A Study of Children and Young People Who Present Challenging Behaviour
A Study of Children and Young People Who Present Challenging Behaviour
A Study of Children and Young People Who Present Challenging Behaviour
challenging behaviour
November 2003
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Contents
Introduction ............................................................................................7
1.0 Purpose and scope.......................................................................8
2.0 Setting the scene ........................................................................10
3.0 Definitions ...................................................................................13
4.0 Challenging behaviour as defined in assessment tools and
research data ..............................................................................22
5.0 Pupils with serious EBD/challenging behaviour: prevalence
and provision ..............................................................................29
6.0 The elements of effective practice ............................................34
7.0 Equal opportunity issues ...........................................................63
8.0 Conclusion ..................................................................................66
References............................................................................................67
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Contents in outline
Introduction ............................................................................................7
1.0 Purpose and scope.......................................................................8
1.1 Overview ...................................................................................................... 8
1.2 Scope........................................................................................................... 8
2.0 Setting the scene ........................................................................10
2.1 Chronic definition difficulties....................................................................... 10
2.2 The Education Act 1944 and consequent definition ................................... 10
2.3 The historical happenstance of assessment and placement...................... 10
2.4 A ‘catch-all category’.................................................................................. 11
2.5 A new, uncertain label but describing real challenging behaviour.............. 11
2.6 Defining EBD: American difficulties............................................................ 12
3.0 Definitions ...................................................................................13
3.1 Introduction ................................................................................................ 13
3.2 Circular 9/94 and other English definitions of EBD .................................... 13
3.3 The first SEN Code of Practice, 1994 ........................................................ 14
3.4 Ofsted ‘Principles into Practice’ report, 1999 ............................................. 14
3.5 Revised SEN Code of Practice, 2001 ........................................................ 14
3.6 DfEE/QCA ‘Supporting School Improvement’ descriptors, 2001................ 15
3.7 Birmingham Council description of ‘emotionally vulnerable’ children ......... 16
3.8 Overlap with definitions of mental health ‘problems’ .................................. 16
3.9 Mental health disorders.............................................................................. 17
3.10 Other English writers’ views ....................................................................... 17
3.11 Scottish definitions ..................................................................................... 17
3.12 Educational Institute of Scotland................................................................ 18
3.13 The American ‘Severe Emotional Disturbance’ (SED) category ................ 18
3.14 Proposal in USA for a new category called EBD........................................ 19
3.15 Challenging behaviour in relation to cognitive disabilities .......................... 20
3.16 Characteristics of challenging behaviour and cognitive disabilities ............ 20
4.0 Challenging behaviour as defined in assessment tools and
research data........................................................................................22
4.1 Defining by tools and data ......................................................................... 22
Diagnostic and assessment tools ..................................................................... 22
4.2 American Psychiatric Association Diagnostic Standard Manual [DSM
Categories]................................................................................................. 22
4.3 DSM - IV: Attention Deficit/Hyperactivity Disorder (AD/HD) ....................... 22
4.4 DSM IV: Oppositional Defiance Disorder [ODD] ........................................ 23
4.5 Conduct disorders...................................................................................... 24
4.6 The Achenbach Child Checklists (CBCL) .................................................. 24
4.7 The Boxall Profile....................................................................................... 25
4.8 ‘Looked after’ children Assessment and Action Records ........................... 25
4.9 The Aberrant Behaviour Scale [ABC]......................................................... 26
4.10 Some British checklists identifying EBD..................................................... 26
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4.11 Goodman Checklist.................................................................................... 26
The characteristics of pupils entering specialist provision for EBD ............. 26
4.12 Research studies and Ofsted data............................................................. 26
4.13 ‘Externalising’ pupils, with social problems outside school ........................ 27
4.14 Ofsted on diverse traits .............................................................................. 27
Assessment tools and faulty diagnosis ........................................................... 27
4.15 Doubts on the accuracy of assessment tools............................................. 27
4.16 Environmental and social factors in schools and at home ‘creating’ EBD.. 28
5.0 Pupils with serious EBD/challenging behaviour: prevalence
and provision........................................................................................29
5.1 Introduction ................................................................................................ 29
5.2 Estimates of prevalence............................................................................. 29
5.3 Numbers with EBD in mainstream schools ................................................ 30
5.4 Prevalence in other countries..................................................................... 31
5.5 Gender imbalance...................................................................................... 31
5.6 Minority ethnic groups................................................................................ 31
5.7 English patterns of provision ...................................................................... 31
5.8 Use of boarding in EBD schools ................................................................ 32
5.9 A continuing need for better mainstream support as well as a range of
specialist provision..................................................................................... 32
6.0 The elements of effective practice ............................................34
6.1 LEAs furthering inclusion, recognising reality, meeting obligations............ 34
School/Unit level................................................................................................. 34
6.2 Introduction ................................................................................................ 34
6.3 A framework for discussing the literature ................................................... 34
The client population.......................................................................................... 35
6.4 Numbers on roll relate to effective provision? ............................................ 35
6.5 Admissions/exclusions - limits to manageable behaviour .......................... 36
6.6 Psychiatric needs beyond schools’ capabilities.......................................... 36
6.7 Parents and carers..................................................................................... 36
6.8 Family therapy/ parent training?................................................................. 36
6.9 Carers of looked after children ................................................................... 37
Staffing ................................................................................................................ 37
6.10 Values and ethos ....................................................................................... 37
6.11 An inclusive ethos ...................................................................................... 37
6.12 A caring, listening staff who learn from their practice................................. 37
6.13 Leadership ................................................................................................. 38
6.14 Teachers .................................................................................................... 38
6.15 Required skills, attitudes and practice........................................................ 38
6.16 Skilled ‘micro-teaching’ .............................................................................. 40
6.17 Strategies used by effective teachers: an American view .......................... 40
6.18 An Australian view ..................................................................................... 42
6.19 Teachers must embrace their pastoral role................................................ 42
6.20 Learning Support/Teaching Assistants ...................................................... 42
6.21 Residential social workers (RSWs) ............................................................ 43
6.22 Other staff .................................................................................................. 43
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6.23 Governors .................................................................................................. 43
6.24 Ongoing and responsive teacher development.......................................... 43
6.25 Approaches to training ............................................................................... 44
6.26 Professional development of other staff..................................................... 44
6.27 Recruitment, retention, conditions of employment ..................................... 44
6.28 ‘Caring for the caregivers (and educators)’ ................................................ 45
6.29 Preventing abuse: staff vetting................................................................... 45
Multi-agency support ......................................................................................... 46
6.30 The need for LEA and other agency support ............................................. 46
6.31 Educational psychology ............................................................................. 46
6.32 Educational Welfare Officers and others.................................................... 47
6.33 Mentors ...................................................................................................... 47
6.34 Social services ........................................................................................... 47
6.35 Health service (including CAMHS)............................................................. 48
Provision of education and care ....................................................................... 48
6.36 Theories underlying sound provision ......................................................... 48
Policies ................................................................................................................ 49
6.37 Behaviour policies...................................................................................... 49
6.38 Time for pastoral work ............................................................................... 49
Programmes responsive to pupils’ educational and social needs ................ 49
6.39 Whole-school/unit programmes and targeted interventions ....................... 49
6.40 A normal curriculum facilitating re-integration ............................................ 50
6.41 Planning, assessment and measuring progression.................................... 50
6.42 Transitions: knowing Year 7 entrants......................................................... 50
6.43 Match teaching to learning style/high expectations.................................... 51
6.44 Lessons where pupils with EBD were motivated........................................ 51
6.45 Effective approaches to engaging pupils with EBD.................................... 52
6.46 Offering support sensitively........................................................................ 55
6.47 Managing the physical ‘behaviour environment’ to minimise disruption..... 55
6.48 ICT as a motivational aid ........................................................................... 55
6.49 Rewards and privileges valued by pupils with EBD ................................... 55
6.50 Psychostimulants and ADHD/EBD............................................................. 56
Content of curriculum ........................................................................................ 56
6.51 The national curriculum and pupils with EBD: general............................... 56
6.52 Core subjects ............................................................................................. 57
6.53 Humanities ................................................................................................. 57
6.54 Inclusion of pupils with EBD, related to subjects taught............................. 57
6.55 Reservations about the national curriculum: modern foreign
languages[MFL] ......................................................................................... 57
6.56 Physical education/outdoor pursuits .......................................................... 58
6.57 Support for a flexible, practical and vocational Key Stage 4 ...................... 58
6.58 Creative subjects ....................................................................................... 58
6.59 Avoiding the low-status ‘alternative curriculum’.......................................... 58
Pastoral support ................................................................................................. 59
6.60 ‘Combining Educational and Therapeutic Approaches’.............................. 59
6.61 A particular therapeutic approach: Nurture Groups.................................... 59
6.62 The extended curriculum ........................................................................... 59
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6.63 Importance of good child care in residential settings ................................. 59
6.64 Flexible use of boarding ............................................................................. 60
6.65 Child care and physical contact ................................................................. 60
6.66 Physical Restraint/ Restrictive Physical Intervention (RPI) ........................ 60
Severe Learning Difficulties............................................................................... 61
6.67 Approaches for pupils with severe learning difficulties............................... 61
The physical environment and resources ........................................................ 61
6.68 Location ..................................................................................................... 61
6.69 The ingredients of appropriate sites........................................................... 61
6.70 Design for curriculum delivery and management ....................................... 62
6.71 Resources.................................................................................................. 62
7.0 Equal opportunity issues ...........................................................63
7.1 Gender issues............................................................................................ 63
7.2. Ethnicity ..................................................................................................... 63
7.3 Interventions that help black pupils ............................................................ 64
8.0 Conclusion ..................................................................................66
8.1 Range of literature ..................................................................................... 66
8.2 Good practice for all................................................................................... 66
8.3 Inclusive practice the key ........................................................................... 66
References............................................................................................67
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Introduction
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1.0 Purpose and scope
1.1 Overview
After a brief historical introduction, which illuminates difficulties that continue in the
present, this literature review covers:
This review acknowledges the literature relating to children and young people with
severe cognitive disabilities and those on the autistic spectrum who exhibit
‘challenging behaviours’. However, the majority of the literature on challenging
behaviour relates to those most commonly referred to in the last decade as having
emotional and behavioural difficulties (EBD). Since the revision of the special
educational needs (SEN) Code of Practice (DfEE, 2001a) the label has widened to
include the term ‘social’. Its use is not as yet widespread in the literature.
