Podcast | Season 1 | Episode 12: Social, Emotional and Mental Health Needs in Children and Young People

Listen to Steve Baker's insightful presentation on how brain development influences behaviours and learning, and what educators need to consider when they interact with children with Social, Emotional and Mental Health (SEMH) needs.

Supporting Children and Young People with Social, Emotional and Mental Health Difficulties

• How the brain develops over time and what influence this has on behaviours and learning
• The impact of threat on our behaviours and the importance of positive relationships
• How to use non-confrontational approaches to modify behaviour over the long term

Steve Baker, Executive Headteacher, Kilgarth School

This session was recorded live on 14th November 2019 in the SEND Theatre of the Schools & Academies Show at the NEC in Birmingham.

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Transcript

Steve Baker
00:25

If you come to listen to me talk about SEMH, good, you're in the right place. What I'm going to do is I'm going to try and do a whistlestop tour of the way that my schools work. If you're asking me a question, we don't have to wait for Q&A at the end if you want to challenge me about any the, the scientific validity behind our approaches that you know, I'm gonna come and talk to you. Is that okay? Fantastic. So my name is Steve. I am currently the Executive Head of two SEMH schools up in Merseyside and I have a secondary school and I was asked to go and take over a primary school was in a spot about I was under threat of closure. Using the approach I'm going to talk about the secondary school is just to be outstanding in all areas the primary school as well as being under threat of closure within two years we got that back to outstanding in all areas as well. We don't use punishment in the secondary school. We don't think it works, particularly for the cohort of young people that we use. And I do a lot of research for people like Goldsmith's and and the University of Liverpool into clinical psychology and, and the development of violence and aggression. So that makes sense. Don't judge me, I used to be an Ofsted inspector as well. But I'm quite a nice guy again now.

Steve Baker
01:35

So this is what we're going to talk about. I'm going to talk about brain plasticity, neurobiology and how the brain develops over time and how we can use that to our advantage in terms of supporting kids with SEMH. My secondary school is 11 to 16 boys only. My primary school is CoEd. Okay, I'm going to talk about the impact of threat on behavior. So why we need to reduce threat within the classroom and developing positive relationships. with young people, I'm going to talk about the non confrontational approaches to behavior modification. I don't talk about behavior management, my staff don't. Because I can manage behavior in my schools by going in and screaming at the little kids in the primary school. That is all about effective management in the short term. We're interested in long term modification of behavior, so children will make better choices. Yeah. Does anyone ever come across McLean's Triune Brain Theory? So I'm going to give you a quick precis of this. It was a theory that came about in the 1970s by a psychologist by called Paul McLean. And what he said was over time, our brain is actually made up of three distinct areas. Now, before I go into detail, I'm not going to get into the nitty gritty of neuroscience. However, what McLean said there are some holes in his theory, like any scientific theory, it can be challenged, there are some holes in it, but the basic premise stands true. Okay, so he said there are three distinct areas in our brain all interconnected, but they all have their own agenda. And in response to any threat, whether it's a real threat, the perception of a threat, or the memory of a threat, our reptilian brain, as he termed it, takes over to keep us alive in terms of evolutionary psychology. So we only started developing cities about 10,000 years ago. And since then we've we've come to the forefront of developments. We have things like the Sistine Chapel and Britain's Got Talent. So we're at the pinnacle of human development, but our brain hasn't caught up with that. That's what it looks like. So McLean, hypothesised that we have this reptilian complex, which keeps us alive, so to deal with unconscious stuff with breathing. Surrounding that is the limbic system, which has to do with our emotional and our emotional well being. And finally, what distinguishes us from the other animals is our neocortex, which gives us our reasoning. Is that okay? Run with me so far.

