Understanding an individuals social, emotional and behavioural difficulties

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'No man is an island, entire of itself;' (Bartleby.com, 1989) John Donne published these words in 1624, reflecting an understanding that all mankind are related: the actions of one affect another, the environment and culture in which we live influences our lives and how we conduct ourselves. Shakespeare's works are also a reflection on man and his environment, whether it be the impact of all-consuming love in the face of familial opposition in Romeo and Juliet, or the consequences of Macbeth's 'vaulting ambition'. (Blakemore Evans (ed.), 1974) Such works, written before the publication of the behavioural and childhood development theories that we access today, identified the impact of the interplay between characters on individual's behaviour, and of the characters and their environment in determining outcomes - had Romeo and Juliet lived in an environment of tolerance and acceptance, their love would not have been forbidden resulting in such tragic consequences; had Lady Macbeth not exercised such a strong influence over Macbeth, would he have had the resolve to commit murder?

So this question of understanding the cause of an individual's social, emotional and behavioural difficulties (SEBD) being essential before a successful intervention can be made has a wider setting within our literary, historical and cultural being. The author opines that the need to understand the causes of such difficulties is a given, although the level of understanding required by individual practitioners in the field of education to effect successful interventions is variable. A certain amount of understanding can be provided through the frameworks and policies provided by the various levels of international, national and local government of which we are subject. These can be a mechanism to support the distribution of knowledge and best practice to practitioners who support children in their development, and within this context, particularly those children experiencing SEBD.

This innate requirement for understanding and desire to support those experiencing particular difficulties is exemplified through the growth in psychological theories of behaviour and its development, particularly during the 20th century. These theories have grown in acceptance and are integrated within government policy. The question then becomes not whether having an understanding of the causes of SEBD is essential before a successful intervention can be made, but to what extent this understanding is required to effect success and what level of understanding do we, as practitioners, need? Are there interventions that can be made without a full understanding of the difficulties experienced by an individual, or is the efficacy of such interventions always predetermined by the level of understanding attained? Can we, in fact, truly understand the complex interactions affecting a single individual and determining their behaviour - are we not making subjective judgements and applying interventions based on these judgements?

It is the author's belief that some interventions can have a positive impact without a full understanding of a child's individual needs, but that where there are complex needs a fuller understanding must be acquired in order to determine an appropriate intervention and achieve success. This argument will be illustrated through the case of child J, who exemplifies a wide range of needs that require support in order to further his successful development and integration into wider society. Reference will be made to the international, national and local framework within which his case resides to illustrate their relevance in the understanding and support provided.

Understanding individual's needs driven by policy

As practitioners we must always remember that the purpose of any intervention is ultimately to benefit the child and their growth into an independent being able to participate in and contribute to wider society. The vision of the Children's Trust in Eastern England (2009) within which Child J resides states:

By the age of 19, as young adults, we want every young person to have the knowledge, skills and qualifications that will give them the best chance of success, so that they are prepared to take their full place in society as a happy, healthy, contributing and confident citizen. (p.8)

This vision of policy at a local level is a reflection of both international and national policy which provides knowledge and guidance to us as practitioners at various levels. At an international level, the fundamental rights of children are enshrined in the United Nations Convention on the Rights of the Child (UNCRC) which came into force on the 2nd September 1990 (Office of the United Nations High Commissioner for Human Rights, 1990). The majority of countries are signatories to this document, including the United Kingdom. UNCRC is important within our current context because it provides children in signatory countries the right to express their views and to have those views listened to and taken account of (articles 12 & 13), and for children with special needs, be they psychological or physical, to be given special care and support (article 23). It provides an international framework within which the issues facing a child displaying SEBD can be heard and support provided.

