1. Policy perspectives on behaviour and well-being and implications for research informed practice within schools. Brahm Norwich Graduate School of Education, University of Exeter

2. Overview
key changes in policy - implications for school based practices.
Importance of focus on mental health and well-being
schools contribution including school based research to improve practice

3. Key points about child and adolescent mental health (CAMHS)
1 in 10 diagnosed MH disorder
1 in 7 less severe problems
No up to date information last survey ten years ago. (HoC Select Health Ctee, 2014)
Focus on early CAMHS intervention urged by Select Ctee.
Health and Well Being Boards at LA level now hold public health funds
Battle to access CAMHS – bridging gap between inpatient and community services

4. SEN Policy and legislative changes
13 years since significant legislative change
Children and Families Act , 2014 – new Code of practice
mental health - first time one of the dimensions of SEN: ‘Social Emotional and Mental Health’

5. Labour Government
many initiatives from early commitment to social inclusion and inclusive education.
BUT SEN and inclusion policies less important than the standards agenda
uncertainty and ambivalence about inclusion: due to adoption of a market oriented / parental preference-based system

6. Conservative policy development
Conservative Party policy during Labour period:
SEN over-identified
Inclusion: ideology that ‘failed a generation of special needs children’
Conservative 2010 election manifesto: promised end to ‘bias to inclusion’
phrase used in the SEN Green Paper

7. Green Paper: Support and aspiration: a new approach to special educational needs
‘radically different system’
better life outcomes for children and young people.
giving parents more confidence and
transferring power to front-line professionals and local communities.

8. Green Paper key elements
new approach to identifying SEN: single assessment process and for Education, Care and Health Plans (EHC plans),
increased integration of education, social care and health service commissioning,
a Local Offer of all services,
parents having an option for a personal budget,
giving parents a real choice of schools,
greater independence in the assessment of children’s needs

9. What overlooked Not address unresolved issues from Labour period.
defining inclusion in a clear and realistic way (House of Commons, 2006),
linking the SEN and disability legislative systems
reconciling inclusivity with parental preference
continued value of statutory assessment for Statement not questioned: despite critique of Statements and alternative suggestion for parents to opt into statutory process
little detailed longer-term vision of how the SEN / disability provision was inter-connected with and dependent on the wider education service.

10. What was radically new proposals not “radically new”
extending, integrating and tightening up existing principles and practices.
EHC Plans an extension of the Statement covering wider age range of 0-25.
Parents already involved in the assessment process and
Some parents already had access to personal budgets.
‘radically new’ was in the wider education system:
governance of schools: Academies and Free schools
accountability system,
funding model for SEN and the strong moves to a user-led model

11. SEN Pathfinders
Green Paper very general - how work through by Pathfinder LAs.
Legislation went through before outcomes reported: only a process evaluation
Pathfinders were extended for a year and await outcomes report.
Evaluation: general feedback positive
key worker role established: a single point of contact.
personal profiles for families and young people to express themselves
person-centred planning approaches had been adopted.

12. Challenges development of outcomes-based plans challenging.
limited progress over implementing some key principles,
involving children and young people and
multi-agency involvement.
involving health service professionals led to incomplete plans.
How to balance of demands from core health work and Pathfinder demands.
Key workers/coordinators were also unclear about their degrees of freedom within the planning process
quality assurance and review process for EHC Plans insufficiently developed.

13. Scale and focus of trials
Independent Panel of Special Education Advice (IPSEA) study:
28 of the 31 authorities questionnaire data
1507 EHC Plans for children / young people.
Only 17% early years and 11% FE
only 36% were undergoing statutory assessment for first time; almost two-thirds had prior Statements
For 25 authorities: 280 personal budgets completed, 143 involving direct payments and only 27% did not cover transport and equipment.
Raises questions about how extensively the proposed changes had been trialled.

14. Children and Families Act (CFA) 2014
the participation of children, their parents and young people in decision making
the early identification of children and young people’s needs and early intervention to support them
greater choice and control for young people and parents over support
collaboration between education, health and social care services to provide support
high quality provision to meet the needs of children and young people with special educational needs (SEN)

15. Code of Practice: person-centred planning (PCP)
focuses on the individual
enables parents, children and young people to express their views, wishes and feelings and be involved in decisions
easy for them to understand and highlight their strengths and capabilities
enables them to communicate their achievements, interests and desired outcomes
tailors support to their needs and minimise demands on the family
brings together relevant professionals to deliver an outcomes-focused and co-ordinated plan

16. PCP issues
new system adopts and extends current principles and practices and changes their terms of reference
Makes principles sound ‘new’:
first 2 SEN Codes of Practice were person-centred without ‘person-centred’ label.
communication and partnership with parents and pupils to person-centred
Statements to EHC Plans

