Participation of Children and Adolescents in Live Crisis Drills and Exercises - Coalition to Support Grieving Students
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POLICY STATEMENT Organizational Principles to Guide and Define the Child Health
Care System and/or Improve the Health of all Children
Participation of Children and
Adolescents in Live Crisis Drills
and Exercises
David J. Schonfeld, MD, FAAP,a Marlene Melzer-Lange, MD, FAAP,b Andrew N. Hashikawa, MD, MS, FAAP,c
Peter A. Gorski, MD, MPA, FAAP,d,e COUNCIL ON CHILDREN AND DISASTERS, COUNCIL ON INJURY, VIOLENCE, AND POISON PREVENTION,
COUNCIL ON SCHOOL HEALTH
Children and adolescents should be included in exercises and drills to the extent abstract
that their involvement advances readiness to meet their unique needs in the
event of a crisis and/or furthers their own preparedness or resiliency. However,
there is also a need to be cautious about the potential psychological risks and
other unintended consequences of directly involving children in live exercises a
National Center for School Crisis and Bereavement, Children’s
and drills. These risks and consequences are especially a concern when Hospital Los Angeles and Department of Clinical Pediatrics, Keck
School of Medicine, University of Southern California, Los Angeles,
children are deceived and led to believe there is an actual attack and not a drill California; bDivision of Emergency Medicine, Department of Pediatrics,
and/or for high-intensity active shooter drills. High-intensity active shooter drills Medical College of Wisconsin and Children’s Wisconsin, Milwaukee,
Wisconsin; cDepartments of Emergency Medicine and Pediatrics,
may involve the use of real weapons, gunfire or blanks, theatrical makeup to Michigan Medicine, University of Michigan, Ann Arbor, Michigan;
give a realistic image of blood or gunshot wounds, predatory and aggressive d
Departments of Pediatrics and Humanities, Health, and Society,
Herbert Wertheim College of Medicine, Florida International University,
acting by the individual posing to be the shooter, or other means to simulate an Miami, Florida; and eDepartment of Public Health Sciences, Miller
actual attack, even when participants are aware that it is a drill. This policy School of Medicine, University of Miami, Miami, Florida
statement outlines some of the considerations regarding the prevalent practice
Policy statements from the American Academy of Pediatrics benefit
of live active shooter drills in schools, including the recommendations to from expertise and resources of liaisons and internal (AAP) and
external reviewers. However, policy statements from the American
eliminate children’s involvement in high-intensity drills and exercises (with the Academy of Pediatrics may not reflect the views of the liaisons or the
possible exception of adolescent volunteers), prohibit deception in drills organizations or government agencies that they represent.
and exercises, and ensure appropriate accommodations during drills and Drs Schonfeld, Melzer-Lange, Hashikawa, and Gorski all contributed to
the manuscript concept and design, critically reviewed and revised the
exercises based on children’s unique vulnerabilities. manuscript and earlier drafts, and approved the final manuscript as
submitted.
The guidance in this statement does not indicate an exclusive course
of treatment or serve as a standard of medical care. Variations, taking
BACKGROUND into account individual circumstances, may be appropriate.
All policy statements from the American Academy of Pediatrics
Historically, children of all ages have generally not been included in crisis automatically expire 5 years after publication unless reaffirmed,
preparedness efforts in the United States, including participation in live revised, or retired at or before that time.
drills and exercises, and certainly not to the extent that children are
represented in the general population. This lack of planning and practice for To cite: Schonfeld DJ, Hashikawa AN, et al. AAP COUNCIL ON
the needs of children represents a significant oversight that increases the CHILDREN AND DISASTERS, COUNCIL ON INJURY, VIOLENCE, AND
vulnerability of children in the event of a crisis.1 However, increasing POISON PREVENTION, COUNCIL ON SCHOOL HEALTH. Participation
of Children and Adolescents in Live Crisis Drills and Exercises.
