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Improving Mental Health and the Ability to Learn

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1 Improving Mental Health and the Ability to Learn
Introducing an observational checklist designed to explore and meet the social and emotional needs of children in educational settings.’ Kim S Golding

2 Overview Attachment Theory: A Recap
Helping the Child with Attachment Difficulties in School Supporting the Child in School Recognising the Emotional Needs of Children in School The Observational Checklist

3 “As adults we have a shared ethical responsibility in ensuring that all children and young people are experiencing safety, security and stability – whatever our role or context. Realising a pupil’s starting point and then intervening relationally and developmentally facilitates growth, enabling the pupil to engage with his or her thinking brain.” (Louise Bomber, 2012)

4 Attachment Theory: A quick recap

5 Sophie is a quiet but confident six-year old who enjoys playing with her friends. She likes mum to be around, but is able to amuse herself. She likes drawing and playing with her dolls. She was a bit alarmed when a wasp flew into the room however, and ran to mum for help. Mum made sure the wasp was gone. Sophie feeling safe readily returned to her playing.

6 When mum brings Sophie to school she is keen to meet up with her friends. Mum leaves her in the playground and she walks in to school with Louise, her best friend. Sophie appears happy at school. She is happy to share and works well in a group. She relates well to the staff. She happily follows the routines that are in place and is achieving academically. If she is frustrated she will appear cross but readily lets a member of staff help her. Generally Sophie is a co-operative, easy going child in school.

7 When Sophie reaches 10 years she is increasingly independent of the need for her mum to be available in the playground before school, she continues to work independently and as an active participant within group work, She is usually very responsive to teacher instruction

8 Internal Working Model
Secure Attachment NOVELTY Exploratory System STRESS Attachment System Parent: Sensitive Accepting Co-operative Accessible Child: Secure Base Proximity seeking Separation protest Internal Working Model Self: Lovable, effective in relationships Other: Safe, helpful, available

9 Internal Working Model
Insecure Attachment Child: Signals attachment needs in distorted way, expressing and hiding different needs. . Parent: Insensitive Rejecting Interfering Ignoring NOVELTY Exploratory System STRESS Attachment System Internal Working Model Self: Unlovable, ineffective in relationships Other: Unavailable, Unresponsive, Unloving

10 Disorganized-Controlling Attachments
Exploratory System STRESS Attachment System NOVELTY Child: Seeks to control the relationship to feel safe: Compliance, and caregiving Self-reliance Coercion and aggression Can’t focus on exploration or comfort seeking Frightening or frightened parenting: Potential for safety is also source of threat Internal Working Model Self: Fearful, angry, powerful/scared Other: Frightening, dangerous, alarming

11 How does this impact on behaviour in school?

12 Kelly is a needy six-year-old who has not yet learnt to play alone
Kelly is a needy six-year-old who has not yet learnt to play alone. She follows her parents around the house, rarely settling to anything. If a visitor arrives Kelly tries to insert herself between her parents and the visitor. Sometimes mum, exasperated by this behaviour, will insist that Kelly play by herself for a time. When Kelly sees the wasp enter the room she screams and shouts. When mum arrives Kelly clings to her. She will not settle even when mum shows her that the wasp has now gone.

13 Kelly is not confident when brought to school
Kelly is not confident when brought to school. She tends to cling to her parents and does not want to be left. Once they have gone Kelly ‘attaches’ herself to a member of staff. She is demanding and ‘attention-needing’. She talks constantly, often asking questions repetitively but not paying any attention to the answers. She likes to stay close to the staff member, not wanting her to go out of sight. She is possessive and jealous when other children want to talk to this member of staff.

14 Kelly will not work independently, always seeking assistance even when she does not need it. If working in a group Kelly quickly falls out with the other children, as she tries to stay centre of attention. If she falls or bumps herself Kelly is inconsolable, clinging to the staff member who comes to help her. By the time that Kelly has reached 10 years, she has developed skills in drawing funny pictures and making jokes and uses this to make her peers laugh and get adult attention, whatever the cost. At breaktimes she finds excuses to stay in the school and 'help' staff rather than mix with her peers.

