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Rights, Support and Wellbeing Team

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1 Rights, Support and Wellbeing Team
Nurture Approaches PiNS October 2014

2 Aims Re-cap of the importance of ‘connectedness’ on the development of social and emotional wellbeing Introduction to Nurture Outline of 6 key principles Nurturing Schools Resource Focus on Secondary Outline of Resource Next Steps

3 Off to a Good Start The brain is shaped by complex interplay of genes and experiences which starts at the point of conception - nature and nurture! The care received as a baby strongly influences the way in which the brain ‘wires’ itself For social and emotional development the most crucial influence is the emotional connection with the care giver – the ‘attachment relationship’ Sensitive and secure interactions and experiences are linked to a wide range of positive outcomes – and, of course, the opposite is also true How does a human baby develop into a physical, psychological, social and emotional being? This is a big and complex subject and our understanding continues to develop and be shaped by an increasing array of research findings. Nature or Nurture? The human brain develops from the interaction of genetically inherited characteristics (nature) and experiences (nurture). It is generally agreed that it is a complex interplay of both that are required to shape the brain and develop the individuals personality, characteristics and skills. These two influences start to shape the brain from the point of conception. It is important to understand that humans develop within a context. The psychoanalyst Donald Winnicott (1996) famously stated that ‘there is no such thing as a baby’ by which he meant that we can only ever understand a baby in relation to the minds and behaviours of those around it. The influence of the environment starts in utero where the developing foetus will be subject to hearing different sounds, smells and be subject to different rhythms. This experience (in utero) influences their preferences once born; for example, research has shown that newly born babies prefer their mothers voice over that of others and prefer similar sleep patterns to their mother. Brain development is ‘experience dependent’ and differs according to the kind of experiences one has. At birth, babies are born with 100 billion brain cells called neurons that need to be ‘connected’ or ‘wired’ to each other. In the first year a babies brain doubles in weight. Between six and twelve months there is a burst of brain development – this is happening at the same time as attachment bonds are being made! Brain development is also ‘experience expectant’ and needs certain input to develop for example, a baby needs exposure to language for their language skills to develop. The absence of certain human input can have devastating consequences. Many examples of ‘wild’ or ‘feral’ children are cited in the literature reared without human contact and do not have the skills and abilities to function socially. Genes are important too. They are responsible for forming the neurons and general connections in brain; but it is the experience from the environment that is responsible for building the connections between the neurons. The type of care a baby receives plays a big role in how the brain chooses to wire itself. For example: Genetically a baby can inherit a variant of a gene that predisposes them to be more novelty seeking and increases the likelihood of developing ADHD (Belsky, Bakermans-Kranenburg & van Ijzendoorn, 2007a) however, this is not a straight forward linear relationship and even if you have this variant you will not necessarily develop this trait. If a child has this gene and receives insensitive parenting then they are more likely to receive a diagnosis of ADHD (compared to those who received sensitive parenting). Genetic influences increase the likelihood of ADHD but the form of parenting determines whether genetic potentials become a reality. The development of social and emotional skills in later child hood is closely associated with the relationships between the baby and caregiver. Re-cap: The interplay between genes (nature) and experiences (nurture) starts at the point of conception. Activity: Nature or Nurture? Discuss: Which is more important: Nature – characteristics we have inherited? Nurture – the experiences we have and the environment in which we live?

4 Parental responsiveness
Solid Foundations Safety from harm; good nutrition; physical support; gentle touch; good predictable daily routines (sleep) Physical Needs Stimulation - people, moving objects; consistency and continuity in care; world safe and predictable; Emotional Needs Sensitive Interactions; responsive to needs; fun; consistency; holding and re-assuring; connectedness Parental responsiveness What are the optimal factors needed for good quality attachments/interactions to develop? Physical Needs: Babies need a safe environment. Touch is a fundamental and important source of security to a child. When the skin is touched, a signal is sent to the brain to grow and make connections. Babies and young children feel security through the gentle touches carers give as well the positive consistent responses for his needs for food and comfort. Predictable daily routines. Emotional Needs: Parental Responsiveness: Babies need carers to be warm, consistent, sensitive and responsive to their needs e.g. picking up baby when it cries; holding and re-assuring them; looking at the baby with warm, loving smiles, INSERT CONTACT PRINCIPLES ______________ Activity: Solid Foundations Discuss: What do babies need to: Physically grow Emotionally grow Socially grow Activity: Shaky Foundations Discuss: What might make these responses more difficult for caregivers? drugs, alcohol, mothers mental health, stress ; mothers attachment style; ill health (e.g. post natal depression); bereavement, poor relationships, finances, divorce, social isolation, age of mother Poor experiences such as insensitive interactions have found to have devastating effects on the brain and the development of social and emotional skills. When children are stressed, a hormone called cortisol is released in the brain. This "stress" hormone slows down the number of the connections in the brain and affects the region of the brain that regulates emotional response and attachment to be smaller than normal. It is thought that this has most effects on the developing feotus between 12 and 22 weeks of gestation. High cortisol /stress levels in mother during pregnancy leads to low birth weights and smaller head circumference of baby. The strongest predictor for children being insecurely attached is having a parent who is not securely attached themselves (Fongagy, Steele and Steele, 1991) ‘Foetal programming’ – WW2 food shortages *remember maternal stress is linked to economic and social factors – ‘trasngernerational‘ factors Need to support pregnant mothers especially in deprived areas There are many possible causes of having a shaky start to the bonding process A parent may love a child but cannot provide adequate food, physical care and protective from dangers. This child may ‘fail to thrive’ which can lead to developmental delay and malnourishment. When a parent is suffering from the effects of earlier trauma in their own life, or when family events during the baby’s early years are traumatic, early relationships can be damages as the parent is unable to respond sensitively to the child. Many parents love their child but are sometimes caught up in their own negative life situation.