concerns about the risk of mass casualty events in schools throughout the
Pediatrics. 2020;146(3):e2020015503
United States have given rise to crisis preparedness efforts that now include
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PEDIATRICS Volume 146, number 3, September 2020:e2020015503 FROM THE AMERICAN ACADEMY OF PEDIATRICSchildren in high-intensity live crisis other means to simulate an actual rare events. These events, therefore,
exercises such as active shooter drills, attack, even when participants are provide limited opportunities to test
which are increasingly held in schools aware that it is a drill.2 the efficacy of interventions in real-life
and involving children of all ages, situations. School safety, especially
including early elementary school- and related to school shootings, has
preschool-aged children as well as STATEMENT OF PROBLEM generated opportunities for products
college students. For the purpose of The majority of school districts and services that together represent
this policy statement, “children” will currently require active shooter drills, major financial investments, without
be used to refer to children and youth among other emergency drills and much or any evidence of efficacy.5
of all ages (ie, 0–21 years of age), exercises within schools and other Products promoted for purchase by
unless stated otherwise. The American community settings.3 If planned and schools now include bulletproof
Academy of Pediatrics (AAP) conducted thoughtfully with sufficient barriers or shelters intended to
recommends that children be included attention to the potential emotional accommodate the full class and
in exercises and drills only to the impact of participation and conducted teacher that can be used as panic
extent that their involvement advances in a manner that is developmentally rooms in the event of a school
adult readiness to meet the unique appropriate, exercises such as shooting.6 These types of training and
needs of children in the event of lockdown drills may be completed interventions proposed have rarely
a crisis and/or furthers their own without a major negative impact to been evaluated, despite an escalating
preparedness or resiliency. However, most children.4 However, in practice, demand for both.
there is also a need to be cautious active shooter drills are often planned
Recently, researchers have begun to
about the potential psychological risks and conducted without guidance from
question the efficacy of some popular
of directly involving children in live those familiar with the unique needs
training approaches. For example,
exercises and drills. These risks are and vulnerabilities of individual or
Dorn7 conducted more than 8000 one-
especially a concern when children are groups of children, which is critical to
on-one controlled video and audio
deceived so that they believe there is inform best practices. The unique
simulations and, in the study, found
an actual attack and not a drill and/or needs of young children (eg, those in
that school personnel who completed
for high-intensity active shooter drills. early care and education settings),
active shooter training designed to
children who suffered traumatic
train people to make decisions among
A lockdown is an emergency events in the past, and those with
various crisis response options (eg,
procedure to minimize risk of harm to physical, intellectual, and
whether to run, hide, or physically
students and staff when a significant neurodevelopmental disabilities are
attack a shooter) were almost twice as
threat of violence within (or near) the rarely considered and addressed in
likely to misjudge many critical action
school is present. A lockdown live exercise planning. Preparedness
steps in simulations compared with
generally involves the immediate initiatives and approaches need to be
untrained school staff who relied on
movement of students and staff into evaluated to ensure that they are
common-sense actions. For example,
rooms in which doors are locked and effective, and research is needed to
adults who completed the training
students remain quiet. Other security demonstrate that these initiatives do
were more likely to attack a child who
measures are often followed, not cause untoward distress or other
was holding a gun and threatening
including darkened lights, shades on unintended consequences for
suicide or run from a classroom when
exterior windows, and covered doors, individual or groups of children and
staying within the room was the safer
and children moving to an area that is school staff or other adult participants.
alternative.