Steve Baker
04:02

In real life, that's what it looks like. So, if I was going to give one of you a Christmas present, I am more likely to give you a puppy. Because a puppy has got emotions, it's happy, it will cuddle you, you can nurture it, you can become its best friend, it can become your best friend. It's more than likely going to reduce your blood pressure, it will lower your heart rate and it will be good for your wellbeing. I am not going to give you a Komodo dragon. Because a Komodo dragon is basically a reptilian complex on legs. It's only going to be interested in survival, aggression, preeding or breeding. By Boxing Day it's going to do a bit of basking in the heat, it's going to do a bit of lurking, follow around the house and bite you and watch you die slowly then eat you so that's not what I'm going to give you. I obviously can't give you Nelson Mandela, but his his neocortex. The outside the wrinkly about the brain is very, very developed. He's a human being that deals with things like language, complex thinking, planning and motor commands. Now the difficulty with our reptilian complex is it's 500 million years old. And so if we see any threat or a perceived threat or the memory of a threat, it takes over to keep us alive.

Steve Baker
05:18

With me so far, it goes that incredibly quickly now you've all heard of the fight or flight response yet, you've probably all heard that the amygdala the part of your brain that switches off the rest. So your reptilian complex suppresses what's going on in the rest of your brain, just to keep you alive. It is incredibly fast, it's spontaneous. Basically, it will raise your levels of aggression. It will and it will make you fail to effectively use your remote, mines kicking off at the moment because want to scream at them to just keep it down a little bit. It will basically upset you and you don't really think about what you're doing. When it's so fast, that it releases loads of adrenaline into your system, adrenaline lasts about 45 minutes in your system at half life is around there. And then it starts to slowly fade away. So if any of you've dealt with a young person who was really upset, and the jaw sticks out and the rise of popping out and the fists clenched, it's no good talking to them until they've calmed down and calming down can take a significant amount of time. The stress hormone cortisol stays in your system for one to two hours. The Happy hormone dopamine stays in your system for one to two minutes. Now just to give you an idea of how long you can be upset for my schools are asking me so we have to do restrictive physical intervention. Occasionally we try to de escalate behaviors, 95% of the time it works the 5% it doesn't. We have to intervene. We have to restrain young people unfortunately, I hate to but we do. We practice on each other as adults, on inset days. Now one day, I said to Mick who was on the most articulate intelligent people who I know. And some on the front row met him and he's fantastic. He's the head of my secondary school I said to make pretend to be a child and crisis, do whatever you want go crazy. You can swear you can scream, do anything. You are only allowed to calm down if someone de escalates you using these words, or if it's a male or if it's a female or someone with a beard because some of our kids don't like me because I've got a beard. Some of them don't like me because I've got a scouse accent so I just said to him go wild. He went absolutely nuts for 25 minutes, he created a table. On top of the table. He had a mountain of chairs and he sat on the top telling everyone to... he was screaming at the staff, and he wouldn't come down for half an hour. Now on a serious note, how long just turn to the person next to you and tell them how long do you think it took for him to calm down? So don't want to just shout out an answer. Three hours, two days. Remember what I said about the memory of a threat? So every time he thought about it, he was made okay? He got to tell us stuff he doesn't really like anyway, to eff off, and he started to wind himself up, your adrenal glands start to release more adrenaline, and he started to getting primed for fight or flight. It is absolutely instantaneous. And they can prove that by showing you this picture. What's going on there? What's everyone doing? That? I love this because I'm having fun. That is the cop. Don't judge me. That is the kop. Everything I say is just theoretical. I will throw a chair right? Yeah, that is the kop absolutely gutted. When Michael Owen has missed an open go. Now thinking back to evolutionary psychology terms. What they're doing is they're communicating with each other that there is a threat, something bad has happened. It's like, back in the day if a sabre tooth tiger, walked through the jungle, and I'm walking along with my mate Johnny, and I hear something and I run off. I'm going to survive and pass my gene pool on. Johnny goes, Oh, I wonder what that was and he gets eaten. He's dead. So that's what happens. We are primed to notice bad things. So everyone there has put their hands on their heads to warn each other. We are social creatures to warn each other. There is a threat, something bad's happened. Another example of threat overtaking our reptilian complex and it suppresses our normal thinking is in 2010, England got beat 4-1 by Germany in the World Cup. What rate turn to the person next to you, say hello if you don't know them, what rate you think domestic violence increased in this country that night, after we got beat 4-1 because we were upset? anyone?

