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

 

Recovery 2020

After a harsh winter, spring has come.

It’s May.  The weather is gorgeous on the Chesapeake, the weather is getting warm, the air is delicious, the flowers are blooming.  From a slight distance, everything seems so normal.   But up close, nothing is normal.  People have settled into patterns of behavior that would be completely bizarre in normal times.  They are wearing masks everywhere as though they have always done so.  Neighbors  are  being as friendly as they can be without getting too close.   Not far away, we know there is chaos and catastrophe, and we all do what we can.  But every day, there is life to be lived, jobs to be done, children to cherish and nurture.

The school year is coming to an end.  In some places, schools have already closed weeks early.   Educators have gotten through the challenges of trying to operate schools when there are no schools to operate.  They have had to use stopgaps, such as distance learning, because there were gaps to stop.  But now we are entering a new phase: Recovery 2020.

Part of Recovery 2020 will be a struggle to open schools while minimizing health risks.  Schools may not even open in September, or may only partially open.  But whenever they fully open, the challenge we face as educators will be to create schools ready to provide extraordinary education to every student, however long they have been out of school and whatever they have experienced in the interim.

In a series of blogs over recent weeks (here, here, and here), I’ve proposed a number of actions schools should take to put students on a new trajectory toward success, engagement, self-esteem, health, and safety.  In this blog, I want to get more specific about some ideas I’d propose to make Recovery 2020 more than a return to the status quo.  More like Status: Go!

  1. Strengthen the Core

First, we have to make sure that the  core of the schooling enterprise, teachers, principals, and administrators, are supported, and their jobs are safe.  There will be a recession, but it cannot be allowed to do the damage the last recession did, when schools could not focus and innovate because they were scrambling to hold on to their staff, just to cover classes.  Federal and state funding must be used to ensure that school staffs can focus on their work, not on managing shortage-induced chaos.  Current school staff should also be able to receive top-quality professional development to enable them to use proven, effective teaching methods in the subjects and grade levels they teach, so they can enhance and accelerate their students’ progress.  School nurses, counselors, and other specialists in whole-child development need to be in every school.

  1. Train and Deploy Thousands of Tutors in Every State and District

blog_5-12-20_tutorcollage_333x500In fall, 2020, schools will open into a recession, yet they will have to make more of a difference in their students’ development than ever before.  Securing the jobs and professional support of school staffs is essential, but not enough.  Students will need personalized, effective support, so they can achieve greater success in school than they have ever had.

If there is a recession, many people will struggle to keep their jobs or to find new ones.  But as always, those who suffer most in a recession are people who are entering the labor market.  There will be millions of college graduates and others ready to work who will find enormous barriers to entering the labor market, which will be overwhelmed keeping experienced workers employed.  This is a huge problem, but also potentially a huge opportunity.  Schools will need help in accelerating student achievement to make up for losses due to school closures and then to continue beyond making up losses to growing gains.  An army of bright-eyed, bushy-tailed young people will be eager to get involved serving children.  Government will have to provide relief to these and other unemployed people, so why not have them make a difference in children’s education, rather than just receiving  emergency support?

The solution I am proposing is for government to create a fund, a Marshall Plan for education, to recruit, train, and deploy thousands of tutors in schools across America.  The tutors would be trained, coached, and supervised by experts to deliver proven small-group tutoring models, focused in particular on reading and math, in elementary and middle schools.  They would be paid as teacher assistants, but equipped with specific skills and supports to work with students who are behind in reading or mathematics in elementary or middle schools.  Schools would receive a number of tutors depending on their size and levels of disadvantage and achievement deficits, up to five or more tutors per school.  The tutors would work with struggling students in small groups, using tutoring models proven in rigorous research to be particularly effective.  These models are known to be able to add five or more months of gain to students’ usual yearly progress each year, more than making up the losses most students have experienced.  As time goes on, students who need more tutoring can receive it, so that they can continue to make more than one year’s gain each year, until they reach grade level.

While tutoring is worthwhile in itself, it will also serve a purpose in introducing promising young people to teaching.  School leaders should be enabled to identify especially capable young people who show promise as teachers.  Someone who has been a great tutor will probably become a great teacher.  These people should then be given opportunities to participate in accelerated teacher training leading to certification.  The quality and commitment the tutors show in their daily work will help school leaders identify an extraordinary group of potential teachers to enter classrooms eager and prepared to make a difference.

