Controlled Studies of Nurture Groups

To date, five nonrandomised studies have researched the effectiveness of nurture group provision by comparing improvements in social and emotional functioning and academic progress for children with social, emotional and behavioural difficulties (SEBD) in nurture groups compared to students with SEBD that remained in their mainstream classroom.  The studies which included 1239 students, 89 schools with nurture group provision and 50 without, show that students with SEBD are significantly more likely to improve in social and emotional functioning and academic achievement by attending NG provision for at least two terms rather than remaining in their mainstream classroom. This was true for both full-time and part-time nurture group models.  All five studies show statistically significant improvements in Boxall Profile scores, and half of the studies show statistically significant improvements using the Similarities and Differences Questionnaire.  Two of the three studies that analysed academic attainment for both case and control groups showed a statistically significant advantage in academic progress for students that attended a nurture group compared to those that remained in the mainstream classroom. 

Main variables and measures of the five studies

Boxall Profile 

The nurture pupils significantly increased their performance on the Developmental Strand of the Boxall Profile compared to the control group following two terms of provision as shown by the increase in scores.  An increase in developmental scores is correlated with more pro-social behaviours such as: giving purposeful attention; participating constructively; engaging with peers/responding constructively; being emotionally secure; accepting constraints; and being accommodating.

In addition, the NG students’ performance on the Diagnostic Profile of the Boxall Profile was also enhanced following the provision, as shown by the decrease in the scores.  A decrease in diagnostic scores is correlated with less anti-social behaviours such as: self-limiting features (disengaged and self-negating); underdeveloped behaviour (craving attachment and showing inconsequential behaviour); unsupported development (having an insecure sense of self and showing negativism towards self and others, avoiding attachment). 


Strengths and Difficulties Questionnaire (teacher version)

SDQ scores significantly improved for the nurture group students following two terms of NG provision compared to the control group as shown by the decrease in the scores. Cooper et al.’s (2001) study, for example, found that, “At entry, 92% of children in Nurture Groups are in the abnormal or borderline range on the SDQ, when they are observed in mainstream classrooms, compared with 84% of matched mainstream pupils with SEBD. By the third term, this has changed to 63% for Nurture Group pupils compared with 75% for pupils with SEBD. The mean differences between these scores is statistically significant (chi square, p=<.000).” (p. 163) 

Academic Achievement
N=319 (163 NG, 156 CG)


Why has there been such a significant improvement for students with SEBD in nurture group provision compared to students in mainstream classrooms?

Seth-Smith et al. (2010):

“The overall decrease in SEBD features in nurture group children may be due to improved social skills. The small group facilitates the development of interactive skills such as turn taking. The sustained emphasis on considerate behaviour facilitates positive social interactions between children that are mutually rewarding … Pro-social behaviour is known to predict peer acceptance (Dodge, 1983; Ladd et al., 1988). Children in nurture groups learn behaviour that renders them more rewarding and likable to both peers and adults. Underlying the development of social and friendship skills are a specific and evolving set of social and cognitive capacities, including empathy (Hay et al., 2004).  Nurture groups place particular emphasis on promoting children’s ability to recognise and communicate about feeling states in themselves and their peers. Improvements in peer group relationships have a protective function if they generalise into children’s lives. Evidence suggests that these improvements are sustained in nurture group children; reintegration into the mainstream class has shown to be successful following time in nurture groups (Iszatt & Wasileska, 1997).  Nurture group children’s interactions are also likely to be influenced by the teacher’s attitudes to their peers, many of whom would in a mainstream classroom be experienced as ‘disruptive.’ Evidence suggests that peers make use of their observations of teacher-child interactions to inform their own interactions with a particular child (Hughes et al., 2001; Meehan et al., 2003), therefore, changed teacher attitudes can impact on peer acceptance (Zionts et al., 2004).” (p. 30)

Cooper and Whitebread (2007):

“Both quantitative and qualitative data … point to the strong possibility that the presence of an effective NG adds value to the work that schools do with the wider population of children with SEBD. The qualitative data in particular indicate that mainstream staff develop more ‘nurturing’ approaches to pupils on the basis of their interactions with NG staff. These interactions are supported by the tangible benefits accrued by NG pupils from their placement in the NG, which are reflected in their mainstream performance as observed by mainstream staff.” (p. 187)

Cooper et al. (2001):

“Such a holistic approach has the potential to produce positive outcomes across a wide range of variables, including social, emotional, behavioural and educational functioning of children; parents’ attitudes towards their own children and the school; and the positive functioning of whole schools.” (p. 165)

Reynolds et al. (2009)

“Nurture groups are grounded in attachment theory (Bennathan & Boxall, 2000), and they represent a clearly-targeted intervention for addressing the emotional and behavioural issues of children with major difficulties in the development of secure attachments. Possible relationships between attachment and academic outcomes have been demonstrated in several studies of children and young people of various ages (see, for example, Jacobsen & Hofmann, 1997; Marcus & Sanders-Reio, 2001; Moss & St-Laurent, 2001).” (p. 20)

Scott and Lee (2009)

“The results [of the nurture group students] do indicate that they were able to maintain and surpass a level of progress comparable to that of their peers. This finding is important because it suggests that the fears of some of the class teachers that children might be disadvantaged by being placed in the group and therefore having less access to the formal curriculum, are misplaced. In fact overall the children seemed to have kept up with or surpassed the gains of their peers academically despite the loss of time, while ‘catching up’ in terms of their emotional and social development.” (p. 10)



Cooper, P., Arnold, R. and Boyd, E. (2001), ‘The effectiveness of nurture groups: preliminary research findings.’ British Journal of Special Education, 28 (4), pp. 160–166.

Cooper, P. and Whitebread, D. (2007), ‘The Effectiveness of Nurture Groups: Evidence from a National Research Study.’ Emotional and Behavioural Difficulties, 12 (3), pp.  171-190.

Reynolds, S., Kearney, M. and MacKay, T.  (2009), ‘Nurture Groups: a large – scale,
controlled study of effect on development and academic attainment.’ British Journal
of Special Education
, 36 (4), pp. 204 – 212.

Scott, K. and Lee, A. (2009), ‘Beyond the ‘classic’ nurture group model: an evaluation of part-time and cross-age nurture groups in a Scottish local authority.’ Support for Learning, 24 (1) pp. 5-10

Seth-Smith, F., Netali L., Richard P., Fonagy, P. and Jaffey, D. (2010), ‘Do nurture groups improve the social, emotional and behavioural functioning of at risk children?’ Educational and Child Psychology, 27 (1), pp. 21-34

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