5 Attachment Theory ‘connectedness’
Develops automatically without exception Refers to a ‘special’ bond of affection Helps infant make sense of the world around them. Two functions 1. security and 2. safety provides emotional security (secure base) and protection against stress (safe haven) Attachment style: is a coping strategy – the infant’s main goal is to stay safe and keep caregiver close is a direct consequence of the caregivers behaviours towards the child (e.g. nurture) predicts social and emotional skills in later childhood Attachment theory describes a framework for understanding relationships between humans from birth through to adulthood. An informed understanding of this framework is crucial for those working with children as it underpins any positive approaches used to support children and young people and allows professionals to consider risks and protective factors in social and emotional development. Attachment theory, as outlined by John Bowlby (1969; 1973; 1980), has had a significant and permanent impact on a number of areas including; child care policies and practice; hospital care for children; fostering and adoption considerations and early years care and education. Attachment is central to the work of Social Workers, Child and Adolescent Mental Health Workers, Family Support Workers and Early Years practitioners. Bowlby’s early studies arose from his work in the 1940’s and 1950’s on the long term developmental impact on children who had been separated from parents for long periods (e.g. war evacuees) or children who has suffered emotional adversity in childhood. His observations (and that of others) convinced him that these children (with disrupted mother-child relationships) went on to suffer range of behavioural, emotional and mental health difficulties that he suggested were directly connected to their early losses/difficulties. Along with his colleague James Robertson, he documented that children experienced intense distress when separated from their mothers, even if they were fed and cared for by someone else (Robertson & Bowlby, 1952 cited in Slater, 2007). Mary Ainsworth was also central to the development of attachment theory. She developed the idea that the infant uses the attachment figure as a ‘safe base’ to explore the environment. She developed the ‘strange situation’ as a procedure to assess a child’s security of attachment. Ainsworth et al. (1978) proposed three attachment categories; securely attached (B), anxiously attached avoidant (A) and anxiously attached ambivalent/resistant (C). More recently a fourth, disorganised attachment (D) has been added. ‘Attachment’ occurs automatically and without exception and is an outcome of early care. It is a special bond of affection which we feel for a selective number of other people. It is normally formed between a baby and his/her primary carer. The carer is usually (but not always) the mother or father. It is through and attachment to a primary carer (allowing the infant to feel safe, protected and nurtured) that a growing infant gains understanding of how the world works, how relationships are conducted, how to make meaning out of what is happening to him and of the way people behave. Our attachment provides emotional security and protection against stress. Attachment is about security and safety. The attachment figure is both 1) a secure base from which infants can explore the environment around them and; 2) a safe haven to whom they can return to in times of stress. The key feature of an attachment (as compared to other relationships) is the seeking of proximity to the attachment figure when experiencing distress. When feeling stressed, frightened, tired or sick, children and young people seek physical closeness to their attachment figure. They want to be as close as possible – both physically and emotionally. The younger the child, the closer they will physically want to be (and for longer periods of time). Even as adults we have a need to be near our attachment figures when under ‘stress’ (in many cases our partner becomes our attachment figure). All children and young people attach to adults who take care of them but the quality of the attachment varies. Attachment develops as a direct result of the relationship between the baby and their attachment figure(s). The framework emphasises the interaction of the baby, caregiver and environment. Most caregivers are highly alert and sensitive to their baby’s physical and emotional states – this reciprocal response to the baby is organised around the goal of keeping the baby safe. Attachment style is a copying strategy and a means for survival. In particular attachment develops as a response to the carers behaviour when the baby is distressed (e.g. ill or upset). From about 6-moths babies are able to anticipate and predict their carers behaviour towards their distress. The behaviours that allow the infant to survive within their environment and get their needs met are the ones that they will hold onto. All babies are hardwired to smile at the human face however this innate response can be over ridden by experience. Indeed, for some babies being ‘happy and smiley’ may be the behaviour that elicits the best reaction from their caregiver however, for other babies crying may be better and for others shutting down (e.g. keeping very quiet) may be the behaviour that works best. Children who have experienced sensitive care responsive to their emotional needs are more able to manage their own feelings and behaviour. Children who feel safe and loved are more confident and more able to relate and interact with others. Re-cap The attachment children have to their parents, particularly as babies and toddlers, is fundamental to the development of social and emotional skills. Video Clips Recommended Reading References Ainsworth, M., Blehar, M., Waters, E., & Wall, S. (1978). Patterns of attachment. Hillsdale, NJ: Lawrence Erlbaum. Bowlby, J. (1969). Attachment and loss: Attachment. New York: Basic Books. Bowlby, J. (1973). Attachment and loss: Seperation. New York: Basic Books. Bowlby, J. (1980). Attachment and loss: Loss. New York: Basic Books. Slater, R. (2007). Attachment: Theoretical Development and critique. Educational Psychology in Practice, Vol. 23 (3)

