www.nurturegroups.org

NurtureGroups What

are they?

How do they work?Why are

they needed?

What are their outcomes?

Nurture groups are an in-school, teacher-ledpsychosocial intervention of groups of lessthan 12 students that effectively replacemissing or distorted early nurturingexperiences for both children and youngadults; they achieve this by immersingstudents in an accepting and warmenvironment which helps develop positiverelationships with both teachers and peers.

Nurture groups were originally developed in 1969 inLondon by educational psychologist Marjorie Boxall whosaw that a large number of children entering schoolarrived with severe social, emotional and behaviouralneeds. These students were unable to form trustingrelationships with adults or to respond appropriately toother children – in effect, they were simply not ready tomeet the social and intellectual demands of school life.

Nurture groups are now in over 1500 schools in the UKand offer the opportunity to experience the earlynurturing experiences some children and young peoplelack, giving them the skills to do well at school, makefriends and deal more confidently and calmly with thetrials and tribulations of life, for life.

Nurture groups are developed around sixprinciples of nurture:• Learning is understood developmentally• The classroom offers a safe base • The importance of nurture for the

development of wellbeing• Language is a vital means of communication • All behaviour is communication • The importance of transition in the lives of

children and young people.

What is a nurture group?

CASE STUDY

Devon NurtureGroup Our primary nurture grouphas been running for morethan two years: Our KeyStage One pupils attendfive mornings a week, KeyStage Two pupils twomornings a week, and ournurture graduates are freeto return one afternoon aweek if they wish. We haveseen significantimprovements inattendance and reducedexclusions, as well as anincreased love of school,confidence, attainment andself-esteem. Whole-schoolplanning is integral to thesuccess of our nurturegroup and we have weeklymeetings with mainstreamstaff where progress isdiscussed and targets canbe reassessed. One of themost integral componentsof our nurture group is theinvolvement of parentsand carers – they are animplicit part of theselection, monitoring andresettlement processesand are welcome to NGsessions.

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Nurture groups are aspecialist form of provisionfor pupils with SEBD.NGs need:

First and foremost NGsfocus on having the studentform attachments to lovingand caring adults at school,unconditional positive regardbeing the most powerfulmechanism for change.

The social and developmental targetsfor each student are devised usingthe Boxall Profile – a detailedassessment of social, emotional andbehavioural functioning. When theappropriate targets are met thestudent is reintegrated.

Thistakes 1-4terms

The pupils starttheir day in theirmainstream class

• A school committed to a nurturing ethos• Two caring and affectionate NG practitioners

• A group of no more than 12 students!

They are picked upby the NG staff andtaken to the NG, ahybrid of home andschool

Activities undertakeninclude emotional literacysessions, news sharing,nurture breakfast andregular curriculum tasks

Pupils still share breaksand lunch with theirmainstream class andregularly return forcurriculum time

The daily primary nurture routine is explicit and predictable:

Nurture Groups

Improvements in social,emotional and behavioural skillsand strengthening of widersocial networks

NGs help create positivechange to SEBD in school andat home (Binnie & Allen, 2008);and allow for a positiveattachment to school (Walker,2010)

NGs help develop affectivebonds between teachers andstudents, reduce exclusionsand help create a wholeschoolnurturing ethos (Cooper &Whitebread 2007)

Studies have found astatistically significant advantagein academic progress for pupilsthat attended a nurture group

Improved wellbeing

Improved behaviour

Improved achievement

Improvedteaching

Nurture groups have a thorough evidence base with over62 academic studies in the last two decades. This arrayof research has highlighted the following outcomes:

Long-term mental healthimprovements: Students withSEBD are significantly morelikely to improve in social andemotional functioning byattending NG provision thanremaining in their mainstreamclassroom. These gains werealso found to be maintainedover time (O’Connor andColwell’s 2002). One studyfound that children’s SDQscores in the abnormal orborderline category improved by29% to normal levels after threeterms of NG provision comparedto only 10% in the control group(see graph, Cooper et al. 2001)

Greater academic attainment:Children attending NGs showedsignificant gains in academicattainment as measured by

their total scores on their baseline assessment. (Reynolds et al. 2009; Seth-Smith et al.2010) This included metacognition skills (Gerrard 2005) and language and literacyskills (Hosie 2013).

