Abstract

From Uganda to Jamaica to the USA, violence against children at schools is widespread.1Hillis S Mercy J Amobi A Kress H Global prevalence of past-year violence against children: a systematic review and minimum estimates.Pediatrics. 2016; 137e20154079Crossref PubMed Scopus (353) Google Scholar, 2Devries K Knight L Petzold M et al.Who perpetrates violence against children? A systematic analysis of age and sex specific data.BMJ Paediatr Open. 2018; 2e000180Crossref PubMed Scopus (55) Google Scholar Teachers are often the perpetrator of this violence,3Gershoff ET School corporal punishment in global perspective: prevalence, outcomes, and efforts at intervention.Psychol Health Med. 2017; 22: 224-239Crossref PubMed Scopus (57) Google Scholar using corporal punishment and sexual and emotional violence against their students. Surprisingly, national prevalence data on teacher violence against children are still not routinely collected in most countries, but surveys show that 90% of primary school students in some areas of Uganda,4Devries KM Child JC Allen E Walakira E Parkes J Naker D School violence, mental health and educational performance in Uganda.Pediatrics. 2014; 133: e129-e137Crossref PubMed Scopus (64) Google Scholar more than 90% in Jamaica,5Baker-Henningham H Meeks-Gardner J Chang S Walker S Experiences of violence and deficits in academic achievement among urban primary school children in Jamaica.Child Abuse Negl. 2009; 33: 296-306Crossref PubMed Scopus (38) Google Scholar and 7% of students in Mississippi, USA6Gershoff ET Font SA Corporal punishment in US public schools: prevalence, disparities in use, and status in state and federal policy.Soc Policy Rep. 2016; 30: 1Crossref PubMed Google Scholar have experienced physical violence from teachers.3Gershoff ET School corporal punishment in global perspective: prevalence, outcomes, and efforts at intervention.Psychol Health Med. 2017; 22: 224-239Crossref PubMed Scopus (57) Google Scholar Despite this high prevalence, and the range of known negative health and social impacts of exposure to violence in childhood,7Norman RE Byambaa M De R Butchart A Scott J Vos T The long-term health consequences of child physical abuse, emotional abuse, and neglect: a systematic review and meta-analysis.PLoS Med. 2012; 9e1001349Crossref PubMed Scopus (1540) Google Scholar there are few interventions available to address violence from teachers towards students that have been robustly evaluated. In The Lancet Global Health, Helen Baker-Henningham and colleagues8Baker-Henningham H Bowers M Francis T Vera-Hernández M Walker SP The Irie Classroom Toolbox, a universal violence-prevention teacher-training programme, in Jamaican preschools: a single-blind, cluster-randomised controlled trial.Lancet Glob Health. 2021; 9: e456-e468Summary Full Text Full Text PDF PubMed Scopus (7) Google Scholar have published results from their cluster randomised controlled trial of the Irie Classroom Toolbox intervention to reduce violence from teachers towards children in pre-primary schools (aged 3–6 years) in Kingston, Jamaica. The Irie Classroom Toolbox was adapted from the Incredible Years intervention in the USA and refined over a decade.9Baker-Henningham H Walker S Powell C Meeks Gardner J A pilot study of the Incredible Years Teacher Training programme and a curriculum unit on social and emotional skills in community pre-schools in Jamaica.Child Care Health Dev. 2009; 35: 624-631Crossref PubMed Scopus (61) Google Scholar The intervention is explicitly teacher-focused and aims to help “teachers to gain skills, motivation, and opportunity to use positive discipline techniques”.8Baker-Henningham H Bowers M Francis T Vera-Hernández M Walker SP The Irie Classroom Toolbox, a universal violence-prevention teacher-training programme, in Jamaican preschools: a single-blind, cluster-randomised controlled trial.Lancet Glob Health. 2021; 9: e456-e468Summary Full Text Full Text PDF PubMed Scopus (7) Google Scholar Teachers are supported via an initial 5-day workshop, and monthly hour-long, in-classroom, follow-up sessions over 8 months. Baker-Henningham and colleagues'8Baker-Henningham H Bowers M Francis T Vera-Hernández M Walker SP The Irie Classroom Toolbox, a universal violence-prevention teacher-training programme, in Jamaican preschools: a single-blind, cluster-randomised controlled trial.Lancet Glob Health. 2021; 9: e456-e468Summary Full Text Full Text PDF PubMed Scopus (7) Google Scholar well documented and careful process of adaptation resulted in an intervention that significantly reduced teachers' use of violence. At 12 months post-intervention, 44 (42%) of 105 teachers in the intervention group but only 27 (32%) of 85 teachers in the control group used no physical violence against their pre-primary pupils over the previous 2 days. The Irie Classroom Toolbox is highly relevant for resource-poor environments, as it does not require teachers to have pre-existing expertise. It is also simple to implement and is therefore likely to be adaptable to diverse settings. These results are particularly interesting because the intervention is implemented in pre-primary schools, and it is likely that preventing experiences of violence against children at this early age will have knock-on positive effects for children's health and positive development. This one intervention might pay long-term dividends across