Stopping School Violence

Margot Kim Image
Tuesday, December 30, 2014
Stopping School Violence
A recent study showed about 33-percent of high school students reported being involved in a physical fight in the last year.

FRESNO, Calif. (KFSN) -- A recent study showed about 33-percent of high school students reported being involved in a physical fight in the last year. Nearly seven-percent of teachers reported being threatened or physically injured by a student. How can we make schools safer for everyone?

It can happen in the classroom....

The hallway.....

Or the cafeteria. When students get angry, violence is often the result.

More than 700-thousand young people are treated in the ER for injuries that happen from physical assaults. Vanderbilt orthopedic trauma doctor Manny Sethi has seen it too often.

"I think it's a problem that is getting worse every day," Manny Sethi, M.D., Assistant Professor of Orthopedic Trauma at Vanderbilt University and Director of the Vanderbilt Orthopedic Institute Center for Health Policy told Ivanhoe.

Dr. Sethi stepped out of the hospital and into the classroom - implementing a program that reached nearly twenty-five hundred middle school students.

The program teaches kids how to calmly solve conflicts.

A pilot study showed it works! At least one-third of students better understood how to solve heated situations without violence. And one out of four felt safer in their schools.

"I think this is really helping them to, just kind of reflect, and to take a moment before you act," Kristian Dennison of Wright Middle School told Ivanhoe.

"Now, it's like, well everyone is not the victim of my problem, so there's no point in just going off on everybody. I should just keep it cool and keep calm, cool and collected," said 8th grader Serena Easley.

A simple program that gives students the tools to prevent a potential tragedy. Submit

"We're reaching these kids on the front end, so on the back end; I'm not having to tell a mother at 3 in the morning that her son was stabbed multiple times in the left leg," said Dr. Sethi.

The program was most effective among seventh graders. 70-percent of them had improved attitudes toward non-violence after participating. Doctor Sethi says he's currently working on expanding the program to more schools.


STATISTICS: Youth violence can have a negative impact on the mental, economic, and sometimes physical health of a community. In the 2011 Youth Risk Behavior Survey (YRBS) conducted every two years by the CDC, 32.8% of students in grades 9-12 had been in a physical fight one or more times within the 12 months prior to the survey. Of those, 3.9% had injuries treated by a medical professional. Since around 2005, when record-keeping of school violence incidents began, the overall statistics have nearly doubled.


THE STUDY: Dr. Manny Sethi conducted a pilot study with 122 middle school students who participated in a conflict resolution program. At the beginning of the program, students were given a questionnaire to evaluate their behavior in violent situations. Upon completion of the program, they were given the same test. Results showed a decrease in victimization and violent behavior, which in turn created an increase in students' ability to deal with violent situations. Subsequent implementation of the program reached approximately 2,400 students in Nashville schools. Early childhood education and intervention programs build a strong foundation for future development. The HighScope Preschool Project is an example of a study which followed students from a preschool age until 40 years old and recorded outcomes of academic achievement, delinquency and violent crimes. The results showed a positive outcome for students who experienced the project as compared with those who did not.



Craig Boerner

Media Director, National News Director

Vanderbilt University Medical Center



Stopping School Violence -- In-Depth Interview

Manny Sethi, M.D., Assistant Professor of Orthopedic Trauma at Vanderbilt University and Director of the Vanderbilt Orthopedic Institute Center for Health Policy discusses how violence in school can lead to physical and mental effects.

So as an Orthopedic Doctor what do you do?

Dr. Sethi: I am an orthopedic traumatologist; so patients who are injured in car accidents, falls or any sort of trauma that come through the emergency room, it is our responsibility to take care of them. Whether that's non-operatively or operatively, meaning we take into the OR, we basically fix broken bones.

Do you deal with children also?

Dr. Sethi: Well, children in the sense of individuals older than fourteen. Sometimes children will come to the adult emergency room; especially if there have been beatings, stabbings, shootings or those types of things.

And how bad are they?

Dr. Sethi: Sometimes I'm seeing kids who have been in fights--one kid stabs another child and they come to the ER. We take them urgently to the operating room and try to fix either a broken muscle - cut muscles or cut tendons- or broken bones. Often times we have to involve other specialties like the general surgery trauma service or the vascular teams if they've had major arteries to their limbs cut. I've seen multiple cases where we've had to amputate limbs secondary to blunt force trauma or other, you know other violent acts. And in talking to these kids, a lot of what I'm seeing is that these violent outcomes started from some form of conflict with their friend or another individual, and things just got heated very quickly, and suddenly led to this. So oftentimes it's the surgeon who has to go and talk to the families about what happened and how all of this happened. And that's a very sad process to do, to tell a parent that, you know your son or your daughter was injured in this senseless violent act. That even one stabbing or shooting or beating among these kids is one too many because I think there are other ways that their conflict and their issues can be dealt with.

Do we have any numbers?

Dr. Sethi: Sure. We did one study looking at shootings and we showed that over the last five years there was a sudden rise specifically in the teenage population. For example, African-American kids between the ages of eighteen and twenty-two who presented at the Vanderbilt ER were three times more likely than anybody else to sustain those sorts of injuries. Even putting that aside, I think over the past four or five years of my experience at Vanderbilt, I can tell you that I have seen so many kids who've been beaten up or have been stabbed or have been shot, regardless of their gender or their race. I think that it's really a problem that is getting worse every day.

