In May 2018, Idil Abdull found her 16-year-old non-verbal autistic son crying on the floor of his classroom in Bloomington, Minnesota. A disruption in routine had caused him great anxiety and stress, prompting the school to suspend him for five days. As Abdull put it, “What could they possibly do wrong that you want to teach them at that age that they’re not welcome in school?”
Exclusionary discipline practices such as detentions, suspensions, and expulsions should be a concern for pediatricians. Students who are Black, Native, or have disabilities are more likely to be suspended or expelled relative to peers, even after accounting for students’ degree of behavioral infarction. Multi-level factors may contribute to this disproportionality, which emerges as early as preschool. For example, educators may subconsciously expect challenging behaviors more from Black children, particularly Black boys, and receive inadequate training on developmentally-appropriate student emotional and behavior management. Punitive practices such as “zero-tolerance” policies and school resource officers were developed to optimize learning environments, yet such approaches have not improved school safety or academic achievement.
Instead, exclusionary discipline can create academic, health, and social challenges for students. Being excluded is associated with reduced academic performance, levels of school engagement, and graduation rates. It can sever ties to supportive peers and adults, impair perceived worth and belonging, and heighten anxiety or mistrust which may collectively worsen mental health.6 Finally, exclusionary discipline involvement predicts a higher likelihood of school dropout and justice system contact, the so-called school-to-prison pipeline.
Such outcomes are likely unsurprising to pediatricians, as we know that childhood experiences set the foundation for lifelong health and social well-being. Moreover, it is clear that children’s behavio
r and biology are often patterned by factors beyond the individual child, such as the presence of sensitive caregiving or stable housing. Physicians can play their role by conducting thorough histories of challenges with learning, behavior, and school discipline, and attending to contributing factors (e.g., parent mental health). They can also collaborate with school staff and administrators to better support students with behavioral needs through individualized education plans or broader initiatives to shift schools towards more restorative, supportive disciplinary approaches. Models such as positive behavior support, restorative practice, and social-emotional learning discern the root causes of student behavior, providing a tailored continuum of support to address student needs and amend harms.5 Finally, pediatricians can use their voice as trusted professionals to advocate for reforms such as increased accountability mechanisms and banning Pre-K through grade 4 suspensions.
For too long, over-reliance on punitive policies have caused exclusionary discipline to fall primarily on the shoulders of children with marginalized identities. As providers for society’s most vulnerable, let us work to lift our children up, not push them out.
Phaneuf T. Looking to reduce discipline disparities, House bill would ban preschool suspensions in Minnesota. MinnPost. March 22, 2019.
U.S. Department of Education Office of Civil Rights. 2013-2014 Civil Rights Data Collection: A First Look. 2016.
Welsh RO, Little S. The School Discipline Dilemma: A Comprehensive Review of Disparities and Alternative Approaches. Rev Educ Res. 2018;88(5):752-794.
Gilliam WS, Maupin AN, Reyes CR, et al. Do Early Educators’ Implicit Biases Regarding Sex and Race Relate to Behavior Expectations and Recommendations of Preschool Expulsions and Suspensions? Yale Child Study Center. 2016.
Lamont JH. Out-of-school suspension and expulsion. Pediatrics. 2013;131(3).
Jones EP, Margolius M, Rollock M, et al. Disciplined and Disconnected: How Students Experience Exclusionary Discipline in Minnesota and the Promise of Non-Exclusionary Alternatives. America’s Promise Alliance. 2018.
|About the Authors
Marvin So, MPH, is a medical student at the University of Minnesota and Public Health Advocacy Fellow with the Twin Cities Medical Society.
Ruth Richardson, JD, is Minnesota state representative for District 52B.
Johannah M. Scheurer, MD, FAAP, is a medical educator and neonatologist in the Department of Pediatrics, University of Minnesota.