15 Ambivalent Attachment Pattern
Expressed Need: I can’t trust in your availability. I need you to attend to me all the time. Hidden Need: I will not show my need to separate and explore. I will pull you in and push you away to keep you noticing me

16 In the classroom I will:
Be attention needing. Have difficulty taking responsibility for behaviour or for learning. Be the class clown. Have difficulty concentrating and focusing on work. Be hyper-vigilant to what adults are doing. Be hyper-aroused – loud, aggressive, talks a lot. Have difficulty following rules, learning from consequences. Have poor understanding of cause and effect.

17 The Learning Triangle (Geddes, 2006)
Pupil Preoccupied with relationship with teacher Unable to focus on task Teacher Task Unwilling to attempt task unsupported

18 Mark is an independent six-year old who makes few demands of his father. Mark will play alone, giving dad a bright smile when he comes in. He is also keen to help his dad, frequently checking he is okay and helping him with little jobs. When Mark sees a wasp come in to the room he keeps a wary eye on it but continues playing.

19 When dad brings Mark to school he enters confidently on his own, barely looking back as dad leaves. He follows the rules and routines making few demands on staff. He approaches other children but tends to hang back waiting to be invited to join in. He enjoys running around at the fringes of their games in the outdoor area. Sometimes he falls over, but generally just picks himself up and continues with the game. Mark prefers to work on his own. He lacks confidence but does not like to be helped. If working in a group he is quiet, tending to follow the lead of the other children. Staff rarely see Mark upset but occasionally when he is very frustrated with something he will ‘explode’ with anger. He resists staff attempts to help him and is quickly back to normal.

20 When Mark reaches 10 years, her remains seemingly independent within the classroom, his work output is usually the minimum required. Mark will just sit rather than ask for help from school staff. He continues to experience seemingly 'untriggered' outbursts from time to time.

21 Avoidant Attachment Pattern
Expressed Need: I will act like I want to explore even when I need comfort I will not show my need for comfort and reassurance Hidden Need: I will do it by myself, I fear my need of you. I will push you away

22 In the classroom I will:
Be withdrawn/quiet. Be self-reliant – reluctant to ask for help. Have inexplicable tantrums or outbursts – appear from nowhere, quickly over. Lack emotional engagement with other children and what is going on in the classroom. Appear isolated, or my friendships will lack depth.

23 The Learning Triangle (adapted from Geddes, 2006)
Pupil Avoids relationship to teacher Focus remains on task Teacher Task Denial of need for support and help from teacher

24 Daniel is an angry, hyperactive six-year-old who is exhausting to his mother. He is on the go all the time, playing loud active games. He frequently puts himself in danger and needs constant supervision. He is bossy, telling his mother what she must do. When she asks him to do something he ignores her. When Daniel sees the wasp enter the room he runs around chasing it. When mum tries to remove the wasp Daniel gets angry telling her to leave it alone.

25 Daniel arrives at school and everyone knows it
Daniel arrives at school and everyone knows it. He comes in loudly and tries to tell the other children what to do. When staff approach he becomes angry towards them. Difficult to contain indoors Daniel prefers to be outside, running around and chasing the other children. He does not like to come back indoors and it is difficult to help him adjust to being back in the classroom. Daniel does not settle to his work, he is too busy seeing what everyone else is doing. He can explode with anger, and often has to be taken out of the classroom. Occasionally he will spend time drawing – He likes to draw soldiers in battle, frequently with lost limbs and lots of blood, soon however he is running around again or fighting with one of the other children. When staff try to intervene they can be physically attacked.

26 When he reaches 10 years, Daniel will often run out of the classroom when he feels challenged by work or relationships. He has difficulty accepting teacher authority and will respond with verbal and occasionally physical aggression

27 Elaine is a quiet, withdrawn six year old who spends a lot of time in her bedroom. As her mother approaches, Elaine is vigilant, keeping an eye on her. At times she will approach her mother, as if to check that she is alright. She is very compliant, doing as she is told and urgently trying to help her mother with household jobs. When Elaine sees the wasp in the room she runs to mum and then quickly away again. She is clearly distressed, but appears confused about whether to go to mum for help or not.

