NURTURE GROUPS

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NURTUREGROUPSFor all educational settings

WHAT IS A NURTURE GROUP?Nurture groups are in-school, teacher-led psychosocial interventionsfocused on supporting the social, emotional and behavioural difficulties(SEBD) of children and young people. They are founded on evidence-basedpractices and offer a short-term, inclusive, targeted intervention that worksin the long term.Nurture groups address the social,emotional and learning needs of individualpupils by providing the necessaryhelp to remove the barriers to learning.There is great emphasis on emotionalliteracy, language development andcommunication. Pupils are immersed inan accepting and warm environment thathelps replace missing/distorted earlynurturing experiences and helps pupilsdevelop positive relationships with bothteachers and peers.Nurture groups are classes of betweensix and 12 children or young people,run by two members of staff trained innurture interventions. Nurture groupscan be set up in early years, primary orsecondary settings as well as in specialneeds schools.Nurture groups are now in over2,000 schools in the UK and offer theopportunity to experience the earlynurturing experiences some children andyoung people lack, giving them the skillsto do well at school, make friends and dealmore confidently and calmly with the trialsand tribulations of life, for life.NURTURE GROUPS AREDEVELOPED AROUND THESIX PRINCIPLES OF NURTURE:CHILDREN’SLEARNING ISUNDERSTOODDEVELOPMENTALLYTHEIMPORTANCEOF TRANSITIONSIN CHILDREN’SLIVESTHECLASSROOMOFFERS ASAFE BASETHE SIXPRINCIPLESOFNURTUREALL BEHAVIOUR ISCOMMUNICATIONLANGUAGEIS A VITALMEANS OFCOMMUNICATION“Overall, since the first yearthe nurture group began, we havereduced exclusions in our schoolby 84%. In 2017 we enrolled onthe National Nurturing SchoolsProgramme and as a result, from thestart of this current academic year,we have achieved three out of fourterms with no exclusions at all.Kent Nurture Group2THEIMPORTANCEOF NURTURE FORTHE DEVELOPMENTOF WELLBEING”

Nurture groups are a targeted intervention for childrenand young people with social emotional behavioural/mental health difficulties (SEBD/SEMH).Nurture groups need: A school committed to a nurturing ethos Two caring and affectionate nurture practitionersFirst and foremost, nurturegroups focus on supportingstudents to form attachmentsto loving and caring adults atschool. Unconditional positiveregard is the most powerfulmechanism for change. A group of no more than 12 studentsTHE DAILY PRIMARY ROUTINE IS EXPLICIT AND PREDICTABLE:The pupils starttheir day in theirmainstream class.They are picked upby the staff and takento the nurture group,a hybrid of homeand school.Activities in thenurture group includeemotional literacysessions, newssharing, nurturebreakfast and regularcurriculum activities.Children return totheir mainstreamclass for someprovision everyday.The social and developmental targets for eachstudent are devised using the Boxall Profile, adetailed assessment of social, emotional andbehavioural functioning of children and youngpeople. When the appropriate targets are met thestudent is reintegrated into their mainstream class.This takes between one and four terms.3

WHAT ARE THEIR OUTCOMES?To date more than 100 academic studies have demonstrated the positiveimpact of nurture groups. Although their primary goal is to improve childrenand young people’s social, emotional and behavioural difficulties, nurturegroups have positive outcomes across a wide range of areas, both for pupilsthemselves and also for teachers, the school community and beyond.IMPROVED SOCIAL,EMOTIONAL SKILLSChildren and young people developconfidence and self-esteem andlearn to take pride in their work and inbehaving positively (Kearney 2005).They become better at managingtheir emotions (Cooper andWhitebread 2007) and atempathising with others (Sanders2007), and as a result are able toform more positive relationshipswith peers and teachers.IMPROVED ATTENDANCEAs pupils feel safe in the nurturegroup and in school, they are able toenjoy school more (Sloan et al. 2016)and their overall attendance increases(Estyn 2014; Sanders 2007).IMPROVED ATTAINMENTStudies have also found that childrenand young people’s academicperformance increases followingnurture provision (Sanders 2007;Reynolds, MacKay, and Kearney2009; Seth-Smith et al. 2010),including language and literacyskills (Hosie 2013).4