  1. Train and Deploy School Health Aides

Especially in schools serving many disadvantaged children, there are many children who are achieving below their potential just because they need eyeglasses, or suffer from chronic diseases such as asthma.  Trained health aides can be deployed to make sure that students receive needed eyeglasses, regularly take medication for asthma, and otherwise solve health problems that interfere with success in school.  Working with school nurses, health aides will also be needed to manage ongoing protections against Covid-19 and other threats to health.

After a harsh winter, spring has come.  The wise farmer celebrates, but then he plants.  In the same way, America’s education leaders should celebrate that we have somehow made it this far.  But celebration is not enough.  We have to plan, and to plant, anticipating the opportunity this fall not just to get back to normal, but to create a new normal, better than the one we had, in which we use our nation’s strengths to heal and to build.

Recovery 2020 will take efforts and expenditures beyond just returning schools and students to normal.  But this is essential, and the short- and long-term benefits to our children and our society are clear.  If we are are wise, we will start this process now, to prepare to mobilize resources and energies to open in the fall the best schools we ever had.

Photo credit: Collage photos courtesy of Allison Shelley/The Verbatim Agency for American Education: Images of Teachers and Students in Action

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

September, 2020: Opening School Doors to New Opportunities for Universal Success

“Now is the time for all good schools to come to the aid of their country.”

In times of great danger, nations have always called upon their citizens to volunteer to do what is necessary to solve their most pressing problems. Today, our most immediate crisis is, of course, the COVID-19 pandemic. This time, the heroes who have come forward are health care providers, who risk their lives to save the lives of others. The many people who work in essential services, such as grocery stores and pharmacies, also subject themselves to risks so that others can survive. Teachers across the country are working day and night to prepare online lessons, as well as helping get food to hungry students.  Behind the scenes, scientists are working to find cures, expand testing, and determine when it will be safe for our society to return to normal.

In a few months, we will face a new emergency. Schools will open. Hopefully, school opening will not pose major health threats to students and staff, assuming that the danger of infection has passed. But we will without any doubt face a new set of challenges in the education of the more than 50 million children in elementary and secondary schools in the U.S., as well as the billion students in the world as a whole.

blog_5-7-20_backtoschool500x333 2In the U.S., children re-entering our schools will have been out of school since March. Some may have kept up with their school work online, but most will have had little formal schooling for six months. This will be most serious, of course, among the students most at risk. By next September, 2020, millions of children will not only have missed out on schooling, but many will also be traumatized by what they have experienced since they were last in school. Many will have experienced the disease or death of a close relative. Many will have parents who have lost their jobs, and may have lived in fear of lacking food or safety.

This is a predictable crisis. No one can expect that schools and students will just pick up and carry on when schools re-open, as though they’ve just had a few snow days.  No teacher is going to say on Day 1, “Please open your textbook to the page where we left off last March.”

As educators and policy makers, it would be irresponsible to wait until schools re-open and only then take action to solve the entirely predictable problems. Instead, we need to prepare, starting today, to create the schools students will need in September, 2020, or whenever it is deemed safe for schools to open.

Here are a few ideas I would propose to address the problems students are likely to have.

  1. Bring all students up to grade level in reading and mathematics.

In two recent blogs (here and here) I discussed one aspect of this problem, the fact that many students will have fallen behind in basic skills because of their long absence from face-to-face school. I proposed a Marshall Plan for education, including mobilization of tens of thousands of recent college graduates, and others eager to help, to serve as paid tutors to students who are struggling in reading and/or mathematics.  As I noted, research overwhelmingly points to tutoring as the most effective strategy to accelerate the achievement of students who are performing below their capabilities.  According to the evidence, several one-to-one or one-to-small group tutoring models can routinely increase student achievement by an effect size of +0.40 in a year (almost equivalent to the difference between middle class and disadvantaged students). But what if students received effective tutoring for two years, or longer? What if their classroom teachers used teaching methods proven to be effective, contributing further to student success? What if schools could provide services to students with problems with their vision or hearing, or chronic health problems such as asthma? Based on what we already know how to do, a goal of steadily increasing the percentage of students performing at today’s definition of “at grade level” could increase each year, until virtually all students could expect that level of performance.

