The impact of school expulsion and ways to create supportive learning environments for all students

Suspending or expelling a student is one of the harshest punishments a school can impose on a student – ​​and it can have lifelong, devastating consequences. In an updated policy statement, the American Academy of Pediatrics recommends a trauma-informed approach to support students and reduce the need for exclusionary discipline.

The policy statement, “School Suspension and Expulsion,” was published online on October 1 during the AAP 2024 National Conference and Exhibitionmarks the first update to the American Academy of Pediatrics (AAP) guidelines since March 2013. The policy statement, written by the Council on School Health, was published in the October 2024 issue of the journal Pediatrics.

Policy statements prepared by AAP are written by medical experts, reflect the latest evidence in the field and undergo several rounds of peer review before being approved by the AAP Board of Directors and published in Pediatrics.

Under the policy, exclusionary practices were first used for more serious behavior, such as bringing weapons to school. These practices increased as a result of the zero-tolerance policies implemented in the wake of the federal “War on Drugs” campaign and other federal police policies.

Data examined during the formulation of the policy statement showed that between 1973 and 2006, the percentage of students punished with suspension or expulsion increased from 3.7% to 6.9% of total student enrollment.

“There is little evidence that zero-tolerance school exclusion policies make schools safer or deter misconduct, but they do cause significant harm to the mental and physical health of the individual child,” says policy author Susanna K. Jain, MD, FAAP. “Schools are responsible for providing a safe learning environment for all students, but it is difficult for students to learn when they are not in the classroom.”

Twenty years of research has shown that suspensions and expulsions do not necessarily lead to behavior change, as 28% of students suspended in the 2020-2021 school year were suspended more than once.

In that same school year, there were approximately twelve times more school shootings with victims than in the 2000-2001 school year.

A related AAP policy statement, “Early Childhood Removal: Policy Guides Pediatricians to Help Teachers, Programs to Discourage Harmful Practices,” published in October 2023, expands the concern to early childhood education and other child care settings, saying that expulsions from these types of institutions can lead to higher dropout rates, poor academic performance, and higher incarceration rates.

Students from marginalized communities, including students with disabilities and LGBTQ+ students, appear to be disproportionately affected by exclusionary school discipline policies.

“We know from research that Black children and adolescents are among the students most affected by expulsion and suspension,” said Dr. Jain.

“When students are out of school, they are more likely to use recreational drugs, participate in fights and carry a weapon, with the potential for increased contact with the juvenile justice system. The school-to-prison pipeline puts these children at greater risk of a cycle of incarceration.”

The AAP recommends an examination of these disparities as part of the collective efforts of students, families, child care providers, educators, and those involved in juvenile justice reform to create alternatives to exclusionary discipline practices.

The AAP recommends:

• Pediatricians are calling for increased access to mental health care for all students and supporting legislation aimed at ensuring that children who are suspended or expelled are educated through distance learning or other means
• School-age children are screened for chronic absenteeism and developmental delays that can make school more difficult
• Schools collect and analyze internal data on exclusionary discipline practices to identify areas for improvement

Pediatricians and school administrators must continue to educate themselves on the disparities in school exclusion practices, especially for students in Black and Indigenous communities.

“A multidisciplinary and trauma-informed approach is crucial when working toward children’s safety and education,” said co-author Nathaniel Beers, MD, FAAP. “The school board must take steps to examine what policies are in place and modify them to better serve students who have experienced trauma.”