Steve Baker
09:31

It wasn't that high. Someone said 70%, that's really catastrophic. It's really depressing. To be honest, it was 29% but like just just back away from the humor element. 29% increase in domestic violence because people are upset because something that happened in South Africa that doesn't really affect those anyway. The same is replicated all the time when the home football team gets beat. Domestic Violence often increases in that area. It's shocking. Let's think about threat within the classroom. School is threatening no matter what you think for all children all the time, it's threatening, not just for the kids for us. I'll be honest with you, I had two Ofsted inspections within six days, six months ago, and I'm not going to be negative. I nearly walked away from the profession because my mental health took such a hit. And I run outstanding schools. It was horrendous. So we're all on the threat of don't get it. It's too loud. It's too hard. I can't read properly. How many of those kids do we see all the time. And you might think I've got no mates. That's not really a threat. There was a piece of research by the marshmallow professor who did the marshmallow test. His name is Professor Walter Michelle. And he showed that the effect of social isolation works on the same neural networks as physical pain. So there has been some research into the theory that taking paracetamol can solve or cure a broken heart. So it's a real threat that we're seeing. And let's be honest, forgive me for saying this. If we're looking at these percentages, free school meal versus non free school meal boys. 12% of free school meal boys and key stage two, with a reading level below in the old level 10s below level three. What that means is they can't read the front page of a tabloid newspaper. They're under threat all the time. Yet at the same time when Ofsted come and see us with the new education inspection framework. We are expected our peoples will read widely and often with fluency and comprehension appropriate to their age, were under threat all the time as well.

Steve Baker
11:31

Piece of research that the DfE did was about all the stresses that affect children. It's not just in the classroom, it's outside the classroom, what's affecting them so we need to remove this threat for them to learn effectively and I'll show you why in a second. You will be able to get the slides by the way. What I want you to do. By the way, this is true. This is a real headline. You can Google it later and it wasn't a soft top. Someone was under that much threat he took a chunk out of a metal roof car. You Because she was on the threat. Let's let's be honest, you can get the Everton theme coming through ex Liverpool Luis Suarez he probably gets paid about £200,000 pounds a week. When he's under threat. He bites people. It just shows we don't think rationally. Does anyone want to have a burning desire to share a time when they were under threat? They may have acted irrationally. I know you've all done it. You've all given someone a finger when you're driving down the M6. I've seen people on the threat all the time. This lady it seems daft she bit a chunk out of a car. She had lost her partner. He drowned off the North Wales Coast in the sea. And it was just after the funeral she was really upset. The other thing that suppresses our neocortex and stops us thinking rationally is drinking alcohol. Not only was she upset she was socially isolated. She was emotional a rattling complexes all over the place. Your body's probably full of adrenaline. She was drunk. She went across the street in a car pulled in front of her and she gave him the finger and started screaming didn't know what to do and better chunk out for car. So we've got to realise that threat does affect us in a massive, massive way.

Steve Baker
13:11

I'm going to start talking about learning, and emotions now and link it all to do with threat. So this is what human brain development looks like. So our brains are really fascinating things. When we're born, we've got big heads, not because our brains are fairly big as human beings, they, they become about 90% full size by the time of six, where you can see initially when we're born, and when we're in second third trimester, we initially develop our, our sensory pathways, then we have this window for developing our language skills. So if you learn a language before the age of 12, you can you can continue to learn things. The old adage you can't teach an old dog new tricks is simply not true. I'm going to talk about neuroplasticity in a moment. But there are windows of opportunity where it's more effective. Early intervention is better than remedial action, so if you learn the language before you're 12, you will probably have a perfect or near perfect accent. If you learn French afterwards, like me, you'll sound like Joey Barton went through his Marseille phase, which is a scouse French thing going on. Then your high cognitive function develops. Now for those who are in secondary settings, it all started again, from the age of 12 to 25. Basically, your brain starts to redevelop and it starts from the back to the front. So the reptilian complex, the brainstem that develops initially, it doesn't get bigger, it just gets more wirery you, you get the laying down of new neuronal connections, and a little fatty substance called myelin on your axons, and it makes it 100 times more efficient. So for those of you remember Harry Enfield and and Kevin, the teenager he was a lovely kid, that when it was his 13th birthday, excuse me, turned into a turd and it's basically to the premise is true, because when you reach the age of 12 to 25, your brainstem starts to redevelop. And remember I said, it's all about aggression, preening breeding, impressing your peers. And that's because in terms of evolution, you're more likely to respond to what your peers are doing. You're not interested in teachers, because simply you can't have sex with them. You can't procreate and pass on your gene pool. So that's why you're interested in your peer group. So any of you towards the bottom set year nine, you probably all have everything that I'm saying is resonating with you.