IMPROVED BEHAVIOUR ANDREDUCED EXCLUSIONSChildren and young people’sbehaviour significantly improves(Sloan et al. 2016). They feel moresettled in their mainstream classroomand are better able to cope withthe challenges of the school day,reducing the risk for anger outburstsand disruptive behaviour.This in turn leads to a reduction in thenumber of exclusions (Ofsted 2009;March and Kearney 2017).IMPROVED PARENT-CHILDRELATIONSHIPSNurture groups also have apositive impact on the parent-childrelationship (Pyle 2015), withchildren being more affectionate andcommunicative at home, and parentsfeeling more confident in being ableto help their children (Ofsted 2011).IMPACT ON THEWHOLE SCHOOLNurture groups help develop affectivebonds between teachers and pupilsand help create a whole schoolnurturing ethos (Binnie and Allen2008; Cooper 2001).“In Glasgow, nurture has been a substantial part of a success storyin education in the city which can point to a clear reduction in pupilexclusions, an increase in attendance and a dramatic improvement inGlasgow establishments.March and Kearney 2017”5

WHY ARE NURTURE GROUPS NEEDED?Reduce the risk of being excluded:Every day in England, 40 children andyoung people are being permanentlyexcluded from school, and more than 2,000pupils receive fixed period exclusions(Department for Education 2018). The mostcommon reason pupils are being excludedremains persistent disruptive behaviour.Nurture groups and nurture principles canreduce the risk for children and young tobe excluded.“Nurture groups [.] were highlyeffective in improving children’sbehaviour and preventingexclusion.Ofsted 2009”Improve children and young people’smental health: 1 in 8 children and youngpeople have a clinically diagnosablemental health problem (Sadler et al. 2018),and half of those with lifetime mental healthproblems first experience symptomsby the age of 14 (Kessler et al. 2005).Moreover, children who develop conductproblems early on are at a greater riskof experiencing delinquency, antisocialbehaviours and substance abuse inadolescence and adulthood (Moffitt2006). Nurture groups can help managethese detrimental cognitive, affective orbehavioural styles by helping children andyoung people develop the social emotionalskills, resilience and positive behavioursthey need to do well in school and in life.6Increase educational attainment for themost vulnerable and disadvantagedpupils: Children and young people withspecial educational needs, poor mentalhealth or living in poverty are much morelikely to get excluded and to have lowereducational outcomes (Gill, Quilter-Pinner,and Swift 2017). By increasing the chancesof having vulnerable and disadvantagedstudents remain in schools, nurture groupshelp break the cycle of intergenerationalpoverty by removing the barriers tolearning and succeeding in schools.Comply with new mental health andwellbeing policy for schools: Across theUK more and more emphasis is being puton schools to support the mental healthand wellbeing of their pupils (Departmentof Health and Department for Education2017). Nurture groups, alongside wholeschool nurturing ethos, can have a realimpact on all pupils’ wellbeing, not onlyon children and young people with SEBD/SEMH needs but across the whole schoolpopulation, by making everyone feel safe,heard and valued.

SEMH AREN’T TRANSIENT PROBLEMSPUPILS WILL GROW OUT OFEXTERNALISING BEHAVIOURSsuch as being aggressive, fighting and violatingrules may lead to persistent difficulties, includingconduct disorders, that can have negativeconsequences both in childhood and later in life(Moffitt 2006).Children and young people experiencingpersistent externalising behaviours are at risk of: Academic difficulties (low grades, truancy andexclusion) Social rejection Antisocial behaviour and substance abuseINTERNALISING BEHAVIOURSsuch as anxiety and depression can lead to: Difficulties forming and maintaining relationships Poor school performance Suicidal behavioursChildren and young people who have experienceddepression are also more likely to have recurrentepisodes later in adulthood (Rao 2006).VULNERABLE AND DISADVANTAGEDSTUDENTSare at high risk of personal and school failure: Young people who are persistentlydisadvantaged are up to two years behindon their learning compared to their peers(Andrews, Robinson, and Hutchinson 2017). Poorer young people are four times more likelyto be excluded than their wealthier peers(Gill, Quilter-Pinner, and Swift 2017).7