The National Curriculum was introduced in 1988 through the Education Reform Act (The National Archives, 1988). The National Curriculum Handbook for Primary Teachers in England (Department for Education and Employment (DFEE) and Qualification and Curriculum Authority (QCA), 1999) incorporates requirements and guidance on inclusion. It includes three essential principles for ensuring all pupils are included in learning:

... A Setting suitable learning challenges

B Responding to pupils' diverse learning needs

C Overcoming potential barriers to learning and assessment for individuals

and groups of pupils. (p.30)

The guidance further elaborates on these principles providing examples for each of the types of actions that should be taken by teachers and schools to ensure inclusion. This advice is based on an understanding of how different children may learn, recognising different physical and environmental factors that may be influencing them and understanding the need to motivate and engage children in the learning process.

The 2001 Special Educational Needs Code of Practice (Department of Education and Skills (DFES), 2001) provides a practical framework for schools to provide support to children experiencing Special Educational Needs (SEN), including those with SEBD. It is important to note the definition of SEN within this document:

Children have special educational needs if they have a learning difficulty which calls for special educational provision to be made for them. Children have a learning difficulty if they:

a) have a significantly greater difficulty in learning than the majority of children of the same age; or

(b) have a disability which prevents or hinders them from making use of educational facilities of a kind generally provided for children of the same age in schools within the area of the local education authority ... (p6,1:3)

As practitioners in education, this definition only requires us to understand the causes of a child's SEBD in as much as it results in a significant issue with their learning. That said, the process of identifying whether a child has SEN within this policy is predicated on understanding the difficulties they are experiencing and determining whether there are modifications/adjustments that can be made, for example in teaching practice, that will ameliorate their problems:

It should be recognised that some difficulties in learning may be caused or exacerbated by the school's learning environment or adult/child relationships. This means looking carefully at such matters as classroom organisation, teaching materials, teaching style and differentiation in order to decide how these can be developed so that the child is enabled to learn effectively. (p44,5:6)

The SEN Code of Practice defines the stages of support a school should provide to children who are experiencing difficulty, from 'school action' where in-school approaches/interventions are put in place to support the child, to 'school action plus' where the assistance of external agencies/experts are sought, to approaching the Local Education Authority (LEA) with evidence of the child's difficulties with a view to obtaining a 'statement of special education needs'. (DFES, 2001, pp.52-57)

The 'Every Child Matters' Green Paper (Chief Secretary to the Treasury, 2003) was encapsulated into law in the 2004 Children Act (The National Archives, 2004). 'Every Child Matters' introduced the 'Common Assessment Framework' (P57-59), incorporating multi-disciplinary teams (p60-62) to which a child may be referred for assessment. It also introduced the Child and Adolescent Mental Health Service (CAMHS) (P93). Introduced from a standpoint of safeguarding children, it has introduced important changes in services and the way they are offered to children and families, also providing a mechanism to cater for those children that are in need of support but do not fit within the definition of need identified in the SEN Code of Practice.

UNICEF UK has provided a useful summary of how UNCRC relates to the Every Child Matters agenda, 'Every Child Matters: The five outcomes and the UN Convention on the Rights of the Child' (n.d.). The Department for Children Schools and Families (DCSF) have provided a comprehensive summary of how UNCRC is met in English legislation (DCSF, 2010).

Specific guidance on the education of children with SEBD was issued with the publication of the 2008 guidance 'The Education of Children and Young People with Behavioural, Emotional and Social Difficulties as a Special Education Need.' (DCSF, 2008) This document states:

The term behavioural, emotional and social difficulties covers a wide range of SEN. It can include children and young people with conduct disorders, hyperkinetic disorders and less obvious disorders such as anxiety, school phobia or depression. There need not be a medical diagnosis for a child or young person to be identified as having BESD, though a diagnosis may provide pointers for the appropriate strategies to manage and minimize the impact of the condition. (p4-5)

This built on the basis provided by the SEN Code of Practice (DFES,2001), providing further guidance.