not visible from hallways. Lockdown
drills are when lockdown procedures It is possible, and even likely, that
are practiced in the absence of EVIDENCE BASE other well-intentioned preparedness
a threat, including as a form of Although there is general agreement efforts may inadvertently cause
preparation for a possible armed that the direct involvement of children children and adults to place
assailant (in which case, some people should be based on the value of themselves in additional danger in
may refer to this as an active shooter including them in crisis drills and a crisis situation. Children (and adults)
drill). High-intensity active shooter exercises, their age and developmental might be taught to fight a heavily
drills may involve the use of real capabilities, and their personal armed intruder, when fleeing or hiding
weapons, gunfire or blanks, theatrical vulnerabilities, there is a limited would be a more appropriate
makeup to give a realistic image of evidence base on how to make these response. Children taught to provide
blood or gunshot wounds, predatory assessments. Mass shootings in first aid to a bleeding peer or remain
and aggressive acting by the schools, although highly visible in the near an injured person to comfort
individual posing to be the shooter, or media and social consciousness, are them may remain in harm’s way in an
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2 FROM THE AMERICAN ACADEMY OF PEDIATRICSactive shooter event and place Law enforcement personnel who complete with a police response and,
themselves at increased risk of place their own lives in jeopardy have in at least one situation, armed
becoming a casualty. the unenviable responsibility of weapons pointed at school-aged
protecting children from such acts of children. This is based on the belief
Some students and school personnel
violence and may understandably that simulations that evoke the same
may feel empowered by being able to
suggest taking virtually any action level of distress as real events better
actively participate in live exercises
that may save a child’s life, thereby prepare participants to act
because they may feel that it better
leading them to recommend involving appropriately at a time of true crisis.2
prepares them for possible events.
children in high-intensity drills. Their During one recent live exercise in
These individuals may, however,
passion may need to be balanced with which high school students were
underestimate how others with
concerns of unintended mental and deceived to believe it was a real
different personalities, coping styles,
physical consequences and/or the event, children sobbed hysterically,
personal histories, and individual
lack of evidence about the efficacy of vomited, or fainted, and some
vulnerabilities may respond. Children
certain approaches. children sent farewell notes to
and adults who receive training to
parents. Children risked physical
respond to a crisis may feel Law enforcement personnel benefit
harm when a stampede ensued, and
comforted because it provides them from regular and realistic
students jumped over fences to
an illusion of control. However, such opportunities to practice critical
escape.10 In one situation, staff were
efforts could result in increased guilt skills, much as physicians do. It,
intentionally shot at close range with
if the individual is not able to respond therefore, stands to reason that these
pellets as part of the training.11
in the idealized fashion in a real professionals would seek
event. For example, children taught to opportunities to identify and then
High-intensity crisis preparedness
fight back against an armed intruder practice how best to respond to active
efforts may contribute to a distorted
or adult staff who are armed with shooter scenarios in schools and
sense of risk in children and perspective
a weapon to shoot a potential other settings. The question is
that adults and peers need to be viewed
attacker may feel substantial guilt if whether and in which situations
as potential killers. More broadly, these
they end up fleeing (appropriately) or children and adolescents should be
activities can increase children’s anxiety
are unable to save the life of a child or actively engaged in such live exercises
and fear that the world is a threatening
peer in an actual attack. These and and how the exercises should be
place.12 This atmosphere of
other unintended consequences need conducted to minimize the negative
a continuous threat of violent death is
to be carefully considered, and impacts on students. Guidelines
likely to increase anxiety further among
programs need to be evaluated more developed by the National
children when frequent threats directed
strategically for efficacy before being Association of School Psychologists
at the school or present in the
widely implemented. Even initiatives and National Association of School
community lead to lockdown
with good intentions may cause Resource Officers recommend that
procedures. It should not be a surprise
serious harm. schools follow a hierarchy of
that there are reports of young children
preparedness strategies, beginning
Unfortunately, there is not much writing frantic notes while in lockdown,
with simple discussion-based
evidence to guide best practices. including one 7-year-old who wrote
exercises, before even considering
Survivors or family members of “Love mom and dad” with marker on
complex (in-person or live)
individuals who died in crisis events her arm and later explained to her
operations-based drills. These
may be powerful advocates for mother that it was “In case the bad guy
organizations also recommend the
preparedness efforts and feel got to us and I got killed, you and daddy
inclusion of school mental health
passionately about the need to take would know that I love you” after her
professionals in both the planning
active steps to protect students and body was discovered.10,13 Even infants
and implementation of drills so that
staff from school crisis events. and toddlers in early child care settings,
careful consideration can be given to
Parents and other community who will have little understanding of the
the appropriate involvement of
members may simply be unwilling to implications of gun violence, may
children and potential means to
wait until preparedness approaches nonetheless react negatively with
minimize distress for all
are adequately evaluated. increased anxiety, stress, and
participants.8,9
Pediatricians and other pediatric helplessness to the stressful context,
health care providers can provide In contrast, some schools have loud noises, and disruptive environment
important insights into the conducted active shooter exercises of active shooter drills, especially when
developmental needs and without advance notice and misled the adults are themselves distressed.
