Book review: The mental health and wellbeing of children and young people with learning difficulties
Book author: Dr Kirstie Rees.
Coffee rating: ☕☕ (2/3) – not too challenging. You might have to stop and think in places.
Star rating: ⭐⭐⭐ (3/3)
The Mental Health and Wellbeing of Children and Young People with Learning Difficulties is written by Dr Kirstie Rees, a child and educational psychologist who specialises in the areas of disability, neurodiversity, mental health and wellbeing. She has conducted research into models of disability and supporting pupils with severe and profound needs, and has authored several articles in these areas.
Kirstie’s book is an evidence-based guide for teachers and teaching/learning support assistants as well as educational psychologists, students and other professionals. She has helpfully split her book into three parts.
- The first part aims to develop the reader’s understanding of children and young people’s (CYP’s) mental health and wellbeing, different models of disability and to encourage the reader to consider inclusion.
- Part two starts with a toolkit of resources (e.g., social stories and intensive interaction) before discussing holistic assessments and preventative approaches.
- In part three, Kirstie explores targeted approaches and interventions, as well as behaviours of concern such as anxiety, challenging behaviours, and loss and bereavement. The book can be read in any order, and makes it easy to find the practical resources needed for assessment.
The book chapters follow a sensible format dispersed with reflections which encourage the reader to think about how the information presented may be relevant to their work. Each chapter ends with a key summary which concisely states key points discussed and then shares “Tools to use” making the book further interactive and valuable.
What is “disability”?
Language around disability and learning difficulties has changed dramatically in the UK over the past century, and Kirstie discusses the growing use of “neurodiversity”. Neurodiversity is defined as “the diversity of all people” (Wendler, 2023), although it can often be used to refer to individuals with specific neurodevelopmental conditions (e.g., AHDH, dyslexia, and autism).
Rather than seeing diversity as disadvantageous, the definition of neurodiversity considers that differences in how people think, or approach tasks, can be beneficial to schools, workplaces and societies when they are embraced and supported. These values are being discussed and adopted in some settings, however there is still work to be done.
Kirstie briefly mentions how cultural norms and values also influence the perception of “difference”, for example Western, individualistic societies value independence and autonomy and this can result in a lack of inclusion. However, Benomir, Nicolson and Beail (2016) found the opposite; attitudes towards intellectual disabilities (ID) were actually more favourable in the UK than in Libya*. For example, in the UK there were more positive views towards empowering individuals with ID to make their own decisions and seeing similarity with neurotypical individuals, and lower scores on excluding them from community life (Benomir et al., 2016). There is an argument made regarding stigma in several collectivist societies (Papadopoulos, 2009; Yan et al., 2017) leading to exclusive rather than inclusive practices. Further insight into the views of difference in collectivist cultures would be relevant, particularly in the current climate.
Whilst the medical model of disability has been common in the UK, school settings adopt different approaches to mental health and wellbeing compared to medical settings. Kirstie considers how the biopsychosocial model defines disability, and how this might be better placed to provide holistic approaches compared to the medical or social models.
The responsibility lies with educational providers to adapt young people’s learning environment to increase engagement and progress. In order to fully understand and support such CYP, we need to know what they are dealing with both medically and within their social and environmental structures. This includes being aware of their diagnosis and/or areas of need, their likes and dislikes, history and context, physical health, and how they communicate.
Kirstie discusses the importance of communication to obtain this information, and suggests that to identify poor wellbeing, particularly for those children and young people who have verbal or expressive difficulties, we need to know what good or healthy wellbeing looks like for them i.e., we need to get to know them so we can identify changes to their normal. This could be through communication with parents and other professionals, round robins to school staff, classroom and other observations, as well as using scaling and open-ended questioning with CYP themselves.
What does it mean to be inclusive?
Kirstie states that inclusion does not mean doing the same thing for each child or young person. Instead, there is a need for meaningful, creative and flexible approaches, particularly in mainstream settings. It is also important to consider that one size does not fit all, and some CYP will need more specialist environments and teaching approaches. The environmental audit in chapter 8 can help guide thinking around what adaptations we might want to make in an educational setting, for example thinking about how the classroom and space could be structured for a range of needs as well as for allowing easy movement of staff, and opportunities for peer working.
Increased understanding of children, young people and their needs means that we can adapt environments to be more inclusive. This can sometimes be more straightforward than trying to influence change more systemically, for example trying to improve school-wide attitudes towards disability. Kirstie argues that the language of neurodiversity has not yet translated to changes in school structures, leading to tokenistic strategies and approaches. This can mean that we often expect the same output from all children, even when we have recognised that they need different inputs, or it can mean we expect less from CYP with learning difficulties.
When we value the potential of all children, including those who are neurodivergent, we are more likely to actively consider how we can not only meaningfully include them, but support them to meet their full potential.
Final reflections – a treasure trove
Kirstie encourages a holistic view to the mental health and wellbeing of young people with learning difficulties. Kirstie’s book covers aspects which are common in the work of target professionals who pick it up, for example, autism, anxiety, trauma, grief, sensory needs and supporting behaviour.
A lot of the content of Kirstie’s book resonates with my practice as a trainee educational psychologist. We used person-centred approaches, considered children and young people’s place within Bronfenbrenner’s ecosystem theory and gathered information from a range of sources to develop a full picture of the CYP, their strengths and areas of need, before considering how we might be able to effectively help and support them.
Having also been a classroom teacher without that training, I can see this as being a useful resource for staff in schools. For me, Kirstie’s book has been a treasure trove of quick information, easy to use resources and opportunities to reflect further. The content of this book is valuable for all those who are working with children and young people. It is accessible to a range of readers, the language is not overly academic, and it is easy to find information in it.
References
Benomir, A.M., Nicolson, R.I. and Beail, N. (2016) Attitudes towards people with intellectual disability in the UK and Libya: A cross-cultural comparison. Research in Developmental Disabilities, 51-52. pp. 1-9. https://doi.org/10.1016/j.ridd.2015.12.009
Papadopoulos, C. (2009). Stigma towards people with mental health problems: an individualism-collectivism cross-cultural comparison (Doctoral dissertation, Middlesex University).
Wendler, D. (2023). Strength in Neurodiversity: Creating a Workplace Where Everyone Can Belong [Video].
Yan, M. C., Kim, S., Kang, H. J., & Wilkerson, K. L. (2017). Perceptions of disability and special education among East Asian parents: US immigrants and non-immigrants. Journal of International Special Needs Education, 20(1), 41-55.
*Other than on the “sheltering” subscale [i.e., “the extent to which the daily lives of people with ID must be supervised by others and/or to protect them from community life’s dangers”] (Benomir et al., 2016, pp. 7)
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