As we can see, each layer of international, national and local policy is predicated on the recognition that each individual child is different and that the systems and policies by which we work need to recognise their individuality and respond to it. Policy recognises that some children require specific recognition and greater understanding of their difficulties within this framework, and hence specific guidance/policy for children with disabilities or special educational needs. But the need for understanding is enshrined within all documents.

The above policies have been enacted/published prior to the change in government in the UK in May 2010. New government policy on education is still being formed, but the White paper published in November 2010 (Department for Education (DfE), 2010) expresses an underlying recognition of the importance of recognising the causes of SEBD in applying effective interventions:

Resources can be ... focused on those with serious behaviour problems who are perhaps at risk of exclusion and may need additional or specialist support to tackle underlying problems that are causing their bad behaviour ... (p36-37,3.27)

In addition, a SEN and Disability Green Paper is planned in the near future. The Department for Education website states:

The paper, ... aims to improve radically the entire SEN system and will cover issues including school choice, early identification and assessment, funding and family support. (DfE, 2010)

The author has hoped to illustrate above that there is an implicit recognition that understanding the causes of SEBD are an integral part of the processes practised in our schools and Local Authorities. Perhaps the importance of this understanding is best expressed by quoting the reflections of a student, not practising in the UK, on the difference in provision here to that provided in their country. J. Climas, a student from Hong Kong, wrote:

... Hong Kong is woefully inadequate when it comes to provisions for children and adults with SEN in general. It's infuriating that so many people are allowed to slip through the net because of 'culture'. Reading about all the different agencies available to people in UK has made me quite envious. Climas,J. (10 December 2010 11.01am), Time to Talk 4 Time to Reflect, Reaffirming, Enlightening and Infuriating, University of Birmingham WebCT MSI section 2010 (accessed 30 December 2010).

Understanding the causes of SEBD: The development of understanding and interventions

The 20th Century saw an increase in the development of knowledge about 'normal' childhood development and theory concerning behavioural development, for example of personality, moral values, and self-esteem. This has included theories examining the interplay between individual's and their environment, both in physical and emotional terms. So established are a number of these theories for a basic understanding of childhood development and behaviour that they are now included in the course contents for the teaching assistant qualification City and Guilds NVQ2 Supporting Teaching and Learning in schools.(City and Guilds, 2009, Unit 1,K7)

Clearly it is neither possible nor desirable to identify and discuss all these theories here, but a good initial source can be found in 'Perspectives on Behaviour: A Practical Guide to Effective Interventions for Teachers' by H. Ayres, D. Clarke and A. Murray. In their preface, these authors emphasise that these theories should be applied with caution and self-reflection on the part of the teacher attempting to assess, understand, and select appropriate intervention's for an individual child's emotional and behavioural issues. They highlight that:

Different perspectives subscribe to different causal models... Teachers should be aware that the causes of a given behaviour are often described according to the perspective a person decides to adopt. (p viii)

Furthermore:

It is often necessary to consider the possibility that a given behaviour is the result of a number of causes (multi-factorial), some immediate and some remote, rather than their being one simple cause. Alternatively one cause can produce a number of different behaviours. (p viii)

They go on to emphasise that:

What constitutes a behavioural problem can vary according to differing perceptions depending on social context, moral codes, cultural norms and historical periods. Therefore it can be the case that a teacher's judgement may disagree with other teachers' judgements because of different social contexts, moral codes or levels of tolerance. (p viii)

The application of these theories, then, can be fraught with difficulty and, as previously stated, must be considered and applied only in so far as they assist the child. Within government policy, this has been towards supporting the child to achieve the five 'Every Child Matters' outcomes:

be healthy

stay safe

enjoy and achieve

make a positive contribution

achieve economic well-being. (Chief Secretary to the Treasury, 2003)

Underpinning this is a recognition of the importance of promoting all children's mental health and emotional well-being, as described in 'Promoting Children's Mental Health within Early Years and School Settings' (DFEE, 2001):

