How do we define our pupils with emotional, behavioural and social needs? Suzanne O’Connell looks at how useful the BESD category is and whether abandoning it might improve children's life chances
"The majority of respondents (52 per cent) judged the current category of BESD to be unhelpful in identifying and meeting the underlying needs of children, such as those with emotional and social difficulties."
The results of the consultation reported in the Department for Education Green Paper on SEN (Support and Aspiration: A new approach to special educational needs and disability, May 2012) seem to confirm that the BESD category is on its way out. Respondents voiced concern that the category is unhelpful, overused and “does not lead to the right support being put in place”.
It is likely that any replacement category will enable more emphasis on identifying “unmet educational or other needs and whether a multi-agency assessment is necessary”.
Will removing or changing the label make a real difference to outcomes for our BESD pupils?
A complicated category
BESD covers a multitude of needs. The document The Education of Children and Young People with Behavioural. Emotional and Social Difficulties as a Special Educational Need (DCSF, 2008) describes BESD as:
- Being withdrawn and isolated, disruptive and disturbing.
- Being hyperactive and lacking concentration.
- Having immature social skills.
- Presenting challenging behaviours arising from other complex special needs.
This represents a real spectrum of symptoms many of which also have their routes in mental health. The behavioural, emotional and social needs title can seem like a catch-all at times and it could be argued that under such a large umbrella there is less impetus to find the primary cause of the difficulties.
Dr Rona Tutt, ex-headteacher of a school for pupils with moderate learning difficulties, is broadly in support of the redesignation. She told Headteacher Update: “I’ve always had a concern about the ‘label’ covering everything from the unusually withdrawn to the aggressive, acting out pupils, particularly when this means they may be put together in BESD provision. I think the need to look beneath the behaviour is paramount, as is the need for accurate diagnosis.”
Irene Grant, national director of Nurture Group Network, agrees that it is the underlying cause of the behaviour that must be the focus: “The label BESD should be changed as it places an undue emphasis on the behaviour being the primary cause of the difficulty rather than the behaviours being the result of social and emotional difficulties.”
Gary Owens, headteacher at Penwith Short Stay School in Penzance, would prefer to see sub-divisions within the BESD category to aid clarity and diagnosis. He explained: “I would sub-divide the grouping into certain syndromes, such as ‘ODD’ (Oppositional Defiant Disorder), ‘ASD’ (Autism Spectrum Disorders), and especially mental health. I also feel the “social” in BESD needs reinforcing, as most, if not all, my students suffer from poor parenting coupled with poverty, low expectations and an endemic lack of trust in education.”
This lack of confidence and clarity in the category is reflected in the inconsistencies in diagnosis. The threshold for being labelled as BESD can vary according to school, local authority, month of birth, level of disadvantage, age and stage.
Concerns around the over-identification of SEN and BESD are highlighted in the 2010 Ofsted report The Special Educational Needs and Disability Review: A statement is not enough. The accusation is that in some cases pupils are diagnosed as having SEN to “make up for poor day-to-day teaching”. The implication is, improve teaching and the number of identified SEN, including BESD pupils, will drop.
Since this Ofsted report, the number of children labelled as having SEN in England has fallen by 90,000. The reasons for this may not solely be attributed to an increase in quality first teaching.
A recent TES article (SEN numbers drop 90K after Ofsted rebuke, August 2012), suggests that other changes, such as the removal of contextual value added and reduction in funding could also be contributing.
Whatever the reasons, the fact remains that there is a bewildering patchwork of identification and provision across the country with insufficient attention paid to where the origins of the behaviour lie.
Focusing on the causes
There hasn’t always been consensus on the origins and treatment for BESD. During the 1960s social disadvantage and early childhood experiences were considered to be root causes of behavioural difficulties.
During the 1980s there was an increasing acceptance that it was not only environmental factors that influenced the child’s behaviour. Two children brought up within the same environment might develop very differently.
There is now generally an acceptance that the way a child behaves comes from a mixture of the two. The interplay between environmental and genetic factors leads to the outcomes that we see in our classrooms on a day-to-day basis. This belief allows us to recognise the importance of classroom practices as helping to develop resilience or exacerbating risk.
Through providing an environment where pupils are focused on their learning, where relationships are developed, where children make choices for themselves and peers are supportive, genetic factors that lead to challenging behaviour can lay dormant. Children can then be helped to identify methods of dealing with their emotions and learn how to transfer these strategies to other environments too.
With a child with BESD there can be several layers of difficulty. They might be aggressive in maths lessons because of their anxiety about maths. This may come from a lack of success in the subject or bad experiences in maths lessons. Its origins might also be based in the home with difficult early relationships leading to insecurities bubbling to the surface in school.
The behaviour might partly be tackled by ensuring quality first teaching but the underlying source of the problem is likely to resurface at other times if the child’s attachment and relationship difficulties are not addressed too. Most schools that deal with pupils with persistent behavioural difficulties are well aware that a simple diagnosis is impossible.