28 Elaine arrives at school late.
She appears unconcerned when mum goes but remains hyper-vigilant, watching what is going on around her but not able to settle to her work either with or without staff. At other times Elaine appears quiet and ‘switched off’’ as she sits at a table paying little attention to what is going on around her. This behaviour pattern continues when she reaches 10 years.

29 In the classroom I will:
Show a diminished range of emotions – rage/terror. Often be scared but masked by anger/aggression or by becoming very withdrawn. Be disruptive or passively unco-operative. Be unable to concentrate, hyper-vigilant to surroundings. Be controlling in all relationships, interactions feel highly manipulative. Have a diminished capacity for enjoyment. Be dissociated or hyper-aroused much of the time. Be socially isolated or attracted to deviant peer groups. When older demonstrate compulsive behaviours eg self harm, drugs.

30 The Learning Triangle (Geddes, 2006)
Pupil Can’t relate to teacher. May seek to control teacher Extreme anxiety Task Teacher Trauma and fear interferes with relationship and attention to task. Fear masked by anger and aggression

31 Disorganized/Controlling Pattern
Expressed Need I will not need you. Needing you is dangerous I must be in control Hidden Need I can’t explore the world. I can’t seek comfort I am too busy checking I am safe

32 Helping the Child with Attachment Difficulties in School

33 The School Environment as a Source of Stress
Children have to tolerate long periods away from their attachment figure. Children have to share adult support with a group of other children. Children have to learn to manage peer relationships, dealing with friendship and conflict. Children cope with increasing demands for independence and self-organization. All of these tasks are more difficult for children with attachment difficulties.

34 Challenges in School Trusting and relinquishing control to adults.
Directing attention away from concern for safety so able to explore and learn. Recognising, naming and regulating emotions rather than displaying through behaviour. Being able to focus attention, to sit, to concentrate. Risking getting things wrong. Coping with feelings of shame and badness. Feeling special, significant, effective, and confident. Able to problem-solve, able to resolve conflict. Managing transitions.

35 The Shield Against Shame
Blame Its his fault Lie I didn’t do it Mimimize It wasn’t so bad Rage You always blame me. I’m rubbish

36 The Painting Lesson asked the new teacher. ‘It’s Mummy,’ I replied.
‘What’s THAT, dear?’ asked the new teacher. ‘It’s Mummy,’ I replied. ‘But mums aren’t green and orange! You really haven’t TRIED. You don’t just paint in SPLODGES -You’re old enough to know You need to THINK before you work …. Now – have another go.’ She helped me draw two arms and legs, A face with sickly smile, A rounded body, dark brown hair, A hat – and, in a while, She stood back (with her face bright pink): ‘That’s SO much better – don’t you think?’

37 But she turned white At ten to three When an orange-green blob Collected me. ‘Hi, Mum!’
The Painting Lesson by Trevor Harvey In Read Me. A Poem a Day, Macmillan Children’s Books, 1998

38 Assumptions Underlying the School Environment
Children will be able to regulate stress, with support. Children have the capacity for emotional literacy. Children have the capacity to manage shame inducing experiences. Children have the capacity to manage relationships. Children’s emotional, cognitive and chronological development are broadly similar. These assumptions are often not true of children with Attachment Difficulties

39 Behavioural Management Programmes
Children need approaches that are empathy and relationship based. Boundaries, limits and consequences occur in the context of highly warm, responsive, attuned and attentive relationships Recognition and support for the feelings underlying the behaviours, including shame, anxiety and fear which are masked by anger and aggression or withdrawal and dissociation. Need to recognise emotional immaturity.

40 Behavioural Management Programmes
Behavioural programmes will fail if: Children can’t regulate impulses – to think before acting. Children have poor causal thinking – don’t understand cause and effect. Children can’t generalize learning from behaviour that has led to a reward. Children don’t find relationships, and pleasing the teacher rewarding. Children quickly experience shame and put up a shield. Feeling in control and avoiding emotional connection are more important than praise and rewards Children are maintaining negative self identity – ‘I will show you how bad I am.’

