1. Children with Learning Disabilities; Emotional Well Being and Mental Health Barbara McIntosh

2. BOND: Children with learning disabilities Children with learning disabilities are the most common group to receive an SEN statement. 1 in 5 children with learning disabilities have a mental health problem – 6 times the incidence compared to children without a learning disability (Emerson and Hatton). This group are less likely to have access to support and specialist services. Children with learning disabilities were prioritised in Staffordshire (one of the BOND sites) which resulted in the production of a pack of resources on learning disability and mental health issues

3. Children with learning disabilities are: 33 times more likely to have autism. 8 times more likely to have ADHD. 6 times more likely to have conduct disorders. 4 times more likely to have emotional disorders. 1.7 times more likely to have depression. (The Mental Health of Children and Adolescents with Learning Disabilities in Britain; Emerson and Hatton 2007) Mental health and learning disabilities: The facts

4. An intellectual disability reduces a child’s capacity for finding creative and adaptive solutions to life’s challenges, which can make them vulnerable to developing mental health problems. A link has been shown to exist between lower cognitive ability and vulnerability to mental health problems. Children with learning disabilities are at risk of poverty and social disadvantage, and poor social conditions are linked to an increased risk of mental health issues. The prevalence rate of mental health problems (particularly anxiety and depression) for children on the autistic spectrum is 68%. This may be caused by genetic predisposition. (National Autistic Society – You Need to Know Report) Why do children with learning disabilities have a high incidence of mental health problems?

5. Those with mild learning disabilities have high levels of school exclusion. Consequences of exclusion include disruption to the child, school and family, and the cost of permanent exclusion to the public purse is approximately £65,000. Over half of children with learning disabilities and autism have been bullied. 74% of children with an SEN statement find lunch and break times frightening. 60% of teachers feel they need more training to teach children with learning disabilities (School Report 2013 and Ambitious About Autism). School: Challenges faced by children with learning disabilities, their families and teachers

6. As a first source of help, parents turn to a range of professionals for support. The following percentages show the most popular sources: Teachers - 42 % Special Education Personnel – 19% CAMHS – 17% G.P. / primary care – 16% Paediatricians – 15% (The Mental Health of Children and Adolescents with Learning Disabilities in Britain 2007) Sources of help: Where do parents turn to for support with their child’s mental health problems?

7. BOND resources BOND, with the help of Staffordshire primary and secondary school staff, is producing an information pack which includes a range of tools to support staff development across the statutory and voluntary sectors. The pack includes a general introduction to mental health, in addition to: Mental Health First Aid resource for those with learning disabilities. Outline for a whole school approach to auditing. NASS online resource / training programme for staff. The Friends for Life Resilience programme, adapted for children with learning disabilities. Resilience Framework and Boing Boing. Person Centred Planning Pack. Information from the Child Bereavement Trust, Relate.

8. What is FRIENDS for Life? FRIENDS for Life is an evidence based programme that teaches children and young people techniques to cope with anxiety and promotes resilience and well-being. It uses a cognitive behavioural therapy (CBT) framework incorporating attachment, mindfulness and health behaviours in school-based groups.

9. It enables children to learn to: ‒ Identify “anxiety increasing” thoughts and to replace them with more helpful thoughts. ‒ Identify anxiety and other difficult feelings and learn to manage them. ‒ Overcome problems rather than avoid them. How FRIENDS for Life works

10. F. Feelings R. Remember to relax I. I can do it. I can try my best. E. Explore solutions and coping step plans. N. Now reward yourself. You’ve done your best. D. Do practise. S. Smile, stay calm, talk to your support networks. The programme builds skills using the FRIENDS mnemonic: FRIENDS for Life Mnemonic

11. −Introduction to feelings −Introduction to body cues and relaxation −Helpful (green) & unhelpful (red) thoughts −Changing unhelpful thoughts into helpful thoughts −Introduction to coping steps plan −Learning from role models and building support teams −Using a problem solving plan −Using FRIENDS skills to help ourselves and others −Review and party FRIENDS for Life – Programme Plan

12. What happens next -We are in the process of preparing information to update our project page on the website, and are writing guidance for others on how to adapt the programme for children with learning disabilities. http://www.learningdisabilities.org.uk/our-work/health-well- being/friends-for-life/ http://www.learningdisabilities.org.uk/our-work/health-well- being/friends-for-life/ -We are seeking funds for a proper feasibility study and are finalising a funding application to the National Institute of Health Research (NIHR) for the following pilot study.