Large-Scale Tutoring in England: Countering Effects of School Closures

The government of England recently announced an investment of £1 billion to provide tutoring and other services to help the many students whose educational progress has been interrupted by Covid-19 school closures. This is the equivalent of $1.24 billion, and adjusting for the difference in populations, it is like a U.S. investment of $7.44 billion, even larger than the equivalent of the similar Dutch investment recently announced.

Both England and the Netherlands have Covid-19 disease and death rates like those of the U.S., and all three countries are unsure of when schools might open in the fall, and whether they will open fully or partially when they do. All three countries have made extensive use of online learning to help students keep up with core content. However, participation rates in online learning have been low, especially for disadvantaged students, who often lack access to equipment and assistance at home. For this reason, education leaders in all of these countries are very concerned that academic achievement will be greatly harmed, and that gaps between middle class and disadvantaged students will grow. The difference is that Dutch and English schools are taking resolute action to remedy this problem, primarily by providing one-to-one and one-to-small group tutoring nationwide. The U.S. has not yet done this, except for an initiative in Tennessee.

blog_6-25-20_brittutor_500x425The English initiative has two distinct parts. £650 million will go directly to schools, with an expectation that they will spend most of it on one-to-four tutoring to students who most need it. The schools will mostly use the money to hire and train tutors, mainly student teachers and teaching assistants.

The remaining £350 million will go to fund an initiative led by the Education Endowment Foundation. In this National Tutoring Programme (NTP), 75% of the cost of tutoring struggling students will be subsidized. The tutoring may be either one-to-one or one-to-small group, and will be provided by organizations with proven programs and proven capacity to deliver tutoring at scale in primary and secondary schools. EEF is also carrying out evaluations of promising tutoring programs in various parts of England.

What Do the English and Dutch Tutoring Initiatives Mean for the U.S.?

The English and Dutch tutoring initiatives serve as an example of what wealthy nations can do to combat the learning losses of their students in the Covid-19 emergency. By putting these programs in place now, these countries have allowed time to organize their ambitious plans for fall implementation, and to ensure that the money will be wisely spent. In particular, the English National Tutoring Programme has a strong emphasis on the use of tutoring programs with evidence of effectiveness. In fact, the £350 million NTP could turn out to be the largest pragmatic education investment ever made anywhere designed to put proven programs into widespread use, and if all goes well, this aspect of the NTP could have important implications for evidence-based reform more broadly.

The U.S. is only now beginning to seriously consider tutoring as a means of accelerating the learning of students whose learning progress has been harmed by school closures. There have been proposals to invest in tutoring in both houses of Congress, but these are not expected to pass. Unless our leaders embrace the idea of intensive services to help struggling students soon, schools will partially or fully open in the fall into a very serious crisis. The economy will be in recession and schools will be struggling just to keep qualified teachers in every classroom. The amount of loss in education levels will become apparent. Yet there will not be well-worked-out or well-funded means of enabling schools to remedy the severe losses sure to exist, especially for disadvantaged students. These losses could have long-term negative effects on students’ progress, as poor basic skills reduce students’ abilities to learn advanced content, and undermine their confidence and motivation. Tutoring or other solutions would still be effective if applied later next school year, but by then the problems will be even more difficult to solve.

Perhaps national or state governments or large private foundations could at least begin to pilot and evaluate tutoring programs capable of going to scale. This would be immediately beneficial to the students involved and would facilitate effective implementation and scale-up when government makes the needed resources available. But action is needed now. Gaps in achievement between middle class and disadvantaged students were already the most important problem in American education, and the problem has certainly worsened. This is the time to see that all students receive whatever it takes to get back on a track to success.

 This blog was developed with support from Arnold Ventures. The views expressed here do not necessarily reflect those of Arnold Ventures.

Note: If you would like to subscribe to Robert Slavin’s weekly blogs, just send your email address to thebee@bestevidence.org

Are the Dutch Solving the Covid Slide with Tutoring?