vulnerabilities of children of all ages students and/or staff members that it Stakeholders can instead be focused on
that can help inform best practices. was an actual shooting event, equipping children with the skills
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PEDIATRICS Volume 146, number 3, September 2020 3needed and expectations of peaceful However, the AAP also recognizes the vulnerabilities, such as anxiety or
coexistence rather than an expectation importance of ensuring that past traumatic experiences) and
for and preparation to recover from preparedness efforts are effective but told that they are under no
mass violence. Resources directed to do not cause children untoward pressure to volunteer. For this
prevention efforts are more cost- psychological distress or lead to other reason, active consent (for those
effective and have wider benefits to unintended consequences. youth able to provide consent) or
potential victims, survivors, and society. active consent from a legal
RECOMMENDATIONS guardian and assent from the
The December 2018 report of the
adolescent should generally be
Federal Commission on School 1. Eliminate children’s routine
Safety14 included the following required for live high-intensity
involvement in high-intensity
statement: “While there is some exercises, rather than the use of
drills and exercises. Children
disagreement over whether it is passive consent procedures.
should generally only be involved
appropriate to subject students to Children who are of an age and
in crisis exercises when their
active shooter training, as school developmental ability to provide
involvement is of direct benefit to
shootings become more prevalent, consent/assent for procedures that
them and/or other children,
more schools are opting to drill their may cause modest physical
rather than only of benefit to
students on how to respond to an discomfort or modest emotional
adult professionals. If the goal of
active shooter situation. According to distress to an average child (eg,
a high-intensity drill or exercise is
a 2016 US Government Accountability donating blood in a blood drive for
for adult responders to practice
Office report, an estimated 67% of example) may be permitted to
their roles (eg, to train law
school districts conduct active provide consent/assent to
enforcement and/or medical
shooter drills involving their participate in such exercises;
personnel), then alternatives such
students. Whether to conduct active younger children should not be
as manikins or adults playing the
shooter drills with the student allowed to participate. Even
roles of children should be
population is something each adolescents who have been
sufficient, or the activity can occur
community must determine for itself. outside of the hours when appropriately briefed and are
For those that do elect to conduct students are present in schools or capable of providing consent/
active shooter drills with students, preschools. First responders may assent may still not disclose
they should ensure that the training is need to practice being in a high- personal vulnerabilities and/or
age-appropriate and designed in stress situation involving active may underestimate the distress
a manner not to unduly traumatize shooters, but the same is not true that participation may
any of the participants.” for school-aged children. ultimately cause.
