Practical support for identifying and meeting need

How to spot signs of SEMH needs in a school or setting

Any child or young person can experience challenges to their mental health, but some children and young people are at greater risk of developing mental health needs than others. This will depend on a range of factors including a child’s temperament, the range and severity of challenging life events that they face and have faced previously, and the extent to which they learn coping skills and get support to build their resilience (support provided by emotionally available adults).

Some children and young people will have a history of needing support to develop social and emotional skills in education settings. For others, there may be a sudden change in their mood, behaviours and relationships due to a life experience or event.

Open, warm relationships with children, young people and their families are key to understanding contextual experiences which may be affecting SEMH.

Children and young people who appear to have emerging SEMH needs may find it harder to:

  • make and maintain appropriate and healthy relationships
  • regulate their emotions
  • focus and engage with rules, routines and the curriculum.

Sometimes these needs will present as:

  • withdrawn behaviour
  • challenging, overactive or disruptive behaviour
  • poor attendance or punctuality.


Some children and young people may have experienced trauma. The UK Trauma Council defines trauma as ‘a distressing event or events that are so extreme or intense that they overwhelm a person’s ability to cope, resulting in lasting negative impact’.

Schools and settings can be a ‘protective factor’. When they have emotionally available adults to support children and young people who, for whatever reason, might not have others around them to offer them the support that they need, the short and long-term impact can be life changing.

Trauma is not an event itself, but an emotional response to an overwhelmingly painful and stressful event where there was no-one there to help you with what was happening at the time.

Margot Sunderland (Trauma Informed Schools UK >)

Identifying the signs of trauma

A child or young person’s trauma will show in their behaviours and become a barrier to their learning.

  • Physical symptoms such as sleep problems including nightmares, headaches/stomach pains, or signs of regression (going back to things they did at a younger age such as bedwetting and thumb-sucking).
  • Becoming preoccupied with thoughts, being unable to concentrate and becoming irritable.
  • Experiencing problems in their relationships with others.
  • Being on edge or hyper vigilant (always on the lookout for danger).
  • Experiencing heightened anxiety or persistent low mood. This can manifest as ‘fight, flight or freeze’ behaviours.

Children or young people who have been traumatised tend to experience toxic levels of stress, which in turn means that their systems are coursing with the stress hormones adrenaline and cortisol. As a result, they are permanently on high alert and the slightest thing (not always discernible to us) can trigger the ‘fight, flight or freeze’ response.

Could it be something other than SEMH needs?

Sometimes children and young people may present with signs of SEMH, but these are a response to an underlying learning need. It is worth asking the following questions:

  • Does the child or young person have any specific learning needs which haven’t yet been identified, e.g. with literacy?
  • Are they struggling to follow classroom talk and getting confused and frustrated? Go to speech and language page >
  • Are they struggling with the level, pace and volume of work? Do they need work further differentiated?
  • How do they feel about themselves as a learner – and how is their self-esteem? Are they avoiding situations where they fear failure?
  • Do they have sensory needs? Go to sensory needs page >

Children and young people who have concentration and impulsivity needs

Some children and young people may have the diagnosis of ADHD or be demonstrating behaviours associated with ADHD such as hyperactivity, impulsiveness and inattention.

Another condition called ADD (Attention Deficit Disorder) has similar symptoms to ADHD, but people don’t feel as hyperactive. For people with ADD, the main need they have is difficulty concentrating.

Sometimes children and young people who have experienced trauma can demonstrate behaviours associated with ADHD, however these behaviours are linked to a need to feel safe and are signs of hyper vigilance.

Support strategies include:

  • Regular breaks which allow for movement
  • Include in everyday practical jobs
  • Ignore ‘low level’ behaviours
  • Provide tactile and sensory aids
  • Exercise and sport
  • Relaxation activities
  • Clear repeated rules
  • Consider the environment – reduce distractions and don’t overwhelm with too many resources
  • Encourage reflection and support with repairing difficult situations
  • Support with managing emotions, especially anger, stress and frustration
  • Teach calming strategies, e.g. deep breaths, counting
  • Check understanding at the beginning of an activity
  • Help with planning and organising activities
  • Think carefully about seating and distractions
  • Provide written instructions and worked examples
  • Use visual aids to help focus
  • Active discussions and practical learning
  • Break activities down into small steps
  • Regular ‘check ins’ and feedback
  • Paired work with a positive role model
  • Personal organisation: lists, reminders, homework