Nurture Group Research FAQ

There are over 62 academic studies in the last two decades researching nurture group (NG) provision. Findings include:

  • Children who attended a NG had a significant chance of improving their learning skills (Gerrard, 2005), including language and literacy skills (Hosie, 2013) and their academic attainment improved, even over the course of just one year (Sloan et al 2016, Reynolds et al 2009);

  • NGs resulted in an improvement in pupils’ behaviour (Sloan et al 2016) and social skills (Cooper & Tiknaz, 2005);

  • Mainstream pupils in schools with NG provision improved in behavioural terms significantly better than mainstream pupils attending schools without NG provision (Cooper & amp; Whitebread, 2007);

  • NGs resulted in a positive change to social and emotional functioning at home (Binnie & Allen, 2008);

  • NGs result in a positive attachment to school (Walker, 2010);

  • Gains in social and emotional functioning are maintained over time by nurture group students (O’Connor & Colwell, 2002);

  • The younger the pupil accessed the nurture group, the more significant the gains in social functioning and academic performance (Scott & Lee, 2009);

  • The best results have been achieved when the nurture group has been in existence for at least for two years (Cooper & Whitebread 2007; Rautenbach 2010; Garner 2010)
     

Why do we need nurture groups?

Many vulnerable children are underachieving because of social and emotional barriers caused by challenging circumstances in the early years– we now know that the early promise shown by the brightest poor students can be lost as they progress through school,1 that only one in three disadvantaged students achieve five good GCSEs passes,2 and that those with a low level of educational attainment are almost five times more likely to be in poverty now as those with a high level of education.3  To highlight how many children could potentially be underachieving due to social and emotional barriers, studies like that of Sutton Trust’s Baby Bonds paper, which found that 40 per cent of children are insecurely attached,4 have certainly helped us to understand the severity and scale of the problem. Currently, one in 10 children and young people aged five to 16 suffer from a diagnosable mental health disorder (around three children in every class),5 and the costs of long-term mental disorders over a lifetime are currently costing the UK an estimated £70 billion annually.6

 

So the earlier the intervention the better?

There is a wide consensus that the foundation years are a critical period for a truly preventative approach. For example, in Early Intervention: The Next Steps, Graham Allen made a compelling case for investing in policies and programmes that promote early intervention, particularly in the foundation years. Graham Allen argues that, “Building their essential social and emotional capabilities means children are less likely to adopt antisocial or violent behaviour throughout life. It means fewer disruptive toddlers, fewer unmanageable school children, fewer young people engaging in crime and antisocial behaviour. Early intervention can forestall the physical and mental health problems that commonly perpetuate a cycle of dysfunction”. However, nurture group provision is never too late.  Children and young people have the same basic needs – to be loved, accepted and encouraged – whether they are four or 14.  Secondary nurture groups support all these needs and minimise the chances of young people becoming non-attendees further through the school system.

 

What evidence do you have that nurture group provision works?

There are over 62 academic studies in the last two decades researching nurture group provision, including five non-randomised studies that have shown children and young people attending nurture groups are more likely to improve in social and emotional functioning than their peers that remain in the mainstream class.

 

These studies are:

Why do nurture groups work?

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 & Wasilewska, 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)

 

What are the most common social, emotional and behavioural difficulties in nurture groups?

The most common social, emotional and behavioural difficulties of children undergoing NG provision in a study of 100 nurture groups were the following:

That list includes both internalising and externalising behaviour - does nurture group provision help with both?

Nurture groups benefit both internalising and externalising behaviour.  In a pilot study of 100 nurture groups7the primary nurture pupils exhibiting unaggressive SEBD increased their performance on the Developmental Strand of the Boxall Profile more than those exhibiting aggressive SEBD, though both groups improved in general.

The primary nurture pupils increased their performance on the Developmental Strand of the Boxall Profile following the intervention as shown by the increase in scores (from blue to orange).  In addition, the pupil’s performance on the Diagnostic Profile of the Boxall Profile was also enhanced following the intervention, as shown by the decrease in the scores (from green to red).

 

Who is the average nurture pupil?

In the pilot study he was a little boy in Key Stage One who lives with his single mother and at least one other sibling and has little to no contact with his father.  He is highly likely to have experienced significant trauma at some point in his life, and his mother is likely to suffer from some kind of mental illness.  His behaviour at school is most likely to be described as aggressive, uncooperative and distracted and he suffers from lack of self-worth.  Though he is described as bright his volatile behaviour significantly hinders his academic progress.  He is more than likely to have a strained relationship with his peers and have no friends at school.  After NG provision he is likely to have at least one more friend at school, a better relationship with his parents/guardians, and be more likely to reach a state of attentive calm in the mainstream classroom which allows him to significantly improve his attainment, attendance and self-confidence.

 

Are nurture groups only for children and young adults with SEBD struggling academically?

No.  Bright children achieving levels at or above age-appropriate targets made up half of the NG students in the 100 nurture group study.  Both bright children and those that were below or significantly below average academically had similar gains in social and emotional functioning post-provision. These gains in emotional intelligence allowed students of all ages and academic levels – both in primary and secondary school – to adopt better ways of dealing with academic stress and have wider social networks concomitantly resulting in improved grades (as noted in their pen profiles).  