multiple sectors. Although these findings are encouraging, the work of preventing violence from teachers towards students is still at an early stage. Further research is needed in at least four broad areas. First, we need to develop a deeper understanding of why teacher violence continues to be widespread in different countries and learning environments, so that we can successfully challenge this behaviour. Second, we need much more research to develop and systematically test different intervention models to address teacher violence, which also account for children's varying experiences of violence as they navigate through pre-primary and primary schools, secondary schools, and tertiary education. Third, we need research on the geographical, socioeconomic, and cultural contexts that might be contributing to normalising teachers' use of violence, so that we can understand the systems that underpin both continued use and cessation of violence. Fourth, we need investments to adapt the few proven intervention models into scalable programmes that can be widely implemented. Finally, we should also invest in refining research methods so that we can collect data to monitor school violence in a safe way. Baker-Henningham and colleagues' study8Baker-Henningham H Bowers M Francis T Vera-Hernández M Walker SP The Irie Classroom Toolbox, a universal violence-prevention teacher-training programme, in Jamaican preschools: a single-blind, cluster-randomised controlled trial.Lancet Glob Health. 2021; 9: e456-e468Summary Full Text Full Text PDF PubMed Scopus (7) Google Scholar successfully used observations to document teacher behaviours. Such observations might provide more objective measures about some forms of violence and are crucial for documenting the experiences of younger children who cannot self-report their experiences. However, direct observations are likely to influence teacher behaviour, and in trials of anti-violence interventions, will introduce bias in the same direction as any intervention effect. Conversely, self-reports might lead to underestimates of prevalence, especially for more hidden or stigmatised forms of violence. Careful thinking about how to measure the effects of interventions is required. Care must also be taken to ensure that children who experience abuse, and teachers who use severe forms of violence, are referred to existing structures for further support. This can be especially challenging in settings where referral systems are weak and under-resourced. Despite these considerable challenges, schools afford us a great opportunity for interventions that have implications for children well beyond their cognitive development. Schools are governed by public policy, and routinely gather large numbers of children in the presence of adults with a duty of care. Therein lies an opportunity for influencing attitudes, beliefs, and behaviours, and therefore cost-effective prevention of violence against children. KMD reports grants from the UK Medical Research Council, an anonymous donor, the Economic and Social Research Council, and the Center for Global Development, and regularly receives grant funding to study prevention and response to violence in childhood from government and private donors. DN regularly receives grants from private foundations and other funding agencies for developing interventions and undertaking research on preventing violence against children. The Irie Classroom Toolbox, a universal violence-prevention teacher-training programme, in Jamaican preschools: a single-blind, cluster-randomised controlled trialIn Jamaican preschools, the Irie Classroom Toolbox effectively reduced violence against children by teachers. The Toolbox was designed for use with undertrained teachers working in low-resource settings and should be effective with early childhood practitioners in other LMICs. Additional research is needed to further develop the Toolbox to reduce class-wide child aggression. Full-Text PDF Open Access

Highlights

  • From Uganda to Jamaica to the USA, violence against children at schools is widespread.[1,2] Teachers are often the perpetrator of this violence,[3] using corporal punishment and sexual and emotional violence against their students

  • The Irie Classroom Toolbox was adapted from the Incredible Years intervention in the USA and refined over a decade.[9]

  • Baker-Henningham and colleagues’[8] well documented and careful process of adaptation resulted in an intervention that significantly reduced teachers’ use of violence

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Summary

Introduction

From Uganda to Jamaica to the USA, violence against children at schools is widespread.[1,2] Teachers are often the perpetrator of this violence,[3] using corporal punishment and sexual and emotional violence against their students. The range of known negative health and social impacts of exposure to violence in childhood,[7] there are few interventions available to address violence from teachers towards students that have been robustly evaluated. In The Lancet Global Health, Helen Baker-Henningham and colleagues[8] have published results from their cluster randomised controlled trial of the Irie Classroom Toolbox intervention to reduce violence from teachers towards children in pre-primary schools (aged 3–6 years) in Kingston, Jamaica.

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