41 Supporting the Child in School
Relationship, Relationship, Relationship

42 A School for Building Trust and Security
SAFETY Recognise fear and anxiety underlying behaviour. Communicate safety explicitly, provide place of safety in school. Meet and greet, support around all transitions. Clear structure, boundaries and routine, flexibly adapted to changing emotional age. Create school and class rituals. Provide and sustain a relaxing environment. Adults set the emotional tone. Provide support from adults as arousal increases. Encourage relaxation, calming strategies and sensory tools. Recognise the level of support the child needs, especially during times of transition during the day.

43 A School for Building Trust and Security
BUILD A RELATIONSHIP Key adult, build sense of belonging. Proactively engage with the child. Pay close attention to direct and distorted requests for help. Support child to regulate emotion. Support child to manage shame. PACE not anger or criticism. Pay attention to interactive repair and re-attunement following difficult times.

44 Communicate with PACE Playfulness – help child to experience enjoyment in the relationship Acceptance – Understand and accept the child’s experience. Thoughts, feelings, beliefs, desires are not wrong. Curiosity – Stay curious, wonder why. Empathy – Communicate acceptance

45 A School for Building Trust and Security
Connection before Correction Empathy first, co-regulate stress and arousal. Match affect to connect with child. Begin where child is, think young. Avoid control battles. Understand and communicate child’s experience before expecting them to think about others. Provide unconditional valuing of the child, whilst supporting feelings and containing behaviour.

46 A School for Building Trust and Security
SUPERVISION AND STRUCTURE Be clear, and appropriate for child (relate to emotional age). Help child to allow adult to be in charge. Provide appropriate time when child can feel in control. Celebrate child taking responsibility for behaviour. Limit and simplify choices and consequences. Help child to understand cause and effect. Celebrate good choices and/or learning from poor choices

47 Support for the Adults Look after yourself.
Those working with the child will need good support. Opportunities for reflection and planning. Good Supervision. Opportunities for training. Be aware of possibility of secondary trauma.

48 Therefore: Secure attachment gives the child the opportunity to feel safe, to trust, to relate, to be dependent and to be independent. The child with attachment difficulties has not had this experience. These children bring their fear, their lack of trust, their difficulties with relationships, their unfulfilled dependency needs and their struggles with independence into school. We need to provide school environments within which we can help the child to develop relationships and to feel safe and secure enough to learn.

49 “Any given day in school holds countless possibilities for learning
“Any given day in school holds countless possibilities for learning. Supportive opportunities provide the vulnerable pupils ... With an alternative lens through which they can interpret themselves, others and their home/school contexts. For these opportunities to be maximised, we need to facilitate real relationships between both adults and pupils. We need to listen well and engage in reflective practice.” (Louise Bombér, 2011)

50 Recognising the Emotional Needs of Children in School

51 Amanda Amanda strides out confidently, a little ahead of her mother. She looks eager to arrive. As they approach the playground she runs up to the gate. She gives a little look back to her mother, who gives a slight nod, and then runs in. By the time mum catches up with her she is already getting into line, chatting to the girl ahead of her. Her school bag has been dropped beside her. Mum picks it up and gently hands it back to Amanda. She reminds her to place it on her peg as soon as the teacher lets them in. Mum steps back and watches the teacher come out and organize the children. Amanda looks over to her mum and gives her a smile. Mum gives a quick wave and then watches as she walks into the classroom, bag in hand.

52 John John appears less confident. He walks with his father who chats to him about the day ahead and what he is going to do. They walk across the playground together and Dad guides him into his line. He does not want to take his place until he is sure that Dad is going to stand and watch him go in to school. Dad shows him where he is going to stand; and, settled now, John gives Dad a hug. He watches Dad as he moves to the side of the playground. The teacher comes out to organize the children. John looks over to Dad anxiously, making sure that he is still there. Dad gives a wave and watches as he walks into the classroom still looking over at him.