Mental health is about maintaining a good level of personal and social functioning. For children and young people, this means getting on with others, both peers and adults, participating in educative and other social activities, and having a positive self-esteem. (p iv)

The increase in understanding in the last century has enabled the classification of various social, emotional and behavioural disorders to be made, for example various conditions on the autism spectrum and ADHD. Again, in the guidance provided within the DFEE 2001 publication 'Promoting Children's Mental Health within Early Years and School settings' (pp 24-36) the government of the period has attempted to provide a summary of the main recognised conditions and their symptoms, valid classroom approaches, and the pathways available to support practitioners when further support is required for the child than can be offered purely within the education setting. Attwood (2007) makes the point that the child's teacher is often the first person to identify that there is an issue:

The child's unusual profile of abilities and behaviour are not conspicuous at home but a teacher recognizes qualitative differences in abilities and behaviour in the classroom and playground. (p15)

The teacher is required to understand 'normal' childhood development so that he/she can recognise variations from that norm and seek, in association with parents, support for the individual. As Attwood states: 'Knowledge changes attitudes, which in turn can change abilities and circumstances.' (2007, p10)

The understanding of causes of behaviour to undertake a successful intervention

Child J has a Statement of Special Educational Needs which lists his difficulties as being:

Demonstrating appropriate behaviours

Concentration and listening

Engaging with teaching and learning

Communication and social interaction (Eastern England LEA, 2010)

Examples from his case will be used to illustrate that there are occasions where not knowing the cause of a behaviour can still result in successful intervention, but that also on other occasions, without the understanding of the cause, a successful intervention is difficult. The knowledge and understanding required by the practitioner will be discussed in each scenario, emphasising the support provided by the policy and guidance issued by government.

Situation 1

As stated above child J has difficulty in demonstrating appropriate behaviours. In the school environment this includes shouting, hiding under tables, lashing out aggressively both at people and objects. In the first instance, this behaviour is addressed through application of the school behaviour and reward policies. This approach is based on Social Learning Theory. Bandura (1977) states:

In the course of learning, people not only perform responses but also notice the effects they produce. By observing the different outcomes of their actions, they develop hypotheses about which response are most appropriate in which settings. This acquired information then serves as a guide for future action. (p.17)

The National Curriculum Handbook for primary teachers in England (DFEE & QCA, 1999) highlights that teachers should help pupils manage their behaviour by 'using positive behaviour management, including a clear structure of rewards and sanctions'. This approach can be seen to be further supported in other literature. Hughes and Cooper (2007) recommend that schools should 'Provide a reward system for appropriate behaviour for all children as the 'norm'.' (p43)

That said, additional understanding is provided to the child with SEBD to recognise that they may require more behaviour reinforcement than the average child in the class. It is suggested that a specific system of immediate rewards can be beneficial e.g. in the advice for a child with ADHD contained in 'Promoting children's mental health within early years and school settings'(DFEE,2001), and in the work by Evans, Harden, and Thomas (2004) which recommends a token reward system:

Behavioural strategies using token systems for delivering rewards and sanctions to either the whole class or individuals within a whole class are effective for reducing behaviour which is disruptive to children's own or others' learning in the mainstream classroom. (p7)

This type of intervention has been successful with certain aspects of his behaviour - particularly aggressive behaviour where he has hit staff/other children. The application of the school behaviour management policy, resulting in his exclusion from school on these occasions, has taught him to abstain from this type of reaction. Understanding the cause of his behaviour has not been required to effect this change, the intervention's purpose was to ensure that he understood that he absolutely must not hit people whatever the circumstances. It should be noted that Child J perceives being allowed to stay at school A as a 'reward' in this context. He frequently describes how much he loves his school, both verbally and pictorially. 'Maladaptive behaviour is simply seen as the pattern symptoms, there are no underlying causes and there is no 'symptom substitution'. When the symptoms disappear, the problem disappears with them.' (Ayers, Clarke and Murray, 2000, p9)

The use of such an approach is not universally accepted:

Punishment is fundamentally ineffective because you cannot respond until students have behaved inappropriately, causing hurt or inconvenience to someone else. (Porter, 2000)

Jull (2008, p13) makes the point that:

Students identified with EBD share an increased risk for disruptive behaviour. The use of exclusions as a strategy for responding to the special educational needs of these children is contrary to the notion of inclusion. Exclusions, by definition, reduce the ability of schools and associated agencies to work with children identified with SEN.