  1. Schools need to welcome back every child.

When students return to school after the long delay and trauma they may have endured, they need to be welcomed back with enthusiasm by all school staff. The return will create a psychological opportunity.  Students will always remember what happened on the first day, the first weeks, the first months. A big party to welcome students back is a good start, but students will need constant and sincere affirmations of their value and importance to the adults in the school. They need to be told, one at a time and by name, how much they were missed, and how glad everyone is that they are back, safe and healthy. I think the theme of each school should be “a once-in-a-lifetime chance to connect with the school,” not “at last, everything is back to normal.”

  1.  Schools need social emotional and health solutions

In addition to using proven academic approaches, schools need to implement proven social-emotional and health promotion strategies to help all students reconnect and thrive.  Strategies to build self-concept, positive relations with peers, concern for the well-being of others, and a commitment to banish violence and bullying will be especially important.  Cooperative learning can help to build friendships, acceptance, and engagement, in addition to improving achievement.

In light of all that has happened, schools need to enthusiastically welcome their students back, and then provide them the success, respect, and love that they deserve.  They need to give them every reason to believe that they have a new opportunity to achieve success.  Students, parents, and educators alike need to have well-founded confidence that out of the destruction caused by the pandemic, there will come triumph.

 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

A Marshall Plan for Post-COVID-19 Recovery

In World War II, my father was in the U.S. Navy.  In 1945, he was serving on a specially outfitted destroyer preparing for the invasion of Japan.  He always claimed that had the invasion gone forward, he would have been doomed.  He was in charge of his ship’s “radio-radar countermeasures,” new technology that would have been able to blind the radio and radar of the Japanese Navy so that there would have been only one ship they could detect: his.  Fortunately, the Japanese surrendered on October 14, before the invasion was set to begin.

I’m sure you’ve seen the famous picture of jubilant crowds in New York celebrating the surrender.  My father’s experience was different.  He was landed in Tokyo as part of the occupation forces.  He described Tokyo as a city whose former industrial and military areas had not one stone standing on another.  Many others have described similar scenes in Europe and Asia.  Like all servicemen, he was relieved that the war had ended, that he had survived.  But the extent of the destruction was horrifying, even to the victors.  How could a normal country grow back from this desert?

But it did.  Even the countries that suffered the greatest destruction were able, with American and other help, to rebuild, and ultimately to prosper.  The U.S. Marshall Plan, in particular, was a far-sighted investment in reconstruction that led the way in enabling destroyed countries to rebuild their societies and their economies.

Now we face another challenge, the COVID-19 pandemic.  I write from Baltimore at the point of inflection, when new cases of the disease have started to decline.  But it will still take a long time for everything to return to normal.  Compared to the death and destruction of World War II, COVID-19 is far less of a challenge, but day to day, it does not feel that way.  And unlike VJ Day, there will not be a day when it all ends, when everyone knows they are safe.

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For Americans, World War II was awful, but it was far away.  Life went on.  Schools and universities were open.  COVID-19 is different, because it profoundly affects the daily life of every American.  Most relevant to the readers of this blog, COVID-19 is severely interrupting the education of a generation.  This is a particular problem, of course, for disadvantaged students, whose parents are more likely to get the virus, who are less likely to have technology at home, and who were often already having difficulties in school.  How will we rebuild?  How will we help students regain the learning and the sense of security they once had?  And can we use this sobering experience to make lasting improvements in education?

Educational leaders are starting to think about what comes next.  Most are overwhelmed with the present, trying to figure out how, for example, to use distance learning to substitute for in-person school.  But anyone who has a child, or knows a child, or has ever been a child or parent, knows that distance education is not going to be enough, certainly not for most children, even in areas where students have plenty of computers, access to the Internet, excellent support from teachers teaching online, and parents who are willing and able to fill in to make sure that students are taking full advantage of whatever the school is providing their children. There will be happy exceptions, but there is a reason that homeschooling is rare.  When the schools open, hopefully next September, there will be a huge job to be done to repair the damage COVID-19 will have done to the educational futures of the 50 million U.S. children in grades PK to 12, as well as hundreds of millions more throughout the world.

