Johnny Brewch, a stocky 15-year-old with a quick smile and tangle of silver chains around his neck, tries to concentrate as his teacher writes President Franklin D. Roosevelt's name on the blackboard. Most of the students in Johnny's social studies class at the Nathan Bishop Middle School in Providence, RI, jot the words in their notebooks. But the 8th grader fidgets, impulsively hopping in and out of his chair.

After fleeing a brutal civil war in his native Liberia, Johnny now struggles in a school system that is under-equipped to deal with him and the thousands of refugees who have settled here in recent years. In addition to newcomers' typical challenges—grasping a strange language, fitting into new social circles, and learning a different culture's customs—refugee children often contend with a host of psychological problems.

Johnny still remembers seeing people killed in the street. "Sometimes when I sit and think, it bothers me,'' he says in his thickly accented English. "I dream about how they killed. I dream how they cut people's hands off.''

Because they have usually witnessed terrible violence, many suffer from post-traumatic stress disorder (PTSD), a condition that can produce flashbacks, sleep disorders, depression, and emotional numbing. They also are more likely to join gangs and abuse drugs and alcohol. Many arrive from places like Afghanistan and Somalia having lost one or both parents, and they frequently have problems at home, including physical abuse.

Since the September 11, 2001 terrorist attacks and the numerous deadly school shootings of the 1990s, many schools are waking up to PTSD's impact on students, and that awareness has expanded to include refugees, experts say. But because teachers are not typically trained to recognize such symptoms and funding for intervention is scarce, many children with PTSD may not get the attention or treatments they need, such as psychotherapy and anti-depressant drugs.

"Children who come here who are displaced already faced stressful problems in their own countries, and the displacement adds significant stress," says Syed Arshad Husain, professor of child psychiatry at the University of Missouri-Columbia. "Psychological treatment is [what's] least available but most needed."

Husain's study of Bosnian adolescents who survived the siege of Sarajevo in 1994 showed that experiencing warfare and the death of loved ones was likely to produce PTSD in children. Bosnian girls were more likely to develop symptoms than boys, says Husain. He suggests three possible reasons why: the girls tended to internalize their feelings more than boys did; they were more socially sheltered in a macho culture before the war and therefore more traumatized by the outbreak of violence; and that particular war sparked daily fear of sexual assault.

School administrators are learning that effectively teaching refugee students usually entails more than simply placing them in bilingual education programs. In working-class Chelsea, MA, many students come from places of war or famine. (About 20 percent of the district's 5,600-plus students are Limited English Proficient.) In recent years, the district has added Somali and Bosnian social workers, and begun providing grant-funded intensive English literacy and math instruction for refugee students before transferring them to bilingual classes.

After years of welcoming students from 50 different countries into her classroom, Linda Quinn, the high school's lead bilingual teacher, knows how to spot traumatized refugees. "Some are very silent. They can be very angry. They'll sit in back and not mix with other kids in the cafeteria,'' she says.

In struggling urban school systems like Chelsea or Providence, crowded classes and high student mobility make it hard for teachers to give enough attention to individual children. Refugee agencies in Providence focus mainly on resettling new arrivals, with little time or money to attend to educational issues. "It's been a nightmare to get any special help for these kids,'' said Betty Simons, director of refugee services for the International Institute of Providence. "The schools just are not prepared and don't have the resources. It's an ongoing struggle.'' Sharon O'Neill, who teaches English as a Second Language, concurs: "They arrive here and they're dumped in a class with 28 kids.''

To aid schools, the federal government has begun providing funds to address the issue of students with PTSD. The National Child Traumatic Stress Initiative, launched last year by the U.S. Department of Health and Human Services, is distributing $30 million over three years to research and clinical treatment centers across the country. Boston Medical Center and Boston University School of Medicine recently were awarded $1.8 million under the initiative to research and treat post-traumatic stress in refugee children and assist schools in dealing with the problem.

The Boston partnership team is made up of ten psychiatrists, psychologists, and social workers who offer therapy and home visits to the families of refugee children. The children they see often "have experienced unbelievable trauma, some of the worst we've seen—torture, physical abuse, rapes,'' says Glen Saxe, chairman of child and adolescent psychiatry at Boston Medical Center. "[These children] may show aggressive behavior and [have] a great deal of difficulty focusing in school because they're processing very frightening memories, and teachers may not recognize that.''