Steve Baker
15:34

If you don't use certain elements of your brain, you simply lose them because they will be used for other things. Okay, so your brain. When you're when you're young, you make about 700 new neuronal connections every single second, like a piece of brain the size of a grain of sand has got about 100,000 nerve cells, and a million neuronal connections or sign lapses, that's how intense it is. Constantly laying them down. If you keep using them, they become stronger. It's called heavy in theory you create instead of having one network of neuronal cells, you create a superhighway, so they all start to connect each other. Okay? There's a piece of research Forgive me for quoting this, it's quite horrendous is a piece of research in Oxford in the 60s where they took a kitten and blindfolded it from bith and left it for a couple of months, and they took the blindfold off and it and it stayed blind. And that's because of this, use it or lose it process. So the kitten remain blind because it wasn't using its its visual cortex. So that's a waste of blood. It's a waste of oxygen, it's a waste of glucose. So all the areas of the brain took over that cortex. So probably the oldest cortex was far more effective. So the kitten probably have better hearing. Okay, so you need to keep using your brain or otherwise your use, you will lose it. That's it. Really nice picture of neuronal architecture. I just wanted to put that as an example of, of how it's not one simple laying down of neurons firing against each other. It's about a massive connection. And the reason why I'm telling you this is because your emotions are not just linked to how you behave, they're linked to learning as well. That's why we need to think about emotions when we're in the classroom for effective progress to be made.

Steve Baker
17:26

I mentioned it's called heavy in theory. Now, I'm going to simplify it, but there are two basic areas in the brain that are that are used to create memories. So the first area is called your corpus striatum. And that's effective in creating habitual memories, or unconscious memories. That's what you do unconsciously. That's how you behave. So I'm going to ask you to think now you don't have to discuss this think now about how you have a shower in the morning. Okay, I bet you you do everything in exactly the Same or that every day because it's unconscious. So you may or may not have noticed I've got no hair. So every day I shaved my head, I start on that side, I then do the back, I then do that side, I then do the front, and then I put my razor down, I'm done. If I ever try and do it in a different order, it just freaks me out a little bit. Another example, please give it a go, you've probably done something similar. But another example of your corpus striatum and habitual memories and unconscious action is just put your hands out. Put them up. Now I want you keeping your palms up to try and fold your arms The other way that you usually do it, but get your foot palms up. So it feels a little bit weird. Now if I asked you to do that every day for five minutes for the next two months, you would just do it naturally because you will create a new pathway in your brain that now you will be able to cope with unconsciously. So that makes sense. There was a piece of research I found is fascinating. I love it. It's not worked for me. And I'll explain why in a minute piece of research in America in Cleveland, and it's been replicated all over the world, where they took some took a control group and a group of people, and, and they gave them weights to do on their finger. Now, the control group didn't do any weights on their index finger, they just imagine doing it. And they had to imagine doing it over time, every single day, the strengthen their index fingers increased by up to 35%, just by imagining because you get a much more effective neuronal connection in your brain. I've been trying it with a six pack for the last 12 years and it's not working unfortunately. The final thing is episodic memory, and that in your hippocampus, that's what we need to know about for learning effectively in the classroom. So can anyone tell me what the capital of France is? Please anyone. Thank you very much Paris. There's no prize. We work in the public sector. So it is Paris. That's an episodic memory. It's something you have to think about. I want you to have a think about what you had for breakfast this morning. Okay, so episodic memory, we have to think about it. Now, I said emotions are really important in learning. And that's because of the use of a neurotransmitter called dopamine. Okay, dopamine is released. I've got time to go into this. I tend to do like a half a day session on it. I've got like 10 minutes left. But dopamine is used in the reward system. And the way it works with emotions is if you are stressed, I'm not talking about being under pressure. You know, we all know the research shows that if you're under pressure, you work more effectively. I'm talking chronic debilitating stress. If you're under stress, dopamine floods your brain. Yeah, absolutely floods your brain. It's like a short circuit. And, and that's what people think happens in depression and chronic fatigue syndrome, you get too much don't mean your brain doesn't work effectively. The other thing that happens is if you get too much stress, you release lots and lots of adrenalin for your fight or flight response that burns memories into corporate striatum, your unconscious part of your brain. So there's research going on at the moment. I think that's what happens with PTSD. So you don't know why. You can't consciously recall something. But all of a sudden, something will trigger you and an unconscious memory will come back I in a weird way, I before I was a teacher, I was a war crimes investigator. So I was exhuming bodies over in the Bosnian Genocide and doing autopsies, and occasionally, something will trigger me, memories will come back to me. So that's PTSD. The other thing that happens is, you release steroids when you're stressed and they actively destroy your hippocampus. Your hippocampus is the bit your brain you need to learn in school. So why would you want to destroy the bit of your brain where you need to learn The only effective way that we get dopamine released is through rewards, or the ancestor the patient of rewards.