1.2 Scope
This review focuses on the relevant English literature published since 1994, but
occasional reference is made to earlier texts to aid understanding (in particular the
Elton Report, DES, 1989a). The choice of any start date is arbitrary, particularly one
as late as 1994. By this time, research into child development and EBD had
established that pupils with EBD often respond positively to appropriate, skilled
teaching and management, paying attention to needs theory (see Maslow, 1943).
Effective interventions with pupils with EBD are based upon sound psychological
principles, of use in any teaching or care setting, rather than specialist approaches
designed specifically for pupils designated as having a ‘disability’ or ‘disorder’ called
EBD (see Kounin, 1977; Wilson and Evans, 1980; Rosenberg, Wilson, Maheady,
Sindelar, 1997). Reference is made to relevant American texts (notably Kauffman,
2001) and to other international literature.
Where possible, the perspective of LEAs and practitioners are represented (e.g.
through Cole, Daniels and Visser’s study of behaviour support plans, 1999, 2003; or
Ofsted, 1999a). Evidence of alleged changes to clientele in specialist provision was
difficult to establish other than Ofsted reporting (e.g. 1999a), as had Cole, Visser and
Upton (1998), that teachers believed their pupils were becoming more complex and
challenging. Ethnicity and gender in relation to EBD are also examined although the
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literature was found to be limited and few specific approaches identified (beyond the
application of approaches known to help all pupils said to have EBD). This review
concentrates on the actual and potential practice of school-based professionals and
support staff; and how they can (or more usually how they find it very difficult to) link
their work with input from other agencies. It does not discuss in detail specialist
interventions by medical practitioners and Children and Adolescent Mental Health
Service (CAMHS) or social services staff. Aspects of CAMHS joint working with
schools are covered by Pettit (2003).
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2.0 Setting the scene
2.1 Chronic definition difficulties
The Audit Commission (1992) wanted ‘research to clarify how many children have
emotional and behavioural disturbance, to discover what provision is currently made
for them and to assess the effectiveness of that provision’ (pp 59-60). A decade on,
another Audit Commission (2002) report called for greater clarity in calculating types
and numbers of pupils with SENs (including those with EBD). Their request will not
easily be met. Defining challenging behaviour, EBD, Attention Deficit Hyperactivity
Disorder (ADHD), disaffection, disruption or other terms preferred by different
professional groups, has always been an unsatisfactory enterprise (see recent
writers: Fogell and Long, 1997; Cooper, 1996, 2001; Daniels et al, 2001; Kauffman,
2001; DfEE, 1998b; Cole, Visser and Upton, 1998; Daniels et al, 1998a; and Thomas
and Glenny, 2000). Cole et al (1998) (see also Daniels and Cole, 2002, and Cole
and Visser, 1999) describe the debate that has persisted through many generations
over who pupils with EBD are, where they should be placed and what interventions
are beneficial.
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be placed in the Home Office Approved Schools. After the Children and Young
Persons Act 1969, Approved Schools evolved into CHEs run by social services
departments. In fact, dating back to the work of the Royal Philanthropic Society in
the 1790s, the precursors of the ‘EBD’ would seem to have been taken under the
wing of any one of four government departments: welfare, juvenile justice, education
or health. Whether the ‘problem child’ has been ‘cared for’, ‘punished’, ‘educated’ or
‘treated’ has often been a matter of chance depending upon which individuals in
which agency happened to pick up his or her case. A child’s placement often
depended on where the vacancies were when the child was perceived by particular
professionals to have reached crisis point or when funding became available
(Hyland, 1993; Grimshaw with Berridge,1994; Cole et al, 1998; Daniels and Cole,
2002). The forthcoming Children Services Act promoting ‘joined up’ children’s
services has much potential to tackle these historical shortcomings.
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aggression, often mixed inextricably with emotional and social difficulties that had
interfered with educational progress. Experience of failure and rejection, usually
mingled with unsettled home circumstances had commonly led to low self-esteem
(certainly in relation to their educational potential) and damaged confidence.
Traumatic life events involving loss and bereavement were not uncommon (also
noted in Daniels, Cole, Sellman, Sutton and Visser, 2003).
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3.0 Definitions
3.1 Introduction
The following definitions are covered:
‘Children with EBD are on a continuum. Their problems are clearer and
greater than sporadic naughtiness or moodiness and yet not so great as to
be classed as mental illness.’ (DfE, 1994b, p4)
EBD range (DfE 1994b) from ‘social maladaptation to abnormal emotional stresses
…are persistent and constitute learning difficulties’, involve emotional factors and/or
externalised disruptive behaviours and general difficulties in forming ‘normal’
relationships. Social, psychological and sometimes biological factors or, commonly,
interactions between these three strands, are seen as causing pupils’ EBD. There
follows detailed amplification in which ‘within-child’ emotional factors are
counterpoised with difficult externalised behaviours including truanting, aggression,
violence and destructive behaviour. Children with EBD have problems in
relationships, the causes are likely to be complex and systemic involving school and
home factors. Determining whether a child has EBD depends on ‘frequency,
persistence, severity or abnormality and the cumulative effect of the behaviour in
context’ compared to ‘normal’ children (p8). A short chapter at the end of the circular
is devoted to the small minority at the psychiatric end of the spectrum for whom
meaningful inter-agency working, with substantial input from specialist services, is
said to be essential. The definition of EBD given in this circular is a comprehensive
summary, including items associated with EBD by leading contemporary academics
e.g. Chazan, Laing and Davies (1994) and Cooper et al (1994) and again Cooper
(1999a). The latter succinctly summarised a perhaps emerging consensus on
causation of EBD: ‘Whilst biology may create propensities for certain social and
behavioural outcomes, biology is always mediated by environment and culture’
(p239). For most pupils, it is the cumulative interactive effects of the different parts of
children’s lives which give rise to their challenging behaviour.
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3.3 The first SEN Code of Practice, 1994
The first SEN Code of Practice (DfE, 1994c) offered a shorter definition (cross-
referenced to Circular 9/94). This stressed that pupils with EBD:
‘have learning difficulties [as defined at paragraph 2:1 of the Code]. They
may fail to meet expectations in school and in some but by no means all
cases may also disrupt the education of others.
Emotional and behavioural difficulties may result, for example, from abuse or
neglect; physical or mental illness; sensory or physical impairment; or
psychological trauma. In some cases, emotional and behavioural difficulties
may arise from or be exacerbated by circumstances within the school
environment. They may also be associated with other learning difficulties…
Emotional and behavioural difficulties may become apparent in a wide
variety of forms including withdrawn, depressive or suicidal attitudes;
obsessional preoccupation with eating habits; school phobia; substance
misuse; disruptive, anti-social and unco-operative behaviour; and frustration,
anger and threat of or actual violence.’ (paras. 3.64 –3.66)
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fellow pupils or with adults; and any other evidence of a significant delay in
the development of life and social skills.’ (para 7:43, p83)
In the next paragraph, the revised Code also urges consideration of environmental
and medical factors and interventions by health or social services. Having talked
thus far of EBD, it moves to a different descriptor in para. 7:52, ‘behavioural,
emotional and social development’ (BESD) (not ‘difficulties’) as one of four areas of
‘needs and requirements’ (the other three, sometimes relating to BESD, being
‘communication and interaction’, ‘cognition and learning’ and ‘sensory and/or
physical’. Recent government documents (e.g. DfES, 2003) keep this order of letters
but talk of ‘Behaviour, Emotional and Social Difficulties’. A similar mixture of referring
to BESD and EBD occurs in para 7:60, where, under the heading ‘emotional and
social development’ another short definition is offered prior to an overview of
approaches likely to reduce EBD:
This same definition of EBD and helpful approaches also appears in Quality and
Curriculum Authority (2001) and the SEN Code of Practice for Wales (NAW, 2002).
