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        • AnxietyAnxiety disorders are one of the most common mental health problems identified in children. Estimates of the rates of prevalence vary greatly from 8% to 27% lifetime prevalence by age 18. Chronic anxiety disorders are associated with increased risk of other serious mental health problems in later life. Therefore, early identification and treatment is key. Watch our information and real life experience films below or view and download our fact sheet and supporting presentation.
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        • TraumaTrauma in children may be: A one-off experience, such as a car crash Living in an atmosphere that feels unsafe, or where they are witness to violence Experiencing, or witnessing, harm Experiences of war, or of becoming a refugee Stressful and challenging experiences are a part of life, and most children will experience these at some point. This becomes traumatic if the event is more than a child can make sense of, or cope with. To learn more about Trauma in Children, please refer to our informational and real-life experiences videos.
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        • DyslexiaDyslexia in children is a common neurodevelopmental disorder affecting language processing, particularly in reading, spelling, and writing. It emerges early in childhood and persists into adulthood. Encourage your child’s strengths and provide a patient, nurturing environment. Remember, dyslexia doesn’t define intelligence. With the right resources like ours below, your child can flourish and excel in their own unique way.
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        • UK Trauma Council ResourcesNip in the Bud is very grateful to the UK Trauma Council for permitting us to show on our website their series of four excellent animation films about Trauma and PTSD. The UK Trauma Council’s work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 License. These animations have been produced with the involvement of young people themselves, and are designed to help young people and the adults around them recognise the signs of post-traumatic stress disorder. They also suggest ways of coping with scary memories, explain the science around the best treatments, and answer any worries you might have about getting support.
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        • Mental Health Conditions