Improved attendance: Nurture groups significantly reduce exclusions and lowertruancy. (Cooper 2011) Both Ofsted (2013) and Estyn [Welsh Ofsted] (2014) haverecommended NGs to improve attendance in both primary and secondary schoolsrespectively.

What are the outcomes?

SDQ scores

% of students

100

80

NGN Pre NGN Post

Borderline AbnormalNormal

Control Pre Control Post

60

40

20

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Why are they needed?Improve children and young people’s mental health: Childhood conductdisorders predict all adult disorders (Kim-Cohen et al 2003), and half ofthose with lifetime mental health problems first experience symptoms bythe age of 14 (Mental Health Foundation, 2014). Nurture groups helpmanage these detrimental cognitive, affective, or behavioural styles as atargeted intervention.

Reduce costs of mental illness to society: Nurture groups help reduce theextra costs of long-term mental disorders over a lifetime, which in the UK isestimated at costing society £70 billion a year (OECD 2014).

CASE STUDY

Tom is in year 9 and is 13 yearsold. He was taken into care at 2,adopted at 3, and his adoptedparents separated when he was8. He was put back into careshortly after, and at the time ofhis NG provision lived in achildren’s home. He has ADHDand is described as aggressive,controlling and suffering from anattachment disorder. After aterm and a half of NG provisionTom was found to have improvedhis attendance, had fewerexclusions and improved hisbehaviour.

Increase educational attainment forthe most vulnerable anddisadvantaged students: By increasingthe chances of having vulnerable anddisadvantaged students remain inschools, nurture groups help break thecycle of intergenerational poverty byremoving the barriers to learning andsucceeding in schools. According tothe Office for National Statistics (2014),those with a low level of educationalattainment are almost five times morelikely to be in poverty now as those witha high level of education.

Comply with new mental health andwellbeing policy for schools: The rolethat schools play in promoting theresilience of their pupils is important,particularly so for some children wheretheir home life is less supportive.School should be a safe and affirmingplace for children where they candevelop a sense of belonging and feelable to trust and talk openly with adultsabout their problems. (Department forEducation 2014)

Nurture Groups

*Lansford 2002

SEBD aren’t transient problems studentswill grow out of. AGGRESSIVE BEHAVIOUR

INTERNALISINGBEHAVIOUR

has a substantial stability into adulthood andtends to put students at risk of:• Higher levels of social rejection• Academic deficiencies (low grades, truancy and exclusion)

• Deficits in problem-solving skills*

and anxiety also has an unremitting course. It can significantly interfere with:• Interpersonal relationships• And academic functioning.*

VULNERABLE ANDDISADVANTAGED STUDENTSare at very high risks of personal and schoolfailure. They tend to have:• Lower grades• Are absent from school twice as much• And twice as likely to be excluded*

*Kazdin 1997

Nurture groups in national policyNurture groups have been endorsed by the UK government innumerous reports and policy papers: The Warnock Report (1978),Green Paper Excellence for All Children (1997), The Steer Report(2005), the Healthy Schools Toolkit (2012) the Mental Health andBehaviour in Schools Report (2014), and Ofsted’s Supporting Childrenwith Challenging Behaviour (2011) which concludes that:

The care, guidance and support of pupils are outstanding innurture groups. Staff are committed to assessing theparticular needs of all pupils and providing well-organisedand intensive support to overcome barriers to learning. As aconsequence, many pupils who have found schoolchallenging are attending regularly and enjoying whatschool has to offer. Ofsted 2011

Nurture groups are recognised by Education Scotland as being oneapproach to developing positive relationships and behaviour. NGs are cited by theScottish Labour Party’s Mind the Gap: Tackling Education Inequality in Scotland(2014) policy paper as an example of best practice, and in the ScottishGovernment’s paper (2014) “What works to reduce crime?” as a school-basedintervention that has been effective in reducing the risk of offending.

