Best Practice

Early identification of SEMH in key stage 1

Early identification of social, emotional, and mental health needs in key stage 1 will better enable schools to support pupils and avoid more serious problems and potential exclusions down the line. Ali Williams explains

The Department for Education recently published figures for SEN in England covering the last academic year (DfE, 2023a). The headline was the increase in both numbers of pupils with SEN (up 4.7% to 1.18 million) and Education, Health, and Care Plans (up 9.5% to 389,171).

However, if you break-down the data further the findings show an interesting picture with how we, as schools, identify SEN and primary need.

My background is working with social, emotional, and mental health (SEMH) needs in both special and mainstream education and I keep a close eye on the trends in this specific area of SEN.

Our school has a designated specialist provision (DSP) for SEMH and over the past two years we have worked closely with the SEMH team at our local authority to focus predominantly on key stage 1 children.

Our view is that SEMH is just as prominent here as it is in key stage 2 and if we target it early then we have a greater chance of reducing permanent exclusions and the need for pupil referral units and special schools at a time when these are in such high demand (DfE, 2023b).

 

So, what do the findings show?

I analysed the DfE's official data for different areas of primary need across primary school ages and across the last three academic years. I compared the percentage of children who have:

  • Autism spectrum disorder
  • SEMH
  • Speech, language, and communication needs (SLCNs).

The findings support our move towards a key stage 1 provision for SEMH and I believe that there is more we can do in mainstream to better support these children in key stage 1 to avoid an escalation in need.

The data is clear, SEMH is not diagnosed early. However, by the end of primary school, SEMH is the most prevalent need in each of the last three academic years (see charts 1, 2 and 3 below).

So what is happening? Does SEMH just appear in key stage 2? Do we misdiagnose early? Do assessments for identifying SEMH not work in key stage 1? Or are we slow to see the signs?

 


 

Chart 1 also shows that we are very quick to diagnose SLCNs. Is this because at the ages of 4, 5 and 6 this is one of the only metrics we are really interested in monitoring? There is a large focus on reading and oracy within early years and key stage 1 and a number of assessment points. As such, practitioners will focus on identifying these needs.

We don’t have the data, but I would like to know how many of the children identified as having SLCNs receive support that means this is no longer a barrier to learning. Is it that schools are not able to provide this intervention due to reduced resources, meaning children are then unable to access the curriculum, leading to SEMH needs becoming prevalent?

Charts 2 and 3 show an increase in SLCNs being diagnosed, perhaps because of Covid-19 lockdown. Could this in turn be contributing to the increase in SEMH figures?

I believe that SEMH is prevalent in key stage 1. I just think it is easier to see in key stage 2.

We typically associate SEMH with indicators such as an ADHD diagnosis or aggressive behaviours. I am not saying these indicators aren’t seen in children in key stage 1, I think they are, but I think it is less common.

One contributing factor is likely to be the waiting times currently being experienced by children for paediatric care. More than 400,000 children are currently on the waiting list to be seen and a large percentage of these have waited for more than a year (RCPCH, 2023). Where getting a diagnosis of SEMH requires input from the medical profession then numbers in key stage 1 will of course be lower given these waiting times.

 

What else is there?

I mentioned the obvious signs for SEMH above, but what else is there? A reluctance to work? Difficulties with social interaction? I believe both stand out more in key stage 2. The demands for output of school work are lower in key stage 1 where the focus is rightly different, therefore spotting a reluctance to work or using behaviour as a pathway to task avoidance will be less prevalent.

Another factor that may be difficult to identify in key stage 1 due to a child’s understanding could be trauma. Adverse childhood experiences (ACEs) affect almost half of the UK population (Young Minds, 2018). From my experience in both special and mainstream I believe that children in key stage 1 are less likely to be aware of it and are even less likely to communicate it. But ACEs are still there and I believe they are a clear indicator for SEMH needs.

 

What can we do about it?

As a school we are in the early stages they are moving towards a trauma-informed approached and there is lots of CPD available for this. However, I think it is simpler than that – positive relationships with children, rooted in trust, mutual respect, and kindness. We have been following this approach, married with an attitude whereby behaviour is looked at as communication.

Over the past 18 months I have focused on children with SEMH in key stage 1 and the clearest reason I have seen for SEMH has been a child’s ability to access the curriculum. I believe Covid and the associated lockdowns have a lot to answer for here. There are so many children who spent a long time at home not reading, writing, or exploring learning during key developmental ages. As such, when we then place high demands on them in school it will ultimately be met with frustration from the child.

The ability to read is, in my eyes, the most important skill we can pass onto children. Without this we cannot expect children to access school nor perhaps access society.

Within our DSP we have made reading the focus for our key stage 1 children over the past 18 months. All the children have gone on to make accelerated progress with their reading ages, leading to them being able to access the curriculum and in turn improving their behaviour.

I am not saying that teaching a child with SEMH needs to read will solve all their problems, it won’t. But it is a key intervention that I believe will have a positive impact on their future.

Within mainstream we can sometimes be guilty of trying to think of clever and creative interventions for children with SEMH needs. I think there is a lot to be said for keeping it simple and focusing on key learning needs such as reading.

 

Looking for clues

I recently wrote about how we can identify vulnerability within children, (Williams, 2023). We have used this approach to look for “clues” for SEMH within key stage 1 children. We will look for factors such as poor attendance, known ACEs, reading ages and other diagnosed SEN. We have then been able to look at how we can further support that child and their family to avoid any escalation in need.

For example, we have offered breakfast provision, after-school clubs, social skills interventions, and reading support. In addition, we have worked closely with the family to identify any additional needs or ways that we can support them. This has been particularly important if there has been known trauma.

If we identify SEMH in key stage 1 then we have a greater chance to support the child. Our DSP has focused on key stage 1 for the last 18 months and we are confident that the majority of these children will be re-integrated into mainstream either for secondary or just before – saving the local authority thousands of pounds on special school funding that can be used for others, but also giving these children a chance to experience mainstream school at a crucial time in their lives.

Most schools don’t have a specialist facility, but I still believe that early identification is key. If we support children at the point where there are indicators for SEMH then we can reduce the severity of the behaviour and provide intervention. As mentioned, this could be reading, social skills, or support with understanding and processing their trauma. If we teach them good strategies early, then this must have a positive impact.

 

Final thoughts

SEMH needs are more prevalent in key stage 2 because they are ignored early on. We have all the clues so let’s do something about it.

The indicators for SEMH are clearer within key stage 2 but they are still there in key stage 1. Look for the clues, support them with kindness and understand what the barrier is. Early identification of SEMH might be the best hope we have of reducing exclusions and giving these children the best chance at succeeding in our school system.

Ali Williams is vice-principal at Willowbrook Mead Primary Academy in Leicester, part of The Mead Educational Trust.

 

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