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off-task behaviour, lack interest, not finish work, not listen or hear etc’ p12). A
second example, ‘Conduct’ is item 7:
‘Shows respect to other pupils’ is set alongside the undesirable ‘a pupil may
aim verbal violence at other pupils, use psychological intimidation, show
social aggression, be scornful with other students, call other pupils names,
tease, try to dominate, use unethical (e.g. inappropriate sexual) behaviours,
blame others, push ahead in queues.’ (p13)
A third example, under the heading ‘Emotional’ is item 15: ‘Is emotionally stable and
shows good self-control’ counterpoised by ‘A pupil may be touchy, display
inappropriate emotional reaction, have difficulty expressing needs and feelings, have
frequent or strong mood changes, be irritable, be tough minded’. The descriptions of
the negative behaviours are very detailed and amalgamate discrete items, creating
problems for the accurate completion of the 15 point record sheet (though the
document indicates that this record sheet was not intended as an assessment tool
for individual pupils).
‘Those pupils who have low self-esteem. They may have characteristics
associated with terms such as depressed, neurotic, school phobic,
withdrawn or suicidal. They are not pupils who would attract the term
conduct disordered.’ (BCC, 1998a, p1; Daniels, Visser, Cole, de Reybekill,
Harris, Cumella, 1998).
These pupils are often overlooked in the literature on challenging behaviour (Daniels
et al, 1998b).
‘Mental health problems in children and young people are broadly defined as
disorders of emotions, or social relationships sufficiently marked or
prolonged to cause suffering or risk to optimal development in the child, or
distress or disturbance in the family or community.’ (DoH, 2000, p25)
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3.9 Mental health disorders
Kurtz, Thornes and Wolkind (1995), reflecting medical tradition, prefer to use the
word ‘disorder’ to ‘difficulties’ or ‘problems’. They give a long list of mental health
‘disorders’ appearing in the school age child. These include conduct, oppositional,
panic, anxiety, and obsessive compulsive disorders; agora and social phobias;
depression; attention deficit hyperactivity disorders, somatic complaints and various
syndromes. A useful classification of the range is given in Health Advisory Service
(HAS), (1995):
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(SEBD) and that the latter was ‘rather, a subjective professional judgement’ and for
the purposes of their study into young women said to have SEBD, they used it as
‘an administrative category rather than an individual psychopathology’ (p38). Two
years later, the Scottish Executive (2001) again found it hard to define SEBD,
expressing reluctance to attach any label to a child. However, the Executive said
there were such children and they clearly had SEN. They could have the following
traits:
‘Children with behavioural difficulties are often the least liked and least
understood of all children with special educational needs. Whether a child
‘acts out’ (demonstrates bad behaviour openly) or ‘acts in’ (is withdrawn),
they may have barriers to learning which require to be addressed. Children
‘acting out’ may be aggressive, threatening, disruptive and demanding of
attention - they can also prevent other children learning. Children ‘acting in’
may have emotional difficulties that can result in unresponsive or even self-
damaging behaviour. They can appear to be anxious, depressed, withdrawn,
passive or unmotivated; and their apparent irrational refusal to respond and
co-operate may cause frustration for teachers and other children. (para.
2.13)
Children with SEBD may :
• be unhappy, unwilling and/or unable to work
• receive less praise for their work and have fewer positive child/adult
interactions
• have learning difficulties or be under-achieving
• have poor social skills and fewer friends
• have low self-esteem
• be emotionally volatile
• be easily hurt.’ (para. 2.14)
Hamill and Boyd (2001) also comment on the difficulties of defining SEBD but offer a
similar list to the above, adding pupils’ ‘feelings of helplessness’.
‘(i) The term [SED] means a condition exhibiting one or more of the following
characteristics over a long period of time and to a marked degree, which
adversely affects education performance:
a) An inability to learn which cannot be explained by intellectual, sensory, or
health factors;
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b) an inability to build or maintain satisfactory interpersonal relationships
with peers or teachers;
c) inappropriate types of behaviour or feelings under normal circumstances;
d) a general, pervasive mood of unhappiness or depression; or
e) a tendency to develop physical symptoms or fears associated with
personal or school problems.
(ii) The term [SED] includes children who are schizophrenic or autistic.* The
term does not include children who are socially maladjusted, unless it is
determined that they are seriously emotionally disturbed.’
(* Nelson and Pearson, 1991, note that the reference to autism was later
removed)
The exclusion of ‘socially maladjusted’, when added to a perceived ambiguity about
much else in this definition, led to ‘widespread professional criticism’ (Nelson and
Pearson, 1991, p12; see also Rosenberg et al, 1997). By 2000, while most of the
definition remained the same, a revision to federal law dropped the word ‘severe’
from ‘SED’. This change was criticised by many according to Forness and Kavale
(2000).
This definition was accepted (Forness and Kavale, 2000) by the federal government,
who met opposition from school boards (education authorities) who feared, for
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financial reasons, an increase in the number of young people identified for whom
provision would have to be made.
‘We have adopted the term challenging behaviour…as a general label for
those classes of behaviour which have previously been called problem
behaviours, disruptive behaviours or behaviour disorders. The term
emphasises that the behaviours constitute a challenge to other people to find
effective ways of responding to them… the problem lies in the interaction
between the person, their behaviour and their social environment.’
Emerson (2001) and Porter (2003) therefore stress the important need to understand
the context in which the behaviour occurs.
‘of such an intensity, frequency or duration that the physical safety of the
person or others is likely to be placed in serious jeopardy or which is likely to
seriously limit or delay access to and use of ordinary community facilities.’
Zarkowska and Clements (1996, p3) offer the following (though are happy to use the
word ‘problem’):
‘Whilst many of the problem behaviours are similar to those which may be
found in the general population (for example, tantrums, aggression,
absconding), there are also other kinds of behaviours less commonly found
in the general population (repetitive and stimulatory behaviours, such as
rocking or finger flicking; socially inappropriate behaviours, such as
masturbating, stripping in public or smearing faeces; and, occasionally, more
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distressing self-injurious behaviours, such as self-hitting, self-biting or eye
poking.’ (p3)
They stress the social, emotional and cognitive factors (such as poor problem-
solving skills, poor communication and social skills) that can contribute to the
development and maintenance of challenging behaviour in this population. Thurman
(1997) and Kevan (2002) see challenging behaviour as a form of communication
used by some adults with severe learning difficulties in order to gain attention and
communicate feelings or needs; or as escape-motivated action (to get out of having
to do a required task). Lowe and Felce’s (1995) Welsh study in relation to an adult
population list the constituents of challenging behaviour as ‘severe management
problems’ (for staff/carers), wandering away, aggression, temper tantrums,
disturbing noises, throwing objects, anti-social behaviours, night disturbance, sexual
delinquency of ‘not severe’ self-injury [sic], destructiveness, attention seeking and
over-activity. ‘Outer directed’ behaviours tended to be rated as more challenging.
Walsh (1994) gave an Irish perspective on stereotypical behaviours: these included
body rocking, hand motions, rubbing, scratching, ‘drilling fingers’ and head banging.
Porter (2003) indicates that pupils with learning difficulties may present behaviours
perceived as challenging because they may be extreme, intense and repetitive,
where the pupil may have a very narrow set of behaviours and little or no set
awareness of the behaviour they are performing.
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4.0 Challenging behaviour as defined in assessment tools
and research data
4.1 Defining by tools and data
The characteristics of challenging behaviour may also be inferred from an
examination of the items used in some common diagnostic and assessment tools by
Ofsted and research that indicate the nature of the difficulties identified in pupils
entering specialist provision. These characteristics must be viewed alongside critical
comment on the use of assessment tools that focus on ‘within’ child deficits, noting
these tools’ shortcomings and their failure to allow for the social construction of much
challenging behaviour
‘A. EITHER six (or more) of the following symptoms of inattention have
persisted for at least six months to a degree that is maladaptive and
inconsistent with developmental level:
• often fails to give close attention to details or makes careless mistakes in
schoolwork, work or other activities
• often has difficult sustaining attention in tasks or play activities
• often does not seem to listen when spoken to directly
• often does not follow through on instructions and fails to finish
schoolwork, or chores (not due to oppositional behaviour or failure to
understand instructions)
• often has difficulty organising tasks and activities
• often avoids, dislikes or is reluctant to engage in tasks that require
sustained mental effort (such as schoolwork or homework)
22
• often loses things necessary for tasks or activities (e.g. toys, schoolwork,
pencils, books)
• is often easily distracted by extraneous stimuli, is often forgetful in daily
activities
23
• arguing with adults
• actively defying or refusing to comply with the request or rules of adults
• deliberately doing things that will annoy others
• blaming others for his or her own mistakes or misbehaviour
• being touchy or easily annoyed by others
• being angry and resentful
• being spiteful or vindictive.