It must be frustrating.

Dr. Sethi: It's extremely frustrating because - when it comes to me in the ER or in the operating room you know it's too late. It's at a point where yes, we can save there leg, we can save their life, but I believe that where the change has to happen is much in advance of that- on the front end. Because we are on the back-end and the front-end is the educators, the people who reach these children and touch them every day. So that's why I think that conflict resolution and really intervening with these children at an earlier age is powerful and I think can really make a difference.

One night at Vanderbilt I was on call, it was a Thursday night and I had a - I believe it was a sixteen-year-old child who had been stabbed repeatedly in his right or left leg. I can't remember. But I remember we took them to the operating room we stabilized him, he's doing fine now. But I remember talking to his mother and I just remember her crying. And I remember in that moment just feeling very powerless in the sense that you know I'm a doctor and I became a doctor because I believe that it's our role as physicians to make a difference in society, to make change. And the community is so important in those two things. But here I was trying to help this kid feeling really that I had done nothing. And so that's when I really started to become interested in what was going on in the world of education. How do you reach these kids, what do you do and that's when we got a grant from Robert Wood Johnson foundation to sort of look around the country and see what was being done. And so we did this, and we reached out to conflict resolution programs across the country and we talked to each of the program directors about what they had done well, what they had done poorly. At that point, we then had three focus groups with victims of violence with my own patients, and really talked to them about the effectiveness of a conflict resolution program. It was a really very powerful conversation for me, because the one thing I took away was that those kids felt that no one cared about them; that no one cared that they were just thugs and gang bangers. So going back, the program gives the children a number of different conflicts and they work through each one. They act out the way to do it, as you saw this morning, and discuss alternative methods to solve the situation calmly. And in doing that, these kids are developing the machinery to solve conflicts peacefully. And I just think that we're not doing that right now. So we used this program, we took it to Cameron College Prep for middle schoolers. We gave a hundred and seventy kids a test before the program- asking them how they would react in thirty situations. They could choose answers from non-violently to very violently. So let's say that someone talks about your mother in the hallway would you either A, say something mean back to them, B, push them, C, hit them, D, threaten them with something else or E, try to solve the conflict peacefully by doing X. And so there were multiple scenarios like this and we gave them this, it was thirty or forty questions, and then we took that data, we entered it into a computer and then they went through the course. The AVB program addresses twelve cases/lessons, so at the end of three months we gave a very similar post-test. We statistically showed there was no pre-test bias. The answer changes were dramatic. In a lot of these situations where the students would have reacted violently before -- now they would really think about a calm way to solve it. And I think that's the power of this. Because in middle school if you start thinking calmly, then maybe in the high school years you'll carry that with you. Then over the course of their lives, they will strengthen this machinery and understand how to effectively solve difficult situations without violence. We're reaching these kids on the front end so that on the back-end, I do not have to tell a mother at three in the morning that her son was stabbed multiple times in the left leg.

Wouldn't that be great if someday you had somebody come in who says okay I got hurt here, but I learned to walk away, you know you never know when they'll come back.

Dr. Sethi: Well the amazing thing was that at CCP, where we did this, they gave us the opportunity to see if the intervention worked. They were not going to do it a second year until a fight broke out at CCP and two of the kids utilized kind of what they had learned in our class to really calm the situation down. And at that point they decided they wanted to continue the program every year and are doing it right now.

So what did you find, I know you gave them pre-test and post-test, how did that come out? Give me some numbers on what you found.

Dr. Sethi: So we just found significant changes in behaviors specifically around calming situations down. Responses to just different questions, like threatening others with knives, threatening with stabbings and shootings went way down...just various threats. Specifically, we showed that more than one-fourth of the students changed their behaviors and beliefs about violence after our program. There was also more awareness about bullying. Overall, our findings showed really impressive things; mostly that these children had a better sort of awareness or sensitivity to violence.

Anything for the program?

Dr. Sethi: I would love for the ABB program to go across Tennessee. We had a successful full-implementation in Nashville metro schools after the pilot study. Mayor Carl Dean was on board throughout the process. So right now we are hoping to expand to Memphis, which is a tougher school area. We met with the Mayor AC Wharton in Memphis and working to start implementation as soon as possible. We partnered with Ron Johnson at the Oasis Center who's going, I believe to the White House to sort of present some of the work that we've done. So my real belief is that we expand it, but even more so than the program itself, I really think what it shows is that, if we just partnered together as people, as a doctor with a teacher, educators with community organizers, we can make a difference. We have been funded by the Robert Wood Johnson foundation at Meharry through two grants. They have been very gracious. The department actually has picked up some of the tab as well at Vanderbilt.

But ultimately the schools, but it couldn't be that out of sight.

Dr. Sethi: No, and think the key part of initiating this is educating the teachers and really getting there by in. And once you do that it's simply some PowerPoint slides and a couple of minutes every week and it literally comes down to that. And so just like we teach social studies or spelling or math, I really think that in the coming years we really need to think about how all of these things have affected our children, social media, etc. We have to teach things like conflict resolution because they don't have the tools; essentially, that the students can solve the everyday conflicts that they face in school without resorting to violence. And even more so today with Twitter, Facebook, etc., it is key that children have the tools to very calmly sort out problems that arise from social media. You know again, I just think that the power of what we are doing is the power of community and the power of people coming together from different walks of life, who see things at different angles, and I think that that is what makes a successful intervention.