 

Does nurture group provision address and remediate social, emotional and mental health problems?

Yes.  Students with SEBD are significantly more likely to improve in social and emotional functioning by attending NG provision than remaining in their mainstream classroom.  One study found that children’s SDQ scores in the abnormal or borderline category improved by 29% to normal levels are three terms of NG provision compared to only 10% in the control group.8 

 

Are gains made in nurture groups maintained over time?

Yes, gains in social and emotional functioning are maintained over time by NG students.9  

 

Does nurture group improve attendance?

Both Ofsted in their 2013 ‘Pupil Premium’ paper, and Estyn in their 2014 ‘Attendance in Secondary Schools’ paper, have recommended nurture groups to improve the attendance in both primary and secondary schools respectively.

 

What evidence-based components are used in nurture groups to address and remediate SEBD?

Nurture group provision uses evidence-based components which aim to address and remediate social, emotional and behavioural problems in children and adolescents. 

These 12 components are:10 

Building affective bonds

  • Builds positive, trusting relationships with pupils/good rapport/familiarity 
  • (Affection, attention, caring physical contact, early basic experiences and the 
  • reassurance that the student is valued)
  • Labelled praise
  • Emotionally nurturing atmosphere
  • Responsive to individual needs

Consensual goal setting

  • Sets achievable targets from Boxall Profile assessment
  • Reviewing/reinforcing target behaviour/skills 

Modelling

  • Role modelling of appropriate behaviour/social skills between two adults participating in constructive interaction
  • Peer modelling 

Coping template / Positive self-instruction / Cognitive restructuring

  • Methods to generate alternative solutions/evaluate options
  • Perspective taking
  • Recognising triggers of anger
  • Forecasting future setbacks
  • Deliberate exposure to what triggers negative thoughts/reactions along with a coping template
  • Distinguishing between helpful and unhelpful thoughts
  • Graded hierarchy approach (breaking-down worrying situations into manageable steps)
  • Identifying other people who use good coping models

Rewards

  • Behavioural reward systems: marble jars, team targets, sticker charts
  • Prizes/gifts/books (dependant on behaviour and achievable targets)
  • Golden time
  • Extra play time
  • Time with favourite teacher/class pet
  • Taking the class toy home

Role-play exercises / Social skills training

  • Practicing/rehearsing skills
  • Re-enacting hypothetical situations

Affective Education

  • Understanding, identifying and labelling emotions
  • Recognising physical and environmental cues of emotions
  • Providing opportunities for pupils to verbalise their emotional experiences

In-session curriculum / Structured tasks

  • Curriculum planning and assessment as a collaborative responsibility between the nurture group practitioner and the mainstream teacher
  • Circle time    

Homework                                                                                                                     

  • Assigning and reviewing tasks to complete
  • Setting up behaviour charts for implementation at home/practicing skills        

 Relaxation techniques                                                                                                

  • Mindfulness
  • Controlled breathing techniques
  • Identifying a range of activities which students find enjoyable and relaxing

Parental involvement 

  • Staff provide ideas/equipment for home activities and support parents to develop  appropriate interaction strategies and management for home
  • Parent praise
  • Open afternoons or evenings are often held termly and younger siblings are welcomed
  • A few parents spend part of the day or the entire day in the nurture group

Limit setting

  • Ignoring negative behaviour
  • Traffic light system
  • Time ‘in’

 

What gaps in the research literature currently exist?

Though there are more than 62 studies (and counting!) involving nurture group research, including 5 non-randomised studies, one randomised control trial, and two systematic reviews, there are still many areas to explore. Including:

  • Longitudinal studies that test the effects of NG provision over longer periods of time;
  • Studies incorporating NG provision in secondary school; 
  • RCT trials; 
  • Qualitiative studies of effective NGs with different mixes of children with externalising/internalising behaviours, ages and gender;
  • Studies on effective practices to involve parents in NG provision, especially hard to reach parents. 

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1 Social Mobility and Child Poverty Commission(2014) https://www.gov.uk/government/news/smcpc-research-on-attainment-of-disad...

2 Adams, R. (2015) http://www.theguardian.com/education/2015/jan/29/gcse-gap-rich-poor-widens

3 Office for National Statistics (2014) Which childhood factors predict low educational attainment 

http://www.ons.gov.uk/ons/rel/household-income/intergenerational-transmi...

4 Sutton Trust (2014) Baby Bonds. Available online: http://www.suttontrust.com/wp-content/uploads/2014/03/baby-bonds-final.pdf

5 Green, H., McGinnity, A., Meltzer, H., et al. (2005). Mental health of children and young people in Great Britain 2004. London: Palgrave.

6 OECD (2014) UK needs to tackle high cost of mental-ill health, says OECD http://www.oecd.org/health/uk-needs-to-tackle-high-cost-of-mental-ill-he...

7 Scott Loinaz (2014) https://www.nurtureuk.org/evidence/ngn-commissioned-research/pilot-study...

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

9 O’Connor, Tina and John Colwell (2002). The effectiveness and rationale of the ‘nurture group’ approach to helping children with emotional and behavioural difficulties remain within mainstream education. British Journal of Special Education, Volume 29, Issue 2, 96–100.

10 Scott Loinaz, E (2014) http://www.nurturegroups.org/what-we-do/research-and-evidence/evidence-b...