Steve Baker
22:08

Now, I said both my schools are outstanding in all areas. And we use rewards based system to develop our our people's choices. When I say rewards, obviously special schools are funded on our local mechanisms that the national funding formula makes no difference towards my schools get half of benchmark. So we are chronically underfunded with a deficit budget. When I'm talking about rewards, I'm talking about things like a pat on the back, or a smile or a well done or a phone call home. That's all I'm talking about, because we literally can't afford anything else. The research also shows punishment doesn't work, particularly those with SMG or callous unemotional traits that which is the precursor to adult psychopathy. Those are social communication difficulties, ADHD, SMH. The thing that punishment does is it causes secondary behaviors. So when we used to give people detentions, we would often see, if someone got a detention on Monday morning that would ruin the rest of their day, they would turn tables there would be screaming, they would be shouting, then, quite often, it would ultimately end in exclusion. It also impacts on our wellbeing. So let me know punishment doesn't work because of the criminal justice system. So the prisons are full SMH schools have full pupil referral units or for AP are full, everything's full. If punishment worked and excluding pupils worked, my schools wouldn't be full. So we need to think a little bit differently. The prisoners Education Trust in 2016 show that 88% of the people in the in the youth system have been excluded from school, high levels of Speech Language communication needs, high levels of dyslexia, lots of learning disabilities, lots of issues around working memory, and understanding what's going on. So we're currently doing some research around alexithymia in my schools, which is actually do children understand their emotions. And if they do, can they verbalise them as well, because we see that behavior as a form of communication, and we're trying to address an unmet need. So that's what we're moving from management's of behavior, as I mentioned earlier, which is basically for efficiency. And it's very short term, it's very impersonal, it's operational into modification, which is designed to to affect permanent change.

Steve Baker
24:26

I'm not going to stay long on Maslow, we all know about Maslow. We know the bottom elements of the the pyramid before you can move to self actualisation, or actually about having your basic physiological needs met or also your social needs met. So the way that we've done this is we've gone by gone about having positive relationships with young people. I mentioned prisons last year, in March 2018. Her Majesty's Inspectorate Prisons like prisons Ofsted, they released a thematic report looking at behavior in prisons, and the very first finding says, positive relationships between staff and those in their care underpin all effective behavior management systems, we need to have really I'm not saying be their mate. I'm saying be friendly and be professional about it, develop a relationship, get to know them. If we can understand the person in front of us, we will develop their self esteem, if we develop their self esteem will develop their sense of self worth. If someone's saying, I thought you're waving at me, I've got five minutes left. We develop their self worth, they are more likely to engage and engagement is the platform for education. The issue is not going away. It's getting bigger. Blackburn Spencer Ried talked about disability in the 21st century actually be a confluence of intergenerational poverty. We know poverty breeds SEND, intergenerational poverty, our modern medical progress. So preterm birth extremely preterm birth, issues with fetal alcohol spectrum disorder disorder, which affects the parietal lobe and mathematical ability.