The four or more behaviours must happen more than typically observed in
comparable children of similar age and developmental stage. They must lead to
significant impairment in social, academic or occupational functioning. Research
indicates that rates of ODD vary from 2% to 16% depending upon the sample and
method of assessment (Elliott and Place, 1998) casting doubt on the validity of this
term as descriptive of an ‘objective’ label.
24
and was chosen as the most appropriate instrument for Daniels et al’s (1998b)
investigation into emotional vulnerability in Birmingham schools. Over one hundred
items form the CBCL; they indicate the presence and extent of ‘disorders’ in eight
separate syndromes:
25
4.9 The Aberrant Behaviour Scale [ABC]
Recent literature suggests one tool being discussed and used quite widely with
adults and children with learning difficulties. This is the Aberrant Scale (ABC),
developed in New Zealand but published in America (Aman and Singh, cited in
Sigafoos, Pittendreigh and Pennell, 1997). This assesses the frequency and severity
of many of the challenging behaviours described earlier in relation to adults and
pupils with learning difficulties. These are then grouped under five sub-headings of
irritability (this includes aggression, tantrums and self-harm); lethargy; stereotypic
behaviours; hyperactivity (boisterousness, running around etc); and inappropriate
speech (talks to self, repetitiveness etc). The scale was first designed for adults but
later modified for children with learning disabilities. Sigafoos et al (1997) claim it to
be a reliable assessment tool for challenging behaviour in young children.
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respect to mental health syndromes, ‘children are continually changing’ (p45). He
warned that:
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5.0 Pupils with serious EBD/challenging behaviour:
prevalence and provision
5.1 Introduction
Following from the difficulties of definition described above, the numbers of pupils
with serious EBD/challenging behaviour in educational settings can only be
estimated. The same applies to numbers said by health service studies to have
mental health ‘problems’ or ‘disorders’. Giving prevalence rates is made more
problematic because data presently collected and analysed on schools’ annual
returns to government do not distinguish pupils with EBD from those with other types
of special educational need.
Table 2: Numbers of EBD special schools and PRUs and numbers on roll in
January 1998
Numbers of
Numbers on
schools/ Notes
roll, Jan 1998
units
(about 30% of pupils were
EBD schools c.280 c.11,400
boarders)
MLD/EBD
c.70 c.6,500
schools
Numbers in PRUs rise to c.10,000
PRUs c.300* 7740
in 2002
[*NB PRUs can be single or multi-site and in 1998 sometimes had less than 10 pupils on roll
and sometimes over 300]
They found that while most pupils with EBD remain on the rolls of mainstream
schools, an estimated 0.3 to 0.4% of the compulsory school-aged population
(c.20,000 to 25,000 pupils) were solely registered in English EBD special schools
and PRUs. Harris, Eden with Blair (2000) cited government figures for 1998
suggesting a further 4000 pupils (some Welsh) who remained on the roles of
mainstream schools while attending PRUs part-time. Daniels et al (2003) found long
waiting lists in some LEAs for places at PRUs, with allegations that local EBD
schools were oversubscribed. A recent study (Cole, Daniels, Berridge, Brodie,
Beecham, Knapp and McNeill, 2003) found ‘good practice’ residential EBD schools
with few or no vacancies. Similarly, Ofsted (2002b) found that places in ‘registered’
independent schools were in demand. Data from the first LEA behaviour support
plans (BSPs) (DfEE, 1998b; Cole et al, 1999) suggested that the numbers of pupils
who were identified as EBD in an area, tended to be linked to local varying patterns
of resource allocation (see Galloway et al, 1994, on availability of resources
determining numbers given labels).
29
5.3 Numbers with EBD in mainstream schools
Cole et al (1999, 2003) found it difficult to arrive at a reasonable portrayal of the
numbers of pupils with EBD in mainstream schools. In the 30 LEAs for which data
were available, rates for pupils with statements for EBD ranged from 0.2% to 1.07%.
The mode was 0.6%, i.e. twice the 0.3% suggested for ‘the most difficult pupils’
commonly reported by LEAs to the Elton Committee (DES, 1989). This 0.6% does
not include those pupils presenting serious behavioural difficulties in mainstream
settings who did not have statements. DfEE figures did not give information on pupils
placed on Stages 1-3 of the first Code of Practice (DfE, 1994c) for EBD and only 6%
of the BSPs offered relevant information on this topic. One English LEA suggested
that 4.4% of its school population fell within the remit of the BSP, a figure Cole et al
(2003) think might be typical in the light of some American evidence (see Table 3).
30
5.4 Prevalence in other countries
Kauffman (2002) estimates that between 3% and 6% of American pupils have
serious behavioural disorders. Fortin and Bigras (1997), in a Canadian review of
literature, arrive at an estimate of about 4%. Egelund and Hansen (2000) give a
Scandinavian perspective, stressing that estimates of prevalence relate to definitions
and the degree of social construction they contain. Their study of Danish teacher
perceptions suggest that about 10% of the Danish school population have serious
behavioural problems, while other Danish studies have suggested between 7% and
11%. In contrast to this fairly high figure, they note that only 1.25% are ‘excluded
from regular classes’ (i.e. placed in segregated provision). Of these, 0.3% have been
‘excluded’ for social and emotional problems (more or less in line with the English
experience). Egelund and Hansen (2000) cite a Norwegian study suggesting about
11% of Norwegian school children are said to have serious behavioural difficulties.
• 101 out of the 131 (77%) LEAs then existing maintained one or more EBD
schools
• 110 out of 131 (84%) LEAs had one or more PRUs
31
• 22 from 131(17%) operated with PRUs but no EBD school of their own
• 5 from 131 ( 4%) had neither PRU nor EBD school (including a small inner-
city and an island LEA and one LEA planning ‘alternative’ full-time provision)
• many LEAs possessed and hoped to expand their support services to reduce
behavioural difficulties in mainstream schools and dependence on
segregated provision.
The BSPs made clear that the LEAs lacking their own special facilities had access
either to other LEAs or non-maintained or independent schools. References were
made in 40% of the BSPs to the usage of other LEAs’ EBD schools. Sometimes this
had been necessitated by the progressive fragmentation of SEN services by local
government reorganisations, particularly of large urban areas, but sometimes of
mixed urban and rural areas. Some LEAs had a primary but not a secondary-aged
school (or vice versa); or their own school was over-subscribed. Some references
were made to LEAs wishing to develop more ‘in county’ or ‘in borough’ resources to
reduce the need for paying to use other LEAs’ facilities. There were references in
70% of BSPs to the LEA placing children in independent EBD schools. Given the
expense of this practice it was an oft-stated aim in BSPs to cut the usage of such
placements.
The SEN Programme of Action (DfEE, 1998a) was cautious, stressing that the
government’s approach to providing for pupils with SENs (including those with EBD)
must ‘be practical, not dogmatic’ putting the needs of individual children first (para.
3.2, p13). Special schools would ‘continue to play a vital role’ (para. 3.5) (the same
message is given in DfES, 2003). Ofsted (1999a) took a similar stance: there needed
to be a range of appropriate provision, including PRUs and high quality special
32
schools as well as imaginative approaches to curricula and FE links - but these links
should be appropriately used. Ofsted (1999b) was concerned that some LEAs did
not provide EBD special schooling, offering their EBD pupils only part-time education
in PRUs, which are not designed to be long-term provision. In Scotland, the
Educational Institute of Scotland (EIS) (2003), noting the lack of support given to
staff in ‘ordinary schools’, pressed for the maintenance of sufficient specialist ‘off-
mainstream-site' provision.
Cole et al (1998) and Daniels et al (1998a), (also Cole, Visser, Daniels, 2000), argue
that reform in attitudes, ethos and curriculum and the development of staff skills is
required for mainstream schools to successfully accommodate and address the
needs of progressively more pupils currently deemed as having challenging
behaviour or EBD (see Hamill and Boyd, 2001; and Munn et al, 2000, on Scottish
situation). Helping ‘learning support units’ to avoid the ‘sin-bin’ function of their
predecessors (DfEE, 1999) (see also DfES, 2002; Sutton, 2002) and to become
vehicles for attitudinal change as well as keeping more pupils in the mainstream,
remains a challenge. Hallam and Castle’s (1999, 2001) study holds out hope for this
type of approach.
The situation in Britain would seem to echo international experience. Egelund and
Hansen (2000) note the continuing provision for EBD outside mainstream schools in
Scandinavia, Jenkinson (1997) in Australia; Macmillan, Forness and Gresham,
(1996) and Kauffman (2002) in the USA. In short, it seems that in many countries,
there remain acute difficulties associated with realising mainstream school inclusion
for pupils with EBD.
In the light of the paragraphs above, it seems that special schools and alternative
forms of provision outside mainstream schools will continue to be required.