Unpicking the different strands that have led to the behaviour can be more than a school feels capable of managing on its own. This sense of helplessness in the face of multiple issues can lead to a school deciding to exclude.
If the category of BESD is to be removed, then teachers will need to feel sufficiently supported and confident in dealing with its early manifestations in the classroom. Lorraine Petersen, chief executive of special needs association nasen, is concerned about inconsistent access to training and professional development.
She explained: “There needs to be much more input around SEN and disabilities including BESD at initial teacher education level as well as on-going whole-school CPD. The new Teacher Standards from September make it very clear about individual teacher responsibility to meet the needs of all pupils. In order to do this some teachers will need more support.”
What are the solutions?
What seems crucial here is that teachers are given the skills to help identify difficulties as early as possible and the support and advice to address them. The Nurture Group Network is concerned that the continuum of provision needed may not be there.
Ms Grant continued: “Surely early intervention and prevention is much better for the child and young person and far more cost-effective than the costlier alternatives. There should be a continuum of provision, with alternative provision only for a very small minority and the money saved used effectively in proven, effective, prevention strategies such as nurture groups in mainstream settings.”
Current investment is mostly directed at programmes to help schools locate effective sources of support and advice, rather than providing the support itself. For example, the Improving Access to Psychological Therapies Programme and the BOND consortium led by YoungMinds both focus on bringing services together and developing capacity and effectiveness rather than developing the services directly.
But will this be enough? There is some anxiety that the focus is being placed back on schools just at a time when the services available to help them are being withdrawn. As local authority support dwindles, will the voluntary and private sectors have the capacity to fill the gap?
YoungMinds has been researching the current level of provision of therapeutic services for children with emotional and behavioural difficulties. It submitted a Freedom of Information request to health trusts and councils across England about levels of funding in 2011/12. Of the councils that responded, more than half (29) said that budgets for children and young people’s mental health services had been reduced.
More can be done within our classrooms, but for some of these children, therapy and specialist support are essential. If this is not available it is hard to see how outcomes for BESD pupils will improve.
Getting the balance right
Over-diagnosis and early, inappropriate categorisation can be seen as guilty of lowering expectations and removing responsibility from the class teacher. However, failure to recognise the different and special needs of a child and deal with it can compound problems too. At the moment the pendulum is swinging. Schools and their teachers are trying to adjust their practice, juggle their resources and identify the support available to meet the needs of all their pupils, whatever the label might say.
• Suzanne O’Connell is a former primary school headteacher.
The results of the consultation reported in the Department for Education Green Paper on SEN (Support and Aspiration: A new approach to special educational needs and disability, May 2012) seem to confirm that the BESD category is on its way out. Respondents voiced concern that the category is unhelpful, overused and “does not lead to the right support being put in place”.
It is likely that any replacement category will enable more emphasis on identifying “unmet educational or other needs and whether a multi-agency assessment is necessary”.
Will removing or changing the label make a real difference to outcomes for our BESD pupils?
A complicated category
BESD covers a multitude of needs. The document The Education of Children and Young People with Behavioural. Emotional and Social Difficulties as a Special Educational Need (DCSF, 2008) describes BESD as:
- Being withdrawn and isolated, disruptive and disturbing.
- Being hyperactive and lacking concentration.
- Having immature social skills.
- Presenting challenging behaviours arising from other complex special needs.
This represents a real spectrum of symptoms many of which also have their routes in mental health. The behavioural, emotional and social needs title can seem like a catch-all at times and it could be argued that under such a large umbrella there is less impetus to find the primary cause of the difficulties.
Dr Rona Tutt, ex-headteacher of a school for pupils with moderate learning difficulties, is broadly in support of the redesignation. She told Headteacher Update: “I’ve always had a concern about the ‘label’ covering everything from the unusually withdrawn to the aggressive, acting out pupils, particularly when this means they may be put together in BESD provision. I think the need to look beneath the behaviour is paramount, as is the need for accurate diagnosis.”
Irene Grant, national director of Nurture Group Network, agrees that it is the underlying cause of the behaviour that must be the focus: “The label BESD should be changed as it places an undue emphasis on the behaviour being the primary cause of the difficulty rather than the behaviours being the result of social and emotional difficulties.”
Gary Owens, headteacher at Penwith Short Stay School in Penzance, would prefer to see sub-divisions within the BESD category to aid clarity and diagnosis. He explained: “I would sub-divide the grouping into certain syndromes, such as ‘ODD’ (Oppositional Defiant Disorder), ‘ASD’ (Autism Spectrum Disorders), and especially mental health. I also feel the “social” in BESD needs reinforcing, as most, if not all, my students suffer from poor parenting coupled with poverty, low expectations and an endemic lack of trust in education.”
