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Social, emotional & mental health difficulties (SEMH) - including behaviour
Some children and young people have special educational needs which are called "social, emotional & mental health" (SEMH) needs.
These needs can appear in a number of different ways, including becoming withdrawn or isolated, as well as displaying challenging, disruptive or disturbing behaviour. These behaviours may reflect underlying mental health difficulties such as anxiety or depression, self-harming, substance
misuse, eating disorders or physical symptoms that are medically unexplained.
Other children and young people may have disorders such as attention deficit disorder (ADD), attention deficit hyperactive disorder (ADHD) or attachment disorder.
As a parent, it can be find hard to find ways to effectively support your child in this area. We have gathered some information together to try and help you manage this at home.
Please see the links at the bottom of this page for some helpful sites which can offer help.
Mental health disorders include depression, anxiety, psychosis, schizophrenia and eating disorders. Mental health difficulties may also be related to drug and substance misuse.
When a child or young person has a social, emotional or mental health difficulty which is impacting on their ability to function and learn at school, and for which they require special educational provision, then they should be regarded and treated as having a Special Educational Need. This applies to pupils whether or not they have a diagnosis, where their difficulties result in special educational provision being required.
Mental health difficulties manifest themselves in many different ways and it is not for teachers to try to diagnose what these difficulties might be. However, teachers have a responsibility to report any concerns that they may have in this area to the SENCO, who will then make the decision about what to do next, in conjunction with the pupil and their parents when appropriate.
If as a parent or carer you have concerns about your child, you should speak with your GP, health visitor or school SENCO about your concerns.
Attachment disorders and issues may develop if a child experiences negative or disrupted interactions or bonding with caregivers in their early life; it is common amongst children who are in care or who have been adopted from care, and its effects are lifelong and can be severe. Children may find it extremely difficult to make and maintain positive relationships, they lack basic trust and have little understanding of ‘unacceptable’ behaviour; they may present as confident or untouchable but usually feel insecure, wrong and powerless.
Attachment disorders are often seen alongside other conditions. This is a very complex area and if there are concerns you should speak with your GP, health visitor or school SENCO about your this.
- Lack of expectation of care and comfort, known as the inhibited form of Reactive Attachment Disorder (RAD)
- Inappropriately affectionate and familiar towards strangers, known as the disinhibited form of Reactive Attachment Disorder (RAD)
- Become distressed when separated from carer but also resist contact when the carer returns. Known as anxious-ambivalent attachment.
- Poor eye contact.
- Difficulty showing affection. An aversion to touch and physical affection.
- Overly demanding or clingy.
- Lack of cause/effect thinking.
- Problems controlling and expressing anger, sometimes violent.
- A need to be in control.
- Erratic eating habits.
- Failure to show remorse or regret after behaving badly.
- Abnormally sociable or superficially charming.
- Tell lies or steal
- Ask persistent nonsense questions or incessant chatter
- Pseudo maturity
- Low self-esteem
Below are some tips on how you can manage SEMH and behaviour needs, they are aimed at teachers but they techniques and advice may be helpful for parents and carers too.
The word de-escalation is used here, it means ways to calm a child or young person and stop the situation getting worse.
De-escalation techniques go against our natural fight-or-flight reflexes. Remaining calm and professionally detached is not natural and therefore it is a skill that will need to be practised. We need to retrain ourselves to respond in a different way when a challenging situation occurs.
Reasoning with an angry child is not possible but, in our role as caring teachers, this is often our immediate response. Our aim instead should be to reduce the level of agitation so discussion then becomes an option and a better outcome is achieved.
When to de-escalate
De-escalation techniques are most successful when used early, before the child becomes physically aggressive. To do this, it is necessary to be aware of and spot early signs of agitation such as:
- balled fists
- ‘eye-balling’ another child
- head thrust forward
- clenched jaw
- speech becoming more rapid or high-pitched.
These signs should not be ignored and you should never turn your back on an angry child in the hope that they just calm down.
Pacing is a cycle of feeding off someone’s emotions and escalating. If the child can make you as angry as them, it gives them permission to become even angrier and the child can justify their own hostility.
You may not always know what you are going to do, but keep in your head what you are not going to do. When the child has least control, it is time for the teacher to have the most control over themselves.
Calm can be just as contagious as fear and must be communicated to the child. Approximately 55% of what we communicate is through physiology, 38% is through the tone of our voice and just 7% is through the words that we use. It is useful to remember these proportions when you are trying to de-escalate. Ensure you are modelling the behaviour you want the child to emulate.
Techniques include the following.
Appear calm and self-assured
Make sure you are not displaying the same signs of agitation that can be seen in the child: unclench your fists, do not hold eye contact and avoid standing square to the child.
Maintain a neutral facial expression
Even our eyebrows can indicate we are surprised or angry, and similarly our mouths can betray our emotions unwittingly. Another natural reaction we often have when under stress is to smirk or giggle, which must be controlled.
Entering a person’s personal space can be useful to refocus on a task when the situation is calm, but when a child is agitated this can indicate aggression and escalate the situation. Staying some distance away will also help keep you safe should the child become physically aggressive.
Control your breathing
When we are stressed, angry or tense, our breathing becomes more shallow and rapid. If we take deeper, slower breaths, this will not only help keep us calm, but the child will begin to match our own breathing pattern. It can sometimes help to match the child’s breathing initially then gradually slow it down.
Lower your voice and keep your tone even.
It is hard to have an argument with someone who is not responding aggressively back to you.
Distraction and diversion are extremely useful.
When a child is aggressive, they are responding with their own fight-or-flight instincts and not thinking about their actions.
Distract them and engage their thinking brain, perhaps by changing the subject or commenting on something that is happening outside the window.
Give choices, repeat these using the broken-record technique if necessary, and do not get drawn into secondary behaviours such as arguing back, which are designed to distract or upset you.
Acknowledging the child’s feelings shows that you have listened to them, and can be crucial when diffusing a situation; for example, ‘It must be really difficult for you ... thank you for letting me know’.
Use words and phrases that de-escalate, such as:
- I wonder if...
- let’s try...
- it seems like...
- maybe we can...
- tell the child what you want them to do rather than what you do not want them to do; for example, ‘I want you to sit down’ rather than ‘stop arguing with me’.
- give the child take-up time following any direction and avoid backing them into a corner, either verbally or physically.
Things to avoid
- Do not make threats you cannot carry through, such as threatening to exclude the child.
- Do not be defensive or take it personally. What is being said may seem insulting and directed at you, but this level of aggression is not really about you.
- Do not use humour unless you are sure it will help and you have a very good relationship with the child.
- Do not use sarcasm or humiliate the child.
Sometimes, no matter how carefully and skillfully you try to de-escalate a situation, it may still reach crisis point. Know your school systems for summoning help and moving bystanders to safety.
After any outburst or incident, always make time to debrief, repair and rebuild, or the relationship will flounder and continue to deteriorate. Problem-solve the situation and teach new behaviours where needed.
Ensure any sanctions are appropriate to what has happened and remember that it is the certainty that behaviour is challenged that is important rather than the severity of what happens. Resolving conflicts is one of the most important skills to model.