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With that, Ms. Dickinson, we welcome you to the committee and are happy to receive your testimony.

STATEMENTS OF CINDY DICKINSON, CRISIS COORDINATOR,
FAIRFAX COUNTY PUBLIC SCHOOLS, ALEXANDRIA, VA, ON
BEHALF OF THE NATIONAL ASSOCIATION OF SCHOOL PSY-
CHOLOGISTS; NIKKI ATKINSON, STUDENT, FAIRFAX COUNTY
PUBLIC SCHOOLS, ALEXANDRIA, VA; CATHERINE MILTON,
EXECUTIVE DIRECTOR AND VICE PRESIDENT, U.S. PRO-
GRAMS, SAVE THE CHILDREN, WESTPORT, CT; DR. JOSEPH
WRIGHT, EMERGENCY MEDICAL AND TRAUMA CENTER,
CHILDREN'S NATIONAL MEDICAL CENTER, WASHINGTON,
DC., ON BEHALF OF THE AMERICAN ACADEMY OF PEDIAT-
RICS; AND
ROBIN GOODMAN, DIRECTOR,
ABOUTOURKIDS.ORG AND PUBLIC EDUCATION PROGRAMS,
NEW YORK UNIVERSITY CHILD STUDY CENTER, NEW YORK,
NY

Ms. DICKINSON. Thank you, Mr. Chairman and Senator Collins. I appreciate so much the opportunity to come and talk to you about my work experience on September 11 and also to talk to you as a member of the National Association of School Psychologists about some of our ideas about how services for children might look in the future.

The school district I serve has 165,000 students. It is in Northern Virginia, and it is only a few miles from the Pentagon. My current role is as county crisis coordinator, and I also deal with a number of other things, but that job has taken on prominence because of the events of September 11.

I work with over 250 school psychologists and school social workers throughout the county when there is a crisis response, but generally speaking, we are talking about a single event in one community and sending in additional support people to help a particular school.

In those schools are school counselors every one of our schools has at least one, and in high schools, there may be as many as five or six. So we do have those types of school-based mental health professionals available to us as well.

When a large crisis or even a small one occurs that affects the community, we expect counselors, social workers, and psychologists to be of support. So part of my job is to mobilize resources.

It is wonderful to be able to talk to you from a school system standpoint and to look at the practicalities. And I cannot overemphasize the fact that we can at least be on the front line when we are looking at children's mental health needs. It is not that we are doing therapy or long-term counseling, but at least we can take a look at children who come through our doors every day and assess where they are in terms of how they are handling life in general.

In terms of what happened on September 11, I have to tell you that I think we did a good job, but I am sure there were many things we could have done differently. Our school district has trained people to deal with crises, but not with traumatic events, and that is what we experienced on September 11. Literally, as Í

looked at the information that came into my office later, we experienced losses of family members, colleagues, and friends in Pennsylvania, New York, and at the Pentagon. It was not just the attack on the Pentagon that affected us.

Before that date, we had a wonderful crisis management plan that is really from a security standpoint and a risk management standpoint, how law enforcement and emergency people get involved. In addition, we knew how our mental health support might look. But again, we really had not planned for such a major devastating blow to all of us.

The immediate impact of the events of that day were dramatic, and I think Nikki will attest to that when you hear from her what she experienced as a high school student that day. But our priority was to maintain order, and our school district remained open on September 11 even though a lot of parents who were very concerned about their children came to dismiss them early. So we had in some schools 50 percent of the students being dismissed, and that took a lot of organization and effort.

Our school district very wisely, I believe, decided to close on September 12 so that we could have a plan of action when we reopened. We wanted to make sure that in every school, people had an orderly way of doing business. We needed teachers to know what to talk to kids about. We needed counselors and other support people, like psychologists and social workers, to be available if there were particular situations that needed coverage and support. And I was able to get all 238 schools and centers covered by that next day; it took a lot of work and a lot of coordination.

We had information packets-and this is one area where the media or communications people are so vital-we had an information packet put together with professional materials, guidelines, checklists, and so on in every school by the time we reopened. That was, I hear, truly a gift. There were information sheets for teachers on what to talk about in the wake of the terrorist attacks, etc, and I think those tools were vital. Some of those materials came right off the Internet-here we are in the Internet era-and frankly, the National Association of School Psychologists prepared quite a few, but there were some wonderful materials from a number of helping organizations and agencies, and we just pulled together the best of the best and got them out to schools.

As we looked at what happened, we had a pretty immediate impact. There were people who found out even days later that they had lost loved ones. But I think that on the whole, we were able to restore some stability in the schools, and that was our goal.

What we need to think about, though, is that all of us need training in dealing with traumatic and critical incidents. Traumatic events training is much different from the general crisis management. We provided the counseling that was necessary, but we have new threats and new worries. Headlines tell us every day that new and persistent and worrisome things might come our way. And all of our professionals need that kind of help and care.

We also need the opportunity to reach out to other people and provide technical assistance where they lack it. There may be people who do not even have a crisis plan; they are not organized to offer support to their schools-and it is really time to do that.

