Complex SEMH

Intent

Pupils with profound and multiple learning difficulties (PMLD) and complex learning needs (CLDD) are more likely to have mental health difficulties than any other group. Therefore, the social and emotional wellbeing of pupils following the complex curriculum pathway is central to the curriculum offer.

We actively seek to support all of the pupils in developing a sense of self and having as much autonomy as is possible in their lives.

Learners following the complex curriculum pathway are as entitled as any other group to be social learners. We support them in being part of social groups, both within their classes and the wider school community. We teach them the skills that they need to be more involved in community, within their class group, in the school community and in the wider community outside of school.

Respect is essential to develop self-worth. It is our intent that all of our learners are treated with the utmost respect at all times. That their care needs are addressed sensitively and that everything that happens throughout the school day is done with them rather than to them.

To support emotional wellbeing everyone needs time to recharge, to be alone and to follow their own interests. We support our learners in following their interests in leisure time, these interests may be idiosyncratic, for example shaking beads or passing objects from hand to hand but they are non the less valid and very meaningful to the individual.

Our pupils are faced with many complex barriers to their learning. They may have medical and physical issues that impact their well-being. The school day can be very tiring for them and pupils may need frequent breaks to be by themselves, ground themselves through sensory activities or rest.

We teach all of the pupils to be as independent as they can be in all areas of their lives, both because it is practically useful and because any level of independence, however small, supports feelings of self-esteem.

Implementation

The complex SEMH curriculum has three stands

• Wellbeing and relationships
• Autonomy
• Community

The three strands are taught through intrinsic activities and strategies throughout the school day and through specific, taught sessions.

These areas of focus allow us to work on skills and tolerance, to increase engagement and to work in a targeted way with families and carers.

A sense of self

We aim to provide a menu of emotionally nurturing experiences woven throughout the day and infused within other curriculum areas. Along with dedicated emotional wellbeing time and activities each day.

We support pupils in developing as rounded a sense of self as possible by teaching awareness of their face/ image

• looking in mirrors, looking photos, videos etc,

Body awareness through

• movement to music
• dance massage,
• Massage
• Sherborne movement
• Swimming/hydrotherapy
• Rebound therapy

Emotions and wellbeing

We acknowledge that managing emotions is very challenging for pupils with CLDD. Pupils need the support of responsive, skilled adults to coregulate their emotions with them. The NAC states of arousal framework allows us to be consistent in our understanding and support for pupils in managing emotions.

We consider emotional wellbeing to be about much more than being happy. It involves enabling expression of all feelings and emotions, whether considered good or bad We do not automatically consider  outward expression of, or outpouring of emotions, such as frustration, rage, fear, anxiety, pain and sadness to be ‘a bad thing’,    ‘Sitting with’, ‘being with’ and responding in ways that validate the person’s experience and supporting them with the more difficult and perhaps ‘negative’ emotions is key to our approach in developing emotional wellbeing

Emotional wellbeing has many components and may include:

• Being and feeling safe and secure (when there is no present danger)
• Having the capacity for feeling comfort, pleasure, enjoyment, contentment, interest and motivation
• Having authenticity of feeling and expression
• Experiencing emotions in a way that ‘fits’ the situation
• The ability to manage, cope with, not be overwhelmed by or stuck with distressing emotions
• Having hope
• Having feelings of self-worth, connection and belonging
• Having agency

We use a range of activities and strategies to support pupil wellbeing

• Arts and creativity
• Music
• Nature
• Mindfullness
• Interactions and relationships
• Movement
• Movement
• Senses
• touch

These are delivered both as part of the curriculum and as additional approaches and activities where we have highlighted concerns about pupil wellbeing

Each day, for the pupils following the complex curriculum, starts with a session centred around wellbeing that supports pupils in making the transition into school and re-establishing the interactions and relationships with familiar staff central to wellbeing.

Choice is built into as many activities as possible. We carefully interpret pre-intentional communication to support pupils in communicating choices.

The learning environment is designed to allow all of the pupils to have as much control in activities as possible. For example, the use of A-frames, position boards etc. that respond to very minimal movement, the use of switches and IT access equipment.

Pupils are supported to take part in activities using hand under hand rather than hand over hand support so there is no compulsion to explore.

Consent

Pupils with CLDD, in common with all other pupils have the right to consent to activities in their day. They do not have the cognitive and communication skills to give informed consent but are able to give implied assent

‘’Implied assent is considered to have been given when a person’s behaviour is interpreted as showing willingness and approval.’ (Guidance NAC wellbeing)

We gain implied assent before every activity and acknowledge that pupils can withdraw their implied assent during an activity. If pupils do not give their implied assent then adults do not insist that they take part.