One thing that seems highly likely is that when schools do open, they will open into an economic recession.  Currently, there is much concern for people who have lost their jobs, and initial efforts by the federal government have focused on propping up businesses and helping people who were employed, but happened to work for companies that had to close due to the pandemic.  This is essential, of course.  However, there is another problem that also needs attention: people who are just entering the workforce.  Since the Great Depression, economists have known how to respond to such crises: invest massively in people, to jump start the economy.

I would propose a solution that could help both with the schools and the recession. Schools should hire, train, and deploy large numbers of recent (and not so recent) college graduates as tutors, and in other essential roles in schools.

There is no intervention known that has an impact larger than that of tutoring.  One-to- one is most effective, but one-to-small group can also make a substantial difference in reading and mathematics performance in elementary and middle schools, and reaches many more students at a much lower cost per student.  Our recent research reviews (Baye et al., 2019; Neitzel et al., 2020; Pellegrini et al., 2020) tell us that teaching assistants, with proven materials and expert professional development, can obtain outcomes as good as those obtained by certified teachers working as tutors.

Imagine that every school could receive up to five well-trained, well-supported teaching assistant tutors, with the number of tutors determined by the school’s needs. This tutor corps could work with the students who are struggling in reading and/or mathematics, for as long as they need the assistance.  Our experience with small-group tutoring of this kind suggests that the cost per student tutored would be around $600 per year (Madden & Slavin, 2017).  Title I schools, especially those serving the most disadvantaged students, should be first in line for this assistance.  $600 per pupil per year is serious money, but well worth it in light of the need.  (Note: there are people suggesting that all students who missed school should repeat their most recent grade.  At an average per-pupil cost of $12,000 to do this, $600 per year sounds awfully reasonable as an alternative).   There are tutoring programs operating right now that can routinely obtain effect sizes of 0.40, or roughly 5 additional months of learning.  This  could go a very long way to not only solve the problems of students whose progress was interrupted by the COVID-19 pandemic, but also help the many students who had problems before, which now need to be urgently addressed).

College graduates could also be trained as health aides, to use proven strategies to ensure that students who need them receive and use eyeglasses, or receive needed medications for asthma and other chronic illnesses that affect children’s school success as well as their long-term health).  They might also be trained and deployed to work with parents on issues such as attendance, social-emotional development, and mental health.

The problems of schools after the COVID-19 health crisis has passed must be addressed, with sufficient power and intensity to ensure that they get solved.  A return to normal is not sufficient.

We may never have a V-COVID Day, as we did a V-J Day after World War II.  But we must have a Marshall Plan for schools.  Universal access to tutoring and other essential services for students who need them would be a feasible, cost-effective start to a plan to reconstruct our schools.

Photo: National Archives at College Park / Public domain

References

Baye, A., Lake, C., Inns, A., & Slavin, R. (2019). Effective reading programs for secondary students. Reading Research Quarterly, 54 (2), 133-166.

Madden, N. A., & Slavin, R. E. (2017). Evaluations of technology-assisted small-group tutoring for struggling readers. Reading & Writing Quarterly, 1-8.

Neitzel, A., Lake, C., Pellegrini, M., & Slavin, R. (2020). A synthesis of quantitative research on programs for struggling readers in elementary schools. Available at www.bestevidence.org. Manuscript submitted for publication.

Pellegrini, M., Neitzel, A., Lake, C., & Slavin, R. (2020). Effective programs in elementary mathematics: A best-evidence synthesis. Available at www.bestevidence.com. Manuscript submitted for publication.

This blog was developed with support from the Laura and John Arnold Foundation. The views expressed here do not necessarily reflect those of the Foundation.

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

COVID-19 and School Closures: Could Summer Help?

If there is one educational benefit of the otherwise dismal experience of closing virtually all of America’s schools in response to the COVID-19 pandemic, it is this: I’ll bet parents are developing a lot of respect for teachers. I’m hearing a lot about parents finding out that online lessons are no substitute for capable, in-person teachers.

Because of the essential health need to reduce contacts among students and school personnel, schools all over the U.S. have closed. School leaders are scrambling to provide on-line coursework. It is difficult everywhere to go from zero to online in a very short time, but in schools in high-poverty areas, where many or most students lack home computers or reliable internet access, it is well-nigh impossible. But even if every student had a working computer and internet access, there seems to be widespread use of computerized worksheets, and other uninspiring content. In some schools and districts, in which online work is already well used and computers are universally available, the situation is surely better, but even there, online all day every day is no substitute for in-person teaching. Very conscientious and self-motivated students, the kind who already use Khan Academy just for fun, are probably thriving, but such students constitute a small minority, even in the finest schools.