We have a unique opportunity as school-based professionals to offer front-line support. It is not the only support kids need, but we have access to them in a stable, very comforting environment, and if information needs to be shared, there is a great forum for it. We also have the support of the community behind us in doing that. So I think we should think about the schools as a possible way to lend support to our Nation's children. Virtually all of them have to be in school somewhere if they are of school age. It is important that we have the appropriate staffing and level of support with school-based mental health professionals to do the job.

Senator DODD. Very good. That was very, very helpful.

In regard to the Internet, have you taken all the things that you used and established your own website so that it would be helpful for other schools, having put together this package and so on?

MS. DICKINSON. We could do that. We have some things still on our website. IT has changed over time, but that is a great idea. We have used a lot of that kind of resource that any public member could access, including "points for parents," "tips about terrorism," "tips about tolerance," and what-have-you. I think that is a great idea.

Senator DODD. Yes, it would be worthwhile. Thanks very much. [The prepared statement of Ms. Dickinson follows:]

PREPARED STATEMENT OF CINDY DICKINSON

Thank you Chairman Dodd, Ranking Member Collins, and the other members of the HELP Subcommittee on Children and Families for hosting this hearing and giving me the opportunity to discuss this important issue. My name is Cindy Dickinson. I am a nationally certified school psychologist working in Fairfax County Public Schools, a large suburban school district in Northern Virginia. I am also here today as a member of the National Association of School Psychologists who represent nearly 23,000 school psychologists around this nation. I serve as my district crisis team manager, working with over 250 school psychologists and social workers on crisis team planning and intervention strategies. We also work closely with the school counselors assigned directly to each school, who are vital to providing student support when a crisis affects a particular school community.

I appreciate the opportunity to share with you my views regarding the impact of current world events on our children's psychological and emotional well-being, and what our response should be as a nation. It is encouraging that you have included a school-based mental health professional in this critical discussion. I don't think I can overemphasize the importance of our ability to meet the mental health needs of our children and youth-certainly during this time of crisis, but on a continuing basis as well. Nor should we minimize the significant role that schools have played in providing mental health and other support services to students, staff, and families since September 11. I think it is fair to say that the resources and sense of normalcy provided by schools over the past six weeks have helped stabilize many communities across the country.

I'd also like to say that it has not been easy. My school district was probably better equipped than most to handle a major crisis, but we are still strained.

Before the terrorist attacks on September 11, my school district conducted training on crisis intervention, developed models of crisis team support, and worked on safety and security procedures for many types of disasters. But we hadn't planned or trained for a traumatic event such as a terrorist attack just a few miles away from many of our schools. Certainly we could not anticipate the double impact of the devastation at the World Trade Center.

No one can describe the variety of emotional reactions that students and school staff experienced that day. Some were in shock; others in disbelief; others in a panic to reach loved ones. As parents were released early from work in Washington, many rushed to their children's schools to take them home. Our first priority was to maintain order and the safety of our students and staff. We were able to do this because of our advance preparation. It also quickly became clear that we would face dramatic needs from students, staff, and their families for information and support. Like many school districts in the New York and Washington areas, we decided to

stay closed the following day in order to plan for the reopening of school on September 13.

My responsibility in the first hours after the attacks was to plan for student services crisis support when school reopened. This support was necessary to permit affected students and staff members the ability to have professional mental health personnel available for consultation and intervention. Further, it would allow the schools to carry on with the routines of handling a school day in the aftermath of a crisis. Because our collective staff is large, we held briefings at three different offices on September 12. We explained to school psychologists and social workers the expectations for the reopening of school. Key pieces of information included: changes in safety and security procedures; coverage for each school site (238 schools and centers); and the availability of information and human resources. We felt that parents and educators alike would need information about the effects of a traumatic event of this scope. We assembled information packets of professional articles, tips for parents and teachers, and crisis team checklists for immediate use by schools. The National Association of School Psychologists provided numerous materials on its website that were exceedingly helpful. Other groups did as well.

On the whole, we were well prepared to address the immediate needs created by the crisis. We assigned at least one student services staff member (school psychologist or social worker) to each school to assist the school counselors, administrators, and teaching staff. Other professionals from the county family services offices were "on call" for immediate support if needed.

We did not know on September 13 the final toll of these two terrible events. Many members of our community were able to get out of the Pentagon devastation alive. But, sadly, many families suffered profound personal losses. In one school community alone, at least four parents were killed_at_the Pentagon. And, staff members lost loved ones at both the Pentagon and World Trade Center.

Much of our focus in the subsequent days and weeks has been to provide grief counseling to those who need it reassure students that they were safe, observe students who might be exhibiting signs of severe stress reactions, prevent aggression against Muslim students (of which there are. many in our district), and give students the opportunity to talk about their feelings. Indeed, our schools have become an important source of information and human resources for those who need guidance and support. Our classrooms have become safe havens in which children can observe and discuss unfolding, unsettling world events as well as develop skills to cope with difficult situations.