For a small country, the Netherlands has produced a remarkable number of inventions. The Dutch invented the telescope, the microscope, the eye test, Wi-Fi, DVD/Blue-Ray, Bluetooth, the stock market, golf, and major improvements in sailboats, windmills, and water management. And now, as they (like every other country) are facing major educational damage due to school closures in the Covid-19 pandemic, it is the Dutch who are the first to apply tutoring on a large scale to help students who are furthest behind. The Dutch government recently announced a plan to allocate the equivalent of $278 million to provide support to all students in elementary, secondary, and vocational schools who need it. Schools can provide the support in different ways (e.g., summer schools, extended school days), but it is likely that a significant amount of the money will be spent on tutoring. The Ministry of Education proposed to recruit student teachers to provide tutoring, who will have to be specially trained for this role.

blog_6-18-20_Dutchclass_500x333The Dutch investment would be equivalent to a U.S. investment of about $5.3 billion, because of our much larger population. That’s a lot of tutors. Including salaries, materials, and training, I’d estimate this much money would support about 150,000 tutors. If each could work in small groups with 50 students a year, they might serve about 7,500,000 students each year, roughly one in every seven American children. That would be a pretty good start.

Where would we get all this money? Because of the recession we are in now, millions of recent college graduates will not be able to find work. Many of these would make great tutors. As in any recession, the federal government will seek to restart the economy by investing in people. In this particular recession, it would be wise to devote part of such investments to support enthusiastic young people to learn and apply proven tutoring approaches coast to coast.

Imagine that we created an American equivalent of the Dutch tutoring program. How could such a huge effort be fielded in time to help the millions of students who need substantial help? The answer would be to build on organizations that already exist and know how to recruit, train, mentor, and manage large numbers of people. The many state-based AmeriCorps agencies would be a great place to begin, and in fact there has already been discussion in the U.S. Congress about a rapid expansion of AmeriCorps for work in health and education roles to heal the damage of Covid-19. The former governor of Tennessee, Bill Haslam, is funding a statewide tutoring plan in collaboration with Boys and Girls Clubs. Other national non-profit organizations such as Big Brothers Big Sisters, City Year, and Communities in Schools could each manage recruitment, training, and management of tutors in particular states and regions.

It would be critical to make certain that the tutoring programs used under such a program are proven to be effective, and are ready to be scaled up nationally, in collaboration with local agencies with proven track records.

All of this could be done. Considering the amounts of money recently spent in the U.S. to shore up the economy, and the essential need both to keep people employed and to make a substantial difference in student learning, $5.3 billion targeted to proven approaches seems entirely reasonable.

If the Dutch can mount such an effort, there is no reason we could not do the same. It would be wonderful to help both unemployed new entrants to the labor force and students struggling in reading or mathematics. A double Dutch treat!

This blog was developed with support from Arnold Ventures. The views expressed here do not necessarily reflect those of Arnold Ventures.

Note: If you would like to subscribe to Robert Slavin’s weekly blogs, just send your email address to thebee@bestevidence.org

Opening Healthy Schools

It seems that every educational leader in America, and every health professional involved in any way with children, is currently trying to figure out how to open schools safely this coming fall. This is a very complex problem, and I would not presume to offer solutions to all of it. But I would humbly offer some thoughts on key health aspects of the school opening problem, beyond the purely educational issues I have been discussing in previous blogs (here, here, here, here, here, here, and here).

I am not an epidemiologist. I don’t even play one on television. However, I do know a little bit about school health, from working with very talented colleagues at the Johns Hopkins School of Medicine, the Baltimore City Health Department, and the Baltimore Cuty Public Schools, on projects involving ensuring that all students who need them receive, wear, and benefit from eyeglasses. Also, I checked this blog out with colleagues who do know what they are talking about.

First, I will start with an observation. So far, it seems that Covid-19 rarely harms children. Using Maryland data, only 2.2% of cases, and no deaths, have involved children ages 0-9, and 4.2% have involved children and teens ages 10-19, and there has been one death statewide, in a state of six million people.  As a point of comparison, about four Maryland children die of asthma each year. In contrast, teacher-aged people, ages 20 to 59, represent 66.8% of Covid-19 cases, and 243 deaths (I would assume that these rates will be much less by September, or the schools would not be opening in the first place). Keeping children safe from the virus is essential, even if they rarely die from it, but from a public health perspective, the problem is not only what opening schools could mean for the health of students. It is also what opening schools could mean for the health of staff, parents, and other adult relatives and friends of staff and parents.  Unless the disease is completely gone by September, or unless there are widespread vaccines or cures, which seem very unlikely, any solution to limit negative health effects of opening is going to have to focus on staff and parents, not just students. Beyond the importance of protecting the health of the adults closest to the children, it is important to be aware that children who do get the disease probably get it from their families or other adults, not just from other children, so keeping these particular adults healthy is going to be a key way to keep children safe. Further, if staff members, parents, and other family members do become ill, this can have a profound impact on children even if the children do not get the disease themselves.