School closures are likely to extend into May, leaving little if any of the regular school year for things to return to normal. Two states, Kansas and Virginia, have already announced that schools will not re-open before the end of the year, and others will surely follow.

The Summer Solution

In light of the realities we face, I think most schools are struggling to teach all of their children during the school closures. Parents are doing their best, as are some students, but nationwide, trying to keep schools going as they always have, except online, is not a satisfying solution.

I have an alternative solution. It has two simple steps.

  1. As soon as feasible, declare schools to be on break. Instant vacation.
  2. When it is safe to open schools, do so. Hold an in-person two-month session, starting (let’s say) on June 1 and running through the end of July.

During the instant vacation, provide parents and students with a menu of engaging activities that are fun, engage students’ energies and curiosity, and optional. These could focus on science, social studies, writing, art, music, and other subjects often blog_4-2-20_masks_500x343given short shrift during the school year.  These would be facilitated by teachers; in my experience, every school and district has many teachers who are crazy about one or more topics that they rarely get to talk about in school.  Teachers may be Civil War reenactors, world travelers, art experts, amateur musicians, or published writers, even if those are not the topics they teach.  In three days, max, any school district could find extraordinary people with fierce passions for something they want to share with kids. Students might be given a choice of activities, and they might choose to do none at all. It’s vacation, after all. The reason to have these activities is to give students shut in at home useful and interesting things to do. I’m sure there are loads of great online activities already out there that are rarely used because of the lack of time for such activities in the regular school year. Imagine any of the following, facilitated by teachers who love these topics:

  • Online trips to faraway places or to periods of history
  • Online book clubs in which students could choose topics they’d like to read about and then discuss age-appropriate books on them with others from all over their school, district, or state.
  • Science clubs, in which students could explore topics of their choice in groups from all over. One interesting topic: epidemiology.  Science clubs could find out everything there is to know about space travel, or the science of music, or the science of sports.
  • Writer’s workshops, in which kids from all over could enroll in groups working on writing their own mystery stories, fantasy stories, sports stories, or biographies of famous people.  That’s how the Bronte sisters learned to write, shut in in small-town Yorkshire, surrounded by poverty and disease.  They wrote stories with and for each other, throughout their childhoods.
  • Art or music appreciation, history, or techniques
  • How students can get jobs and internships (in normal times)
  • Post-secondary options for secondary students

I think you get the idea. Trying to cover all the usual school subjects in the usual way, but online, is sure to be boring and ineffective for most students. But on vacation, shut in students could select learning activities to do not for a grade, not under pressure from parents or teachers, but to satisfy their own curiosity.

When the crisis is over, presumably in the summer, students could return to school and resume their usual lessons, with in-person teachers.  I’m sure there would be practical difficulties, but I’m willing to bet that this could work, perhaps in some places, perhaps in many. At least it seems worth a try!

Photo credit: zhizhou deng / CC BY (https://creativecommons.org/licenses/by/2.0)

This blog was developed with support from the Laura and John Arnold Foundation. The views expressed here do not necessarily reflect those of the Foundation.

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

After the Pandemic: Can We Welcome Students Back to Better Schools?

I am writing in March, 2020, at what may be the scariest point in the COVID-19 pandemic in the U.S. We are just now beginning to understand the potential catastrophe, and also to begin taking actions most likely to reduce the incidence of the disease.

One of the most important preventive measures is school closure. At this writing, thirty entire states have closed their schools, as have many individual districts, including Los Angeles. It is clear that school closures will go far beyond this, both in the U.S. and elsewhere.

I am not an expert on epidemiology, but I did want to make some observations about how widespread school closure could affect education, and (ever the optimist) how this disaster could provide a basis for major improvements in the long run.