This lack of confidence and clarity in the category is reflected in the inconsistencies in diagnosis. The threshold for being labelled as BESD can vary according to school, local authority, month of birth, level of disadvantage, age and stage.
Concerns around the over-identification of SEN and BESD are highlighted in the 2010 Ofsted report The Special Educational Needs and Disability Review: A statement is not enough. The accusation is that in some cases pupils are diagnosed as having SEN to “make up for poor day-to-day teaching”. The implication is, improve teaching and the number of identified SEN, including BESD pupils, will drop.
Since this Ofsted report, the number of children labelled as having SEN in England has fallen by 90,000. The reasons for this may not solely be attributed to an increase in quality first teaching.
A recent TES article (SEN numbers drop 90K after Ofsted rebuke, August 2012), suggests that other changes, such as the removal of contextual value added and reduction in funding could also be contributing.
Whatever the reasons, the fact remains that there is a bewildering patchwork of identification and provision across the country with insufficient attention paid to where the origins of the behaviour lie.
Focusing on the causes
There hasn’t always been consensus on the origins and treatment for BESD. During the 1960s social disadvantage and early childhood experiences were considered to be root causes of behavioural difficulties.
During the 1980s there was an increasing acceptance that it was not only environmental factors that influenced the child’s behaviour. Two children brought up within the same environment might develop very differently.
There is now generally an acceptance that the way a child behaves comes from a mixture of the two. The interplay between environmental and genetic factors leads to the outcomes that we see in our classrooms on a day-to-day basis. This belief allows us to recognise the importance of classroom practices as helping to develop resilience or exacerbating risk.
Through providing an environment where pupils are focused on their learning, where relationships are developed, where children make choices for themselves and peers are supportive, genetic factors that lead to challenging behaviour can lay dormant. Children can then be helped to identify methods of dealing with their emotions and learn how to transfer these strategies to other environments too.
With a child with BESD there can be several layers of difficulty. They might be aggressive in maths lessons because of their anxiety about maths. This may come from a lack of success in the subject or bad experiences in maths lessons. Its origins might also be based in the home with difficult early relationships leading to insecurities bubbling to the surface in school.
The behaviour might partly be tackled by ensuring quality first teaching but the underlying source of the problem is likely to resurface at other times if the child’s attachment and relationship difficulties are not addressed too. Most schools that deal with pupils with persistent behavioural difficulties are well aware that a simple diagnosis is impossible.
Unpicking the different strands that have led to the behaviour can be more than a school feels capable of managing on its own. This sense of helplessness in the face of multiple issues can lead to a school deciding to exclude.
If the category of BESD is to be removed, then teachers will need to feel sufficiently supported and confident in dealing with its early manifestations in the classroom. Lorraine Petersen, chief executive of special needs association nasen, is concerned about inconsistent access to training and professional development.
She explained: “There needs to be much more input around SEN and disabilities including BESD at initial teacher education level as well as on-going whole-school CPD. The new Teacher Standards from September make it very clear about individual teacher responsibility to meet the needs of all pupils. In order to do this some teachers will need more support.”
What are the solutions?
What seems crucial here is that teachers are given the skills to help identify difficulties as early as possible and the support and advice to address them. The Nurture Group Network is concerned that the continuum of provision needed may not be there.
Ms Grant continued: “Surely early intervention and prevention is much better for the child and young person and far more cost-effective than the costlier alternatives. There should be a continuum of provision, with alternative provision only for a very small minority and the money saved used effectively in proven, effective, prevention strategies such as nurture groups in mainstream settings.”
Current investment is mostly directed at programmes to help schools locate effective sources of support and advice, rather than providing the support itself. For example, the Improving Access to Psychological Therapies Programme and the BOND consortium led by YoungMinds both focus on bringing services together and developing capacity and effectiveness rather than developing the services directly.
But will this be enough? There is some anxiety that the focus is being placed back on schools just at a time when the services available to help them are being withdrawn. As local authority support dwindles, will the voluntary and private sectors have the capacity to fill the gap?
YoungMinds has been researching the current level of provision of therapeutic services for children with emotional and behavioural difficulties. It submitted a Freedom of Information request to health trusts and councils across England about levels of funding in 2011/12. Of the councils that responded, more than half (29) said that budgets for children and young people’s mental health services had been reduced.
More can be done within our classrooms, but for some of these children, therapy and specialist support are essential. If this is not available it is hard to see how outcomes for BESD pupils will improve.
Getting the balance right
Over-diagnosis and early, inappropriate categorisation can be seen as guilty of lowering expectations and removing responsibility from the class teacher. However, failure to recognise the different and special needs of a child and deal with it can compound problems too. At the moment the pendulum is swinging. Schools and their teachers are trying to adjust their practice, juggle their resources and identify the support available to meet the needs of all their pupils, whatever the label might say.
• Suzanne O’Connell is a former primary school headteacher.