6 Cycle of Secure Attachment
Express need e.g. crying Need is met consistently, promptly, reliably Feel relaxed, soothed Distress, displeasure, stress Secure Children: Better language Better learning Positive self-beliefs Good relationships More sociable Ready for school Cycle of Secure Attachment: Cycle of Secure Attachment: Distress or crying leads to prompt, predicatable, reliable soothing In the first days and months of life, the baby expresses his need for food, attention and comfort. As the mother soothes her baby and meets his needs a bond of trust develops through touch, eye contact and smiles. If this cycle is repeated over and over again and the baby gets a consistent response from caregiver, who shows appropriate caregiving responses, the baby will learn to calm, reduce stress levels and learns over time that adults are predictable and reliable. This allows the developing child to see the caregiver as a ‘safe base’ and from this they start to widen their experience, explore and learn about the world and others. This cycle is supported by attuned behaviours like good eye contact, smiles, touch. Children securely attached are ready for school: Feel secure, will trust their teacher, will be responsive Will understood cause and effect Will recognise emotions in themselves and others (Theory of Mind) Can tolerate not succeeding Find school stimulating and not overwhelming This type of secure attachment leads to better outcomes for children including: Language: development & understanding develops earlier Better able to learn Have positive self beliefs (self esteem) Develop real ‘partnerships’ / attachments More outgoing and sociable Ready for school

7 Cycle of Insecure Attachment
Express need e.g. emotional comfort Need is not consistently or appropriately met Feel anxious, restless and fearful Distress, displeasure stress Insecure Children: Poor language Poor learning Poor self-beliefs Poor relationships Un-sociable Risk taking NOT ready for school Insecure Attachment Cycle: Insecure attachment cycle: Distress or crying leads to unresponsive, unpredictable and unreliable soothing As you compare the Secure Attachment Cycle to the Insecure Attachment Cycle, you can see how the baby has a need, cries, but this time, the need is not met by his mother (primary caregiver). Sometimes, the need is met but it is inconsistent, or there are different caregivers who are not attuned to this particular baby. Sometimes the baby's cries go unanswered as in the case of neglect or the baby's cries are met with a slap as in the case of physical abuse. Whatever the cause, the baby's needs are not met in a consistent, appropriate way In the first days and months of life, the baby expresses his need for food, attention and comfort. If the baby gets no response or an inconsistent response from his caregivers he does not learn to trust and bond with them. Because a baby’s needs are so basic and so all consuming (he has no way of working out how to get what he needs by acting differently) he becomes, and remains, highly aroused and distressed when he needs attention. The attachment figure cannot just be PHYSICALLY PRESENT, the child has to believe the figure is available to meet their needs. In some cases parents are unable to be there in both ways for their children. Some are looked after, some are in homes where there is alcohol/drug misuse, some are emotionally neglected but have material care. It is important to note that being emotionally unavailable and unresponsive can lead to as much anxiety and distress as physical absence of the caregiver. The insecure child who has to learn to defend himself against threat, inconsistency and incomprehensible behaviour on the part of his carer will be more likely to block out his natural developmental challenges. They are a luxury he can’t afford – he has to focus his attention on having his basic needs met and he is forced to adapt his behaviour accordingly in ways which may limit and distort his natural, healthy desire to grow and to learn. This type of secure attachment leads to poor outcomes for children including: Poor language Poor learning Poor self beliefs Poor relationships Poor social skills Risk taking behaviours Not ready for school Children with insecure attachments are not ready for school: Fragile sense of self Blocks out developmental challenges Can’t regulate emotions Can’t tolerate not succeeding Wide range of behaviours Poor attention, can’t follow instructions, don’t trust anyone, can’t get along with others School is scary and overwhelming The ability to regulate emotions and behaviours in the context of developing relationships is an important prerequisite skill required for school readiness and academic success. Emotional, social, and behavioural adjustment to school is just as important as cognitive and academic preparation. Children who cannot pay attention, follow teacher directions, get along with others, or control negative emotions do relatively poorly in school. Insecure children are anxious, hypervigilant and as a result cannot engage in exploration, play, learning & dealing with others for reasons other than protection. Children who experience continuous regular or high levels of anxiety (for whatever reason, e.g loss of figure, fear of being away from figure –not being kept in mind or not experiencing people as being responsive to their needs), will have less time & energy to benefit from opportunities in class for exploration, being curious, interested in learning etc.