53 Nico Niko holds on to his mother’s hand, almost holding back as they walk up the road. When they reach the playground he falters, not wanting to go in. Mum bends down and encourages him on, giving him a light hug to reassure him that she will support him. Slowly they move across to the gate. Niko makes no attempt to go in or to join the line. Mum accepts this and stays with him whilst he gathers up his courage to move on. A teaching assistant comes up to support Niko. She encourages mum and Niko to follow her to the line where mum leaves him with her as they have agreed. Niko cries as she goes but allows himself to be comforted by the teaching assistant who keeps him close to her.

54 Emotionally Resilient Children
Amanda, John and Nico represent the range of individual differences that children can display emotionally and socially. The sensitive teacher adapts her approach tailored to the children’s individual needs. The children grow in confidence and security. They remain different from each other but each child is able to benefit from the experience of school.

55 Children with Emotional Difficulties
These children require a more specialised help within school. Recognising these children can be difficult because children show a range of individual differences.

56 Amanda and Karen Amanda is sociable, and confident. How can we distinguish her from Karen who also comes in confidently in the morning? Karen however is a little overly boisterous. Other children warm to Amanda but appear more wary of Karen, who can be controlling and domineering. When it is time for assembly, Amanda and Karen are keen to go in. Amanda walks into the hall, seeking out her friends to sit with, whilst being aware of where her teacher is. Karen rushes into the hall, pushing herself amongst the children. She takes no notice of the teacher as she demands that the child next to her move up a little.

57 John and Jack John is quieter, and more reserved. Jack also appears quiet and reserved, but when the boys are observed together there is a confidence in John that is not apparent in Jack. John will get on with the task in front of him, but as the adult approaches he is able to accept support and to go further in what he is doing as a result. He tends to gravitate to one or two of the other children, but is not overly concerned when paired up with a different child. Jack on the other hand is less easy to support, and progresses less well under the adults careful gaze. He finds it harder to adjust to children outside of his small group. When it is time for assembly, both boys will respond to the teacher’s instruction and move on into the hall. Jack however will appear more on edge during the assembly. He complies, with the teachers encouragement but is less comfortable doing so.

58 Nico and George Niko is shy and quiet. He needs extra support to cope with daily routines and to cope with change and transition. George also appears shy, but is much more clingy and needy of support. Neither Niko nor George will cope well with assembly. Niko however will cope as long as he is supported by a familiar adult whereas George is more likely to go to pieces, clinging to the adult until the assembly is over.

59 Amanda, John and Nico will thrive with sensitive, responsive adults, but Karen, Jack and George are more emotionally troubled and remain of concern to those supporting them. Therefore need to distinguish between the different but emotionally secure children and those who are more emotionally troubled, who will need different support.

60 Observational Checklist A tool to increase understanding and support for children’s social and emotional needs in school

61 Attachment Theory The development of the checklist is underpinned by Attachment Theory.

62 Amanda, John and Niko Experienced security of attachment.
Whilst they all approached school differently they each could use their parent to support them to make the transition to school. They could transfer this ‘secure base’ to the teacher or teaching assistant and therefore be supported to manage the day away from the parent.

63 Karen, Jack and George Do not have security of attachment.
Less able to draw security from parent to make the transition to school. Struggle to use teacher/teaching assistant as a secure base in school. Impacts on feelings of safety and security. Impacts on emotional development and social development Impacts on learning.

64 When we do not feel secure we become preoccupied with the need for safety, and this makes it much harder to face outwards to the world, to enjoy challenges, and to learn and develop new skills.

65 Identifying the Emotionally Troubled Child
Behaviour: understand the child and how he copes with different situations. Progress: is the child making good social, emotional and learning progress? Contextual experience: knowledge of the child’s current and early experience at home and school.

66 Identifying the Emotionally Troubled Child
The observation checklist can guide staff to observe behaviours and monitor progress of children. This interpreted in the light of contextual information can inform the support that the child is given. In this way the emotionally troubled child can be identified and appropriately supported.

67 All behaviour is a communication of need.
Who is this book for? All Early Education settings, (appropriate from age 2 years to end of Foundation stage at 4 years). Schools - Children aged 5 – 11 (sometimes beyond). Anyone who wishes to reflect on a child’s emotional needs using Attachment Theory to guide interventions and help them to be measurable. All behaviour is a communication of need.