HOW DO NURTURE GROUPS WORK?ATTACHMENT THEORYThe fundamental theoretical model thatunderpins the effectiveness of nurturegroups is John Bowlby’s attachmenttheory which argues that children acquireage-appropriate behaviour throughinteractions with significant others (Bowlby1969). If a child’s early experiences werecharacterised by missing or distortednurturing, it can lead to stunted social,emotional and cognitive development. Yetnurture is not a once-and-for-all event thatmust take place in a critical period, andmissing or distorted early experiences canbe overcome with the help of nurturingadults. Teachers, youth workers andsignificant adults in a child’s life canprovide important attachments for children.“The roots of a child or youngperson’s social-emotional wellbeingare found in their first attachment totheir primary care-giver. The natureof that attachment determinesnot just their ability to formrelationships but their capacityto learn. Educators must establishattachment-like relationships withtheir students, particularly withchallenging and vulnerablechildren and young people,in order to improve their chancesof learning and achieving.”Attachment Aware Schools 20178“Classroom learning cannot occurif the child is in either a persistentstate of arousal or anxiety [.].When in this state, the key partsof the cortex are not receptive tocognitive information that is notrelevant to survival. The traumatizedchild’s brain is essentiallyunavailable to process efficientlythe complex cognitive informationbeing conveyed by the teacher.Perry 2002”THE NEUROSCIENCE BEHINDNURTURE GROUPSMany children and young people in nurturegroups have experienced significant traumain their young lives, including bereavement,neglect and abuse, or witnessing parentsexperiencing mental health issues,incarceration, or substance abuse.Though a few stressors can be manageablefor young children, there is a point whereprolonged stress becomes toxic andneurobiological factors are affected. Iflevels of glucocorticoids, particularly thestress hormone cortisol, remain high forprolonged periods of time, stress canimpact the developing brain and alterthe structure and function of key brainareas. As a consequence children maybecome hypervigilant, highly irritableand may have a short temper. They willhave difficulties with attention, learning andemotional control. In turn these difficultiesmay translate into anger outbursts,aggression and challenging behaviours.

Effects of stress on the brain and behaviour of children and young peoplePrefrontal CortexReduced executive functions(self-regulation, workingmemory, concentration.)AmygdalaIncreased hypervigilance andhyper-reactvity to stressorsHippocampusPoor learning and memoryThe good news is that with sufficientnurture and support from adults, childrencan develop the skills and resilience theyneed to cope with stressful experiencesand return to manageable levels of stress,in turn allowing them to become ready tolearn (Shonkoff et al. 2015).Nurture groups help students return tohealthy levels of stress by:1) Providing a consistent, predictablepattern to the day;2) Having nurturing, comforting andaffectionate nurture practitioners trainedin attachment theory;3) Having expectations of behaviour clearlydiscussed with the child/young person;4) By providing a safe space where thepupil feels protected, is given choicesand some sense of control.SOCIAL EMOTIONAL LEARNINGUsing the Boxall Profile, the social andemotional needs of individual children/young people are identified and targetedsupport is provided to encourage socialemotional learning.The relationship between the two nurturepractitioners, always nurturing andsupportive, provides a role model thatchildren observe and begin to copy.Pupils are given ample opportunities tounderstand and manage their emotions,reflect on their behaviours in a nonjudgmental way, and develop positivefriendships. Food is shared at ‘breakfast’ or‘snack time’ with much opportunity for sociallearning, helping pupils to attend to theneeds of others, with time to listen and belistened to.As the children learn academically andsocially they develop confidence, becomeresponsive to others, learn self-respect andtake pride in behaving well and in achieving.9

NURTURE GROUP PROVISION SHARES MANY EVIDENCE-BASEDCOMPONENTS WITH OTHER EFFECTIVE PSYCHOSOCIAL INTERVENTIONS:Building affective bonds:Forming positive, trusting relationships withpupils and being responsive totheir individual needs.Cognitive restructuring:Perspective taking; recognising triggers ofanger; distinguishing between helpful andunhelpful thoughts.Modelling:Role modelling of appropriate behaviour/social skills between two adultsparticipating in constructive interaction.10Consensual goal setting:Setting achievable targets fromthe Boxall Profile.Emotional literacy:Understanding, identifying and labellingemotions; recognising physical andenvironmental cues of emotions; providingopportunities for pupils to verbalise theiremotional experiences.Relaxation techniques:Mindfulness; controlled breathingtechniques.

SECONDARY NURTURE GROUPSChildren and young people have the same basic needs – to be loved,accepted and encouraged – whether they are four or 14. Secondary nurturegroups support all of these needs and minimise the chances of young peoplebecoming non-attendees or excluded further through the school system.There are currently more than 200 nurturegroups running in secondary settings,demonstrating that nurture group practicecan be successfully adapted to supportyoung people.Secondary nurture groups have beenrecommended by various governmentpapers (Estyn 2014; Ofsted 2008) and theiroutcomes investigated in several academicstudies (e.g. Chiappella, 2015; Colley,2012; Grantham & Primrose, 2017).Just like in primary school, the sixprinciples of nurture underpin the nurturepractice in secondary schools. Social anddevelopmental targets for each student aredevised using the Boxall Profile for YoungPeople (Bennathan, Boxall, and Colley2011) – a detailed assessment of social,emotional and behavioural functioning.“Along with other provisions within the school, the nurture group hashelped reduce the number of fixed term exclusions in [our school].Many pupils have exceeded expectations at Key Stage 3 and Key Stage 4.The nurture group is now a key factor in parents choosing [us] as theirfirst choice secondary school.”Secondary school with nurture groups in Year 7, 8 and 9, Wales11

