Ordinarily Available Inclusive Provision

Wellbeing and mental health in the early years

What is wellbeing and mental health?

Mental health refers to our emotional, psychological and social wellbeing. It affects how we think, feel and act and affects how we cope, interact and form relationships with others, as well as our daily functioning.

In the early years it is important to bear in mind the child’s age and stage of development when identifying need.

  • Identification – what you may see in the child

    • Significant emotional distress such as crying and screaming. This may include dysregulated behaviours such as hitting, biting or throwing resources.
    • Show more subtle signs of emotional distress such as biting nails, twirling hair, sucking or biting the edge of clothing and/or being overly compliant.
    • Appear isolated and alone or withdrawn. Avoiding interaction with others.
    • Show significant separation anxiety at the beginning of the session.
    • Struggle to attend the setting consistently. Parents/carers may report difficulties getting the child to the setting.
    • Have difficulties with certain aspects of the day, for example transitions to different activities or spaces.
    • Speaking more freely at home or with familiar practitioners yet are more silent around most adults and children.
    • Report physical symptoms that are medically unexplained, for example, stomach pains.
    • Difficulty sleeping and/or eating.
    • Appear to be tired.
    • Show changes in personality or mood.
    • Often show emotional distress, including tearfulness, irritability or anger.
    • Have difficulties forming relationships with adults and children.
    • Show obsessive behaviours or rituals, such as having to sit on the same chair at snack time, having to walk over the door mat a certain number of times, etc.
    • Find it difficult to manage changes in their daily routine or environment.

  • Planned provision in the setting

    Based on need, some of this provision will be effective (depending on the age or developmental stage of the child).

    • Adults spend time building relationships with the child. Ensure the child’s Key Person is someone they bond well with and spend regular time with them doing something they enjoy.
    • Manage concerns around attendance with the parents/carers. Put a plan in place to support any separation anxiety and regular attendance. For example, use of a transitional object or toy, arriving at the setting before or after most of the children so it is quieter.
    • Use personalised visual supports to lower anxiety and support understanding of routines, for example objects of reference, visual timetables, Now and Next boards.
    • Pre-warn about changes in advance. Pre-warn parents/carers in plenty of time, giving as much notice as possible. Talk to the child at an age-appropriate level about the changes and use visuals to support. Talk about what will stay the same as well as what will change.
    • Prepare for planned events outside of the ‘normal’ activities, to lower anxiety. Use visuals and give children opportunities to role play different situations if appropriate.
    • Support the child to make sense of their emotions using age-appropriate stories, social stories, puppets and role play or small world play.
    • Use simple approaches to allow the children to share their worries, for example stories such as Everybody feels Worried, A Huge Bag of Worries, puppets, worry monster, etc.
    • Use simple relaxation strategies such as yoga poses, basic breathing techniques, playing relaxing music, using relaxing scents (lavender, chamomile, etc) around the setting.
    • Provide daily opportunities for outdoor learning.
    • Use ‘heavy work’  or large physical and sensory experiences for example carrying a backpack with heavy items in it to transport, pushing heavy things in a wheelbarrow.
    • Audit the sensory environment reflecting on which sensory experiences may be contributing to an increase in the child’s anxiety. Put into place appropriate strategies to address these as needed, for example noise cancelling headphones.

    You may also find of the strategies in the emotional regulation section helpful.