8 Internal Working Model
Attachment relationships create an ‘Internal working model’ Guides our behaviour in all future relationships Largely unconscious (memories, expectations) but demonstrated by child through behaviours Our attachment style is re-enacted in relationships with others – we ‘normalise’ our own parental relationship Internal Working Model Bowlby (1969) proposed that the organisation of the attachment involves a cognitive component in the shape of ‘mental representations of the attachment figure, the self and the environment (e.g. the cognitive representations of the attachment). He referred to these representations as the ‘internal working model’ and suggested that this (unconscious mechanism) was the foundations for all subsequent relationships. Our attachments are formed very early on in our lives and it is those primary attachments which enable us to form subsequent relationships. Children who have warm, satisfying early relationships internalise this experience and use it to regulate their feelings and guide their subsequent behaviours. Internal working models are the cognitive representations of early attachment relationships. It is now widely accepted that these are memories and expectations that children carry into new interactions with others. These models serve as a basis for understanding current and future interactions and help the child evaluate, predict and choose (what they think are) appropriate behaviours. The internal working model affects how the child interprets events, stores information in memory and perceives social situations. These internal models are not consciously available to the child i.e. they don’t know they feel this way about themselves, carers and the world. But they demonstrate this experience through their behaviours. In essence we ‘normalise’ our own parental relationship into our relationships with others. Activity Recap Children’s later relationships with others are significantly influenced by the nature of early attachment patterns with caregivers. References Dodge, Bates & Petti, 1990 Further Reading Video Clips

9 Secure Internal Working Model
Self: I am good, wanted, worthwhile, competent, lovable, interesting, effective My carers are responsive to my needs, sensitive, caring, trustworthy The world is safe, I can trust others, I can seek comfort from others, Secure Internal Working Model The internal working model of children with a secure and warm attachment relationship will allow the child to feel loved and valued and this is internalised and guides their future behaviours towards others. A secure, positive internal working models allow children to develop positive beliefs and expectations about themselves, relationships & life in general. Activity Recap References Further Reading Video Clips

10 Insecure Internal Working Model
Self: I am bad, unwanted, worthless, helpless, unlovable, ineffective My carers are unresponsive to my needs, insensitive, hurtful, untrustworthy The world is unsafe, I cannot trust people, others will let me down, I must be on my guard Insecure Internal Working Model The internal working model of children with insecure attachment include negative self evaluations and self contempt. They internalise lack of adequate care, love , protection, as self blame and perceive themselves to be unlovable, helpless and responsible for maltreatment. An insecure, negative attachment relationship has been found to lead to misinterpretation of social cues and the tendency to attribute hostile intentions to others (Dodge, Bates & Petti, 1990). This model is carried into adulthood and many therapeutic interventions are often focused on helping adults challenge and change their ‘internal working model’. Can you imagine if you are constantly driven to emotionally protect yourself? Anger, violence and lashing out might be the way you would behave. For many children their behaviour is a means of emotional survival. Activity Recap References Further Reading Video Clips