The determination of what is Therefore, only adolescents who 3. School personnel or other adults
generally age-appropriate and/or have a personal desire to present during drills should
likely to be traumatizing to children participate (eg, volunteers from remain vigilant for psychological
when conducting a live crisis exercise a drama club or teenagers who distress. It is critical to minimize
or drill is something that can be plan a career in law enforcement the distress children may
determined at a national level. There or as an emergency medical experience throughout any
is a general lack of national technician) should have the exercise. Simulations involving real
recommendations on whether to option to be included in high- weapons, gunfire or blanks,
include children in active shooter intensity drills and exercises until theatrical makeup to give
exercises and other crisis drills. This evidence is gathered that such a realistic image of blood or
policy statement aims to provide drills or exercises are of sufficient gunshot wounds, predatory and
those recommendations. benefit to warrant the likely aggressive acting by the individual
distress of other participants. posing to be the shooter, or other
2. Obtain active consent/assent of means to accurately simulate an
CONCLUSIONS adolescent volunteer participants. If actual attack are likely to still be
The AAP supports advocacy efforts at adolescents volunteer to be traumatic to some and should
the national and state levels to ensure involved in high-intensity live require careful justification. Even
that the unique needs of children exercises, they should be carefully if children have agreed to
are fully considered in crisis briefed on what will be involved participate in an exercise, they
preparedness efforts, including, when and the feelings that the experience ought to be instructed to
appropriate, the involvement of may engender (including for those discontinue participation if it is
children in live exercises and drills. with undisclosed personal causing any physical or emotional
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4 FROM THE AMERICAN ACADEMY OF PEDIATRICSdistress and explicitly given actively testing them in a more or guardians can be notified at
permission to take a break from pressured context that may the start of a school year about
the exercise for any reason. Adult degrade performance, thereby the likely drills that will be held
monitors should be observing helping to promote and and invited to bring any concerns
children’s reactions and checking demonstrate competence rather about their child’s participation
on them periodically throughout than overwhelming people by their to the school’s attention.
the exercise. Even when exercises failures. Stakeholders planning Pediatricians who become
or drills do not include any drills and exercises should aware of such concerns should
elements that may be felt likely to articulate that the learning encourage and assist parents to
engender distress, some children objectives for adult and child communicate them directly to
and adults may nevertheless participants are different and school authorities. In some
experience distress. For this ensure that the drills and exercises situations, the accommodations
reason, adults should carefully highlight or teach specific may be part of a 504 Plan or
monitor the reactions of children behaviors that promote safety incorporated into a student’s
and adults to any exercises and rather than simply being used to Individualized Education
drills, with oversight by an highlight potential dangers or Program. School personnel must
experienced member of the team convey the seriousness of a crisis be conscious of the unique needs
planning the exercise or drill, and event. Feedback from all of early childhood, child care,
provide supportive services as stakeholder groups, including Head Start and Early Head Start,
indicated. students and staff, should be or preschool programs located on
obtained after exercises and drills campus and consider ways to
4. Eliminate deception in drills and
to identify any remaining gaps in exclude or mitigate the impact on
exercises. Notice of drills should
knowledge and skills and ascertain this vulnerable population.
be provided to parents, students,
if participation caused any distress 7. Seek and incorporate student
and staff members. Students,
or other unintended consequences. input. School personnel can give
staff, and families of students
should not be led to believe that 6. Make accommodations that are thought as to how to incorporate
an exercise is a real event or based on children’s unique the input of students into safety
misled about the injury to or vulnerabilities. In most discussions and planning for
death of others. Such a practice is situations, active shooter drills exercises and drills. Students can
harmful and unethical and is not should be conducted as fire drills provide important insight into the
justified by a theoretical benefit are generally conducted (without risks that students may face in the
of evaluating people’s response simulation of there being an event of a crisis, vulnerabilities
under extreme levels of stress. active fire) using a well- that adults may not anticipate, and
State AAP chapters can advocate discussed, calm approach to the how best to prepare peers for
that schools and emergency safe movement of students and exercises and drills and minimize
response agencies prohibit the staff in the school building. In their distress while participating. It
use of deception in live drills and general, adults should avoid is important, though, to remember
exercises and any related referencing these drills with that some students and staff may
simulations (eg, mock death names that may engender further feel empowered by opportunities
notifications and funerals). distress, such as calling them to engage actively in exercises and
Instead, it should be mandatory “active shooter drills”; instead, underestimate the distress it may
to notify parents, students, and terms such as “lockdown,” cause other students with different
staff members of planned live “shelter in place,” or “safety personalities, coping styles, or
crisis drills and exercises. drills” are preferable. Children preexisting vulnerabilities. Adults
Pediatricians can review the with a high level of personal can talk with students after
policies of local school districts, vulnerability (eg, students with conducting drills and exercises to
inquire about their current an anxiety disorder, previous obtain their feedback about the
practices related to drills and traumatic experience, or physical experience and suggestions on
exercises, and offer guidance as disability) may require particular how to optimize future exercises
described in this policy. accommodations, including being and drills.