33
6.0 The elements of effective practice
6.1 LEAs furthering inclusion, recognising reality, meeting obligations
The evidence from Cole et al (1999, 2003) and Ofsted (1999a, 2003) suggest that
LEAs recognise the reality presented above. They encourage greater inclusion of
pupils with EBD but the view of the Elton Report remains inescapable:
‘Ordinary schools should do all in their power to retain and educate all the
pupils on their roll on-site. However, we recognise that in the case of a small
number of pupils this may be difficult, and in some cases impossible’ (DES,
1989, para. 6.39, p152).
Circular 1/98 (DfEE, 1998b) required LEAs to make comprehensive, co-ordinated
provision for pupils with EBD but they frequently have difficulties in achieving this.
(Cole et al, 1999, 2003). Where they are relatively successful, they pay careful
attention to the elements of effective practice described below – as do the schools
and units within their borders.
School/Unit level
6.2 Introduction
Weber (1982) claimed ‘The teacher is the key’ and this summarises the position of
much literature on effective practice in relation to EBD (including Ofsted, 1999a).
Visser (2000) lists research giving rise to his chapter headed ‘Teachers make a
difference’. However, elsewhere he and his colleagues stress that it is not just
teachers, rather any person working in a setting for pupils with EBD, providing
positive relationships, becoming a ‘significant other’, can make a positive difference
(Cole et al, 1998; Daniels et al, 2003). A focus on teaching and learning in the
classroom is very important, but without considering wider whole school or unit,
community and familial factors, progress can be limited (Ofsted, 1999a; Cole, 1999;
Cooper et al, 1994; Cole et al, 1998; Munn et al, 2000; Daniels et al, 2003).
Sometimes events beyond the classroom make it very difficult for the children, in
Greenhalgh’s (1994) phrase, ‘to make themselves available for learning’. ‘Joined-up’
multi-professional approaches are needed to tackle these wider difficulties (e.g.
Ofsted, 1999a). Intervention must take into account the wider bio-psychosocial
factors, in constant interaction, in the child’s life (Cooper, 1999a, 2001; Daniels and
Cole, 2002).
Client population
• Children/young people: violent or disruptive not allowed to undermine the
maintenance of a safe, caring school environment; in general, numbers on
34
roll sufficient to allow for peer relationships and employment of range of staff
able to offer broad and responsive curriculum
• Parents: the support of parents/carers should be won and sustained.
Staffing
• Leadership: energetic and proficient headteacher and SMT.
• Teachers, LSAs, residential social workers (RSWs) with appropriate
values base, empathy, skills and knowledge; and commitment to pupils; able
to offer a broad and balanced curriculum and quality group and individual
care.
• Professional support: commitment and practical support from governors,
LEA or proprietors, educational psychologists, education welfare service,
local CAMHS and other agencies.
Provision
• Policies: comprehensive whole-school policies on education, and care,
‘owned’ by staff and pupils, implemented and regularly reviewed.
• Programmes: individual education and/or care plans addressing pupil’s short
and long-term affective and educational needs, allowing for respite,
relationships and resignification. Efficient assessment, implementation and
review. Pupils actively contribute to their own programme planning and
monitoring.
• Time for talking and listening in one-to-one and small group situations.
Place
• Physical plant: ‘the home that smiles, props which invite, space which
allows’ (Redl and Wineman, 1957) catering for individual, group and whole-
school/unit needs.
• Links to the local community.
• Appropriate transport links to pupils’ homes.
(Adapted from Cole et al, 1998, p147 and Cole et al, 2002).
35
6.5 Admissions/exclusions - limits to manageable behaviour
When challenging behaviour is characterised by violent and aggressive behaviours it
can be difficult to place a pupil. Cole et al (1998) and Daniels et al (2003) reported
headteachers and other teachers’ view that pupils’ behaviour should not be of an
excessively violent or criminal nature, which makes the achievement of a positive
ethos impossible. Headteachers want and need a degree of choice over whom they
admit and (importantly - and not discussed by Ofsted, 1999a) which pupils stay at
their schools. On occasion, planned transfers may be in the young person’s and the
school’s interests. Exclusions should be used as a last resort but can be necessary
(DfES, Circ 10/99). Ofsted (1999a) commends the practice of admissions panels
(involving other headteachers and sometimes social service officers) in helping to
avoid inappropriate placements.
‘Schools must recognise that getting parents on their side is not a luxury, but
a necessity - and not just the job of a social worker or a psychologist, but
their own. This means treating parents with particular care to raise their
sense of self-worth, gently creating shared expectations and making it worth
their while to help manage their disaffected, poorly-achieving children’ (p15).
This reiterated a long held recognition that the support of the parents or carers must
be gained and sustained (DfE, 1994a; Ofsted, 1999a, 2001c; Daniels et al, 2003)
and that this can prove very difficult, particularly in the light of intractable family
difficulties (Lloyd Bennett, 1999) - but not impossible. Ofsted (1999a) noted the high
esteem in which many parents held EBD schools, which had been pro-active in
engaging their support. Cole et al (1998) and Daniels et al (1998) found staff in
special and mainstream schools placing faith in home-school diaries, telephone
contact and home visits to gain and sustain partnerships. Ofsted (1999a) similarly
argued for these forms of contact. Informing parents of their children’s achievements
at school, through certificates, notes, letters or phone calls was thought by senior
staff to be valued by many pupils and their families. Ofsted (2001c) also stresses the
need for schools to form relationships with parents to get them to assist in the
attainment of better attendance levels by their children. Effective provision must
therefore encourage a partnership with the pupils’ parents or carers.
36
parent training schemes, both in America and Britain while Bishop and Swain (2000)
outline difficulties in involving parents in nurture group work or extending nurture
group approaches to the home. However, Ofsted (1999a) reports some schools
experiencing success in helping parents to understand and to better manage their
children’s behaviour; or to develop new skills e.g. in playing with children.
Staffing
• communities that were open, positive and diverse; not selective, exclusive or
rejecting
• barrier-free in terms of curricula and support systems
• collaborative within the school between staff and between staff and pupils
(stressed by Cooper, Smith and Upton, 1994; DfE, 1994b; Garner, 1996;
Ofsted, 1999a; (in relation to black pupils – Blair, 2001; Majors, 2003); with
outside agencies (DfE, 1994 a and b; Ofsted, 1999)
• equality-promoting schools stressing every pupil’s rights and responsibilities.
37
teachers and support staff to their work in general and to each of their pupils. The
staff members of inclusive communities are caring people who create caring
communities. They talk to each other, support each other and learn from ongoing
review of their practice (this is also stressed as important in DfE, 1994b). They also
made themselves available to talk and importantly to listen to pupils (particularly
those with EBD) and parents (Cole et al, 1998; Daniels et al, 1998a; Cole, Visser
and Daniels, 2001).
6.13 Leadership
Whatever the educational setting, a keystone of effective provision is the quality of
leadership provided by the senior management, in particular the headteacher
(Cooper, Smith and Upton, 1994; Ofsted, 1995, 1999a; Cole et al, 1998). Charlton
and David (1993), amongst others, suggest that a consultative, co-operative style of
leadership which allows staff to develop ideas within an overall set of parameters set
by the headteacher, makes for proficient provision (see also Cole and Visser, 1998).
In mainstream settings Daniels et al (1998a) found key staff giving direction, creating
coherence and leading by example: at the heart of staff discussions on behavioural
issues, before, during and after the school day, were key members of senior staff.
They expressed and lived the values and practices described in written school
documentation. The difficulties of recruiting quality headteachers and other senior
managers is noted in Ofsted (2002a) as well as the beneficial effect the appointment
of a new headteacher can have on a school in special measures in Ofsted (1999b).
6.14 Teachers
The thrust of much work in the 1990s was to increase the number of skilled, subject
specialists working with children with EBD and to improve recruitment and retention
of skilled staff (Bull, 1995; Ofsted, 1999a, 1999b, 2001a, 2002a, 2003). Pupils with
EBD respond well to skilled teaching and tend to be the first to be disruptive when
faced by inappropriate or unskilled teaching. Ofsted (2002a, 2003) records some
progress in the quality of teaching in special schools, including EBD schools but
worsening difficulties in recruitment and retention of staff. Achieving better behaviour
management, thereby increasing inclusion, is in part a training issue, as the Green
Paper (DfEE, 1997) recognised: teachers should receive relevant professional
development to enhance their competence in managing challenging behaviour.
38
the characteristics of effective teachers. The answers are shown in rank order in
Table 4:
This list overlaps substantially with the qualities identified by Ofsted (1999a).
Paragraph 120 of the latter advises staff in EBD schools: to be assertive but not
aggressive; able to listen to pupils and empathise with them; not tolerate slipshod or
careless work; keep reprimands brief; give clear directions with no back-tracking;
foresee and forestall disruption; create a climate of trust and care unconditionally for
the pupils thereby winning their confidence and respect. The emphasis on
organisation and preparedness in Cole et al’s (1998) list is repeated by other
commentators (e.g. DES, 1989; DfE, 1994a; Galvin, 1999; Rogers, 1997). In
effective lessons, there tended to be warm relationships, even an emotional
engagement between teachers and pupils, a prerequisite for successful practice
according to Greenhalgh (1994).