17. PCP practices
origins in social care and health of people with learning disabilities
use in the SEN field very limited
Corrigan (2014) - small scale study, suggested facilitators and barriers to the effective use of PCP:
skill level and availability of lead staff,
level of training and ongoing supervision provided to lead staff,
strength of relationships and collaborative skills within the group,
ability of all members to attend throughout the process,
quality of communication between settings and agencies,
ability to elicit the genuine voice of the child or young person,
degree to which PCP approaches were compromised by funding issues

18. PCP risks
Some practitioners report that some reviews are not genuinely person-centred.
when a single inflexible approach is adopted regardless of the identified needs of the child or young person and their family.
for example, need to be adapted for a young person exhibiting highly avoidant attachment strategies or someone who has experienced severe relational trauma

19. Inter-service collaboration
CFA duties on local authorities to ensure
‘that services work together where this promotes children and young people’s wellbeing or improves the quality of special educational provision’ (Section 25 CFA).
Local authorities and health bodies required to plan and commission education, health and social care services jointly for children and young people with SEN or disabilities (Section 26 CFA).
Key developments in 3rd SEND Code of Practice compared to the two previous ones is detail about how inter-service collaboration is to work.
done in some detail in 22 pages

20. Inter-professional collaboration
How are local authorities to integrate educational provision … with health and social care provision?
Different multi-agency groups are unique with own socio-political context, objectives, working processes, internal dynamics and external pressures.
Townsley et al (2004) found there were persistent multiple barriers to communication
focus of meetings was often found to be multi-agency structures rather than improved outcomes for young people and their families.

21. Successful multi-agency working
Eaton (2010) review of successful multi-agency – summarised in terms of
Strong leadership with a clear vision and a drive to get things done,
Well-managed conflicts and the absence of ‘a competitive blame culture’,
Opportunities for joint training,
Time for reflective learning

22. Eco-systemic model of multi-agency working
(Eaton 2010)
System level
Group focus
Micros:
Ethical consideration
Shared terminology and language: challenging and clarifying language used to define CYP needs and context
Roles
Clearly defined roles and responsibilities: differentiated, shared core skills and domain specific expertise
Meso:
Positive team-oriented attitudes, such as respect, trust , flexibility.
Exo:
Wider pressures
Adequate budgetary, staff and time resources, common lines of accountability
Macro:
Philosophical context
Shared goals, values and beliefs about interventions, case priorities, appropriate settings
Chrono:
Patterns of working over time
Absence of negative robotic thinking in group working patterns

23. Social, Emotional and Mental Health
Replaces Behavioural, Social and Emotional Needs
described in the following manner:
‘Children and young people may experience a wide range of social and emotional difficulties… These behaviours may reflect underlying mental health difficulties … [or] disorders such as ADD, ADHD or attachment disorder.’ (Section 6.32)

24. SEMH category: issues
behaviour difficulty no longer seen as a special educational need:
but never was in previous Codes either
Underlying category changes: removal SA and introducing SEMH is policy of reducing the number of pupils identified as having SEN (high incidence SEN, like MLD)
new SEMH category no different from the previous BESD one:
No clear process for specifying the thresholds for identifying such difficulties.
problem with BESD category was its ambiguity and diverse use,
problem persists with the new Code.

25. language of psychiatric disorder
‘these behaviours may reflect underlying mental health difficulties … [or] disorders’ (COP, 2014)
CoP: no reference to social context in SEMH definition
continuing issues about reliability and validity of psychiatric diagnoses.
educational significance of impairments / difficulties need to be seen in functional and contextual terms.
Crucial point : the gap between general diagnostic categories and the particular individual characteristics and context of children in educational terms.
why term ‘special educational needs’ was originally introduced
Not all children identified, for example, as ADHD, have the same educational needs;
other personal and contextual factors are also important to understand individual cases.

26. The need for an interactive model of mental health relevant to education
interactive model recognises the interaction of child and environmental factors in a developmental context
bio-psycho-social model that integrates medical and social models (Cooper and Jacobs, 2011; Hollenweger, 2011)
WHO’s child / young person’s International Classification of Functioning (ICF)

28. Targeted Mental Health Support (TaMHS) national initiative
children aged 5–13 at risk of developing mental health problems
by March schools involved in delivering TaMHS projects.
national review Wolpert et al (2013)

29. TaMHS review: factors and issues
Location:
- School based MH services promotes inter-agency collaboration and increased access to these services
Language:
- significant barrier to effective, integrated provision - absence of a common language across mental health and education services
- exacerbated by differences in philosophy and working practice between agencies,
Ownership:
- dilemma about targeted provision:
- balancing the need for implementation fidelity (by MH professionals) with the need for school ownership, embedded practice and reduced costs.
Scope:
educational policy encourages balance between universal, preventive provision and supplementary targeted programmes for at-risk pupils,
little evidence to inform this position