68 Contents: The Checklist
The observation checklist Detailed guidance for completing and analysing the observations made with the checklist Worked examples of the observation checklist: Chloe and Jacob Suggestions for developing an action plan to meet the needs identified

69 Contents Supplementary Information
Attachment Theory & Child development Helping the child with attachment difficulties in school Supporting children with multiple difficulties – when attachment difficulties co-exist with other difficulties including learning difficulties, ADHD, Autism, Sensory integration difficulties. Glossary, further reading and useful websites

70 The aims of the checklist:
Highlight Emotional Needs of child Reflect & Unpick Behaviours To consider further strategies To support adults to make interventions measurable To inform & sit alongside other assessment tools

71 The contents of the checklist
The key person considers a child’s behaviour in the following 5 areas: Behaviour Play & relationships with peers Attachment behaviours Emotional state Attitude to attendance in early years setting Observations & notes Strategies Key Person

72 Supporting Evidence and Comments
1. Behaviour checklist Almost always Sometimes As child of same age or stage of devpt. Almost always What is child’s behaviour like? Resists boundaries, non- compliant√ Overly compliant, accepts boundaries with little fuss Difficult behaviour that is overly challenging Passive but difficult behaviour that is expressive subtly Unpredictable, easily triggered emotional outbursts Appears very self- contained, too good Attention, concentration and activity levels? Loses concentration easily Concentration can be intense, becomes absorbed in tasks, hard to interrupt I mpulsive, often acts without thinking Overly controlled, rarely impulsive Restless, highly active Less active than expected. Supporting Evidence and Comments

73 Helping the child with attachment difficulties in school
Raising awareness of attachment needs. Building relationships. Supporting key person role. Reflect on emotional needs and ideas for meeting these needs. Model relationship building activities. Plan with the network

74 A Case Study. J – 9yrs old Request for support –
“J is currently struggling with his numeracy in school. When he struggles he puts up a barrier and will not try to take part in the subject. His Mom and teachers feel that he would benefit from some support to build his confidence with numeracy to help him begin to access the subject and enjoy and achieve within lessons. Teachers also feel that they would benefit from advice as to how to best support him with this in the daily numeracy lessons.”

75 Although his behaviour is not overly challenging to staff it is clear that he:
Frequently loses concentration Occasionally resists boundaries Sometimes seems restless and highly active.

76 Less interested in relating to peers than typical – support to develop relationships?
Play behaviour is immature – need more adult support? Can sometimes become over excited by a task and become competitive and needing support when he does not “win”.

77 J seems to experience security with parents but struggles more away from them – he needs a substitute attachment figure in school to help him to cope with school and being away from his parents. He needs support and attention from teachers to feel settled and engage fully in learning – this is why he prefers to be close to an adult and talks a lot.

78 J presents as a child who hides feelings and sometimes it might be hard to know how he is feeling - it may be because he needs a little help to recognise when he is anxious and support to express how he feels. Sometimes in contrast he might appear overly worried or happy – but at these times it was noted that he struggled to talk about his feelings and found it tricky to become calm again.

79 This supports the thought that J was experiencing general anxiety about school and on occasions was not coping well. Taking the overall picture from the checklist it is clear that J can often show signs of anxiety and will benefit from extra support in school. This anxiety is particularly apparent to teachers when it comes to taking part in numeracy lessons but the checklist reveals a more pervasive pattern of anxiety in school.

80 Actions planned; School allocated a Key TA for J Attachment Training for Teacher and Key TA. Relationship Based Play support for TA – building her relationship with J. Numeracy sessions replanned – using rel based play, 1:1 instruction from TA, whole class working. ISL Direct Work with J teaching Protective Behaviours Strategies to help him to recognise anxiety and build strategies for managing it.