The Welsh Department for Education and Skills’ Inclusion and PupilSupport guidance (2006) highlights the use of nurture groups as an effectivestrategy in aiding pupils who are experiencing behaviour and attendance issues,with nurture groups also recommended as an intervention in Estyn’s Attendancein Secondary Schools (2014). The Welsh Government has also published NurtureGroups: A handbook for schools (2010) outlining how to set up and run a nurturegroup.

In Northern Ireland, the Department for Social Development hascited nurture groups as an important tool in challenging some of the barriers thatresult in low educational attainment, and has made additional funding available toestablish new nurture units across the country.

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Nurture Groups

Secondary nurture groups Children and young people have thesame basic needs – to be loved,accepted and encouraged - whetherthey are four or 14. Secondarynurture groups support all theseneeds and minimise the chances ofyoung people becoming non-attendees further through the schoolsystem. Secondary nurture groupshave been recommended by variousgovernment papers (Estyn 2014;

Scottish Government 2014) and have been the focus of 11 differentacademic studies. Just like primary school, social anddevelopmental targets for each student in secondary school NGsare devised using the Boxall Profile for Young People – a detailedassessment of social, emotionaland behavioural functioning.Secondary nurture groups requirethat practitioners focus on youngpeople’s need to:

- Feel competent

- Be socially connected

- Feel valued and respected

- Make a difference in one’s social group

- And feel that one has some control over one’s own behaviours and experiences. (The National Research Council and Institute of Medicine, 2002)

The NGN 2014 pilot study foundstudents had similar SEBD inboth primary and secondarynurture groups, including:- Acting aggressively

- Being uncooperative

- Being easily distracted

- Having low self-esteem

- Frequent outbursts

- Withdrawn behaviour

- Running away and/or leaving class

- Disruptive behaviour

- Being disengaged/lethargic

“Sometimes at schoolpeople egg me on to dobad things and I getmad, but I’ve learnt tobreathe in and breatheout… count to seven.

Year 7 NG student,Staffordshire

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How to start your ownnurture group: 1 Most nurture groups are established by a member of the senior leadership teamin the school. The Head needs to decide on a budget, a suitable room and twopermanent staff to act as NG practitioners. Most nurture groups cost less than£10,000 to establish, and a large number are funded annually by the Pupil Premium.

2 Visit our website www.nurturegroups.org and look atthe courses available near you. Learning about thepractice and principles of nurture, along with thetheoretical models that underpin the effectiveness ofnurture group provision, is essential becauseintegrated concepts and practice lead to a betterservice for the child, and equip the teacher to meet awide range of needs. Ring our friendly team andthey’ll help you book a course near you.

3 Arrange to visit a local Quality Mark Award nurturegroup in your area. A nurture group with a QMA has been established for at leasttwo years, and has one member of staff who has taken a three-day course on thetheory and practice of nurture groups accredited by the Nurture Group Network.

4 Complete several observations using the Boxall Profile assessment tool to choosethe children/young adults who will make up the first NG.

5 Send letters to parents asking for their permission to involve their son ordaughter in the nurture group. Part of the success of NGs is the regularinvolvement of parents who are given ample opportunities to provide feedback, andstaff in turn provide support to parents and give them ideas/equipment for homeactivities.

6 Update relevant school policy to reference the NG in behaviour, inclusion, specialneeds and staff support policies. Itis fundamental that a whole schoolnurturing policy be established forthe success of the nurture group. Itis recommended to create aseparate NG policy also.