At this point, many students seem to be doing pretty well. But this can be difficult to judge because of the potential for severe delayed post-traumatic reactions and ongoing threats. Many children and adults are still coping with the grief, anxiety, and frustration associated with this experience. Those who have lost a loved one are most in need, but there is also a ripple affect throughout the school community. We have students trying to comfort grieving friends; concerned about a parent taking a plane or being called to active military duty; fearful because of their ethnicity, or worried about another attack like September 11. We also have parents who are more anxious and perhaps less able to deal with the normal stresses and strains of life. And, we have teachers and other staff who must maintain the normal classroom atmosphere and academic expectations while simultaneously meeting their students heightened emotional needs while managing their own.

As I said, this is not easy. And I am not sure I can predict the long-term evolution of reactions in the coming months. Crisis response and recovery is difficult enough when you have a succinct event from which you clearly can move on. But when crisis conditions continue without relief, the effect can be exponential.

This situation has that potential. Not only have we lost thousands of American lives, Americans have lost their sense of stability. Disasters spawn a sense of anxiety, of foreboding, or negative feeling about the future. The children we serve want to trust that their world is under control, and, most of all, safe. But that very sense of safety continues to be threatened.

Each time a media account wants of further acts of terrorism; describes another anthrax case; highlights the war in Afghanistan; and predicts further economic difficulties, one's sense of security is threatened. Even the most resilient child or adult must feel as if it is difficult to plan for tomorrow, or even next week.

Those who lack the internal resources to cope with continued stress are most vulnerable. Children with chronic health or mental impairments, have experienced a traumatic event or personal loss, are isolated, or lack an adequate support network stand to lose ground emotionally. They may feel vulnerable and threatened, and may experience more "sick days." They may have difficulty sleeping, eating, socializing and concentrating. Their academic performance may suffer or they may exhibit behavioral problems. Children who already felt as if life was difficult may begin to

think that life isn't fair and experience thoughts of hopelessness, perhaps leading to depression. They might think about "escaping" in an unhealthy way through the use and abuse of drugs and alcohol, aggressive violence, or suicide.

It is more vital than ever that school-based mental health professionals be available to help these children and their families.

Schools have tremendous importance when community, and even national, crises occur. This has become dramatically clearer in the days following September 11th. Virtually every community has a school, and most children spend six hours a day there. We provide a safe, secure environment where children are able to learn, process, and even challenge what is happening in the world, what they are viewing in the media, and what they may be hearing from adults or other children. When children are affected by a crisis of any type, they experience a very vulnerable period in which they are forced to deal with painful issues affecting their emotional equilibrium. They need an opportunity to sort out just what has happened, what the impact has been, and what it means to them.

School-based mental health professionals have a unique opportunity to work with children experiencing these difficulties because we have regular access to them in a safe, non-threatening environment. We work with, understand, and appreciate their normal routines, and can interact with their teachers and other educators to offer competent, caring support. We can also extend help to families affected by significant losses. In the school setting, we have the additional advantage of a structure familiar to the student, their families, and the community.

Those of us who work in school-based crisis response and mental health know that most children are remarkably resilient-provided that their support systems continue to meet their needs. Children cope quite well when they know that caring adults are there to protect them and help them regardless of their problems.

We also know what happens when these support systems break down over extended periods of time. Youngsters who live daily with a persistent lack of security because of poverty, violence, and an absence of adult care cannot function. We see the consequences in their physical, emotional, social, and academic problems.

This is an extreme, but relevant, analogy to our current situation. If we continue to experience risk, our ability to cope and to help our children cope may be eroded. I believe we have done a good job so far at keeping the school/family support system whole in the wake of the attacks. Our challenge is to maintain this support into the future. We must shore up the people and processes that have proven so effective in recent weeks. Teachers need back up from skilled pupil support personnel, like school-based mental health workers. These include school psychologists, social workers, and counselors who will continue to need training and technical support in school-based crisis response and long-term recovery? We need to work within the framework of our school districts to offer support in the most responsive and least intrusive manner.

We must have time to plan our crisis team approach, focus on evidence-based approaches to effective crisis care, and determine the best resources to meet community needs. This may mean additional finding, increased staffing, and wider recognition of the role that mental health plays in students' learning and development Less advantaged school districts, in particular, will need outreach and additional resources to gear up for the future. And, as the adults upon which our children depend, we must remain vigilant of our own needs so that we are equipped to meet theirs.

Mr. Chairman, I realize that the government's priority in terms of responding to this crisis is on national security, the war effort, and stimulating the economy. Obviously these are extremely important. But I urge you to find a way to provide the funds necessary to support and even increase the kinds of school-based mental health services that have proven so critical in the past few weeks.

In closing, I would like to add that one of the most important and uplifting aspects of our experience over during this difficult time has been our commitment to a common goal. We have truly been united in the need to secure our children's emotional and psychological well-being. Doing so is essential to their healthy learning and development today and their prospects as good citizens tomorrow. We should not lose sight of this shared sense of purpose as we move forward.

Thank you. I would be happy to answer questions.

Senator DODD. Ms. Atkinson, thank you so much for being here. We are happy to hear what you have to say.

Ms. ATKINSON. Thank you, Mr. Chairman and Senator Collins and the subcommittee for holding this hearing.

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