By: Susanna K. Jain, MD, FAAP & Ryan Padrez, MD, FAAP
We want our schools to be safe, welcoming spaces where all children can learn and thrive. This is why school districts across the country need effective ways to deal with students who break rules or threaten to hurt others.
One way to respond to problem behavior is to keep kids out of school for a short time (suspension) or for good (expulsion). But based on research that goes back three decades, it's clear that removing kids from school doesn't make school communities safer. Instead, we are seeing harmful outcomes as millions of kids are excluded from learning environments that teach cooperation, respect, boundaries and more.
AAP policy explained
As pediatricians, we are deeply concerned about school safety. We also know that kids need the kind of discipline and support that helps them do their best. For our American Academy of Pediatrics (AAP)
policy statement on school suspensions and expulsions, we've evaluated the latest research on what works and what doesn't. Read on to learn more.
Effects of zero-tolerance policies in U.S. schools
Every year, more than 1.4 million children in kindergarten through 12th grade are suspended or expelled from schools across the country. The number is has climbed in recent decades, partly due to strict guidelines adopted in the 1990s, including
zero-tolerance policies that give schools no choice but to kick kids out when they break specific rules.
In earlier decades, suspension and expulsion were tools for dealing with serious misconduct–like when a student attacked someone or brought weapons to school. But now, most suspensions and expulsions are given for actions that are not violent or criminal.
One example is the practice of suspending or expelling students for skipping school (truancy). It's a serious offense, but not one that directly harms others. And sending kids away from class while hoping they will come to class in the future isn't likely to work.
What happens when students are suspended or expelled?
As we learned during the COVID pandemic, being away from school is harmful for kids. Just like adults, they need a sense of belonging to stay healthy and balanced.
Working side-by-side with their peers helps kids learn how to:
Deal with strong emotions
Work out conflicts without fighting or hurting anyone
Contribute to a safe, caring community
The more time kids spend building
resilience, the better their chances of behaving well in the classroom, on the playground and in other school spaces.
Are some students more likely to be suspended or expelled from school?
With more zero-tolerance policies in place, suspension and expulsion rates for all kids are higher now than in the past. But some groups face especially high risks of getting kicked out of school, including:
Male students, who accounted for 70% of all expulsions in 2020-2021.
Black students. Studies show they are not more likely to misbehave, but are punished more harshly for smaller offenses–for example, making noise or hanging out too long in the same spot (loitering).
American Indian and Alaska Native students, who in one state-level study were suspended or expelled 2.4 to 4 times more often than their white peers.
Students with disabilities, especially those with
ADHD, intellectual disabilities or emotional disturbances.
Students who identify as LGBTQ+, who may be suspended for not following dress codes or fighting back when they are
bullied.
Kids from low-income families or those experiencing
serious childhood trauma are also more likely to be suspended or expelled.
What happens over the longer term to kids who are suspended or expelled?
Research shows that school suspensions and expulsions are harmful for all kids. The experience of being kicked out of school makes it much more likely that kids will drop out of high school. This, in turn, leads to career struggles and lower income potential. Kids who are expelled or suspended are more likely to get in trouble with the law as juveniles, a pattern blamed for what many call the
school-to-prison pipeline.
But the difficulties don't end there. Kids caught up in these negative cycles tend to suffer bad health as adults. Asthma, heart disease, substance use and depression are some of the life-threatening issues linked with early-life struggles.
How can we heal these behavior patterns while holding kids accountable?
Schools can build a strong framework for discipline without relying on suspensions and expulsions. Recent studies show the value of fostering strong relationships among teachers, staff, administrators, students and families in setting high standards for school behavior.
Offering
multi-tiered systems of support (MTSS) surrounds kids with positive energy. It gives examples that show what adults expect of them and tools to do their best.
Other helpful methods include:
A trauma-informed framework for understanding the difficulties a child faces outside school, putting negative behavior in perspective
Restorative practices that help students see the impact of their actions, requiring them to make things right with anyone they have harmed
Anti-bias training that helps teachers and staff avoid punishing some kids more harshly than others
Are there other ways to help address school discipline issues?
Parents can play a central role in shaping how schools deal with disciplinary issues. The AAP is also asking pediatricians and family physicians to take an active role by:
Screening children for health issues or developmental delays that can make school harder.
Referring families to local resources for therapy, treatment, nutrition, housing and other supports so children can do their best in school.
Supporting new laws that require schools to keep students connected to school through distance learning and homework during suspensions.
Speaking out for school-based mental health programs that offer easy access to wellness screening, counseling and support for all kids.
More information
About Dr. Jain
 Susanna K. Jain, MD, FAAP, is a member of the AAP Council on School Health and lead author of its policy statement, "School Suspension & Expulsion." Dr. Jain is an Assistant Professor in the Division of General Pediatrics at University of California San Francisco.
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About Dr. Padrez
Ryan Padrez MD, FAAP, a co-author of the AAP school suspension and expulsion policy statement, is a Clinical Associate Professor in the Division of General Pediatrics at Stanford University School of Medicine. At Stanford. Dr. Padrez is Co-Director of community engagement within the Office of Child Health Equity and in the community is Medical Director for The Primary School.
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Editor’s note:
Nathaniel Beers, MD, FAAP, also contributed to this article.