5. Focus on teaching skills rather excused from certain drills or 8. Obtain multidisciplinary input into
than simulating distressing crisis exercises when such exercise and/or drill planning. To
events. The goal of live exercises participation may be give careful consideration to the
and drills is to teach skills before overwhelming.15,16 Parents and/ needs of all children in drills and
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PEDIATRICS Volume 146, number 3, September 2020 5exercises, planning teams should 10. Promote legislative advocacy. All COUNCIL ON INJURY, VIOLENCE, AND
be multidisciplinary and include legislation requiring active POISON PREVENTION EXECUTIVE
pediatricians or other shooter drills in schools should COMMITTEE, 2019–2020
professionals with expertise in be required to follow best- Benjamin D. Hoffman, MD, FAAP,
child development and behavioral practice guidelines, such as those Chairperson
from the National Association of Phyllis F. Agran, MD, MA, MPH, FAAP
health, such as school mental
Michael Peter Hirsh, MD, FAAP
health providers (eg, school School Psychologists and the Brian Duncan Johnston, MD, MPH, FAAP
counselors, psychologists, and National Association of School Sadiqa Kendi, MD, CPST, FAAP
social workers). Such planning Resource Officers.8 Among other Lois Kaye Lee, MD, MPH, FAAP
recommendations, these Kathy Wingo Monroe, MD, FAAP
teams should also explore how
guidelines recommend that Judy Schaechter, MD, MBA, FAAP
best to incorporate the input of Milton Tenenbein, MD, FAAP
students, school and/or preschool schools begin with simple Mark R. Zonfrillo, MD, MSCE, FAAP
staff of different professions, discussion-based exercises (ie,
parents, and other community tabletop exercises) before
considering complex live drills. LIAISONS
partners. Teachers and other
Suzanne Marie Beno, MD – Canadian
school professionals care deeply 11. Conduct research on the impact
Paediatric Society
about protecting children and may, of exercises and drills. Funding Jonathan D. Midgett, PhD – Consumer Product
therefore, have more emotional for research is needed to evaluate Safety Commission
reactions to such exercises and the goals, efficacy, and potential Bethany Miller, LCSW-C, MEd – Health
unintended consequences of Resources and Services Administration
drills than planners anticipate, Alexander “Sandy” Sinclair – National
even in the absence of any crisis preparedness activities
Highway Traffic Safety Administration
personal vulnerabilities such as involving children. Strategies that
preexisting trauma or loss. The are likely to cause significant
distress or other unintended STAFF
impact of drills and exercises on
consequences, such as high- Bonnie Kozial
adults should be given careful
intensity live exercises, should be
consideration as well.