11 The Stress Response System
Attachment relationships develops our stress response system Initially caregiver acts as external stress regulator – manages and contains emotions Internal regulation develops over time in response to discomfort via patterned, repetitive, moderate activities Leads to self understanding & management of emotions – i.e. self regulation What is the Stress Response System? Our stress response system (is a bit like our immune system) guides our reaction to stress and the ability to recover from stressful events and situations. Our brains have a widely distributed network of systems that receive input from both our senses and our bodies. This stress response system is always monitoring these sources of information for potential threats or needs. For example, internal receptors in our body lets us know if we our blood is low on glucose by making us hungry. Likewise, if we spot a stranger with a gun we feel fear and adrenaline will start pumping preparing us for fight or flight. We rely on this system to keep us safe from danger. The ability to respond to stress and control this response is a crucial aspect of development. Babies ability to manage stress develops gradually and takes until around 4-years to be in place. Exposure to stress and the ability to manage stress is essential for optimum health and wellbeing. How does it develop? The stress response system develops by 1. being exposed to stress and 2. how we are supported and helped to recover from stress by our caregivers i.e. being soothed, held and being made to feel safe in early years. Our stress response system develops as a direct consequence of our early years attachments and the responsiveness of the caregiver to manage and develop ‘stressful’ situations. An infant has no experience of the future or the outside world so they experience their needs as being overwhelming. New experiences are initially perceived as a ‘stressor’ (source of stress). The ‘sensitive-enough’ caregiver understands this and can support the baby to bear the anxious feelings of discomfort. The baby needs to feel that their distress is understood through the communication (e.g. verbal and non-verbal behaviours) received from their caregiver (e.g. comforting, holding, responding, touching, eye contact, signing rhymes). In this way, the caregiver is acting as the external stress regulator, managing and helping the baby deal with their emotions - this is known as ‘emotional containment’ and in the early stages of infant development it is important that the caregiver ‘contains’ the discomfort that the baby is feeling. Initially babies need to experience emotions being managed and contained so that they learn not to be overwhelmed by experiences or stressors. However, over time, small amounts of stress to new situations and unfamiliar experiences is required to help the brain develop and learn how to deal with these situations. Frequent activation of the stress response system is necessary for learning and healthy development. The stress response system needs to be activated in small moderate ‘doses’ so that it can become stronger over time (Szalavitz & Perry, 2010). It needs the right kind of exposure to stress to develop strength and resilience. Only with thousands of repetitions of little doses of stress do these neural networks become ‘strong’ – and so when it later needs to respond to large stressors it is much more able to cope. Normal child-parent interactions provide these small, manageable dosses of ‘stress’ that are essential for the development of the stress regulation system, self regulation and the development of social and emotional skills. Activity Recap The attentive care received in the first few months of life develops the babies capacity to ‘self regulate’ – that is to control responses to feelings, thoughts, and experiences. References Szalavitz, M., & Perry, D. B. (2010). Born for Love: Why empathy is essential – and endangered. New York: Harper. Further Reading Video Clips

12 The roots of empathy develop from soil of stress response system and flourish into empathy and self regulation (Bruce Perry, 2010) The stress response system is the initial building block that allows self regulation and empathy to develop. These systems are interdependent and develop together.

13 Negative Effect of Stress
Mild, predictable stress is essential Prolonged, severe or unpredictable stress can alter the brain’s normal development Under stress the brain releases high levels of ‘cortisol’ This can lead to a range of negative outcomes affecting learning, social and emotional development Brain is wired to survive – it cant focus on cognitive activity when ‘stressed’ and cortisol levels are high Learning cannot occur if the child is in either a persistent state of arousal, anxiety. When in this state, the key parts of the cortex are only receptive to cognitive information that is relevant to survival. Keep looking for Sabre-tooth tigers!! Effect of Stress on Development Babies need exposure to mild, predictable stress to develop their stress response system (and thereafter self regulation and social and emotional skills). Exposure to prolonged, severe or unpredictable stress can alter the brain’s development. Negative looks, loud angry voices and hostile attitudes from caregivers can result in a biochemical response in a baby’s brain releasing the stress hormone cortisol. Cortisol is linked to a range of negative outcomes including: lowering the child’s immune system; impairing the ability to learn and relax; impairing the ability to store and retrieve memories; adversely affecting the part of the brain which is responsible for reading social cues and adapting behaviour to social norms. Repeated exposure to high levels of cortisol changes the way the brain develops and processes information. Raised cortisol is linked to heightened activity on the right frontal lobe of the brain which generates anxiety, fearfulness, irritability and withdrawal from others. At times of stress when cortisol levels are high the brain will not be able to focus on learning tasks. The brain is wired to focus on survival. It can’t (and won’t) focus on any cognitive activity when stressed. Activity Recap The attentive care received in the first few months of life develops the babies capacity to ‘self regulate’ – that is to control responses to feelings, thoughts, and experiences. References Szalavitz, M., & Perry, D. B. (2010). Born for Love: Why empathy is essential – and endangered. New York: Harper. Further Reading Video Clips

14 “Research demonstrates that investing time and resources into improving relationships and behaviour in establishments leads to positive outcomes around inclusion, engagement and achievement in the short term and community safety and cohesion in the long term.” Better Relationships, Better Learning, Better Behaviour, SG, 2013 Children’s social emotional and mental wellbeing is critical to school success and attachment is the foundation of social and emotional wellbeing. Therefore schools can be more effective if we understand how attachment influences young people – in Scotland we do this through C4E and in particulat the Health and Wellbeing Responsibilities for All guidance So when children feel safe and secure with staff in schools, learning is optimal and children are most likely to get the most out of their learning environment