Nurture Groups

NG makesmy brainsmile.Key Stage 1 pupil,Northern Ireland

AVERAGE NG STATSSessions per week: 5 Length of provision: 3 termsTotal hours of provision: 487.5 hoursCost: £1.62 per hour, per childSources: QMA course, Pilot Study 2014,Staff Questionnaire 2015

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Funding and cost breakdown How are most nurture groups funded? The most popular option to fund NG provision in a questionnaire of over 80 NGs inthe UK was found to be the Pupil Premium. This is followed by LEA funding whichincludes nurture groups in the East Midlands, North West, South East, Wales andScotland, followed by school funding.

How much does a nurture group cost to run annually(including NG practitioners’ salaries)?A part-time nurture group (from 3-15 hours a week) costs an average of £48.58 anhour to run. If the nurture group has at least 30 students passing through each yearthat is £1.62 per hour, per child (487.5 hours, 5 mornings a week for 3 terms).A full-time nurture group (16+ hours) costs an average of £54.89 an hour to run. If thenurture group has at least 30 students passing through each year that is £1.83 perhour, per child (721.5 hours, 5 mornings and 4 afternoons a week for 3 terms).

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How do they work? Nurture Groups

Attachment TheoryThe fundamental theoretical model that underpins the effectiveness of nurturegroups is John Bowlby’s (1965) attachment theory which argues that children acquireage-appropriate behaviour through interactions with significant others. If a child’searly experiences were characterised by missing or distorted nurturing, it can lead tostunted social, emotional and cognitive development. Yet nurture is not a ‘once-and-for-all event that must take place in a critical period’ (Gopnik et al, 1999), and missingor distorted early experiences can be overcome with the help of nurturing adults.

The neuroscience behind nurture groupsThe NGN 2014 pilot study found that 3 in every 5 students in NGs had experiencedsignificant trauma in their young lives. Though a few stressors can be manageablefor young children, there is a point where prolonged stress becomes harmful andneurobiological factors are affected (Poulsen & Finello, 2001). In turn, the levels ofglucocorticoids in the brain, particularly the stress hormone cortisol, get raised andmaintained at a level that becomes neurologically harmful. The region of the brainthat is most affected by increased levels of cortisol is the hippocampus, the region ofthe brain predominantly involved in memory. (Gunnar & Lonard, 1998). Stress inearly life could thus permanently impair hippocampus-dependent learning andmemory (Karten et al., 2005), and children who have experienced more intense andlasting stressful events in their lives have been found to post lower scores on tests ofspatial working memory, and short-term memory. (Hanson et al. 2012) As Perry(2002) explains, “When in this state, the key parts of the cortex are not receptive tocognitive information that is not relevant to survival … the capacity to internalize newverbal cognitive information depends upon having portions of the frontal and relatedcortical areas activated, which in turn requires a state of attentive calm.” The goodnews is that with sufficient nurture and support from adults, children can return theirstress to tolerable or good levels (Middlebrooks & Audage, 2008), and high-quality

Social and emotional learning interventions have an identifiable and

significant impact on attitudes to learning, social relationships in school,

and attainment itself (on average around three to four months additional

progress). Improvements seem more likely when approaches are

embedded into routine educational practices, and supported by

professional development and training for staff. Education Endowment Foundation Toolkit

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interventions can eliminatethe negative effects of earlypsychosocial deprivation onexecutive functioning – acore set of self-regulationskills that regulatethoughts, actions andemotional responses thatpromote goal-directedbehaviour. (McDermott etal. 2012) Nurture groupshelp students return tohealthy levels of stress by:1) Providing a consistent,predictable pattern to theday; 2) Having nurturing,comforting and affectionateadults trained in attachmenttheory run the group; 3)Having expectations ofbehaviour clearly discussedwith the child/young adult;and 4) By providing a spacewhere the student feels protected, is given choicesand some sense of control.

NG provision shares manyevidence-based componentswith other effective psychosocialinterventions including:Building affective bonds: Forming positive, trustingrelationships with students and beingresponsive to their individual needs.Consensual goal setting: Setting achievable targets from TheBoxall Profile.Modelling: Role modelling of appropriatebehaviour/social skills between twoadults participating in constructiveinteraction.Cognitive restructuring: Perspective taking; Recognisingtriggers of anger; Distinguishingbetween helpful and unhelpfulthoughtsAffective education: Understanding, identifying andlabelling emotions; Recognisingphysical and environmental cues ofemotions; Providing opportunities for

pupils to verbalisetheir emotionalexperiences.