Visser (2002) points to the possibility of a set of teacher characteristics, which are
common to all successful practice in meeting the SEN of pupils whose behaviour is
challenging. Drawing upon a wide range of work, he sets out eight characteristics
that he associates with successful practice:
These factors were described by Visser (2002) as ‘eternal verities’ and are in accord
with the lists of characteristics given earlier.
40
• Model the behaviours they desire in their students and convey that such
behaviours are truly important.
• Encourage active student participation in decision-making.
• Strive not only to teach pro-social and to reduce undesirable behaviour, but
to develop cognitions and emotions related to pro-social behaviour.
• Work to develop peer acceptance, peer support, and close friendship among
students.
• Appreciate and respect diversity.
• Appreciate and respect students’ opinions and concerns.
• Emphasize fairness: then allow for flexibility in application of consequences
for rule violations.
• Use co-operative learning activities.
• Discourage competition and social comparisons.
• Avoid producing feelings of shame (focusing more on pride and less on guilt).
• Reinforce acts of kindness in the school and community.
• Communicate often with each child’s home.
• Provide frequent and positive feedback, encouragement, and praise,
characterized by:
- sincerity and credibility.
- special suggestions and opportunities for good behaviour.
- attributing success to effort and ability, which implies that similar
successes can be expected in the future.
• Encouraging students to believe that they behave well because they are
capable and desire to do so, not because of consequences.
• A focus on both the process and the product of good behaviour.
• Reference to prior behaviour when commenting on improvement.
• Specification of what is being praised.
• Praise that is contingent upon good behaviour.
• Establish clear rules, beginning during the first few days of school, which are
characterized by:
- clear and reasonable expectations
- ‘dos’ and ‘do nots’ regarding classroom.
41
• Clear examples of appropriate and inappropriate behaviour related to each
rule, and direct teaching of appropriate behaviour if necessary.
• Clear consequences for rule infractions.
• Distributing of a copy of rules and consequences to children and parents.
• Their consistency with school rules.
• Frequent reminders of rules and expected behaviours.
• Their non-disturbance of the learning process. That is the rules do not
discourage healthy peer interactions such as co-operative learning or
appropriate peer discussions.
(Bear, cited in Kauffman, 2001,p278)
42
LSAs can also make a positive contribution to the emotional support of pupils with
EBD in mainstream schools (see Daniels et al, 1998). Lacey (2001) describes how
they should and should not work in relation to pupils with severe learning difficulties
and challenging behaviour. Striking a balance that avoids a stifling over-attachment,
being in unwanted and ongoing close proximity, while providing sufficient support to
a pupil with EBD is not easy for LSAs to achieve without some professional
development opportunities.
6.23 Governors
Cole et al (1998) also talked to headteachers of EBD schools who valued the
support they received from their governors as confidantes and supporters; as allies
in relation to other staff, parents or local community; as advocates on behalf of the
school to LEA. Ofsted (1999a) agreed and regretted the difficulties EBD schools had
in recruiting and retaining effective governors.
43
6.25 Approaches to training
On-site training, as part of teachers’ usual daily lives, can be effected through help
from Behaviour Co-ordinators (see the Birmingham ‘Framework for Intervention’ –
Daniels and Williams, 2000; Cole, Visser and Daniels, 2000) who in turn receive
assistance from specialist advisory teachers. Teachers can help themselves by
using instruments such as ‘the Framework for Intervention’s, Behavioural
Environment Checklist’ (Daniels and Williams, 2000; Cole et al, 2000) or similar
forms such as Galvin’s (1999) ‘Classroom Management Checklist’. An outside
‘critical friend/adviser’ or specialist EBD advisory teacher can assist individual
teachers or school communities working to the principles described by Hanko
(1995). To assist their development, peer support systems for teachers can be
developed (Cole et al, 1998; Hill and Parsons, 2000). These could take the form of
‘teacher support teams’ (Creese, Daniels and Norwich, 1997). Ofsted (1999a)
approved of schools instigating formal regular observations of teachers by
colleagues followed by review meetings of the teachers’ performance. They also
approved the use of LEA advisers and educational psychologists acting as staff
developers. Specialist, award-bearing courses at or linked to a range of universities
are needed to try to at least retain the percentage of staff holding a specialist
qualification related to SEN and/or SEBD. Cooper, Smith and Upton (1991) found
that only 30% of teachers in EBD schools had undertaken any additional relevant
training. Cole et al (1998) found that in 46% of 156 schools, no member of staff had
been funded to take an award-bearing EBD or SEN course between 1993 and 1996.
There is currently no evidence to indicate that this situation may be improved.
44
turnover: the replacement of unsuitable staff by more skilled and/or enthusiastic
newcomers can make a rapid contribution to the creation of safe, supportive
environments likely to support mental health needs (see also Ofsted, 1999b on
schools recovering from special measures).
Cole et al’s (2002) data suggest that building relationships supportive of mental
health needs relates to longevity of contact between adult and child – an additional
challenge for staff offering only a few hours a week to many pupils attending PRUs.
Also to be noted is the insecurity of employment of some teachers and support staff
working in ‘education otherwise’ services and PRUs (Daniels et al, 2003). Cole and
Visser (2000) suggested that stretched LEA services, often in a state of flux, have
difficulty in offering continuity of employment to skilled staff. They also continue to
employ staff whose abilities might not suit them for working with children who are
disruptive or have statements for EBD (Daniels et al, 2003). Cole et al (1999) further
point to useful staff working with children in PRUs being employed only for the
duration of time-limited government grants such as Standards Funds. These can
include highly respected youth workers, EWOs, Connexions officers as well as
teachers.
45
schools, leading to successful prosecutions and children’s allegations of wider abuse
(Grimshaw with Berridge, 1994) highlight the need for thorough vetting of staff prior
to their appointment, and the ongoing monitoring of staff once employed. It is to be
hoped that measures now in place will prevent future abuse by staff. Pupils making
false allegations are perceived as presenting particularly difficult-to-handle
challenging behaviour (Visser and Cole, 2001).
Multi-agency support
6.30 The need for LEA and other agency support
The complex social and emotional difficulties of most pupils with EBD reach into their
homes and communities. It is therefore unsurprising that many texts stress the need
for effective, co-ordinated input from a range of other professionals (e.g. DfE, 1994;
DfEE, 1997; Ofsted, 1999a; Cole et al, 1998; Daniels et al, 1998 a and b; Visser
2000 and EIS, 2003). The literature suggests there are still very large deficiencies in
England in the quantity and quality of support offered to schools and units for pupils
with EBD. Even where it is good, it appears to be ‘down to a few keen people at local
level’ (Ofsted, 1999a).
46
6.32 Educational Welfare Officers and others
Cole et al (1998) and Ofsted (1999a, 2001c) found that assistance from EWOs was
variable but the input of some officers, particularly in providing home links, was rated
highly. Some help was received from careers officers. Occasional input was received
in a handful of EBD schools from LEA advisers, youth workers and support teachers.
Cole et al’s (1999) study of English LEAs’ behaviour support plans indicated some
support offered to some PRUs from these LEA services. Nationally, there seems
limited direct input into supporting the mental health needs of pupils in many special
schools and PRUs from LEA support services. However, Daniels et al (2003) found
EWOs and specialist teachers in four LEAs attached to PRUs providing useful liaison
and practical support on a regular basis with pupils’ homes. Social skills training,
drug awareness programmes and outdoor activity programmes offered by youth
workers offered to pupils on the rolls of PRUs have also been praised by PRU staff
(Daniels et al, 2003). After initial teething difficulties, the Connexions services for 14
to 19 year olds could foster a better targeted, more holistic approach.
6.33 Mentors
The use of mentors has been encouraged by government (e.g. through the
Excellence in Cities programme) and is apparently increasing. Harris (2003), Majors
(2003) and Osler and Hill (1999) make claims for the effectiveness of mentors
particularly working with ‘at risk’ black students. Roberts and Constable (2003) offer
practical advice to those taking on this role and research by the National Foundation
for Educational Research shows their positive impact (NFER, 2002) but also worries
about the terms and conditions under which mentors are employed and their need
for access to continuing professional development. Mentors have a role to play but it
seems unlikely they should be regarded as a panacea.