What these observations mean is that to be truly safe after re-opening, each school should create and implement plans to keep their entire community safe and healthy. One aspect of this might be to have schools build capacity to serve as a local health information and referral center, at least as regards Covid-19, for children, staff, and parents. My proposal would be first, to make sure that each school has a full- or part-time school nurse (currently, approximately 25% of America’s schools do not have even a part-time nurse). Then, I would propose that states, local health departments, or school districts assign one or more well-trained school health aides to each school, to work in partnership with other school support staff under the direction of the school nurse. These health aides might be people with college degrees, such as recent college graduates, trained specifically for this role. They would need to be paid for with federal funds intended to provide employment.

The purpose of the school health aides would be to use whatever resources are available by next fall to ensure that every child, parent, family member, and school staff member, is free of Covid-19, or if they have the disease, they are being directed to local health professionals for isolation and treatment. School health aides might take temperatures of anyone who enters the school, and take appropriate actions if anyone has a high temperature (as hospitals are doing now for everyone who enters). They could provide up-to-date information to parents, staff, and students about social distancing, symptoms of Covid-19, and sources of care. When a cure becomes available, the school health aides’ function could include notifying school community members about the availability of the medication, making sure that all who need it are receiving it, taking their medicine as directed, and doing whatever else is medically necessary. As vaccinations become available, they could help notify school community members about the vaccinations, and help keep track of who has been vaccinated and who has not. The health aide would not be expected to directly provide medical services, of course, but would be charged with keeping track of the health status of the whole school community (with all due concern for confidentiality consistent with HIPAA) and coordinating with local health providers to provide information to parents and staff on available services.

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Why is the school the right place to house health aides to serve the school’s own children, parents, staff, and community? One answer is that schools, especially elementary schools, are available in every community, and they are trusted and familiar places.  In inner city and poor rural areas, they may be the only trusted institution in the community. A key function of the school health aides would be to form positive relationships with children, parents, and community members. This is easiest in schools, where concern for community health can clearly be seen as concern for children, something that every community values. Providing services to school staff members would allow schools to help staff members stay safe. Services to parents would be purely voluntary, and would hopefully supplement services parents might receive in other ways. People who are not involved with schools should be able to receive similar information services from hospitals or community health centers, but the school community has unique needs and strengths that a health aide could help mobilize.

Covid-19 will, we hope, diminish in numbers and impact, so after schools have successfully opened and the virus begins to affect fewer and fewer people, the role of the school health aides could change. At least in high-poverty communities, many children have chronic health problems that seriously interfere with school success. Examples include students who have vision problems, students with asthma, and students with auditory problems. Especially in disadvantaged communities, children may not have treatment for these problems, and even if they have been prescribed eyeglasses, inhalers, medications, or other necessary treatments, they may not be using them regularly, so the problem remains unsolved. In addition to whatever they need to continue to do to keep Covid-19 under control, school health aides could take on roles in which they ensure that students who need eyeglasses receive them and wear them, students who need asthma inhaler medication are observed every school day to ensure that they are taking their medicine, and so on. I have proposed these functions previously, but in the age of Covid-19, the need for people in the school who can help make certain that all children are receiving needed health interventions has become even more important.

School health aides would provide a front line of information gathering, dissemination of information to school community members, relationship formation, and referral to established health providers.  As children or adults are found to need services, the school health aides would help link them up with hospitals or community health centers, as appropriate.

I am only roughing out what a system might look like, and there are many aspects that could be done differently, or adapted to local circumstances. My hope is just to provide an overview of a system of supports, based in schools, capable of helping entire school communities do the detailed family-by-family work necessary to eliminate Covid-19, and at the same time build up a trusted, capable, and community-friendly network to improve the health of all children. Whether or not this is the right system, something much like it will be necessary if we are to be able to strengthen the health of our schools and our communities in the aftermath of the Covid-19 crisis.

This blog was developed with support from Arnold Ventures. The views expressed here do not necessarily reflect those of Arnold Ventures..

Note: If you would like to subscribe to Robert Slavin’s weekly blogs, just send your email address to thebee@bestevidence.org

Thorough Implementation Saves Lives

In an article in the May 23 Washington Post, Dr. John Barry, a professor of Public Health and Tropical Medicine at Tulane, wrote about lessons from the 1918 influenza epidemic.  Dr. Barry is the author of a book about that long-ago precursor to the epidemic we face today.  I found the article chilling, in light of what is happening right now in the Covid-19 pandemic.