evaluated before they are COUNCIL ON SCHOOL HEALTH EXECUTIVE
9. Emphasize the role of prevention. implemented, especially in the COMMITTEE, 2019–2020
Sufficient emphasis should be absence of evidence of their Cheryl L. De Pinto, MD, MPH, FAAP, Chairperson
placed on the prevention of efficacy. Marti Baum, MD, FAAP
violence, including the necessary Nathaniel Brittingham Savio Beers, MD,
financial resources and MPA, FAAP
professional efforts. These efforts LEAD AUTHORS Sara Moran Bode, MD, FAAP
include, among others, efforts in Erica J. Gibson, MD, FAAP
David J. Schonfeld, MD, FAAP
Peter A. Gorski, MD, MPA, FAAP
social-emotional learning, positive Marlene Melzer-Lange, MD, FAAP
Viju Jacob, MD, FAAP
Andrew N. Hashikawa, MD, MS, FAAP
school climate and culture, early Marian Larkin, MD, FAAP
Peter A. Gorski, MD, MPA, FAAP
identification and effective and Sonja C. O’Leary, MD, FAAP
readily accessible treatment of Ryan Christopher Padrez, MD, FAAP
Heidi Kristen Schumacher, MD, FAAP
behavioral health concerns and COUNCIL ON CHILDREN AND DISASTERS
mental illness, educator and school EXECUTIVE COMMITTEE, 2019–2020
administration training, Steven Krug, MD, FAAP, Chairperson LIAISONS
deployment of sufficient mental Carl Baum, MD, FACMT, FAAP Shashank Vishnuprasad Joshi, MD – American
health and support personnel in Sarita Chung, MD, FAAP Academy of Child and Adolescent Psychiatry
Deanna Dahl-Grove, MD, FAAP Linda Mendonca, RN, MSN, PHNA-BC, NCSN,
schools, and interdisciplinary H. Dele Davies, MD, MS, MHCM, FAAP FNASN – National Association of School Nurses
threat assessment.5 The AAP and Eric Dziuban, MD, DTM, CPH, FAAP
its members can work with others Aaron Gardner, MD, MS, FAAP
nationally to balance the rights of Stephanie Griese, MD, MPH, FAAP STAFF
Scott Needle, MD, FAAP Stephanie Domain, MS
gun ownership with the need to
David J. Schonfeld, MD, FAAP
protect the safety of children in Joelle Simpson, MD, MPH, FAAP
a way that does not allow society
to view mass shootings involving ABBREVIATION
children as inevitable or as a “new STAFF AAP: American Academy of Pediatrics
normal” in society. Laura Aird, MS
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6 FROM THE AMERICAN ACADEMY OF PEDIATRICSThis document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors. All authors have filed conflict of interest statements
with the American Academy of Pediatrics. Any conflicts have been resolved through a process approved by the Board of Directors. The American Academy of
Pediatrics has neither solicited nor accepted any commercial involvement in the development of the content of this publication.
DOI: https://doi.org/10.1542/peds.2020-015503
Address correspondence to David J. Schonfeld, MD, FAAP. E-mail: schonfel@usc.edu
PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275).
Copyright © 2020 by the American Academy of Pediatrics
FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
FUNDING: No external funding.
POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.
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PEDIATRICS Volume 146, number 3, September 2020 7Participation of Children and Adolescents in Live Crisis Drills and Exercises
David J. Schonfeld, Marlene Melzer-Lange, Andrew N. Hashikawa, Peter A. Gorski
and COUNCIL ON CHILDREN AND DISASTERS, COUNCIL ON INJURY,
VIOLENCE, AND POISON PREVENTION, COUNCIL ON SCHOOL HEALTH
Pediatrics originally published online August 24, 2020;
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020-015503#BIBL
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Downloaded from www.aappublications.org/news by guest on August 24, 2020Participation of Children and Adolescents in Live Crisis Drills and Exercises
David J. Schonfeld, Marlene Melzer-Lange, Andrew N. Hashikawa, Peter A. Gorski
and COUNCIL ON CHILDREN AND DISASTERS, COUNCIL ON INJURY,
VIOLENCE, AND POISON PREVENTION, COUNCIL ON SCHOOL HEALTH
Pediatrics originally published online August 24, 2020;
The online version of this article, along with updated information and services, is
located on the World Wide Web at:
http://pediatrics.aappublications.org/content/early/2020/08/21/peds.2020-015503
Pediatrics is the official journal of the American Academy of Pediatrics. A monthly publication, it
has been published continuously since 1948. Pediatrics is owned, published, and trademarked by
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