'Exponential' increase in school shooting drills since Sandy Hook Schools have focused on how to best prepare teachers and students to respond.

 -- The secretary at the Rancho Tehama Elementary School made a split-second decision on a Tuesday morning last month: to get all the children inside the building within seconds of hearing gunshots.

"Because that call was made then, 47 seconds later, we had a completely locked-down school. Ten seconds after that, the shooter was in the quad firing shots," Rick Fitzpatrick, the superintendent of the Corning Union Elementary School District in California, told ABC News. "We had a 10-second cushion."

But almost five years before the Rancho Tehama shooting, the fate of students at an elementary school on the opposite side of the country was very different. On Dec. 14, 2012, 20 first-graders and six educators were killed at Sandy Hook Elementary School in Newtown, Connecticut. And in the years since, school administrators and safety consultants have grappled with how best to secure schools to keep students safe in worst-case scenarios.

"There's a lot of things about Sandy Hook that they did right, and it still didn't work," said Fitzpatrick, who was the site principal of an elementary school at the time of the Sandy Hook shooting. He said he remembers "thinking it could have been any of us."

While little action has been taken at the federal level in terms of gun control, school shooting drills and preparation have increased dramatically.

In March 2016 the U.S. Government Accountability Office released a study looking at federal coordination of how schools prepare for emergencies. The study cited the Sandy Hook shooting as one of the motivators and found that 40 states required individual schools to conduct emergency exercises and 32 states required school districts to conduct such exercises. The nature of the exercises mentioned in the report, however, was not specified.

But just how students and teachers should prepare to face active shooter situations has been the subject of intense debate.

Lockdown drills vs. full-scale simulations

Katherine Cowan, the director of communications for the National Association of School Psychologists, said that there is a spectrum of kinds of drills that schools use and that the level of interaction varies.

Options include simple, announced lockdown drills and the much more controversial full-scale simulations, which sometimes feature actors with air rifles simulating shooters and local law enforcement officers responding to the scene.

Such full-scale simulations have caused outrage in some cases, including one in Winter Haven, Florida, in 2014 in which teachers, students and parents weren't told until afterward that the police officer who barged into their middle school classroom with an assault rifle was participating in a drill.

"It is not possible to know exactly how many schools are doing full-scale simulations versus other types of drills along the spectrum of training possibilities. However, it is pretty clear that it is exponentially more than before Newtown," Cowan told ABC News.

She said that law enforcement officials and school administrators "need to understand the cost-benefit and risks associated with whatever it is they choose to do," including the "potential psychological and emotional impacts of full-scale simulation."

Teaching students and teachers to fight back

The shift from solely using shooting drills to incorporating possible action by teachers and students against a would-be attacker started before Sandy Hook, experts said.

Greg Crane, a former Dallas-based police and SWAT officer, said that he and his wife, Lisa Crane, who was a high school principal, formed their approach to school safety — and their training company — after the Columbine High School shooting in Colorado in 1999.

"While I understood a securing-in-place mindset and protocol, my question ... was, 'What about when that specific response plan does not fit the scenario?'" he told ABC News, citing the possibility of a shooter breaching a school's secured area.

The name of the Cranes' company, the ALICE Training Institute, incorporates the acronym for people's response options to a school shooting: alert, lockdown, inform, counter, evacuate, Greg Crane said. He said the order of the responses in the acronym is not sequential for how individuals should respond but just the options they have.

The company holds 500 to 600 training sessions annually, Crane said, and sessions are adapted to each venue.

One part of the ALICE training model that has raised some experts' eyebrows is the suggestion that people throw items — including pencils and possibly canned goods — at attackers. Crane said while throwing things at shooters might not incapacitate them, doing so could make it harder for them to kill.

"I may not be able to stop him shooting at me, but if I can stop him from shooting accurately at me, then that's a huge benefit because that drives his hit rate down, and that drives his accuracy down," Crane said.

Beyond that kind of interaction with the shooter — which falls under the acronym's counter category — Crane said "the priority needs to be an empowerment and authorization of the people on the scene. Don’t tell them what they should do. Tell them what they can do."

Crane is not the only one to favor this model. Fitzpatrick credited the success of the lockdown at Rancho Tehama to the authority that the secretary had to immediately call the lockdown when she felt it was needed.

"If she had had to say, 'I need to call the principal, I have to call the superintendent’... we would have had a body count," Fitzpatrick said.

But school security consultant Ken Trump believes that the ALICE model is one of a number of proposals that "prey on the emotions of anxious parents and educators looking for a 'quick fix' to the complex issues of school safety and emergency planning," he writes on his website.

Trump, who is not related to the president, told ABC News that the focus on active shooter situations leads to school administrators' overlooking other security threats at schools like abductions by noncustodial parents, natural disasters and sexual assaults.

"It's not to say that you shouldn't prepare for active shooters, but we have a tunnel-vision focus on this, and we're losing focus on more day-to-day security issues," he said.

He called on schools to diversify the nature of their lockdown drills as well as the times when they are held, including while students are in class, during lunch or on the playground.

Trump said school administrators should also ask themselves, "Are we crossing the line of reasonableness with some of these over-the-top drills and theories and fads?"

Prevention is key

One group working to stop shootings before a person even plans an attack knows the subject matter all too well. Sandy Hook Promise is a group founded in 2013 by parents of two Sandy Hook victims, and it aims to prevent gun-related deaths and raise awareness about mental health issues.

The group holds training sessions at schools nationally, and a number of its initiatives, like one called Start With Hello, address issues surrounding social isolation that it believes can help prevent students from becoming violent.

"Everything that we do at Sandy Hook Promise has the nexus back to what happened with the Sandy Hook shooting," said Mark Barden, one of Sandy Hook Promise's founders, whose son Daniel was killed at the school. Barden said the shooter "was chronically socially isolated."

"We also know that the shooter was planning this for over a year and giving off all of these warning signs," Barden said. "We could have connected this person with the help that he needed before he committed this tragedy."

Barden said that the group has received feedback that its programs have helped prevent at least three school shootings.

He said a school guidance counselor told him that after taking Sandy Hook Promise training, a student at the school said something after the student saw a social media posting from another student that raised concerns. Barden said that officials were "able to uncover a very serious incident that was about to happen and they stopped it because of the model."

"I literally had goosebumps when this guidance counselor [was] telling me this story," Barden said. "To think that after all this work, we're making an actual difference — that's an incredible feeling for me. That’s the ultimate way to honor my little Daniel."