15 Why Nurture Approach? Whether young people feel connected to a school depends on the structure of the school to present opportunities for meeting their: attachment and; social and emotional needs Nurture offers a framework informed by theory to support these needs. Children’s social emotional and mental wellbeing is critical to school success and attachment is the foundation of social and emotional wellbeing. Therefore schools can be more effective if we understand how attachment influences young people – in Scotland we do this through C4E and in particulat the Health and Wellbeing Responsibilities for All guidance So when children feel safe and secure with staff in schools, learning is optimal and children are most likely to get the most out of their learning environment Developed by Marjorie Boxall as a response to needs in London 1969 Addresses barriers to learning arising from SEBD in an inclusive, supportive manner Balance of learning & teaching, affection & structure delivered within a home like environment Children are not limited in ability but have missed out on early experiences that promote good emotional development

16 What is Nurture? Reliable adults who have time to respond (connectedness) Adults who respond sensitively to needs (external stress regulator) Predictable, consistent, routines and interactions (patterned, repetitive activities) Some degree of dependency from secure base (exercise the stress system) Challenge to negative internal models

17 Nurture Principles

18 1. Learning Understood Developmentally
Staff K&U of social, emotional development & attachment on brain Get to know the child Think young! Assess needs not skills for age Explore background Use of standardized assessment tools /tracking & monitoring Respond to child ‘as they are‘ not as ‘they should be’ Offer a range of experiences Think young- child social and emotional age, not chronological Avoid “should” assumptions Think about short term versus long term Know the background of a young person and what part it has played- experience, opportunity, trauma etc Check expectations of ourselves and others Be aware of the factors that support a child to be resilient “second chance learning” through attachment figures What bits of social development has this child missed and with what impact, what bits might they need to relearn- in school, as part of our focus on health and wellbeing “this child should be able to do this” –why- normally comes from a narrow frame of reference- eg why should a child be able to use a knife and fork if they have always eaten their supper off their knee Nurturing School Nurturing schools have a high level of staff awareness and training about attachment and brain development The practice of staff will reflect the belief that nurturing relationships bring about meaningful change Nurturing schools understand where children and young people are developmentally, and offer differentiated opportunities for social and emotional learning of specific skills Nurturing relationships are modelled by staff and respectful, consistent and positive interactions are clearly identified as the appropriate communication style within the establishment Expectations are reviewed in the light of what we know about an individual’s development and appropriately challenging targets are set for progress and shared with all staff who work with the child/ young person.

19 2. Safe Base The environment is welcoming, safe, structured and predictable - great attention is paid to detail! Good provision of safe spaces (inside and out) to support emotional regulation Boundaries are set and delivered clearly, fairly and with sensitivity (emotional warmth) Adults are reliable and consistent in their approach to the children acting as ‘parent surrogates /mentors’(Ainsworth, 1995) The YP feels secure & comfortable and can move from safe base to explore therefore allowing increase coping strategies and engagement in learning Pupils need to retain contact ‘in person’ or ‘in mind’ Nurturing School There is a welcoming and safe environment for all, that is, parents/carers, pupils and staff, which encompasses all areas of the school, inside and out Boundaries are set and delivered clearly, fairly and with sensitivity (emotional warmth) There will be consistent evidence of highly attuned de-escalation practice during high stress situations, including use of positive body language, minimal use of language, body space awareness and appropriate use of tone and volume, and avoiding escalation traps There is good provision of safe spaces, inside and out, to support emotional regulation and feelings of safety and security. Based on individual needs of children and young people, additional structure and supervision is provided by staff across the school, including at key times and in key areas The establishment is sensitive in maintaining and promoting key nurturing relationships for the most vulnerable pupils across the establishment, for example by giving key time with a specific staff member. Nurturing Classroom Controlled emotional atmosphere Consistent over time and between adults Clear parameters, boundaries Okay to fail Options for praise De-escalation Understanding of need to get back to baseline Offering a way out Understanding where a young person is on arousal continuum Available adults

20 3. Nurture Develops Self Esteem
Understand internal working model and gently challenge through positive interactions Talking therapy - ‘everything is verbalised‘ Engage in reciprocal shared activities e.g. play/ meals/reading/talking about events and feelings. Value YP as individuals by noticing and giving positive attention Awareness of ‘growth mindset’ and improvement Celebrate success Understanding the child’s internal working model of themselves, others and the world - Their view of themselves- bad, unlovable, who thinks things are their fault Congruence means trying to get the child view of themselves to match up to ours- no point dismissing their view- “don’t be silly, you are great at this” as they will dismiss if they have a strong negative internal working model Importance of modelling and shaping through positive behaviour management. What we need to do is gently boost them over time, - I don’t experience you like this, you have come a long way, etc point out successes. Support and challenged Valued as individuals Feedback / praise Know their next steps – know how to improve/move forward Safe to make mistakes Feel their voice is valued and worthwhile – pupil consultation/commities/opportunities for consultation Nurturing Schools The overall approach balances the need to support self-esteem and provide challenge and develop resilience as appropriate Use of praise, reinforcement and feedback is consistent with a nurturing ethos; a high level of positive attention specifically rewards progress and effort, and is accessible to and suitably differentiated for all The establishment identifies and shares personal achievements of pupils, including explicitly celebrating social and emotional competences and progress The establishment devotes time and energy to identifying and celebrating broader achievements of pupils and builds opportunities for success There are excellent opportunities for social and emotional development over the four contexts of learning CYP are given support to challenge unhelpful and negative beliefs about themselves and build resilience