81 Impact of using the Observational Checklist?
Staff became more aware of J’s anxiety in school and how this was impacting upon his learning and enjoyment of school – particularly concerning numeracy. The tool helped to show staff why traditional support methods that they had tried were not working for J at that time. Staff developed a greater understanding of J as a whole child and could meet his emotional needs more fully. J began to feel more settled and happy in school – his esteem grew as he learned to take control of his feelings using the strategies that he was learning. J began to take part in numeracy with enjoyment and success – declaring it “easy-peasy”.

82 Case Example Two S. is 6-years-old. Removed to foster care 1-year-old
She was adopted with her elder sister 11 months later. Birth parents had learning difficulties and a volatile relationship. Early care was chaotic, inconsistent and neglectful Sarah has always been delayed reaching developmental milestones

83 Behaviour

84 Behaviour Attention Needing –anxiety is raised when S. perceives that attention does not appear to be available. S. strives to control her environment in order to feel safe. Fear driven – that attention may not be available or may go away. Doesn’t always understand what is required of her – risky, challenging, scary. The intention of all behaviour, positive or negative, is to get her needs met. Outbursts occur when Sarah struggles to regulate her emotions and needs. Hypervigilant, High levels of anxiety

85 Behaviour with other children

86 Behaviour with Other Children
No secure base to support exploration – she doesn't feel safe in school Socially immature and confused by unwritten rules Difficulty in taking turns and sharing Low self-esteem Feeling out of control will lead to feelings of wanting to feel powerful/ in control

87 Play Behaviour

88 Play Behaviour Hypervigilant – may be focused on keeping an adult engaged or knowing what adult is doing – attending to play may be difficult Poor right brain/left brain development In control of own world

89 Attachment Behaviours Separation and Reunion

90 Attachment Behaviours with familiar adults

91 Attachment Behaviours with unfamiliar adults

92 Attachment Behaviours Minor Hurts

93 Attachment Behaviours
S. appears to find it extremely distressing when leaving her parents. Extreme separation anxiety which leads to her dysregulating on a regular basis. Sarah's 'default' behaviour appears to be along the Avoidant Attachment style – this is where she finds the intimacy of relationships and eye contact threatening. However, she also very anxious about keeping the adults around her close. Therefore, depending on her emotional state during the day she will push adults away or try to draw them close –often inappropriately or in a confused way. – disorganized presentation.

94 Attachment Behaviours
S. has learned to do things for herself and has learned self-reliance. She may have learned to self-sooth and may appear independent from adults. S. is fundamentally untrusting of adults May focus on something else to manage the anxiety of caregiver leaving them. In order to feel safe S. will strive to control her environment.

95 Attachment Behaviours
S. may find safer not to respond or engage with others and prefer to remain invisible. She may not necessarily seem distressed, even though she is highly anxious. S. may find the intimacy of eye contact threatening Lacks social competence

96 Attachment Behaviours
S. may be suffering extreme emotional distress when hurt, and needs to maximise the opportunity to engage the adult. Although she appears not to need comforting, she is unable to regulate her own emotions – pushing the adult away but still needing comfort. Very confusing for the adult. May be disassociating when stressed.

97 Emotional State

98 Emotional State Display Feelings

99 Emotional State Confused emotions - mood swings Easily shamed
Energy used up on anxiety Low self-esteem Emotional outbursts – holding in emotions that 'spill' over Dysregulates quickly S. may want to control her environment to get predictability

100 Emotional State Empathy hasn't yet developed.
Sarah doesn't really understand social inferences/rules - Misunderstands verbal cues Feelings of worthlessness may provoke rage. She may want to get feeling of being powerful Vents anxiety Not able to verbalise feelings – may react physically.

101 Attitude to Attendance

102 Action Plan



105 Outcome Emotional difficulties recognised alongside learning difficulties. Action plan implemented. S. responds well to a high level of structure although continues to demonstrate her need to control. She responds better to relationship support than behavioural strategies. Anxiety reduces. Requires long-term support

106 Much of what these pupils need to learn can’t be learnt alone through textbooks. They need you and me. Relationships matter. In school let’s take up our responsibility in ensuring that these pupils experience healthy secure attachment in our care so that they can be all that they can and want to be, making valuable contributions towards our shared society . (Louise Bomber, 2012)

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