What are the reasons a child has SEMH needs?

Reasons why a child may have SEMH needs vary wildly, but include early emotional development challenges, trauma, family dynamics, life events and genetic predisposition.

SEMH needs may arise or become an area of need for a range of social, emotional, developmental, and environmental reasons. Life events, family dynamics or emotional upheaval, such as the introduction of a new sibling, a pet dying, moving to a new house, can all manifest as SEMH difficulties.

Challenges within early emotional development, genetic factors, developmental delay, learning disabilities or neurodiversity can also play a role in SEMH needs. Challenges related to the educational experience and environment, cultural identity or acculturation, disability or chronic illness, poor nutrition, digital and social media influence and even hormonal imbalances during key developmental stages can be significant factors.

It’s important to recognise that these factors rarely occur in isolation – many children experience multiple, overlapping challenges that can compound and intensify their SEMH needs.

Factors that may contribute to SEMH needs in children include:

Reasons a child has SEMH needs?

Early emotional development

  • Attachment difficulties or inconsistent caregiving
  • Unmet emotional needs or lack of acceptance
  • Limited emotional warmth or positive reinforcement
  • Caregivers struggling to manage their own emotional responses
  • Missed opportunities to develop core social and emotional skills
  • Low self-worth or poor self-image

Experiences of trauma

  • Abuse: physical, emotional, or sexual
  • Neglect: physical or emotional
  • Living in or moving through the care system
  • Exposure to domestic violence

  • Unsafe or unstable living environments

  • Poverty or ongoing financial hardship
  • Bullying, discrimination, or hate-related incidents
  • Social exclusion or isolation
  • Bereavement or significant loss

Educational and school-based factors

  • Academic pressures and/or repeated experiences of academic failure ‘feeling behind’ peers

  • Lack of inclusive practices or understanding of individual needs and feeling unsupported

  • Unidentified or unsupported special educational needs

  • Transitions between schools or frequent school moves especially mid-year

  • Repeated school exclusions or suspensions

  • Bullying

Family and home dynamics

  • Household dysfunction or conflict
  • Divorce or parental separation
  • Parental substance misuse
  • Caregiver with a mental health condition
  • Incarcerated parent or family member
  • Responsibilities as a young carer

Neurodiversity

  • Conditions that impact capacity to understand, communicate and manage emotions, such as: ADHD (Attention Deficit Hyperactivity Disorder), ASC (Autistic Spectrum Condition) or PDA (Pathological Demand Avoidance)

Health-related challenges

  • Chronic physical illness or disability

  • Frequent hospitalisations or medical interventions
  • Undiagnosed or untreated mental health conditions (e.g. anxiety, depression)

  • Sleep deprivation, poor nutrition, eating disorders

  • Undiagnosed health conditions (e.g., sensory processing difficulties)

Cultural and identity-related issues

  • Challenges related to cultural identity or acculturation (refugee or asylum-seeking children)

  • Language barriers impacting connection, learning, and inclusion (e.g. EAL learners without support)

  • Being part of a marginalised group (e.g., racialised children, LGBTQ+ young people)

  • Lack of representation or cultural understanding in curriculum and staffing

Digital and media influence

  • Anxiety triggered by the 24/7 nature of digital life
  • Exposure to harmful content or unrealistic ideals via social media
  • Online bullying or digital exclusion
  • Disrupted sleep patterns due to excessive screen use

Research demonstrates that children with SEMH needs often have a high level of adverse childhood experiences (ACEs).

ACEs refer to intense and frequently occurring sources of stress or trauma during childhood, including – but not limited to – experiencing or witnessing domestic violence, physical or emotional abuse, neglect, parental separation, or having caregivers affected by mental health issues, substance misuse, or incarceration. Factors such as being in care, living in poverty, or being exposed to community or collective violence also contribute significantly to a child’s adversity.

The toxic stress resulting from these ACEs or experiences can severely disrupt early brain development, impair the regulation of emotions and behaviour, and negatively affect the functioning of the nervous, hormonal, and immune systems. Without appropriate support and intervention, the long-term effects of ACEs can be profound, impacting not only a child’s ability to engage in learning and form healthy relationships but also increasing the risk of physical and mental health challenges across the lifespan.

Positive childhood experiences (PCEs) are beneficial experiences that help buffer the effects of toxic stress and build a child’s emotional resilience. PCEs are not just the absence of trauma – they’re the presence of connection, support, and belonging.

Research shows that PCEs can reduce the negative effects of ACEs ¹

The seven Positive Childhood Experiences or PCEs

“The children who need love the most will always ask for it in the most unloving ways.”

Russell Barkley

¹ Bethell, C. D., Jones, J., Gombojav, N., Linkenbach, J., & Sege, R. (2019). Positive childhood experiences and adult mental and relational health in a statewide sample: Associations across adverse childhood experiences levels. JAMA Pediatrics, 173(11), e193007.