Anxiety isn’t always a negative thing, it is common to be worried, nervous or afraid of things such as exams, spiders, or speaking out in class.

Feelings of worry, being scared, afraid and nervous may impact on a young person’s attention, socialising, sleep and involvement in daily activities. They may also experience physical feelings such as feeling shaky, being sick, funny feeling in the stomach, heart palpitations or panic attacks.

Young people (with or without appropriate or positive adult/peer support) may be able to identify the triggers for their anxiety, know how to manage their anxiety and what supports them.

Does the young person currently experience worry or anxiety and how does this impact on their daily life?

Young people can experience changes in mood. This could include low mood such as: feelings of sadness, irritability, guilt, loss of interest or pleasure and lack of energy. It may also include elated mood such as overexcitement, increased energy, exaggerated beliefs about themselves and impulsive behaviours.

Mood changes can have an impact on a young person’s everyday life which may explain behaviours such as: slowing down, getting agitated and/or moving more than usual. Changes with sleeping and eating habits or patterns may be noticed.

Does the young person currently experience any difficulties with mood and how does this impact their everyday life?

Emotions can be unexpected, intense and overwhelming. For young people to be able to cope with their emotions they first need to notice and identify their emotions (e.g. feeling sad/happy), they need to be able to understand why they feel the way they do and know that it’s ok to feel these emotions.

At times young people can select how to respond, other times they can’t do this and may react with agitation, outbursts, harm to self or others.

Support from others and coping strategies such as: breathing exercises, sensory or physical activity may help the young person notice, identify and express their emotions.

How does the young person currently cope with their emotions?

These skills are important for a young person’s engagement in play, learning and other activities of daily life. For example, a young person may struggle to: find their way around school, follow a recipe or be able to follow the steps to complete self-care tasks.

Does the young person’s thinking and memory skills currently impact on their everyday life?

Young people may have imaginary friends, may hear their own voice in their head, have vivid imaginations and enjoy fantasy as a way of coping, escaping or for enjoyment. As young people develop, they may begin to differentiate reality from fantasy/pretend.

Young people may appear to have some loss of contact with reality due to their thinking style and/or sensory differences. They may focus intently on a topic or an idea (e.g. everything relates to Star Wars), have less flexible thinking (e.g. all TV is real life) or describe sensations that others don’t notice (e.g. smelling food when others don’t notice).

For some young people their loss of contact with reality can lead to severe distress and/or increased risk to themselves or others. They may be seeing, hearing, tasting or feeling things that do not exist outside of their own mind but can feel very real to them (hallucinations). They may not be able to accept that what they believe is untrue or not shared by others (delusions). They may have disturbed, confused and disrupted thoughts (disordered thinking and speaking).

Does the young person currently experience a loss of contact with reality and does this cause them distress and/or put them or others at risk?

Young people may sometimes struggle to understand who they are, their personality, what they like about themselves or alter their behaviours depending on the surrounding environment (e.g. pretending to like a tv show to ‘fit in’). This may in turn affect a young person’s self-esteem, confidence, determination and a sense of belonging.

Sometimes young people can have difficulties in participating/completing activities of everyday life and this may be due to: physical differences (e.g. bed wetting, constipation and mobility issues), sensory (e.g. not liking smell or bathroom environment) or emotional (e.g. anxiety and not feeling safe to use toilet alone).

Does the young person currently have difficulties with participation in activities of daily living and what impact does this have?

Young people may find it hard to manage and keep a healthy sleep routine (sometimes called ‘sleep hygiene’). This may include trouble falling asleep, staying asleep, waking up multiple times in the night and a reversed sleep pattern (sleeping in the morning and staying up at night).

Sleep issues in young people may help to explain daytime sleepiness, changes in mood and behaviour and engagement in learning.

Does the young person’s sleep currently impact on their everyday life?

Trauma is an emotional response to a situation which makes us feel unsafe. Young people may have experienced one or more events that cause disruption, distress, and suffering. This may include abuse (verbal/physical/ emotional/sexual), bullying (online/in person), accidents, assault, neglect and abandonment.

There is no wrong or right way to experience or process trauma and the response may look different for different young people (e.g. crying or difficulties attending school following a traumatic event). 

Support from others, such as family members, friends, religious/cultural communities, schools and professionals, may help the young person manage this.  

Has the young person experienced (currently or previously) a traumatic event/s that caused them distress and impacts on their daily life?

Young people can become overly attached to certain habits, activities or objects such as mobile phones, social media, video games, TV shows, drugs (e.g. cannabis), smoking and vapes.

Whilst some habits are managed by the young person or supervised by an adult (e.g. limiting time for watching television), other habits can become uncontrollable and lead to addictions (e.g. smoking tobacco). This can be risky and have a negative impact on their wellbeing, social relationships and everyday life.

Does the young person’s attachment to an activity, object or habit currently have an impact on their everyday life?

Hobbies and Interests can be a source of enjoyment and accomplishment and may help the young person build confidence, manage their emotions and engage with their peers.