        • AnxietyIt is becoming increasingly common that children and young people in your school or classroom may be diagnosed with anxiety. Symptoms of anxiety in children vary, but it’s important that you are able to understand and recognise how this might affect learning in a classroom environment. It’s normal for everyone to feel anxious from time to time – it’s a normal response to stress. However, some young people may experience uncontrollable levels of anxiety that are excessive in relation to what’s happening around them –can therefore struggle with their day-to-day tasks and schoolwork. Common worries can become overwhelming for children and young people with anxiety leading to them becoming quite distressed. If this does happen there are a few ways in which you can respond to try and calm the situation. Some signs and symptoms to look out for include tears when entering school, being withdrawn from their peers, concentration difficulties, fidgeting, changes in appetite, and irritability. Download our factsheet for more information on what to look for if you suspect a child or young person in your class is suffering from anxiety. Getting the conversation going can be a good starting point – for example, planning lessons themed around…
        • DepressionDepression is a common yet serious mood disorder that involves a persistence of deep sadness, hopelessness, and numbness. Someone experiencing depressing may feel a constant melancholy that prevents them from enjoying their everyday life. Children and young people especially can feel alone and misunderstood which often stops them from expressing how they feel to people close to them. This isolation can lead to suicidal feelings, self-harm and, in a worst-case scenario, suicide. Parents and teachers are often the first to identify the symptoms of depression in children and young people. Some key symptoms of depression include excessive and persistent worry, moodiness, over or undereating, and self-harm. Some symptoms manifest in physical ways that are a little easier to spot as a teacher during school time such as frequent aches and pains, not wanting to play, either complete isolation or clinginess, and uncharacteristic irritability and anger. There are many risk factors at school that can lead a child to develop depression. As a teacher, you should be on the lookout for children experiencing bullying, social isolation, a lack of self-confidence, and an inability to keep up with schoolwork, among other factors. Children particularly vulnerable to depression are ones who experience abuse,…
        • OCDObsessive compulsive disorder (OCD) is a mental health condition that involves repetitive, intrusive, and impulsive thoughts and images entering the mind, causing intense anxiety. As a result of this anxiety, the child or young person engages in compulsive or repetitive behaviours designed to ease their anxiety. They then obsessively repeat these behaviours to rid themselves of the anxiety, causing detriment to their daily life. Early signs of OCD can include excessive worrying and feeling a strong sense of responsibility over yourself and others. A child or young person will ask for constant reassurance about whether their homework is correct or whether they are doing something right or being a good student as they no longer trust their own judgement. As a teacher, these are early signs you can look out for which can inform how you approach the child going forward. Stress at school and bullying are key factors which exacerbate the development of OCD – the more overwhelmed a child feels, the more they give into their compulsive, repetitive behaviours to ease their anxiety. As a teacher, it is your duty to make sure the classroom is a safe space for all, keeping an eye on students who seem…
        • PTSDPTSD or post-traumatic stress disorder can be triggered in children and young people when they experience a particularly horrifying or scarring event. The cause can be as varied as a car crash or sexual assault. A child can develop PTSD if they are involved in this event, witnessed it, or even heard about it second-hand. It can be difficult to identify PTSD in children and young people, as they are reluctant to talk about the trauma they experienced as a way to protect themselves. However, there are some tell-tale signs of PTSD that you can look out for in your students. Children with PTSD will often have trouble concentrating and may even fall asleep during school time due to the lack of sleep they’re having at home, making learning much harder. A sudden plummet in grades is also a red flag – in such cases, it is important to check up on the student rather than reprimand them, which can cause further harm. PTSD also causes many children or young people to become highly irritable and angry due to the intense emotions they’re experiencing, often making them see other people as a threat. In this case, it is important to…
        • Eating DisordersAn eating disorder develops when a child’s and young person’s emotional well-being gets tangled up with their eating habits – for example, if their self-esteem is dependent on how much they eat or don’t eat. Eating disorders are most common in teenagers between the ages of 13 to 17 and they can manifest in a multitude of ways. Anorexia nervosa is a serious mental illness where a person has an intense fear of gaining weight, often accompanied by body dysmorphia – a distorted view of one’s body. This fear leads them to eat very little or nothing at all, leading to severe and potentially life-threatening weight loss. Bulimia nervosa is a serious mental illness that stems from being shamed about consuming large amounts of food, and your weight. A person will binge eat as much food as they can in a short space of time – this is often out of their control. They will then purge – making themselves throw up all the food they have eaten to avoid putting on weight from the binge. This leads to severe and potentially life-threatening weight loss. Binge eating is a serious mental illness which, similarly to Bulimia, involves consuming large amounts…
        • Self-harm in the ClassroomSelf-harm in children and young people happens when a person experiences an overwhelming flood of emotions such as guilt, shame, anger, hate, and a lack of control. This leads them to inflict deliberate harm upon themselves as a way to relieve the flood of emotions they are experiencing and punish themselves for feeling them in the first place. This can take the form of cutting themselves with sharp objects, over-eating or under-eating, pulling their hair out, burning themselves, and misusing intoxicants such as alcohol and drugs. Distress and overwhelming emotions often manifest during school time, and as a teacher it is important to have an awareness that school can be a trigger for students struggling with self-harming tendencies. Create a safe and open space for all students by letting your students know you are always here to support and hear them out whenever they need it. Common signs of self-harm include cuts, burns, and hair-pulling – these are easier to spot as they are often visible on the student’s body. However, young people can be very good at hiding their scars under long jumpers and trousers. If a student is adamant about keeping their jumper on even during hot temperatures,…
        • TraumaIf a child in your care is suffering with Trauma, they will be very distressed. This may be obvious, or it may show up in the form of physical ailments such as headaches or vomiting. They may show signs of regression in toileting or feeding, struggle with their schoolwork or find it difficult to concentrate. Watch our Informational film on Trauma and Children with Dr Sian Williams and Dr David Trickey to understand how children react to Trauma and how they can be helped.
        • Body dysmorphic disorder
        • Neurodivergent Conditions

        • ADHDADHD, or Attention Deficit and Hyperactivity Disorder, presents itself in many ways which can sometimes make it difficult for teachers to spot the signs. It is characterised by difficulties in the areas of attention, level of activity and impulse control. ADHD is a recognised developmental disorder which can affect many areas of a child’s life – including in a learning environment. It is common for ADHD to be misdiagnosed in girls, as the symptoms of ADHD present differently to that of boys, and aren’t as commonly shared. One of the most important things you can do as a teacher for a student with ADHD is to learn and understand how they are feeling, and how they see the world around them. Sometimes for students with ADHD it may feel like nobody understands them. In this video, we go through our tips for teachers who have a child in their class who has Attention Deficit Hyperactivity Disorder (ADHD). Also, view our Practical Tips for Teachers in the Classroom below .
        • Autism
        • Conduct Disorders/ODDODD, or oppositional defiant disorder, is diagnosed in children and young people that are persistently and repetitively antisocial, disobedient, have frequent tantrums, can not listen to authority, and purposely harm others. Conduct disorders are the most common disorders in children and are more frequent in boys, with 7% of boys and 3% of girls meeting the criteria for conduct disorders. It is normal for children and young people to be defiant towards authority to some degree, but if a particular student stands out from the others in your class and is perpetually defiant, violent and resentful towards others, this can develop into ODD. A child or young person with ODD will often engage in a range of violent and destructive behaviours such as fighting, temper tantrums, arguing with adults and peers, and lying and blaming others for their behaviour. In some extreme cases, the child or young person may engage in being cruel to animals and starting fires. As a teacher, it can be difficult to know how to handle a student with ODD in a way that ensures they make the most of their learning and helps their behaviours and social relationships. However, there are things you can do…
        • DyslexiaChildren with Dyslexia have a different intelligence, way of thinking and way of seeing the world.  Many innovators, inventors and successful entrepreneurs have been Dyslexic.  Dyslexic thinking skills include imagination, inspiration, creativity and the ability to solve things. They sometimes find it difficult to fit into rigorous, inflexible education methods. Our resources for teachers and professionals on Dyslexia explain that if the condition is spotted early, there are strategies that can be used to work on the strengths of Dyslexic children which will allow them to develop different talents and thrive in life.
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        • UK Trauma Council ResourcesNip in the Bud has been given permission by the UK Trauma Council to share this series of four short animations which they have produced on the topic of Trauma and PTSD. The UK Trauma Council’s work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 License. These animations have been produced with the involvement of young people themselves, and are designed to help young people and the adults around them recognise the signs of post-traumatic stress disorder. They also suggest ways of coping with scary memories, explain the science around the best treatments, and answer any worries you might have about getting support.
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Podcasts / Barry Carpenter – Girls and Autism

