Strategies

Delay school start times for middle and high schools to better align with adolescent sleep-wake cycles; often until after 8:30 or 9:00 a.m.

Focus heavily on reading and math achievement, enforce high behavioral expectations through a formal discipline system, lengthen instructional time, and increase feedback on teacher performance

Provide culturally sensitive assistance and care coordination, and guide patients through available medical, insurance, and social support; also called systems navigators

Teach positively stated behavior expectations to all students, often reinforced with prizes or privileges and supported with coaching and data

Provide interpretation services for patients with limited English proficiency (LEP) in outpatient and inpatient health care settings, following training and certification

Create a school culture of high behavioral and academic expectations, with intense tutoring, increased teacher performance feedback, lengthened instruction time, and health care services

Require school officials to apply predetermined consequences for certain infractions, regardless of situational context or circumstances; consequences are usually severe (e.g., suspension or expulsion)

Support programs to provide students with a nutritious breakfast in the cafeteria, from grab and go carts in hallways, or in classrooms

Provide health care services on school premises to attending elementary, middle, and high school students; physical and mental health services provided by teams of nurses, nurse practitioners, and physicians

Implement focused efforts to help children recognize and manage emotions, set and reach goals, appreciate others’ perspectives, and maintain relationships; also called social and emotional learning (SEL)