Relaxationtechniques: Mindfulness;Controlled breathingtechniques.

Key Stage 3 pupil, Lancashire: Before I came into nurture I used to come into school and run away

because I didn’t feel safe and secure…Now I’ve picked up my attendanceand know how to react and not panic… I think staying in school andsorting the problem out is the best solution.

Infant and Nursery School Headteacher, Warwickshire: Attendance improves with nurture and since the nurture group was

formed there have been no exclusions at all …[this is because of] theimpact nurture has on vulnerable children and families.

Parent of Key Stage 1 nurture group pupil, Walsall: Her confidence has improved and her learning, she can ask for help in

class now. It's changed her, it's focused her, she's a lot moredetermined. What we have here I couldn't dream it. Everything is focusedupon what the child needs.

Nurture Groups allow for pupils to make considerable progress fromtheir starting points, both in the social, emotional and behaviouralaspects and with their reading and writing skills. Pupils became moreconfident in their main classes and this increased their participation.Parents reported that the children were happier and their behaviourwas more settled at home. Attendance also improved for those forwhom it was an issue.

The Pupil Premium: how schools are spending the funding successfully to maximiseachievement (2013)

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Ofsted

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Nurture Groups

In their own words:

Kevin Kibble, CEO of The Nurture Group Network: Sometimes children need extra support to help them with theirlearning, making friends and growing into confident and successfulindividuals. Nurture groups can help provide that support forchildren and parents to give them the skills they need to do well atschool, and deal more confidently and calmly with the trials andtribulations of everyday life.

Most children start school with confidence and enthusiasm but notall. Some do not respond to teachers or teaching methods, leavingthem disengaged from their surroundings. This can evidence itselfin a child being withdrawn and inward-looking, or ‘acting out’,behaving aggressively to teachers, fellow pupils or others aroundthem. These behaviour traits limit the child’s ability to absorbinformation and learn and may even reach the stage of exclusionfrom school, a damaging and emotionally charged experience forboth child and parents.

The behaviour of these children also impacts adversely on others inthe class, disrupting lessons and taking up a disproportionate shareof the teacher’s time and attention. Class morale suffers, learningis inhibited and standards and levels of attainment can fall. In manycases this can be prevented. For more than 40 years nurture groupshave demonstrated that, with the right help, support and resourcesapplied, these children can be taught successfully, cost-effectively,and reintroduced to mainstream classrooms to continue theireducation with their peers.

The development of nurture groups led by trained practitionersoffers an effective intervention both in primary and secondaryeducation (indicating that it is never too late). The nurture groupsolution has been shown to be effective in enabling emotionallyvulnerable children to engage in, and benefit from, mainstreameducation.

www.nurturegroups.org

Visit our website for references and more informationNational Office t 020 3475 8980 e info@nurturegroups.org18A Victoria Park Square, Bethnal Green, London E2 9PB

Tweet us! @nurturegroups

The Nurture Group Network exists to promote the development ofnurture groups and to ensure the continuing quality of their deliverythrough accredited training programmes, research on effectivepractice, relevant publications and information exchange. Our aim isto make the nurture group approach available to all pupils who needit and also to ensure that the connections between learning and

early development are understood throughout education.

About the Nurture Group Network

Registered England and Wales, charity number: 1115972. Scottish registered charity number: SC042703

• Increase educational engagement• Reduce exclusions• Ensure academic progress• Foster emotional wellbeing• Reduce aggression and incidents of withdrawn behaviours

• Create a more inclusive ethos• And ultimately remove barriers for learning for ALL children and young people

Introduce Nurture as both a way ofthinking and as a targeted intervention!

It works.

So, if your school wishes to: