Working with young children to prevent and treat mental health issues

Tackling serious mental health issues through play

Play is the primary way that children first interact with and learn about the world. Adventurous play sees children given the space to explore feelings of thrill and excitement, perhaps testing the edges of their comfort zone. Our team at Exeter is studying the extent to which adventurous play can help young children develop a healthy understanding of risk, uncertainty, and feelings of fear - and the impact this learning has on their handling of stressful situations in later life.

Adventurous play triggers physiological arousal, such as the heart racing or butterflies in the tummy. Problems arise if children experience physiological arousal for the first time in a stressful, scary situation.

Helen Dodd, Professor of Child Psychology at the University of Exeter Medical School, leads the research and said: “If children are climbing a tree or jumping off something, and experience exciting and thrilling emotions, they learn about physiological arousal while having fun. When they are then faced with those feelings later - be it their first day of school, an exam, or a change at home - they're not scared of their feelings and are less likely to respond to them in a negative way.”

The team has partnered with an organisation called Outdoor Play and Learning (OPAL) who deliver a play improvement programme in schools. OPAL provide a mentor to help transform school playtimes, giving children more space for play, more things to play with, and the opportunity to take risks in their play. By evaluating the impact these changes have on children’s mental health, our researchers will provide evidence that informs policy and practice around children’s play opportunities.

Professor Dodd said: “Our previous work shows that children who spent more time playing adventurously before the pandemic had more positive mood during lockdown and fewer symptoms of anxiety and depression. Our programme of research drives forward the idea that children need these opportunities for play to prevent future mental health problems.”

Developing tools for schools to support children with ADHD

Attention deficit hyperactivity disorder (ADHD) affects one child in every classroom in the UK, on average. Children with ADHD have impairing problems with attention, impulsivity, and hyperactivity. This not only interferes with their ability to learn but can also be disruptive in the classroom, which can cause stress and burden for teachers who aren't generally well equipped to support young people with ADHD.

Evidence shows children with high traits of ADHD are less likely to do well at school, and more likely to be expelled or suspended. Dr Abby Russell, Senior Lecturer in Child and Adolescent Mental Health, focuses on how schools and the education environment can do a better job of supporting young people with ADHD. Her ‘Tools for Schools’ project has developed a toolkit of strategies that primary school staff can use to support children with ADHD, based on existing evidence about what is known to work through medical and clinical interventions.

Dr Russell said: “Uniquely, this toolkit is individualised. Teachers can pick out different strategies based on the child they're working with. It’s also mostly focused on a group level, so rather than taking a child out of the classroom to work one-on-one, we look at changing the environment around the child and adapting the school and the teachers. This makes it easier for that child to simply be themselves. 

“We’re also creating lesson plans or activities for the whole class that the all the children take part in. It’s targeting that one child with ADHD but is potentially benefitting everyone in the class at the same time. It’s positive and inclusive, so rather than pathologizing a child, we're embracing their diversity.

"Schools are already contacting me to ask to use the toolkit, which was the first version that we developed and it's increasingly being taken up across the UK. I'm also working with colleagues in Finland who have contributed some of the components that go in the toolkit, and I’m talking with people who work in Sri Lanka about how we could adapt the toolkit for use in different contexts and cultures.”

Exeter’s Science of ADHD and Neurodevelopment (SAND) group coordinates the array of researchers working within ADHD and the interdisciplinary approach to analysing the biological mechanisms and neuroscience underpinning the disorder, in order to understand what can be done to support better positive outcomes.