Barry Carpenter – Girls and Autism

We discuss girls with Autism in this short clip from our conversation with Professor Barry Carpenter and look at how many mask their symptoms, particularly at primary school, only to struggle with eating disorders, self harm or other mental health issues during their teen years. Early diagnosis and spotting the signs that a girl may have autism is key and Barry shares helpful ways to recognise these and respond through differentiation and adaptive teaching, in order to make an important and lasting difference. Listen now to find out how you can support the children in your classroom and make an important and lasting difference.

Transcript

00:00:05.201 – Alis

In these short podcast clips, we offer nuggets of information from our longer podcasts that give advice and quick tips to help you, as teachers, recognize children’s needs and respond more efficiently, empowering you to adapt teaching effectively. Barry Carpenter is the UK’s first professor in Mental Health and Education, and his honorary professor at universities in the UK, Ireland, Germany, and Australia. In July 2020, he was awarded the Distinguished Fellowship of the Chartered College of Teaching for his leadership of the education field during the pandemic. He’s been awarded an OBE and a CBE by the late Queen for services to children with special educational needs. In this nugget, we discuss girls with autism, the signs we can be looking for in girls in our classes that will help us to notice specific needs and ideas on what we can do as teachers to support girls with autism. All too often, girls with autism become excellent at masking their differences and challenges, especially at primary school, only to struggle alone during the teen years. Barry talks about ways that we can recognize and respond early in order to make an important and lasting difference. You’ve also written and co-authored a book about girls with autism, so a little bit of a tangent off of what we were talking about there. Could you tell us a bit about that? What led you to getting involved and interested in this area?

 

00:01:50.181 – Barry

Yeah. So, autism has been a major platform for my career. It’s been the focus of one or two of the professorships that I held. It’s been a major part of my work, whether it be as a head teacher, whether it be as an academic. It’s an area that I’m passionate about. What became very obvious, probably from the mid 2000s onwards, was that we were missing a lot of girls with autism. I have to give some credit to my youngest daughter, Grace, for the insight she gave me that really helped me to deeply understand how we were missing these girls. Grace is an occupational therapist by background, but specializing in child mental health. She would come home and tell us about girls that she had seen who’d been referred for eating disorders or self-harm. But when she began to peel that back, the underlying issue was undiagnosed autism. And yet these children then were 14 and 15. Why have we missed it? So by then, they had to deal with not only their autism, but a mental health issue as well, which was going to really affect their developmental trajectory. Why was all of that happening? It’s because the girls were masking and camouflaging. They’re great imitators, they’re great mimickers. So the girl with autism would be listening to the conversations of her peer group who were talking, let’s say, about boy bands. And the next day she’d be able to say, ‘Oh, this group is my favourite boy band’. And she could tell you lots about that boy band. In fact, if you let her carry on for the next 2 hours, she wouldn’t stop because she’d have so much detail, including inside leg measurements of each of the members of the boy band. It was just prolific. But she did that because she wanted to be seen to be the same as the other girls. But of course, in adolescence, all of that begins to unravel because whereas they contained their autism and made themselves seem like the other girls during the primary years, in adolescence, with all of that hormonal raging, Keeping it in was impossible, and they began to fall apart. And I realized that we needed a piece of work around this. And at that time, NASEN, the National Association of Special Educational Needs, invited me to chair a group that they had come to the same conclusion, we needed to look at girls with autism. So I began to chair this group, and eventually it grew so exponentially that National Association of