21 4. Language as Communication
Language puts feelings into words. Tells YP ‘you belong here, I like you, your safe here’ Instead of ‘acting out' their feelings YP are helped to understand and ‘name' how they feel Importance of non-verbal communication Talking therapy: Provide informal opportunities for talking and sharing, e.g. welcoming the children into the group; having breakfast together Words are used instead of actions to express feelings and opportunities are created for extended conversations or encouraging imaginative play to understand the feelings of others Nurturing Schools: All staff, children and young people work from a model of nurturing relationships, which clearly identifies respectful, consistent and positive interactions as the appropriate communication style within the establishment Specific, positive, expected behaviours: listening, showing empathy, caring and having positive regard - are named and modelled explicitly by staff. Children and young people are given the appropriate level of support and challenge to develop these behaviours Children and young people are helped to understand and express their feelings and given the opportunity for extended conversations if needed The language used suits the developmental needs of the child The language used by adults in the establishment with children and young people and families is consistent with nurture, so that all are supported to feel: • You belong here • You are welcome here • I like you • You are safe here • You can explore and learn • Your feelings are okay with me • You can work with me on this problem that is getting in the way right now • I will be thinking about you, and keeping you in mind There is effective awareness and use of non-verbal language in all interactions and this is consistent with a nurturing approach The establishment considers the application of this principle in all forms of communication with parents and children and young people, including meetings, written communication

22 5. Behaviour as Communication
‘Given what I know about this child and their development what is this child trying to tell me?‘ Understanding what a child is communicating through behaviour helps staff to respond in a firm but non-punitive way by not being provoked or discouraged. If the child can sense that their feelings are understood this can help to diffuse difficult situations. The adult makes the link between the external / internal worlds of the child. Restorative approaches Nurturing Schools There is high staff awareness of the relevance of children and young people’s non-verbal language, and staff are attentive in tuning in to it Staff are supported to show high level of awareness of their own emotions and how this links to their communication behaviour. There is good understanding of the function of negative behaviour, generally, and good systems for exploring the function of more challenging behaviours, including high quality collaborative problem solving. The overall approach should aim to be restorative “in essence


24 6. Importance of Transition
Awareness of the numerous daily transitions the child makes Changes in routine need to be carefully managed with preparation and support. Care given to beginnings (welcome) and endings Clear welcome routines at transition points Nurturing Schools: There is a high level of awareness of transitions and disruptions in the lives of children and young people, in planning and providing for the meeting of needs. Transition points, internal and external, are well managed. Appropriate information is shared and, where necessary, there is high quality agency and family work. There are clear welcome routines at transition points: At the start of classes/sessions At the start of the day At the start of term Where appropriate, there are opportunities to touch base with key staff early in the day. Supported understood ? -timetabling Care giving to beginnings and endings Introduction of staff / new children taken seriously Children prepared for changes

25 Research Evidence (Binnie & Allen, 2009)
C&YP Social & emotional skills Self esteem Engagement Attendance Exclusion Carers Relationships Communication Behaviour at home Whole school Staged intervention Ethos Senior management ‘stress’ Wider authority effect Onward referrals Realign audit resources