Team members instruct teachers to find out more about students' backgrounds, and how certain classroom factors can trigger traumatic memories. Interpreters from the hospital staff provide critical help in this work. For example, roughhousing in the classroom or schoolyard can be upsetting to children who have experienced intense violence, Saxe says. "Teachers may not know that speaking in a certain tone of voice that is highly reminiscent of what they've gone though can trigger bad memories,'' he says. "Some have witnessed assault by someone in the military, and they may be mistrustful of anyone in authority.''

Indeed, many teachers have realized on their own that they need to know more about how to teach the newcomers who end up in their classrooms. With some 75,000 refugees arriving in the United States each year, school systems are starting to routinely prepare teachers to handle refugees from the new conflict zones in Africa, Central America, Europe and the former Soviet Union.

In the Miami-Dade County public schools, the newly minted Project Flourish' is using a $600,000 federal grant for training to help youths who were caught up in the murderous guerilla war in Colombia and others who left poverty and civil strife in Haiti. Weekend training conferences have proved popular, with 100 teachers showing up for recent sessions, and a three-day institute this past summer filled quickly.

Teachers are shown how students' ability to learn is often inextricably linked to what they went though in their flight from their home country. "They need to understand where the kids come from and what kind of history they have. Why are they here?'' says Mercy Suarez, the project's manager. She says teachers should invite students to tell their stories: Who did they leave behind? What has the journey been like? "People think that if you don't talk about it, they'll forget,'' says Suarez. "But when you have a trauma, you need to talk about it.''

Educators should know that displaced trauma can be long lasting, says James Garbarino, a Cornell University researcher who studies the impact of violence on kids. In a study of Cambodian and Khmer children, Garbarino found that half his sample group showed signs of post-traumatic stress even after ten years in the United States. One way to treat the disorder is to involve youths in community projects such as gardening or taking care of animals, he says: "Particularly with chronic stress, it's not enough to treat them clinically. Sometimes you have to restore their faith in the future.''

Many children thrust into U.S. schools after surviving mayhem and privation arrive with the added burden of a fragmented or foreshortened formal education. While refugee experiences vary, it is common for displaced children—particularly Africans—to miss out on school or receive a substandard education. In Guinea's Forest Region, where more than 200,000 Liberians fled in the 1990s, refugees were placed in camps far from the capital and reached only by rutted dirt roads. The few schools were poorly equipped, and the language of instruction was generally French, while Liberians are primarily English speaking. In similar camps throughout the world, families are sometimes charged fees for their children's school, forcing penniless refugees to somehow come up with money for uniforms, shoes and school supplies.

The educational quality and customs in refugee camps in developing countries are often much different from those in industrialized countries. In some cultures, schoolchildren are not allowed to speak in class, or must look down and answer quietly out of respect for the adult teacher. "It's one of the big challenges for kids when they come here. Not only are they facing a new language, new environment, and new culture, they are facing a new educational culture,'' says Hiram A. Ruiz, spokesman for the Washington, DC-based Immigration and Refugee Services of America.

Of course, the range of experiences among refugees is wide. Experts note that the most extreme cases—the students who tune out completely or turn to violence or serious drug abuse—are just that: extreme and still somewhat rare. Although refugees' passage from one world to another is frequently arduous and painful, the transition is often ultimately successful—and a relief.

For example, Aladin Milutinovic escaped Bosnia with his Muslim mother and Eastern Orthodox Christian father when he was ten years old. His father is now Chelsea High School's soccer coach. Growing up amid civil war, Aladin remembers hearing the gunfire and bombing. "My family came here because of the troubles,'' says Aladin, now 18 and one of the top students in his graduating class. "I don't dwell on them. I am looking forward to a better future.''

Madina Mohamed, a 19-year-old senior at Chelsea High School, is another good example. She left Somalia as a young child, leaving behind a chaotic civil war among rival warlord gangs. During her five years in a refugee camp in Kenya she never attended school. Though she speaks English fluently, she reads and writes with difficulty, and her goal of graduating this year and attending college may be unattainable. "If I had been more in school, I would be in college by now,'' she says. "I had to catch up.''

Despite Madina's struggles, she and many of her peers remain highly motivated, says Chelsea High School principal Harold B. Elder Jr. Some have advantages: they come from middle-class, cosmopolitan backgrounds and arrive with both parents. Many Bosnian and Croatian refugees who experienced the war got good schooling in Germany's refugee camps, says Elder. "They realize the value of an education because of what's happened to them.''

Shaun Sutner covers politics and education for the Worcester (MA) Telegram & Gazette.