Sometimes, it may be difficult for a young person to access their hobbies and interests or for parent/carers to support them. This could be due to money or time/schedule difficulties and mobility or movement difficulties (e.g. being a  wheelchair user may make it difficult to engage in specific sports) amongst other reasons.

Hobbies and interests are varied and can be common, popular, specific (e.g. gardening, Lego, sports) or less common (e.g. watching the washing machine cycles).

Does the young person currently have active hobbies and interests, are they able to access them and does this put them or others at risk?

This may include long term health (e.g. diabetes, heart conditions, asthma or cancer), neurological (e.g. epilepsy), musculoskeletal (e.g. hypermobility), gastrointestinal conditions (e.g. chronic constipation) and/or the effect of hormones or medication on wellbeing.

The young person may need reasonable adjustments and support to help manage their physical health or keep fit.

https://www.nhs.uk/conditions

Sexual development and exploration is a healthy part of growing up and changes with age and developmental stages.

Some young people may struggle to recognise when their sexualised behaviours are inappropriate or harmful towards themselves or others (e.g. exposing or touching themselves in public, viewing or sharing nude/explicit material online and underage sexual relationships).

How does the young person currently experience and manage their sexual behaviours?

Education and training can include learning that can be in the classroom or hands on (e.g. woodwork and carpentry) and can be provided in different ways (e.g. online, home learning, in person and forest schools).

Sometimes, the social environment (e.g. friendship issues or bullying), rigid structure, sensory challenges, academic demands, lack of resources or teaching style at school or training may affect attendance, engagement levels and learning.

Learning can also be in the form of work experience which may be paid, voluntary and/or apprenticeships.

Some young people may not know what their interests and skills are, how to access work (e.g. applications or interviews) and how to keep a job, which can affect their ability to engage in work and learning as a result.

Does the young person currently access and engage in education, training and/or work?

Young people may deliberately (self-harm) or unintentionally (self-injury) do things that put themselves at risk. This risk to themselves may be due to them struggling to communicate their needs, feelings of frustration, lack of an awareness of danger, impulsivity and/or in response to being overwhelmed. Self-injury may include hitting, biting, picking or scratching themselves. Self-harm may be deliberately cutting, burning, hitting or scratching themselves.

In some cases, young people may experience suicidal thoughts (e.g. thoughts of dying, ‘giving up’ or ‘things would be better if I wasn’t here’), actions, and intentions (e.g. researching online for ways to harm themselves).

Some young people may also pose a risk to others which may include physical violence, damage to property and/or criminal behaviour.

Has the young person (currently/previously) experienced, intended on or acted on any suicidal thoughts, self-harm behaviours or risk to others?

Loss is personal, some loss may be considered small (e.g. taking away a comfort blanket) or large (e.g. loss of a loved one) but the impact of this on the young person may be experienced as significant for either.

Does the young person currently experience motor skills and/or coordination difficulties and how does this impact on their daily life?

The financial situation at home can affect both parent/carers and children and young people. Financial strain may affect children and young people through feeling helpless, deprived or neglected and also difficulties managing their own finances (e.g. pocket money).

Poor housing may reduce stability for a young person and affect their physical and mental health and overall wellbeing.

Poor housing may include: homelessness, shared or overcrowded accommodation, unsafe or antisocial neighbourhoods, damp or mould problems and heating, electrical or plumbing issues.

How does the financial and housing/ accommodation situation affect the child or young person’s current physical and mental wellbeing?

A supportive environment is one that meets a young person’s social, physical and emotional needs. This includes a social environment that is inclusive, the people around (e.g. family members or friends) have a good understanding of a young person’s needs and can support. It is a space where a young person feels they can ask for help and are able to accept support from others when needed (e.g. when being bullied in a social setting).

A supportive physical environment (e.g. home or school) is one that is accessible to their needs. For example, the school providing step-free access for wheelchair users or maintaining noise levels in class to address the young person’s sensory needs.

Some factors may make the environment restrictive or enabling. For example, not being able to engage in movement breaks during the school day may make the environment restrictive, whereas a strong connection with a community sporting team may make the environment enabling.

An environment that is not supportive or accessible can affect a young person’s level of distress and their engagement in everyday life.

Are the young person’s environments currently supportive and do they meet their needs?

Change is a part of our everyday life, big or small. Some young people may struggle to cope with change, also referred to as transitions, including moving from primary to secondary school, change in classrooms and/or staff, moving from childhood to adulthood or moving house amongst others.

They may respond with anxiety, difficulties adjusting to the new environment/situation or avoidance.

During this period, support from education settings and parent/carers can help support the young person better prepare for and manage this change or the transition.

A young person’s experience of change may impact their everyday life and in turn the support that they need.  

How does change currently impact a young person’s everyday life and do they have the support they need?  

Sensory preferences can vary, young people may enjoy specific sensations which help them feel calm (e.g. rocking or chewing). Whereas some sensations (e.g. loud noises) may be overwhelming and the young person may respond with frustration, irritation and/or withdrawing themselves.