HOW TO START YOUR OWNNURTURE GROUP1.Most nurture groups are established by amember of the senior leadership team inthe school. The Head needs to decide on abudget, a suitable room and two permanentstaff to act as nurture practitioners. Mostnurture groups cost less than 10,000 toestablish, and a large number are fundedannually by the Pupil Premium.2.Visit our website nurtureuk.org and lookat the courses available near you. Werecommend that at least one member ofstaff in the nurture group completes thethree-day training course Theory andPractice of Nurture Groups, to learn aboutthe principles and practice of nurture,along with the theoretical modelsunderpinning the effectiveness andimpact of the intervention.3.Arrange to visit a local nurture groupthat has been accredited a MarjorieBoxall Quality Mark Award. The MBQMAensures that the nurture group has beenassessed and recognised by nurtureuk asfollowing good practice set against nationalstandards. The practitioners will be able toshare their learnings and insights beforeyou embark on your nurture journey.4.Complete observations and assesschildren/young people using the BoxallProfile to choose the pupils who will makeup the first nurture group. Consider thepupils’ strengths and difficulties and howchildren might learn from each other.12“Fantastic course, I feelequipped to take forward thenurture approach.Delegate, Scotland”5.Make positive contact with parents todiscuss their child’s place in the nurturegroup. Part of the success of the nurturegroup is the regular involvement of parents,who are given ample opportunities toprovide feedback, and staff in turn providesupport to parents and give them ideas/equipment for home activities.6.Update relevant school policy to referencethe nurture group in behaviour, inclusion,special needs and staff support policies.It is fundamental that a whole schoolnurturing policy be established for thesuccess of the nurture group. It is alsorecommended to create a separate nurturegroup policy.7.Introduce the nurture group to otherstaff and to the senior leadership team.Although they may have heard of nurturegroups before, they may not be aware ofhow they work or what their outcomescan be.

FUNDING AND COST EFFECTIVENESSHOW ARE NURTURE GROUPSFUNDED?ARE NURTURE GROUPSCOST-EFFECTIVE?The cost of opening and running a nurturegroup will vary considerably depending onyour context. However, most nurture groupswill cost less than 10,000 to establish.A recent report from the Queen’s UniversityBelfast concluded that the initialinvestment through nurture groupsis likely to be cost-effective and torepresent a significant economic returnon society (Sloan et al. 2016). They foundthat the cost of a pupil with behaviouraldifficulties being provided with just oneof the additional educational resourcesduring their school careers (eg. attendinga Pupil Referral Unit, accessing outreachbehaviour support, etc) is at least twiceas much as the cost of effectivelyaddressing those difficulties througheffective nurture group provision.Moreover, it has been estimated thatpreventing conduct disorders would savepublic services 150,000 per case averted.Once established, the intervention costson average 8,700 per child who isexperiencing challenging behavioursto develop the skills and resilience andbecome competently functioning. This isonly an estimate and will vary dependingon your context e.g. how many childrenare reached through the nurture group,whether it is running part time or full time,whether other children use the resourcesoutside nurture group hours, etc.The majority of schools use their ownbudget and Pupil Premium funding to fundtheir nurture groups. Local authorities andgovernments have also provided fundingin the past, for example in Scotland andNorthern Ireland, but also across Walesand North West England. Some localauthorities have authority-wide nurturestrategy and it is worth getting in touchwith them to enquire about fundingopportunities.13

FUNDRAISING FOR YOURNURTURE GROUPWith school budgets becoming increasingly tight, it may be difficult forschools to find the funds available to open and maintain their nurture groups.Despite evidence showing how cost-effective they are, nurture groups canoften be one of the first initiatives to be cut in times of limited funding forschools. This does not need to be the case. Your school can fundraise for itsnurture group and help it to be the best it can be for your pupils.FUNDRAISING EVENTMAKING THE MOST OF EVERY DAYFundraising events are great as you cando whatever works best for your school.You ma

nurturing experiences and helps pupils develop positive relationships with both teachers and peers. Nurture groups are classes of between six and 12 children or young people, run by two members of staff trained in nurture interventions. Nurture groups can be set up in early years, primary or second

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