Head Teachers agreed to host the group because as you well know, again, from your own experience, unless we change the hearts and minds of school leaders, we’re going to get nowhere. I, for two, three years, chaired this group, and they were a fantastic group of people. Women with autism, head teacher of Limsfield Grange, Sarah Wild, which is the only state school for girls with autism, people as eminent as Professor Francesca Happè, who eventually co-authored the book with me. All sorts of people that had rich experiences, Sarah Jane Kirchley from Autism Education Trust, Cary Grant, the TV presenter, who is the mother of daughters with autism. So lots of multiple perspectives on this. And during the course of the campaign we had and the work we were doing, we produced a pamphlet. Eventually, I just turned to the group and said, We need to write a book. Well, many of them had never been authors. And so we set up a system where they could be coached and mentored into writing. And so it was a big piece of work. And the book was a real labour of love, but a very purposeful one. So you have some great scientific chapters, but equally, you have a mother or mothers telling the story of raising their daughters, or indeed, women with autism, talking about what it was like to be a girl with autism in the school system.

 

00:06:26.571 – Alis

I’ve got a couple of questions around that. Why do girls with autism respond differently to boys? That’s one thing that is of interest. But also, as a teacher and a parent, what are the signs that you would look for in a girl that you might not look for in a boy that might tell you, actually, they’re having trouble here and you could support them?

 

00:06:52.561 – Barry

Let me start with that first question then. It’s down to the social biology of the brain. I don’t need I can tell you that men are different. The male brain is different. It just is. And women, I’m generalizing, but I hope not offensively generalizing, women are naturally more social creatures than men. And therefore, a girl with autism is a girl first, which is why we called the book Girls and Autism. I mean, though it was a movement because of the people first approach, which I very much support, that we should have called the book Autistic Girls. But the issue, the problem, as it was, is the fact that they were girls. Their feminine traits were masking and camouflaging what was going on underneath. So parents, when they’re thinking about their daughters… I’ll give an example. A woman in the village I live in stopped me a couple of years ago, and she knew me from some children’s activities we’d done in the village. And she said, ‘I’ve heard you talk about girls in autism with other people. My daughter’s adolescent now, and suddenly she won’t comb her hair, her Personal hygiene is awful. She won’t change her clothes. She’s become very faddish about her foods’. Any one of those things on their own, you could just put down to adolescence, you start to get a combination of them, then in this mother, the alarm bells are going off, and rightly so. Let’s just say, subsequently, the girl has had a diagnosis of autism. But what I’m trying to say there is the starting point for personal hygiene. You’d never think normally of starting a diagnosis for personal hygiene. That’s one of the indicators.

 

00:08:48.501 – Alis

That’s good to know. What about younger girls? I’m thinking primary. How would you nip that in the bud, if you like? What are the signs before they get to adolescence and start to struggle? Or are there none?

 

00:09:05.601 – Barry

Well, that’s a good question. No, there are signs, but it’s a very good question because I can’t fully answer it because the research study to answer that is currently happening. I’m supervising my last PhD student who is looking at that very question because when we’d finish the book, Alis, And it’s been the most successful special needs book for the last four consecutive years.

 

00:09:38.441 – Alis

Well done. Amazing.

 

00:09:40.301 – Barry

It’s had a huge impact internationally, and I’ve been around the world, from Dubai to New York to Sydney to Auckland to launch it. But for me, the question that we hadn’t answered but I don’t think we’d even asked the question because there were so many questions to ask, because it wasn’t a complete holistic piece, you know? We had fragments and they needed cohering. But for me, I just asked myself this question, why did I miss it? Why did those girls have to get to 13, 14, 15 and lose good quality mental health? Why? Because those were little girls of 3, 4, and 5. Why did I miss it? What did my teacher eyes not let me see? And the indicators of early childhood autism in girls is different again to adolescent indicators, because I’ve talked about eating disorders and self-harming. You don’t really get that in little children, nor do you get some of those things in boys. The little girl of 3, 4, 5 is not as loud and out there as the boy of 3, 4, and 5 with autism, who is probably already showing some disturbed and disturbing behaviours. I’ve done a preliminary piece of work, not necessarily published, but I’ve done a comparative study in three countries, where I’ve asked teachers, where you’ve had a girl with autism or you’ve had a girl that you think should be referred because you suspect autism, what did you see? They said things like, the girl would play, say, with the dolls, say, a horse and a toy doll, and even when other children came to play alongside her, if they asked if they could now play with that toy, she would often let them play with that toy. So again, stick with that image of the horse and sitting a doll on top of the horse. Except, if the other child then placed the doll on the horse facing the wrong way, the end of the world would come. The girl with autism, question mark, would lose it. The teachers then said, when they say, as teachers of young children do, ‘Children, it’s time for story. Come and sit on the carpet in front of me,’ the little girl with autism would come but she always sat on the edge of the group. If the teacher said, ‘Oh, why don’t you come and share the story with me today with the rest of the class? Come and sit by me’. Then the meltdown would come. The demand was too much socially for her. So there are indicators, but if you just take both of those scenarios, A, the child was compliant and came to sit on the carpet for story time, so where’s the problem? There isn’t one. And if you looked across, as a busy teacher in that earlier setting, you looked across, oh, yes, she’s playing alongside other children appropriately with the dolls. Where’s the problem? In that busy classroom, let’s be honest, you’re not going to pick up nuances. So

