Prior to widespread school closures due to COVID-19, increasing concerns about mass casualty events in schools led to a burgeoning investment in school security and routine lockdown drills by most U.S. school districts.
Some districts utilize high-intensity active shooter drills that involve real weapons, gunfire or blanks; theatrical makeup to give a realistic image of blood or gunshot wounds; predatory and aggressive acting by an individual posing to be the shooter; or other means to simulate an actual attack. At times, students and staff are deceived into believing they are responding to an actual active shooter event, presumably to create an even more realistic experience for participants.
These practices occur despite an absence of research demonstrating their efficacy and with little guidance on how best to protect children and staff from unintended negative psychological and emotional harm from such exercises.
A new policy statement, Participation of Children and Adolescents in Live Crisis Drills and Exercises, provides some guidance. The policy, from the AAP Council on Children and Disasters, Council on Injury, Violence and Poison Prevention, and Council on School Health, is available at https://doi.org/10.1542/peds.2020-015503 and will be published in the September issue of Pediatrics.
A better approach
The policy outlines considerations regarding live active shooter drills in schools. It recommends eliminating children’s involvement in high-intensity drills and exercises (with the possible exception of a limited number of adolescent volunteers who have provided active consent/assent); prohibiting deception in drills and exercises; and making appropriate accommodations that address the unique vulnerabilities of individual or groups of children.
In most situations, active shooter drills should be conducted like fire drills — which don’t simulate an actual fire — using a calm approach to the safe movement of students and staff in the school building. Even if exercises and drills are conducted in a thoughtful manner, children with a high level of personal vulnerability (e.g., students with prior traumatic experience) may require accommodations. In all situations, adults should remain vigilant for student or staff distress and be prepared to intervene.
Pediatricians’ roles
Pediatricians should become acquainted with local and state policies on the conduct of live exercises and drills in schools. They should advocate that any legislation mandating active shooter drills also require that schools follow best practice guidelines, such as those from the National Association of School Psychologists and the National Association of School Resource Officers (https://bit.ly/2XkNqQD).
The policy also stresses the need to evaluate preparedness initiatives and activities to ensure they are effective and do not cause untoward distress or other unintended consequences for individual or groups of children as well as school staff and other adult participants.
Invest in positive outcomes, especially during pandemic
Rather than focusing only on preparing for mass casualty events, schools and communities are encouraged to increase efforts to prevent violence. This would include investments in social-emotional learning; positive school climate and culture; early identification of behavioral health concerns and mental illness and effective and readily accessible treatment; training for educators and school administrators; sufficient mental health and support personnel in schools; and interdisciplinary threat assessment.
A crisis event — whether real or imagined — can uncover concerns and worries about other potential or past crises. The pandemic is a frightening time for students and staff, with warnings to presume that anyone you meet is potentially infected and may pose a threat to your health. High-intensity crisis drills — largely in response to rare but widely publicized school shootings — may contribute further to a distorted sense of risk in children and a perspective that adults and peers need to be viewed as potential killers. More broadly, these activities can increase children’s anxiety and fear that the world is a threatening place, which is especially concerning given the current pandemic.
Many of the strategies for violence prevention also are critical to promote recovery and resiliency among students during the pandemic. However, the current economic climate and the costs associated with reopening schools safely are likely to lead to reductions in funding for many critical support and recovery services. Advocacy will be important to ensure the necessary steps are taken to keep children physically and emotionally safe.
Recommendations
- Eliminate children’s routine involvement in high-intensity drills and exercises.
- Obtain active consent/assent of adolescent volunteer participants.
- Eliminate deception in drills and exercises.
- Make accommodations based on children’s unique vulnerabilities. Remain vigilant for psychological distress.
- Obtain multidisciplinary input into exercise/drill planning; seek and incorporate student input.
- Emphasize violence prevention. Focus on teaching skills rather than simulating distressing crisis events.
Dr. Schonfeld is a lead author of the policy statement and a member of the AAP Council on Children and Disasters Executive Committee.