26 Extension into Secondary Schools
Increase in provision and increasing research evidence Recognition of wider social and emotional wellbeing of young people. Recognition of the importance of building positive relationships. Transition into secondary environment can highlight the needs of YP (previously coped well) Adolescence is characterised by physical and emotional changes. Also, significant neurological changes. There is a marked change in the way the adolescent brain handles information and deals with problems. Second ‘window of opportunity’ for change & growth. Significant neurological, cognitive & social-psychological development (Moretti & Peled, 2004) Development of pre-frontal cortex Early Can see differences in the self – can lead to difficulties in view of self Can think in polarised ways (black & white world view) Late Conflicting aspects of the self start to integrate Both early & late Egocentrism Feelings that experiences are ‘unique’ Attachment status can change if parent-child interaction changes So little is known about brain developmental during adolescence because: The notion that the brain continues to develop after childhood is relatively new (late 1960s and 70s) Until recently the only way time we could study the structure of the brain was after death. However nowadays there are lots of techniques that can produce high quality images of the living human brain (eg MRIs) Now know that brain maturation is not complete until late teens/ early 20’s. So what happens: 2nd wave of synapse formation shows a spurt of growth in the prefrontal cortex just before puberty (11 for girls and 12 for boys) This stabilises and strengthens connections and serves to consolidate learning. Then a pruning back in adolescence – eg cutting back weak branches to that others will flourish Therefore as a teenager progresses through adolescent years, the skills of judgement, organisation and planning get better and better. Eg if a teenager is doing music or sports those are the connections that will be hard-wired; if they are lying on the couch or playing games, those are the ones that will survive. Many parts are mature and some important long range connections between different brain areas are in place as well. This enables them to be rather clever and deal with several intellectual problems in addition to becoming more sociable GOOD BITS Also parts of the brain that signal fun and enjoyment area also very well developed NOT SO GOOD BITS Frontal lobe which adults use to plan for the future isn’t fully developed in teenagers. And we are asking them what they want to do when they leave school?!!!! Using the amygdala and the connections between the frontal, temporal and parietal lobes being immature means that teenagers cannot always put instant gratification and enjoyment in the context of possible future losses, resulting in poor judgement, failure to control impulses and more recklessness (especially with peers). Not until about 19 years old where there is a shift from the amygdala to the frontal lobe leading to more reasoned perceptions and improved performance (Baird et al, 1999) Unused connections in the thinking and processing part of a child’s brain (called the grey matter) are ‘pruned’ away. Connections that are used regularly are strengthened. This pruning process begins in the back of the brain. The front part of the brain, the prefrontal cortex is remodelled last. The parts of the adolescent brain which develop first are those which control physical coordination, emotion and motivation. As the brain is developing, teenagers tend to rely more on the amygdala to make decisions and solve problems The amygdala is associated with emotions, impulses, aggression and instinctive behaviour. The back-to-front development of the brain explains why a child’s thinking and behaviour can sometimes seem quite illogical, impulsive or emotional at times. The Prefrontal cortex, which is responsible for more "top-down" control, controlling impulses and reasoning isn’t fully mature until the age of 25.

27 Adolescence: Re-wiring of the Brain
Psychological tests with teenagers show that they are notoriously bad at detecting fear in the faces of others. Brain scans show in early adolescence, teenagers use the amygdala to interpret fear in a facial expression. This is an ancient part of the brain and forms part of your "gut reactions" - instincts that do not involve much thought.

28 National Nurture Steering Group
Focus on secondary schools Training pack Overview Theory Nurturing schools Nurture Groups Assessment & Evaluation Framework for Implementation Nurture Group level Whole School level

29 Next Steps: Finalise training resource
Pilot with 5 or 6 secondary schools across Scotland – any interest? Consultation with key stakeholders Incorporate feedback National Launch available electronically

30 Relationships are key! 30 30

31 Further Reading: Bennathan, M. & Boxall, M. (2000). Effective Intervention in Primary Schools. David Fulton Publishers: London. Bishop, S. (2008). Running a Nurture Group. Sage: London. Boxall, M. (2002). Nurture Groups in School: Principles and Practice. Paul Chapman. London. Cooper, P. & Tiknaz, Y. (2007). Nurture Groups in School and at Home. Jessica Kingsley: London. Music, D. (2011). Nurturing Natures. Psychology Press: London. Bennathan, M. & Boxall, M. (2000). Effective Intervention in Primary Schools. David Fulton Publishers: London. Binnie, L. & Allen, K. (2008). Whole school support for vulnerable children: The evaluation of a part time Nurture Group. Emotional and Behavioural Difficulties, 13 (3). Bishop, S. (2008). Running a Nurture Group. Sage: London. Boxall, M. (2002). Nurture Groups in School: Principles and Practice. Paul Chapman. London. Cooper, P. & Tiknaz, Y. (2007). Nurture Groups in School and at Home. Jessica Kingsley: London. Cross, M. (2004). Children with Emotional and Behavioural Difficulties and Communication Problems: There is Always a Reason. JKP: London. Daniel, B. & Wassell, S. (2002). The School Years: Assessing and Promoting Resilience in Vulnerable Children. JKP: London. Gerhardt, S. (2004). Why Love Matters: How Affection Shapes a Baby’s Brain. Routledge: London. Gray, P. (2002). Working with Emotions: responding to the Challenges of Difficult Pupil Behaviour in Schools. Routlege; London. Lucas, S. Insley, K. & Buckland, G. (2007). Nurture Group Principles and Curriculum Guidelines. The Nurture Group Network: London. Music, D. (2011). Nurturing Natures. Psychology Press: London. Szalvitz, M. & Perry, B. (2011) Born for Love: Why Empathy is essential and endangered. Harper: USA.

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