In particular, he wrote about a study of Army training camps in 1918.  Army leaders prescribed strict isolation and quarantine measures, and most camps followed this guidance.  However, some did not.  Most camps that did follow the guidance did so rigorously for a few weeks, but then gradually loosened up.  The study compared the camps that never did anything to the camps that followed the guidelines for a while.  There were no differences in the rates of sickness or death.  However, a third set of camps continued to follow the guidance for a much longer time. These camps saw greatly reduced rates of sickness and death.

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Camp Funston at Fort Riley, Kansas, during the 1918 flu pandemic, Armed Forces Institute of Pathology/National Museum of Health and Medicine, distributed via the Associated Press / Public domain

Dr. Barry also gave an example from the SARS epidemic in the early 2000’s.  President George W. Bush wanted to honor the one hospital in the world with the lowest rate of SARS infection among staff.  A study of that hospital found that they were doing exactly what all hospitals were doing, making sure that staff maintained sterile procedures.  The difference was that in this hospital, the hospital administration made sure that these rules were being rigorously followed.  This reminds me of a story by Atul Gawande about the most successful hospital in the world for treating cystic fibrosis. Researchers studied this hospital, an ordinary, non-research hospital in a Minneapolis suburb.  The physician in charge of cystic fibrosis was found to be using the very same procedures and equipment that every other hospital used.  The difference was that he frequently called all of his patients to make sure they were using the equipment and procedures properly.  His patients had markedly higher survival rates than did patients in similar hospitals doing exactly the same (medical) things with less attention to fidelity.

Now consider what is happening in the U.S. in our current pandemic.  Given our late start, we have done a pretty good job reducing rates of disease and death, compared to what might have been.  However, all fifty states are now opening up, to one degree or another.  The basic message: “We have been careful long enough.  Now let’s get sloppy.”

Epidemiologists are watching all of this with horror.  They know full well what is coming.  Leana Wen, Baltimore’s former Health Commissioner, explained the consequences of the choices we are making in a deeply disturbing article in the May 13 Post.

The entire story of what has happened in the Covid-19 crisis, and what is likely to happen now, has a substantial resonance with problems we experience in educational reform.  Our field is full of really good ideas for improving educational outcomes.  However, we have relatively few examples of programs that have been successful even in one-year evaluations, much less over extended time periods at large scale.  The problem is not usually that the ideas turn out not to be so good after all, but that they are rarely implemented with consistency or rigor. Or they are implemented well for a while, but get sloppy over time, or stop altogether.  I am often asked how long innovators must stay connected with schools using their research-proven programs with success.  My answer is, “forever.”  The connection need not be frequent in successful implementers, but someone who knows what the program is supposed to look like needs to check in from time to time to see how things are going, to cheer the school on in its efforts to maintain and constantly improve their implementation, and to help the school identify and solve any problems that have cropped up.

Another thing I am frequently asked is how I can base my argument for evidence-based education on the examples of medicine and other evidence-based fields.  “Taking a pill is not like changing a school.”  This is true.  However, the examples of epidemiology, cystic fibrosis (before the recent cure was announced), dealing with obesity and drug abuse, and many other problems of medicine and public health, actually look quite a bit like the problems of education reform.  In medicine, there is a robust interest in “implementation science,” focused on, among other things, getting people to take their medicine or follow a proven protocol (e.g., “eat more veggies”).  There is growing interest in implementation science in education, too.  Similar problems, similar solutions, in many cases.

Education, public health, and medicine have a lot to learn from each other.  In each case, we are trying to make important differences in whole populations.  It is never easy, but in each of our fields, we are learning how to cost-effectively increase health and education outcomes at scale.  In the current pandemic, I hope science will prevail in both reducing the impact of the disease and in using proven practices, with consistency and rigor, to help schools repair the educational damage children have suffered.

References

Barry, J.M. (2020, May 23).  How to avoid a second wave of infections.  Washington Post.

Wen, L.S. (2020, May 13).  We are retreating to a new strategy on covid-19.  Let’s call it what it is.  Washington Post.

This blog was developed with support from Arnold Ventures. The views expressed here do not necessarily reflect those of Arnold Ventures.

Note: If you would like to subscribe to Robert Slavin’s weekly blogs, just send your email address to thebee@bestevidence.org