He illustrates this argument further by comparing the treatment of the child assessed as EBD with the child assessed as dyslexic. The same approach to the application of a punitive behavioural management system would result in the exclusion of children experiencing severe reading difficulties:

If this were the case, students identified with SEN that include conditions/contexts such as cognitive impairments like dyslexia, would confront ongoing uncertainty regarding their placement in schools simply because of their SEN. (Jull, 2008, p13)

Behaviour management policies and reward systems have their place in managing children with SEBD, but their application should be used with caution and in conjunction with a preventative approach to try and avoid such outbursts occurring in the first place:

... all parents share responsibility with school staff and pupils for making sure that learning in any class is not disrupted. ..we will encourage schools to address at the earliest opportunity underlying learning difficulties which can lead to challenging behaviour. (DCSF, 2009, p2).

Situation 2

Child J has 'difficulty in engaging with teaching and learning' (Eastern England LEA 2010). He has learning difficulties and, despite a variety of interventions, is still making minimal progress, particularly in literacy. Teaching has been adjusted in line with the guidance provided in the National Curriculum Handbook (DFEE & QCA, 1999) following the guidelines for supporting inclusion. Interventions, such as those suggested in the guidance 'Promoting Children's Mental Health within Early Years and School Settings' (DFEE,2001) have been used and, whilst having some success in reducing outbursts, have not contributed to a resolution of his underlying difficulties. Every Child Matters (Chief Secretary to the Treasury, 2003) resulted in the development of multi-agency assessment groups staffed by professionals from various disciplines. This route has been used to discuss his case, and School A is now awaiting a visit from an outreach support worker from a specialist EBD school in the Eastern region.

Understanding that the cause of outbursts is resulting from anxiety about his understanding and capability to undertake the work required and his low levels of self-esteem, means that, following the concerns expressed in situation 1, behaviour management techniques according to Social Learning Theory (Bandura, 1977) have not been applied in such instances. Rogers in 'Freedom to Learn' (1994, pp 151-167) emphasises the importance of the teacher-child relationship and the need to develop empathy with the child to facilitate their learning. Understanding has been offered and work separated into small tasks, also recognising the times when 'the child is working at his ...best.' (Hughes and Cooper, 2007) for scheduling work which he finds most difficult to attempt. Such interventions have enabled his disruptive behaviour in these circumstances to be reduced, but not for them to cease. It is to be hoped that the findings criticising the quality and availability of some services in the 2005 Ofsted report 'Inclusion: the impact of LEA support and outreach services', will not prove accurate in this case, and that their following key findings will incorporate Child J and School A's experience:

􀂈 Support service staff were particularly valued where they brought

knowledge and skills usually unavailable in a mainstream school. Specialist

teachers were most effective when they demonstrated effective strategies

for others to observe.

􀂈 Other outreach and support service staff provided important information

and a thorough understanding of particular special needs or disabilities,

making a major contribution to pupils' progress. (p3)

Conclusion

Understanding the cause of an individual's social emotional and behavioural difficulties is mostly essential to enable a successful intervention, particularly in the case of a child with complex needs as described here. However, some progress can be made without this full understanding and in a child with comparatively straightforward issues the guidance provided by Government may be sufficient to affect a resolution. The frameworks provided by government certainly provide a useful mechanism to support the education practitioner and to help them obtain specialist support when it is recognised that a child requires more support than can be provided by the school alone.

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