Often when a child is feeling sad, angry or anxious there will be a change in behaviour. The child may cry, hit out, withdraw… Something will happen to let you know there is a problem. For some children however, the signs that they are struggling may be minimal; perhaps even completely masked. Children with additional needs, such as ASD and DLD, are at an increased risk of developing social, emotional and mental health problems (SEMH). The very nature of these difficulties means that the way in which they share emotions and ask for support may be different to that of their peers.


  • 1 in 8 children aged 5-19 have a mental health disorder and 35.6%of these have SEND.
  • Approximately 40% of individuals with ASD have symptoms of anxiety (compared with 15% of the general population).
  • 81% of children with SEMH needs have significant unidentified language deficits.

Difficulties experienced

Children may struggle to communicate how they are feeling because they:

  • Are unable to label their emotions. You cannot tell someone you are worried if you don’t know what that word means or what it feels like in your own body.
  • Don’t have the language skills to explain how they are feeling. Talking about a situation or event that has upset you requires many skills, including being able to remember and sequence events, construct sentences that are meaningful, and select key information.
  • Struggle with the social aspects of communication, such as knowing who you can talk to and when it is the best time to talk to them.

Differences in behaviour at home and school:

A child may appear to be coping at school (e.g. following instructions, joining in with activities) but the child’s parents may tell you a completely different story. Their child cries every day before school, ‘trashes’ their bedroom, because they can’t cope with the events of the day, or self-harms. It can be hard to reconcile what you see with what you are being told, but there may be a number of reasons for these differences:

  • Behaving appropriately at school can use up all of the child’s resources for coping. When they get home they need to let out all the anxieties of the day.
  • A child may be worried about the opinions of others. They may suppress behaviours that make them stand out, in order to ‘fit in’ with their peers.
  • Home may be the child’s safe space where they can act out and know that their parents will still love them.

Supporting a child when you can’t see the problem

It can be challenging to support a child when you don’t know what the problem is. Even the child may not know what is causing their distress. There are however some things you can do:

  1. Work collaboratively with parents. Believe what they are saying. Share information and strategies that you both find helpful.
  2. Identify things that you can change within the environment to make it easier for the child to cope.
  3. Help the child to find different ways of managing their emotions.

Changes to the environment

  • Make the day predictable. Not knowing what is going to happen can increase anxiety, so try to make each day as routine as possible. A schedule or visual timetable can be helpful – refer to it throughout the day so that the child learns what the timetable is for and what the symbols used mean.
  • Provide support when transitioning between activities. E.g. let the class know you are about to move onto something new by providing a countdown or visual support, such as a sand timer.
  • Consider where the child sits in the classroom. It could be an individual workstation with fewer distractions; sitting near a trusted adult or nearer the door so they can access time out if needed.
  • Use clear, simple language when addressing the class. Not understanding what is being said can be very frustrating. Consider tone of voice as well. Many children are sensitive to shouting, even if it is not being directed at them.
  • Find out about the child’s sensory needs. Coping with sensory challenges, whilst trying to complete work, demands a great deal of effort and can increase anxiety. Work with the child and family to think of ways to minimise these additional stressors.
  • Create a culture that is accepting of difference, including different ways of communicating.

Helping the child to cope

  • Make emotions easier to understand by turning them into something concrete, such as colours. E.g. sadness may be ‘blue’ and excitement could be ‘yellow’. Talk about what colour you are feeling throughout the day.
  • Use scales, such as numbers or a thermometer, so the child can say what level of stress or anxiety they are experiencing. Try to catch the child before they reach the top of their scale so they can implement calming strategies (e.g. deep breathing, having an agreed time out) before they become overwhelmed.
  • Work with the child and family to identify strategies that help with reducing anxiety. Social Stories may be useful in supporting the child to understand and implement these strategies. E.g. “If my anxiety is at a level 3, I can try taking some deep breaths or showing my ‘help card’ to an adult…”
  • Schedule times throughout the day where the child can ‘check in’ with an identified adult. The adult should initiate talking to the child, as approaching an adult can in itself be difficult.
  • Talk to parents about introducing a calming period straight after school.

Finding something that works will likely take some trial and error, as well as lots of patience and persistence. A child may also need specialist support from local mental health services in addition to what you are doing. When you do find something that works, you will likely end up with a child that is happier and better able to cope with life.

About Elm SLT

Since becoming an SLT 11 years ago, I have been lucky enough to work with children of all ages who have a variety of needs. I am particularly interested in supporting individuals with ASD and Learning Disabilities.

If anyone would like to know more they can visit my website – www.elmslt.com or e-mail me: laura@elmslt.com

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