can you see already the masking, camouflaging and because they’re more compliant, frankly, is obliterating your ability to bring out an understanding of their profile of need. So we need to change the lens. We’re working on a profile, not a diagnosis, but a profile tool that teachers could use, therapists could use to start to collect information where… And again, you will know, but sometimes some of our best responses are gut reactions. That’s not quite right with that child. And you start to look more, don’t you? Yeah.

 

00:13:54.801 – Alis

Is there something around the setup, the way we do education, especially in the UK, that almost feeds that compliance, feeds that ability for the girls to be able to mask? Because we’re actually, as you say, we give a directive, the child follows it, there’s a tick. If there’s a boy that’s kicking off, then we don’t come back to look at the girl that’s sitting on the edge of the carpet. As teachers, our minds are taken up with the non-compliance. So I’m just wondering, is there something different that teachers could do in their class routines and processes that might actually rattle rather than just feed the ‘This is what we do at nine o’clock. This is what we do at quarter past. Come and sit here, hang your coat up here, put your shoes there,’ which is all one compliant behaviour after another.

 

00:14:59.081 – Barry

That is a massive, huge question because it’s going to demand total reform of the education system to give you an honest answer to that.

 

00:15:12.451 – Alis

You’ve got time for that, haven’t you?

 

00:15:14.371 – Barry

No. What I could say could be very contentious. I’m just going to take it back a little bit because some of the difficulty for teachers will be the rigidity of our curriculum, the rigidity of our system, the Ofsted fear that thankfully at last, but tragically because of Ruth Perry’s death, has been exposed. But we’ve got an Ofsted-driven school system. People dance the tune because we live in fear. It’s not a good healthy state for teachers, and it’s certainly, therefore, not a good healthy state for children. I think my answer in brief would be, if we look at some of our contemporaries in other countries, they have far more play-based learning for those very early years, right through to the age of seven. I mean, the Finns, who consistently top tables in the international league tables, do not begin formal education until seven. It doesn’t say the children don’t read before they’re seven, but it’s done in a very play-based, not pressurized role. I mean, I have a grandson of four who the head teacher is thrilled to tell his parents he’s got all of his initial sounds and some blends after one term in school. Well, that’s great, but I’m not sure that would be the major priority for a child who’s actually still socially quite withdrawn.

 

00:16:50.761 – Alis

I wonder, and I don’t know if this is part of your PhD students’ research, is what does that identification earlier on of girls with autism look like in other education systems? Those play-based systems, for example. Can you see a little bit earlier on what you need to be able to see? Because there is that sense of creative play, that sense of choice making, the slightly lighter control.

 

00:17:25.641 – Barry

I can see where you’re going with that question, and therefore you think it’s probably going to be a stunning answer from somewhere else in the world. I’m now going to be completely contradictory again, because believe it or not, our thinking about the education of children with autism is probably the best in the world. So in consequence, Other systems are not even asking these questions. The book has been translated into several languages, and the demand to speak internationally is still very great. I’m just back from the international conference in the States, where everybody thinks it’s the Mecca of autism. And yes, there’s some fantastic research coming out. But the whole question of female autism is still like, ‘really?’ They haven’t gone into the depth of thinking we’ve gone into. So we do some things very well in this country and thinking about children is still a great strength. How we do it when I consider the constraints our system is under, I don’t know, but we do. I still think British teaching is some of the best in the world. You just do wonder, though, if we didn’t have all of these constraints and frankly, the wretchedness of Ofsted, would we be in a very different place again?

 

00:18:55.621 – Alis

I hope you enjoyed that Nip in the Bud nugget. If you want more, why not go back and listen to the whole episode with my guest? If you enjoyed this episode, please share it with others and visit our website for more information, advice, and resources.

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