Being Social

Many of our pupils enjoy being part of a social group. All pupils take part in some group activities each day. Most pupils have limited awareness of stimuli that is presented at a distance from them so activities are carefully structured to maximise engagement. Some pupils find being part of a group difficult; we balance teaching the skills to tolerate groups with a respect for the distress this can cause.

Community

An understanding of self in community starts first, for many pupils with CLDD, in being part of a class group. Each class will have a minimum of 2 circle times each day that focus on being part of a group.

Regular activities of school life such as assembly and play time allow pupils to develop skills in being part of a larger group. We also support pupils to manage change, for example taking part in occasional school activities such as whole school assemblies and performances and tolerating fire drills

We acknowledge that being part of the community is enriching for our pupils. Being able to access life outside of school can be challenging for pupils following the complex curriculum pathway. We implement a programme of community activities for our pupils that allows them to learn the skills that they will need to be able to enjoy being in the community safely. The programme includes

• Travelling safely on the minibus
• Using public transport
• Road safety
• Visiting local parks
• Countryside visits
• Supermarkets
• Local shops
• cafes

RSE

RSE for pupils following the complex curriculum forms a part of the intrinsic SEMH curriculum. Key elements to the RSE curriculum are

• Making choices as part of activities and interactions
• Making a negative choice – saying no
• Appropriate touch – staff ensure pupils are cued in before they are touched, that pupils remain clothed during activities that require touch such as story massage or movement to music other than hands or feet.
• Age appropriateness – as they move through the school pupils are given as many opportunities to take part in activities common to other pupils of their age as possible, for example, music, popular culture, clothes etc.

As such our approach to personal and intimate care is central to RSE for pupils with complex needs.

Personal care is always carried out in a way that is respectful and where appropriate follows the lead of the pupil

Personal exploration of anatomy at school during personal care is not encouraged but where it occurs staff label anatomy using correct anatomical vocabulary and allow some time for pupils to explore before redirecting. This is in line with cognitive stage development.

However, if exploration happens in a public or communal area such as the classroom pupils are redirected, and staff use the language of privacy ‘pants are private’. We are aware that pupils may not understand the verbal message but work towards a consistent approach and vocabulary supporting privacy and safety.

Spirituality

We acknowledge the value of spirituality to everyone, including those with complex learning needs.

Classes following the complex curriculum have a time of reflection each day. This is a quiet time for the whole group – pupils and staff, to be together. The session is often multisensory and follows a familiar pattern to support the pupil’s memory and anticipation.  The session may celebrate a pupil or a religious festival or may focus on an element of the class theme – for example using images of nature, music or sound.

Faith

We seek to celebrate the faiths of our pupils’ families and the wider community in ways that are accessible to them. This includes

• sharing multi-sensory faith stories
• Taking part in whole school activities and celebrations
• Visiting religious buildings

Autonomy and care routines

A substantial part of the school day for our learners is taken up in care routines. Many of our pupils will need some adult support to manage eating, drinking, dressing and toileting needs throughout their lives.

We work with families and with therapists to devise programmes around eating, drinking, dressing and toileting.

For some of our pupils it is more relevant and more respectful to think in terms of autonomy rather than independence. Maximum autonomy can be achieved by being aware of what is happening to them and by making choices about what happens to them wherever possible. Therefore, pupils are cued in about what is going to happen using a range of strategies including body signs, objects of reference, photos, symbols, signs and words.

We endeavour to maintain the highest standards of respect for all our pupils by never discussing intimate care needs in a public space.

Waiting

Research suggests that one of the main causes of poor mental health amongst learners with the most complex needs maybe boredom. We acknowledge that the high care needs of complex curriculum classes together with the time taken to ensure everyone is in the appropriate position or piece of equipment can mean there are times when pupils are without direct adult input and are waiting.

We address this concern by planning activities that pupils can engage in independently, for example listening to music, sensory exploration etc. We also incorporate routine and careful use of cues so that pupils learn that the time they are waiting will be limited.

Curriculum coverage

Snack time and lunchtime 45mins each day

Intimate care 20 – 45 minutes each day

Reflection 15 mins daily

Community – weekly timetabled session – varying according to individual need

Autonomy – self help skills – intrinsic to school day + 15 min taught session daily in US

Impact

The impact of learning opportunities is assessed on an ongoing daily basis through careful staff observation. Learning is evidenced using video and photographs. Impact is evidenced using the Evidence for Learning online system.

We use the engagement model to assess pupil engagement across the range of learning opportunities given to pupils following the complex pathway.

We work collaboratively with parents and other professionals to set long-term SEMH targets as part of pupil EHCP reviews as appropriate. These long-term targets are broken down into termly Individual learning intentions (ILIS).