47
6.35 Health service (including CAMHS)
Nationally, the assistance given by CAMHS to EBD special schools and to PRUs is
variable and often very limited (HAS, 1995; Ofsted, 1999a). HAS (1995) states that
80% of EBD special schools surveyed by their team reported that help from CAMHS
was minimal. 86% felt that the NHS did not provide the resources they needed (e.g.
visits from specialists). Headteachers of EBD schools estimated that 46% of their
pupils needed therapeutic help while only 14% had statements specifying such: only
9% actually received such help. 64% of EBD schools had had no visit from a
psychiatrist in the past year. Psychotherapists and counsellors were employed by
19% on a consultation basis, clinical psychologists by 12%. Psychiatric social
workers, drama and art therapists were employed on a sessional basis in a small
number of schools. Cole et al (1998) reported some input to EBD special schools
from nurses (occasionally psychiatric nurses), speech therapists, physiotherapists,
counsellors (perhaps employed by health authorities), and occasionally clinical
psychologists. Direct support from psychiatrists was very rare (confirmed by Ofsted,
1999a). HAS (1995) also noted the retreat of educational psychologists from working
alongside health service staff in, for example, the Child and Family Services.
According to the Audit Commission (1999), only 18% of clinical psychological
services gave regular sessions in special schools. Difficult access to CAMHS
(usually through GPs or educational psychologists) and long waiting periods are also
well documented (Audit Commission, 1999). A picture emerges of CAMHS support
to special schools and PRUs as worryingly infrequent.
‘It is important to set short-term targets and goals which will stretch but not
overwhelm them, to involve them in the formation of these learning goals
and to establish high expectations of their performance’ (p23).
The implication is that the collaborative approach to learning (strongly advocated by
e.g. Cooper et al, 1994; Garner, 1996; Cole, 2003) can assist staff in helping pupils
to break out of the children’s negative cycles of pessimistic thinking in which they
may be locked. The current authors urge a eclectic use of underlying theory (Cole,
1998, 2003; Visser 2000, 2002) emanating in a range of practical approaches that
48
can include counselling, peer support, behaviourist approaches such as target
setting and contracting (see also: Jones and Charlton, 1996; Gray, Miller and
Noakes, 1994).
Policies
49
and high achievement in pupils with EBD are facilitated when skilful teaching is
matched to pupils’ abilities and learning styles. Lesson content is to an extent
prescribed by national legislation, but within that compulsory framework there is
scope for choice of material and style of delivery. The organisation of teaching
groups, the structuring of the timetable and support packages can also impact on the
performance of pupils with EBD, lessening the frequency and intensity as well as the
opportunities for challenging behaviours to be presented.
50
(2001c) urges mainstream secondary schools to form close links with their feeder
primary schools and for their staff to familiarise themselves with Year 6 pupils about
to transfer, particularly those at risk of presenting challenging behaviour. Ofsted
(2001c) also stresses the need for the early identification of potential learning
difficulties, particularly in literacy, of pupils who have not been placed on the Code of
Practice stages in primary school. The close links between unidentified or un-
addressed learning difficulties and challenging behaviours have been often noted
(e.g. Daniels et al, 1998).
• were well controlled from before the children entered the classroom until the
last pupil left the room at the end
• were well planned and delivered authoritatively by teachers who were clearly
authorities on their subject
51
• incorporated good differentiation to allow for individual needs and to minimise
the difficulties of those with EBDs
• took cognisance of pupils’ current levels of attainment and understanding and
offered new tasks which extended and built on these levels
• where possible, utilised pupils’ known interests
• contained many small tasks with built-in mechanisms for frequent positive
feedback
• were structured to allow some freedom but avoided open-ended approaches
which placed too much responsibility on the child
• were well paced and varied in approach
• were not over-burdened with writing tasks
• contained a practical element.
52
Cole et al (1998) stress the importance of setting realistic and quickly achieved
targets that build on pupils’ present level of knowledge and understanding (the ‘plus
one principle’). Ofsted (1999a) similarly stresses the need for pupils with EBD to
experience ‘immediate success’. Other important elements identified by Cole et al
(1998) are included in Table 6.
53
Table 6: Elements in addressing the needs of pupils with EBD ranked
according to perceived importance across the items ( n ranges from 141 to
153) figures are in %
Very Quite Un-
Important
important important important
Frequent encouragement and
1= 92 5 2 1
praise
Clear expectations and firm,
91 6 3 0
consistent discipline
3 A well-established daily routine 89 9 1 1
Caring, long-lasting relationships
4 76 20 3 1
between staff and pupils
Helping children to express their
5= 63 30 7 1
feelings appropriately
Staff who listen to children and
65 28 6 1
reflect back their feelings
Key-worker or named person for
7 41 24 14 21
each child
Groups discussions/meetings with
8 27 38 27 8
skilled staff
Touch/holding children by staff to
9 22 37 30 11
comfort/ease tantrums
Regular individual counselling with
10 11 26 38 25
qualified counsellor/therapist
‘Sorting out’ pupils’ EBD before
11 12 16 20 74
stressing their education
Use of drug therapy (other than for
12 3 3 20 74
the control of epilepsy)
(Cole et al, 1998)
Ofsted (1999a) stresses the importance of the following features to minimise the
potential for challenging behaviours to occur:
54
6.46 Offering support sensitively
Observations in Daniels et al (1998a) and Cole et al (1998a) back other studies (e.g.
Lacey, 2001) indicating that some pupils, usually those with cognitive as well as
behaviour difficulties, were quite at ease with the presence of an LSA beside them.
In contrast other pupils disliked their presence, seeing it as a highly visible stigma.
Daniels et al (1998a) cite the example of a Year 10 pupil appreciating a teacher who
sometimes managed to brief the pupil ahead of the lesson about its contents. The
pupil alluded to other staff, who would wait until the other pupils were engaged in
quiet writing before discreetly moving to him to offer support. LSAs also described
their tactics for giving help. Daniels et al (1998a) describe a trained social worker
who made a point of sitting close to the girl who liked her in close proximity. In
contrast the social worker would bide her time and wait until the teacher was moving
round a room offering support to other children so that it was not unusual or
stigmatising for her to go over and offer to be a scribe for the second child she
supported.
55
6.50 Psychostimulants and ADHD/EBD
Debate continues about the desirability and ethics of prescribing methylphenidate
('Ritalin') to control the behaviour of pupils diagnosed as ADHD. Cole et al (1998)
heard opinion for and against this type of intervention but found a large majority of
senior staff wary of ‘drug therapy’ (see Table 4). Wurtzel’s (2000) account of
addiction to methylphenidate would seem likely to fuel their fears. How the phrase
‘drug therapy’ was interpreted by respondents to the national survey (Cole et al,
1998) is unfortunately unclear but it was probably connected in the minds of many to
the use of ‘Ritalin’. Cooper and Ideus (1997) and Elliott and Place (1998) give
guidance as to when the use of psycho-stimulants is appropriate, stressing (as does
Kewley 1997) that it should be one part only of a multi-modal approach. Baldwin
(2000) remained highly suspicious of the validity of the concept of ADHD, the
accuracy of diagnoses and the use of drugs while Armstrong, Belmont and Verillon
(2000) noted that in France it is illegal to prescribe ‘Ritalin’ to children under the age
of five. Local variations in diagnosis rates in relation to ADHD continue to give cause
for concern. While it is hard to argue that there might not be a medical or genetic
reason for some forms of behaviour, the literature remains divided as to which
behaviours have a more predominantly genetic base. In practice, the label ADHD is
in wide use and provides a conceptualisation of challenging behaviour as at least in
part a ‘medical’ issue, involving a medical diagnosis which can be difficult for
educators to challenge. The concerns of educators are therefore sometimes of a
practical rather than of an ethical nature with regard to drug therapy. Cole et al
(1998) heard first hand of a few cases where medication was unevenly administered
by parents and where school staff were worried about the responsibilities of giving
out medication. Clear policies and carefully monitored practice are required in this
area. The literature does not provide evidence that this is the case in all schools.
Content of curriculum
56
teachers talking to Daniels et al (2003), when linked to flexible modes of delivery and
widened accreditation opportunities (see paragraphs 6.52 and 6.53 below).
6.53 Humanities
Ofsted (1999b) had particular praise for the rise in standards in geography. This was
attributed to the employment of more specialist teachers and a more varied
approach to teaching, involving practical survey work, map reading and
investigational skills. Ofsted (2001a) noted the importance of specialist subject co-
ordinators in developing curricula and skills in teaching across schools for
humanities and indeed for all areas of the curriculum.
57
some children with EBD from the one in which they were least successful and in
which they tended to cause most problems. Ofsted (1999a, 2001) noted the
continuing difficulties in employing and retaining teachers of MFL and MFL was
commonly not offered in EBD schools.
58
EBD schools, were often linked to EBD schools introducing national accreditation
thereby raising expectations and giving pupils a sense of purpose. Ofsted (1999a)
expressed concerns that vocational courses at FE colleges sometimes did not
complement what was taught in school.
Pastoral support
59
1998. The items listed in Tables 3 and 4 earlier often apply as much, sometimes
more, to the hours pupils spend outside the classroom.