Right now, schools are closing for a few weeks, with an expectation that after spring break, all will be well again, and schools might re-open. From what I read, this is unlikely. The virus will continue to spread until it runs out of vulnerable people. The purpose of school closures is to reduce the rate of transmission. Children themselves tend not to get the disease, for some reason, but they do transmit the disease, mostly at school (and then to adults). Only when there are few new cases to transmit can schools be responsibly re-opened. No one knows for sure, but a recent article in Education Week predicted that schools will probably not re-open this school year (Will, 2020). Kansas is the first state to announce that schools will be closed for the rest of the school year, but others will surely follow.

Will students suffer from school closure? There will be lasting damage if students lose parents, grandparents, and other relatives, of course. Their achievement may take a dip, but a remarkable study reported by Ceci (1991) examined the impact of two or more years of school closures in the Netherlands in World War II, and found an initial loss in IQ scores that quickly rebounded after schools re-opened after the war. From an educational perspective, the long-term impact of closure itself may not be so bad. A colleague, Nancy Karweit (1989), studied achievement in districts with long teacher strikes, and did not find much of a lasting impact.

In fact, there is a way in which wise state and local governments might use an opportunity presented by school closures. If schools closing now stay closed through the end of the school year, that could leave large numbers of teachers and administrators with not much to do (assuming they are not furloughed, which could happen). Imagine that, where feasible, this time were used for school leaders to consider how they could welcome students back to much improved schools, and to blog_3-26_20_teleconference2_500x334provide teachers with (electronic) professional development to implement proven programs. This might involve local, regional, or national conversations focused on what strategies are known to be effective for each of the key objectives of schooling. For example, a national series of conversations could take place on proven strategies for beginning reading, for middle school mathematics, for high school science, and so on. By design, the conversations would be focused not just on opinions, but on rigorous evidence of what works. A focus on improving health and disease prevention would be particularly relevant to the current crisis, along with implementing proven academic solutions.

Particular districts might decide to implement proven programs, and then use school closure to provide time for high-quality professional development on instructional strategies that meet the ESSA evidence standards.

Of course, all of the discussion and professional development would have to be done using electronic communications, for obvious reasons of public health. But might it be possible to make wise use of school closure to improve the outcomes of schooling using professional development in proven strategies? With rapid rollout of existing proven programs and dedicated funding, it certainly seems possible.

States and districts are making a wide variety of decisions about what to do during the time that schools are closed. Many are moving to e-learning, but this may be of little help in areas where many students lack computers or access to the internet at home. In some places, a focus on professional development for next school year may be the best way to make the best of a difficult situation.

There have been many times in the past when disasters have led to lasting improvements in health and education. This could be one of these opportunities, if we seize the moment.

Photo credit: Liam Griesacker

References

Ceci, S. J. (1991). How much does schooling influence general intelligence and its cognitive components? A reassessment of the evidence. Developmental Psychology, 27(5), 703–722. https://doi.org/10.1037/0012-1649.27.5.703

Karweit, N. (1989). Time and learning: A review. In R. E. Slavin (Ed.), School and Classroom Organization. Hillsdale, NJ: Erlbaum.

Will, M. (2020, March 15). School closure for the coronavirus could extend to the end of the school year, some say. Education Week.

 This blog was developed with support from the Laura and John Arnold Foundation. The views expressed here do not necessarily reflect those of the Foundation.

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

Ensuring the Physical Health of Students: How Schools Can Play an Essential Role

           Schools have a lot to do. They are responsible for ensuring that their students develop skills and confidence in all subjects, as well as social-emotional learning, citizenship, patriotism, and much more.

            Yet schools also have a unique capability and a strong need to ensure the physical health of their students, particularly in areas of health that affect success in the schools’ traditional goals. This additional goal is especially crucial in high-poverty urban and rural schools, where traditional health services may be lacking and families often struggle to ensure their children’s health. In high-poverty schools, there are many children who will unnecessarily suffer from asthma, lack of needed eyeglasses, hearing problems, and other common ailments that can have a substantial deleterious effect on student learning.

            In partnership with health providers and parents, schools are ideally situated to solve such chronic problems as uncontrolled asthma, uncorrected vision problems, and uncorrected hearing problems. One reason this is so is that every student attends school, especially in the elementary grades, where the staff is likely to know each child and parents are most likely to have good relationships with school staff.

