themselves going. We have things like lava lamps that are calming to look at. It’s a small space that’s organized and not overwhelming where kids can go to come back to themselves, whether it’s journaling or jumping on the trampoline or the bouncy ball or building with Legos, you know, whatever it is that they need at that point in time.”
On the social-emotional learning program that every child attends
Cram: “We are implementing a social-emotional learning program at our school where every child in kindergarten through fourth grade comes for 45 minutes and every single week.
“I see about 500 children a week. They come in for 45-minute sessions. So our children have activities like music and gym and library, but they also have social-emotional learning as an activity. So they have a scheduled time … to make social connections and interpersonal connections, doing mindfulness activities and learning about establishing and maintaining positive relationships and how to manage their emotions, how to set and achieve positive goals and how to feel and show empathy for other people, how to make responsible decisions and to have effective communication. So during our sessions we’re talking about how to manage our emotions.”
Applegate: “One of the key components to that is the modeling and practice. We do a lot of modeling of it, a lot of practice with it in Kendra in her setting, and then we work for that carry over into the classrooms. Our teachers know what Kendra is working on and what the skill is, and oftentimes, they feed her what the concerns are and what they’d like her to focus on.”
Cram: “We want to teach children coping skills that they can have with them no matter where they are. … First we look and recognize how are you feeling today? Where are you as far as your emotions? Are you feeling anxious or angry or sad? And then what are some strategies and coping skills that we can do to help you to get into the green zone? The zones of regulation that we’re teaching our children and working with them on. What can we do to help you to get to a place where you’re calm and focused and ready to learn?”
On why social-emotional learning is important for all children
Cram: “All of our children can benefit from social-emotional learning, and whether they’ve had significant trauma in their life or not. And it’s important to note that a lot of families in our area have had a lot of trauma. And what we’re doing is we’re really taking that research seriously about educating the whole child and looking at that and saying, ‘You know what? We need to provide more than just thinking about reading, writing and math. We need to help these children to become productive citizens, to be happy and to really look at mental health.’ ”
Applegate: “Every family in the community is impacted in some way whether there’s a friend a family member. The majority of the members of our community are feeling some type of overflow from it. … What some of these kids see as normalcy is so much different than what we see as normalcy. So you talked about kids not wanting to share what’s going on at home, and what we see with the younger kids is they really don’t know that it’s wrong or different. It’s what they’ve always known and what they’ve always seen. So they do share and we get lots of information, and they share with their peers and then so there’s a lot of conversation back and forth. And you know, helping them to try to while respecting their family and their families’ issues that are going on, also help them to realize that there’s other ways to do things. There’s other ways to be in this world.”
On the district’s program to help kids meet basic needs in and outside of school
Applegate: “We have kids who are showering at school. We have agencies we work with that provide us new clothing to provide to kids. We have laundry accessible at school.
“We have the Steve Hunter Hope Fund Foundation program where kids get weekly power packs, which is a weekly food pack to take home on the weekend that has shelf stable food in it, so we know they have food. Then during the summer, they facilitate summer feeding sites at some of the schools where kids have access to. But we’re so rural they come to us once a week and pick up food or if some of them can’t pick up, there’s a couple of us, we load our van up and we go out and deliver the food to the families. So there’s all of these amazing things that are occurring and they’re mostly locally driven by somebody within the community that’s been impacted that is wanting to make a change.
On providing opportunities for one-on-one counseling at school
Cram: “We also had four children who we know are experiencing acute trauma, and we have counselors coming in from outside agencies to work one-on-one with those students in the school setting so their parents don’t have to drive them to counseling outside of school. We also have a check in and check out program where children have a caring adult that is their person, and they go and see their person in the morning and they have just an emotional check in. How are you doing today? And building some relationships. And then before they leave that evening to go home, they go and check out with their person and say, ‘Do you have everything in your backpack for tonight? Do you need anything? How was your day?’ ”
On the importance of not attaching stigma to the issue of addiction
Applegate: “I think that we’re a pretty caring and connected community, and kind of like I said before, most members of our community are impacted in some way or another, whether it’s a parent or grandparent, an aunt, an uncle, a cousin. The issue is so widespread that most of our kids have some type of impact. … So it’s mostly an open conversation and I don’t really see a lot of stigma around it. There’s a lot of recognizing the issue and what can we do? And kids come first and this is a community issue, and if we don’t solve this issue, where’s our next generation? If we don’t give everything that we can give to this, you look at the numbers and it’s almost like wiping out a whole generation.”
Karyn Miller-Medzon produced and edited this interview for broadcast. Samantha Raphelson adapted it for the web.
This article was originally published on WBUR.org.
Copyright 2021 NPR. To see more, visit https://www.npr.org.