60
Severe Learning Difficulties
6.67 Approaches for pupils with severe learning difficulties
As indicated earlier, a comprehensive coverage of interventions with pupils with
severe learning difficulties (SLD) who present challenging behaviours is not offered
in this literature review. Carpenter, Bovair and Ashdown (1996), Tilstone, Florian and
Rose (1998) and Tilstone and Rose (2003) report research and good practice in
relation to curriculum (including the application of the national curriculum) for pupils
with severe learning difficulties. As for all pupils, children with SLD require good
planning and careful teaching which can in themselves lessen challenging
behaviour. To manage behaviours particularly associated with pupils with cognitive
disabilities (e.g. stereotypical behaviours, tantrums, self-harm) specific approaches,
such as the use of Snoezelen rooms (Withers and Ensum, 1995); or cognitive
behavioural approaches to anger management (Rossiter, Hunnisett and Pulsford,
1998) or touch (in this case, massage) as ‘ a therapeutic medium’ (Hegarty and
Gale, 1996), might be useful. The issue of RPI, in a scale and manner that is
different to physical restraint for pupils without SLD, is important: useful advice on
situating RPI within a wider framework of care and positive relationships is given by
Stirling (1998) and the various publications of the British Institute of Learning
Disabilities (e.g. Harris and Hewett, 1996; Harris, Allen, Cornick, Jefferson and Miles,
1996). Speech therapy to develop expressive language is vital as is work to gauge
and develop young people’s and adults’ receptive language: communication
difficulties are believed to link to challenging behaviour, indeed the latter can be a
vehicle for communication of feelings and wishes (Thurman, 1997).
6.68 Location
Ofsted (1999a) stresses that EBD schools should not be remote from mainstream
society. This should not be gauged simplistically by citing the number of miles a
school is from a child’s home (Cole, 1986; Berridge et al, 2002). Good schools,
although sometimes distant from pupils’ homes, are able to forge close links with
pupils’ homes. The challenging behaviour of some pupils can be lessened by
developing and maintaining such close links with the pupils' families and homes
(Cole et al, 1998).
61
(1998), DHSS (1970), the Schools Premises Regulations (DfEE, 1996) and Visser
(2001). Morgan’s (1993) advice, which fed into social service requirements for
children’s homes, is crucial. He described the six key welfare areas for which the
physical environment should allow: privacy, dignity, independence, choice, rights and
fulfilment. Kahan (1994) argued that high quality physical provision showed the
young people that they were worthy of adult respect and attention.
6.71 Resources
Beyond the physical environment, the provision of appropriate and sufficient
teaching equipment and materials is an obvious and important ingredient of effective
schooling. Yet Ofsted (1999b) found that provision for pupils with challenging
behaviour had a narrower range of resources for English and mathematics; fewer
than half of the inspected special schools (particularly EBD schools) had adequate
libraries. Resources for science were said to be improving in EBD schools. Ofsted
(2002a) reported an improving situation in relation to resource provision, contributing
to a rise in overall standards. In the independent and non-maintained special schools
sector, Ofsted (2002b) noted that substantially higher levels of fees did not
guarantee better resourcing for education: some lower charging schools offered
better value.
62
7.0 Equal opportunity issues
7.1 Gender issues
The contrast in numbers of girls identified as having challenging behaviour compared
to boys has already been discussed (see also Arnott and Martin, 1995; Connor,
1994). There is very little published in the last decade on why this is so, or on
specific treatments/approaches that are gender specific and effective. What literature
there is raises issues about ‘what is effective practice in relation to girls?’ but
provides no clear answers. In relation to Scotland, Lloyd (1992) reported that girls
were less likely to invoke sanctions, to be excluded or to commit offences or to show
overtly disruptive behaviours - thereby escaping notice and the need for referral.
Lloyd and O’Regan’s (1999) small-scale study of 20 female pupils’ views on their
education found the girls tending to value their alternative education higher (notably
the support they received from staff) than their previous mainstream experience,
mirroring the views of girls interviewed as part of Daniels et al, (2003). Solden (1996)
reported that American girls with attention deficits but no hyperactivity escaped
diagnosis, and, she claims, suffered damaged self-concept as a result. The day
conference held by AWCEBD (1995) tried to fill an identified gap in discussing girls
and EBD but provided little guidance.
Clubb (2003) also noted the lack of a literature on gender-specific issues in relation
to adolescent girls. She applied nurture group principles in group discussions with
girls identified by staff as having EBD in a secondary school. This study had hopeful
outcomes but involved very few girls and lasted for a limited period only. Cruddas
and Haddock (2000), reporting a small project in one London borough, repeated
arguments put forward by Arnott and Martin (1995) and heard by Cole et al (1998) in
the course of their study: it is boys rather than girls who ‘act out’ and push schools
into segregating them into special provision. Girls more commonly experience
internalised difficulties that attract less teacher attention and challenge school
communities less. Cruddas and Haddock (2000) want schools that do not allow boys
to 'drown' girls’ voices and that identify and address girls’ emotional difficulties better.
Ofsted (1999), echoing Cole et al (1998), was concerned about gender imbalances
in EBD school rolls: sometimes boys heavily outnumbered a small group of girls.
Some ‘mixed’ schools had opted to admit boys only.
7.2. Ethnicity
Little has been written directly about ethnicity and EBD but some insights are given
in a wider literature associating black and some Asian students (though generally not
Indian pupils) with school disaffection and exclusions. Cooper, Smith and Upton
(1991) highlighted the over-representation of black students in specialist settings for
pupils with EBD. Soon after, government statistics on disaffection and exclusions
clearly showed the substantial and perhaps increasing over-representation of black
students amongst excluded students. This was of concern to researchers (e.g.
Parsons et al, 1995; Parsons, 1999; Osler, 1997, Osler and Hill, 1999, Osler et al,
2001; Ofsted, 2001c). Similarly, in the United States, Forness and Kavale (2000)
recorded a disproportionate representation of youth from minority ethnic groups in
special education. Majors (2003) worried about the exclusion from schools of black
youth for fairly minor offences and sometimes for culturally specific behaviours (e.g.
63
wearing dreadlocks). The government has been seriously concerned, and the DfES,
in commissioning Daniels et al (2003), asked for black Caribbean and black African
students to be ‘over-represented’ in the sample. Given a perhaps widespread belief
that black students continued to be over-represented, Berridge et al (2002) found it
remarkable that so few black students attended the eight residential EBD schools
studied as part of their pilot. At least one of the schools in this study reported a
decrease in referrals of black students in recent years. Firm evidence is lacking but it
might be that the situation reported by Cooper et al (1991) no longer obtains or the
problem of over-representation has lessened. Also to be noted is data in Daniels et
al (2003) showing black students sometimes appreciating better relationships and
new educational and training opportunities in alternative settings (usually PRUs, FE
but occasionally special schools) compared to their previous experience in
mainstream settings.
‘is (in most instances) so different from that of their teachers, teachers often
misunderstand, ignore, or discount Black children’s language, non-verbal
cues, learning styles and worldview…When teachers are colour-blind to the
culture of others, and therefore ignore or are unwilling to affirm another’s
culture, it often leads to hostility and conflict between White teachers and
Black pupils’ (pp2-3).
This conflict between white teachers and black students was also noted by Ofsted
(1996). Blair (2001) advocated ongoing training for established teachers to help their
understanding of issues surrounding ethnicity and to help them to guard against
common stereotyping of black students. Sewell and Majors (2003) stress the
diversity of black youth: black-Caribbean boys are not ‘one big lump of rebellious,
under-achieving, phallocentric underachievers’ (p182) (see also, Sewell, 2001).
64
Ofsted (1999b) seemed sympathetic to these criticisms; reporting (Ofsted 2003) an
improvement as schools provided an education that better reflected cultural diversity.
In the main, Blair’s (2001) and Majors’ (2003) recommendations do not have a
particularly ethnic slant: they are in line with much of what has been identified as
good practice in relation to general school inclusion issues and pupils whatever their
ethnicity, in mainstream or special settings. Blair (2001) urges a humanistic
approach to teaching and skills training in understanding and dealing with
adolescents, as well as skills in conflict management, appreciation of the
vulnerability of students, and staff who listen to parents and students and involve
them in decision-making processes. Staff must know their students and have close
relationships with them. Praise and quality time must be found for students. Pupils
must be treated with respect. Staff must work closely with parents. All qualities
evidenced in earlier paragraphs in relation to all pupils with EBD. Majors (2003)
stresses the value of mentoring (as had Osler and Hill, 1999), but this also has
potential value for all young people at risk of disaffection/with difficulties (Roberts
and Constable, 2003). He praises the social inclusion policy and practice of the
government but a radical alteration to the fabric of British education is indicated.
Drawing on his research, he suggests:
65
8.0 Conclusion
8.1 Range of literature
This review has reported the international difficulties of defining
challenging/emotional and behavioural difficulties and given details of its associated
traits. It has outlined the difficulties of assessing numbers of pupils who present
challenging behaviour/EBD. It has discussed in some detail the literature on
approaches that prove effective, drawing from the available published research
base. It has concentrated on the recent English literature but has drawn on
American, Australian, Scottish and occasionally European sources. It has sought to
include the published views of practitioners on what challenging behaviour is and
how to address it. In the main, the practitioner view is in accord with and often drawn
from the research findings.
66
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