Steve Baker
26:01

So, I wanted to talk about SEMH and support. And then I do a lot of work with a friend of mine, Alice Jones, who's who's the head fo one of the psychology department at Goldsmiths. And she's the, she's the editor of the educational Journal of educational psychology and, she did a lot of work with us as we removed our, our, our sanctions. And she says, from a meta analysis point of view, looking at lots and lots of studies, the key pieces of behavior management or social skills, training, relationships, are about having system wide behavioral interventions, doing it effectively, and making sure you do it consistently, whatever you do, and modifying the curriculum to make sure that we can engage our young people.

Steve Baker
26:47

Basically, we need to positively reinforce peer to peer, peer to teacher and teacher to teacher interactions. My wife says happy wife happy life. I say happy staff, happy kids better outcomes. Now we all know that too, don't we? No one's ever done a piece of research to linking all three. I put a bid in to try and get some funding from a charity to do that. And we, unfortunately weren't successful. But I went to advise the DfE in the summer, and I summed it up is that just treat people humanely. Let's be honest, we don't see enough of that within education, sometimes not from a school point of view, from the powers that be by won't be political because we're PURDAH. So we need to promote positive mental health in schools, be non confrontational, and break down barriers for pupils with additional needs. For those of you wanted to look at it from an individual cluster class basis. There are some strategies on there. I'm going to have to sum up, so I'm going to sum up because I like this slide. So no one ever come across that story. Kyrie and Brielle Jackson, so this is two they were born extremely preterm. They were less than two pounds in weight in America. And basically, I always forget the names. Brielle was dying. So after three weeks been under two pounds, he started to die. They're in separate cots. Kangaroo care, which is what is done globally wasn't done in America at the time the nurse thought I'm gonna let the sister say goodbye to each other. She picked up Kyrie, put her in Brielle's cot, someone happened to have a camera and took this photo. This is absolutely true. Kyrie immediately put her arm around Brielle and this reinforces the idea positive relationships immediately her vital signs stabilised and she has gone on to live a normal, fulfilling happy life. What I'm not saying is just go out and huig children but actually in a way I am because we are doing some research with a guy called Professor Francis McGlone is a world leader in terms of social touch. And if we don't have social touch, areas of your brain simply don't develop and it causes emotional and social issues. We know it from the 60s when Harvey Harlow, a psychologist did work with baby monkeys. He took them away from mummy monkey and some he put in a cage with a bottle of milk and a wire. Mommy thought they couldn't cuddle. And they had massive social issues, behavioral issues, and they didn't survive. The others who he put with a soft stuffed toy with the milk. They did relatively well. If you're interested in in an early intervention, I would recommend looking at the Hackman equation. He's a Nobel Prize winning economist from the state who talks about early intervention isn't reception. It's not nursery. It's second and third trimester when we start to educate people about the importance of effective parenting. Okay, so what Francis McGlone says is he says, there are certain fibers and neuronal fibers in our body called afferent c-fibres. And if you stimulate them at the rate of five centimeters per second, you develop social brain architecture. Now if I translate that into lay terms, you go like this. Not rocket science. We do that when our kids are in bed taking their SATs at year six. We even do it with some of the older lads in the GCSE. There was a great article in the TES a couple of months ago about social panic about touching children. I'm not saying go out and talk to children, but we need to have relationships with each other. And the last thing I'd say is, a lot of the work started from a lady called Sonja Lyubomirsky, who did research on I just like the word on spiderlings, their baby spiders. And she showed that the spiderlings who were relatively touched more often by mummy spider, we're more likely to go and investigate novel areas and environments. So basically, we need to have positive relationships to develop people. Now. I'm running out of time, I haven't got time to talk about our reward system effectively. But if any of you are interested in finding out any more, we have loads of people. I do lots of work with the Ministry of Justice in prisons. I have prisoner Governors visit. You're always, not all at once, but you're very welcome to come and visit. There's me. There's my Twitter handle. If you've enjoyed, let me know if you've got any questions, fire away and thank you for being so attentive.

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