30. TaMHS review: factors and issues
Timing:
- impact of TaMHS interventions more for primary children
- amplified by differences between primary and secondary - place greater emphasis on the relation between children’s mental health and academic attainment may help to lessen primary-secondary difference
Evidence-based practice:
- engagement in using / developing evidence-based practice was disappointing in schools,
- lack of awareness of evidence-based materials and a lack of access to the appropriate training and materials.
- Australian ‘Kidsmatter’ programme: guide to over seventy evidence-based interventions,
- recent UK MindEd web based learning programme

31. Mental health and behaviour in schools Departmental advice for school staff
In order to help their pupils succeed, schools have a role to play in supporting them to be resilient and mentally healthy..
Where severe problems occur schools should expect the child to get support elsewhere as well,
Schools should ensure that pupils and their families participate as fully as possible in decisions
Schools can use the Strengths and Difficulties Questionnaire (SDQ) to help them judge whether individual pupils might be suffering from a diagnosable mental health problem
MindEd, a free online training tool
There are things that schools can do – including for all their pupils, for those showing early signs of problems and for families exposed to several risk factors – to intervene early and strengthen resilience,
Schools can influence the health services that are commissioned locally through their local Health and Wellbeing Board •
There are national organisations offering materials, help and advice. Schools should look at what provision is available locally

32. Risk and protective factors for child and adolescent mental health (DFE, 2014)
In child
In family
In school
In community

33. In school *Bullying • Discrimination
RISK FACTORS
Protective factors
*Bullying
• Discrimination
• Breakdown in or lack of positive friendships
• Deviant peer influences
• Peer pressure
• Poor pupil to teacher relationships
* Clear policies on behaviour and bullying
• ‘Open-door’ policy for children to raise problems
• A whole-school approach to promoting good mental health
• Positive classroom management
• A sense of belonging
• Positive peer influences

34. Wave / tier 3: specialist
Wave / tier 2: targeted
Wave / tier 1: Quality first /
universal

35. Universal provision Health Select Ctee CAMHS Report 2014:
Mandatory module in ITT on MH and for CPD (section 210)
Difficult to ensure that all schools use tools DFE guidance and MindEd website
Role for Ofsted and tension between standards agenda and wider well-being ones
Example of universal public health intervention – protective factor
‘Supporting Teachers And childRen in Schools’ (STARS) project
evaluating the Incredible Years Teacher Classroom Management (TCM) intervention.
TCM: 6 day training course to groups of 8–12 teachers.
STARS trial aims to improve children’s behaviour, attainment and wellbeing, reduce teachers’ stress and improve self-efficacy.

36. Targeted interventions
Supporting teacher problem solving approaches
Teacher Support Teams (Creese, Norwich, Daniels)
Collaborative groups (Hanko)
Circles of Adults;
Teacher Coaching;
Collaborative Problem-Solving Groups
Staff Sharing Scheme.
Bennet and Monsen (2011) review EPIP

37. Lesson Study: universal and targeted approach to integrating cognitive and social/emotional aspects into teaching
LS as practice-based research / inquiry
Distinctiveness
study of lesson (pedagogic focus)
For and by teachers
focus on learning / learners
Case pupils (UK version)
research oriented (RQ :how improve learning of ?)
Research lesson
collaborative
LS team involved at each stage (lesson observation by team)
enables inter-disciplinary collaboration
reflective practitioner
use of craft and research informed knowledge

38. Lesson Study logic

40. How adapt LS to researching lessons with pupils with SEMH difficulties
Research lesson goals – both subject based, e.g. maths, and about learning behaviours (emotions, relationships etc.)
LS team to include class teachers and those with specialist knowledge, e.g. SENCo, specialist teacher, Edpsych and/or MH worker
use research-based knowledge about emotional / behaviour functioning in lesson review/planning , e.g. self regulating strategies

41. Concluding comments
Crucial importance: whole school policies and practices – senior management commitment to broader achievement and well-being
Current ‘standards’ agenda undermines this commitment
Important things schools and teachers can do
Practice-based research – inter-professional, collaborative & research evidence informed, e.g. LS
MUCH WORTH DOING AND CAN BE DONE

42. References
Norwich, B. & Eaton, A. (2014): The new special educational needs(SEN) legislation in England and implications for services for children and young people with social, emotional and behavioural difficulties, Emotional and Behavioural Difficulties, DOI: /
Norwich, B and Jones J. (2013/4) Lesson Study: making a difference to teaching pupils with learning difficulties. London: Continuum Publishers.
Ylonen, A. and Norwich, B. (2012) ‘Using Lesson Study to develop teaching approaches for secondary school pupils with moderate learning difficulties: teachers’ concepts, attitudes and pedagogic strategies’, in European Journal of Special Needs Education, Vol. 27 (3):

43. MindEd web based learning programme https://www.minded.org.uk/
Web sources:
LS for Assessment:
Department for Education, Advanced training materials for SEN, Lesson Study, available at:
MindEd web based learning programme