            Every school should have a qualified nurse every day to deal with routine health problems. It is shocking that there are no nurses, or just part-time nurses, in many high-poverty schools. However, in this blog, I am proposing a strategy that could have a substantial impact on the health problems that need constant attention but could be managed by well-trained health aides, following up on more time-limited assistance from other health professionals. The idea is that each school would have a full- or part-time Preventive Health Aide (PHA) who would work with students in need of preventive care.

            Asthma. In big cities, such as Baltimore, as many as 20% or more of all children suffer from uncontrolled asthma. For some, this is just an occasional problem, but for others it is a serious and sometimes life-threatening disease. In Baltimore and similar cities, asthma is responsible for the largest number of emergency department visits, the largest number of hospitalizations, and the largest number of deaths from all causes for school-aged students. Asthma can also cause serious problems with attendance, leading to negative effects on learning and motivation.

            There is a very simple solution to most asthma problems. Based on a doctor’s diagnosis, a student can use an inhaler: safe, effective, and reliable if used every day. However, in high-poverty schools, the great majority of students known to have asthma do not take their medicine regularly, and they are therefore at serious risk.

            Asthma cannot be cured, but it can be managed with daily inhaler use (plus, as necessary, access to rescue inhalers for acute situations). For the many children in high-poverty schools who are not regularly using their inhalers, there is a simple and effective backup: Directly Observed Therapy (DOT), which involves a health aide or nurse, most often, giving students their full daily dose of inhalant. As one example, Baltimore’s KIPP school has a specially-funded health clinic, and they have a health aide work in a room near the cafeteria to give DOT to all students who need it. Research on DOT for asthma has found substantial reductions in emergency department visits and hospitalizations, possibly saving children’s lives. By the way, at a cost of about $7,500 per hospitalization and $820 per emergency room visit, it would not take much reduction in asthma to pay the salary of a health aide.

            Vision. Along with the Wilmer Eye Clinic at Johns Hopkins Hospital, the Baltimore Department of Health, the Baltimore City Public Schools, Vision to Learn (which has vans that do vision services at school sites) and Warby Parker (an eyeglass company that provides free eyeglasses for disadvantaged children), we have been working for years on a project to provide eyeglasses to all Baltimore City K-8 students who need them. We have provided almost 10,000 pairs of eyeglasses so far. It is crucial to give students eyeglasses if they need them, but we have discovered that giving out free eyeglasses does not fully solve the problem. Kids being kids, they often lose or break their glasses, or just fail to use them. We have developed strategies to observe classes at random to see how many students are wearing eyeglasses, with celebrations or awards for the classes in which the most students are wearing their eyeglasses, but this is difficult to do across the whole city. Preventive Health Aides could easily build into their schedules random opportunities to observe in teachers’ classes to note and celebrate the wearing of eyeglasses once students have them.

            Hearing. Many children cannot hear well enough to benefit from lessons. The Baltimore City Health Department screens students at school entry, first grade, and eighth grade. Few students need hearing aids, but many suffer from smaller problems, such as excessive earwax. Health aides might supplement infrequent hearing screenings with more frequent assessments, especially for children known to have had problems in the past. Preventive Health Aides could see that children with hearing problems are getting the most effective and cost-effective treatments able to ensure that their hearing is sufficient for school.

            Other Ailments. A trained Preventive Health Aide ensuring that treatments are being administered or monitored could make a big difference for many common ailments. For example, many students take medication for ADHD (attention deficit-hyperactivity disorder). Yet safe and effective forms of ADHD medication work best if the medication is taken routinely. A treatment like DOT could easily do this. Other more rare problems that could be managed with regular medication and observation could also help many children. With greater knowledge and collaboration with experts on many diseases, it should be possible to provide cost-effective services on a broad scale.

            Health care for children in school is not a frill. As noted earlier, many common health care problems have serious impacts on attendance, and on vision, hearing, and other school-relevant skills. If school staff take up these responsibilities, there needs to be dedicated funding allocated for this purpose. It would be unfair and counter-productive to simply load another set of unfunded responsibilities on already overburdened schools. However, because they may reduce the need for very expensive hospital services, these school-based services may pay for themselves.

            You hear a lot these days about the “whole child.” I hope this emphasis can be extended to the health of children. It just stands to reason that children should be healthy if they are to be fully successful in school.

This blog was developed with support from the Laura and John Arnold Foundation. The views expressed here do not necessarily reflect those of the Foundation.