Seeing the Whole Picture: Neurodiversity, Mental Health and School Exclusion
Words First IDP Spotlight
At Words First, our IDP Spotlight sessions bring together professionals from Speech and Language Therapy, Occupational Therapy, and Educational Psychology to explore complex topics through a shared, interdisciplinary lens. These sessions focus on strengthening formulation, improving collaboration, and supporting earlier intervention for children and young people.
This Spotlight was led by Sonali Haridass, SEMH Pathway Lead and Clinical Specialist Speech and Language Therapist, alongside Linda Bresgi, Senior Educational Psychologist. Together, they explored the relationship between neurodiversity, mental health, and school exclusion, focusing on the concept of lost learning and how exclusion is often the end point of unmet need rather than a single behavioural incident.
Drawing on her speech and language and SEMH specialism, Sonali framed behaviour as communication and highlighted how language, regulation, and access to learning are deeply connected. Linda brought a mental health and systemic lens, exploring how distress develops over time and how school responses can either protect or increase vulnerability.
What do we mean by lost learning?
Lost learning refers to the academic and social experiences a child misses when they are out of class, removed from lessons, absent from school, educated outside their local setting, or physically present but unable to engage.
Exclusion is often understood as a formal process, but many children experience repeated removal from learning through internal exclusions, isolation rooms, managed moves, alternative provision placements, or persistent absence.
Sonali described this as a continuum. Early experiences such as lateness, time spent outside classrooms, or frequent disengagement may appear minor but can become precursors to more significant exclusion if needs are not recognised early.
Who is most affected?
Evidence shows that lost learning disproportionately affects children who already face disadvantage.
Children with SEND, particularly those with SEMH needs and speech, language and communication differences, are significantly more likely to experience exclusion. Children with social care involvement, those living in poverty, and some racially minoritised groups also face increased risk.
These patterns reflect systemic inequality rather than individual behaviour. Exclusion often occurs at the intersection of neurodivergence, communication differences, mental health needs, and social context.
Behaviour as communication
A central theme of the session was understanding behaviour through a communication and mental health lens.
For many neurodivergent pupils, differences in language processing, sensory regulation, and emotional expression mean that distress is shown through behaviour rather than words. What may appear as refusal, avoidance, or disruption can reflect overwhelm, anxiety, or reduced felt safety.
When behaviour is misunderstood, responses often focus on compliance rather than understanding. Repeated sanctions reduce a child’s sense of belonging and increase distress, contributing to a predictable pathway towards exclusion.
From a psychological perspective, exclusion is rarely about a single incident. It is more often the outcome of cumulative strain where a child’s needs have exceeded the system’s capacity to respond flexibly.
Distress is not always visible
Not all pupils show distress through external behaviour. Many internalise their difficulties.
Some children appear compliant or withdrawn while experiencing significant anxiety or shutdown. Their needs may only become visible when difficulties escalate. This pattern is particularly common among neurodivergent girls, whose profiles are more likely to be overlooked.
Recognising these less visible presentations is essential for early intervention.
Understanding the pathway to exclusion
The pathway to exclusion is often gradual:
- Early differences in regulation, communication, or anxiety
- Needs not recognised or understood
- Behaviour interpreted as defiance or lack of motivation
- Sanctions and removal from learning
- Reduced sense of belonging and safety
- Increased distress and reduced capacity to cope
- Escalation towards exclusion
By the time exclusion is considered, there have often been multiple earlier opportunities to intervene. Exclusion is an indicator of where the system lost the chance to change the trajectory rather than a solution to behaviour.
A different way of understanding behaviour
Ross Greene’s framework offers a helpful reframe: children do well if they can.
This shifts the focus to identifying barriers:
- communication and problem-solving skills
- emotional and sensory regulation
- relational and psychological safety
- consistency and timing of support
From a speech and language perspective, this includes recognising when language demands exceed a pupil’s processing capacity and when communication differences are misinterpreted as non-compliance.
This approach moves practice away from punishment and towards skill-building, co-regulation, and collaborative problem solving.
Protective factors that make a difference
Research and practice consistently show that exclusion risk reduces when key protective factors are present:
- one consistent, attuned adult relationship
- predictable routines and calm responses
- opportunities for repair after incidents
- identity-affirming and inclusive practice
- early support before difficulties escalate
These foundations support regulation, communication, and learning for neurodivergent pupils and their peers.
The importance of interdisciplinary practice
Effective support requires shared understanding across education, health, and families. When systems operate in isolation, information is lost and children can fall through gaps.
Interdisciplinary practice allows communication needs, sensory differences, mental health, and contextual factors to be considered together. Families are central to this process and often need validation and partnership as much as strategies.
This shared approach creates coherence and supports earlier, more consistent intervention.
Early identification and systemic change
Moving from reactive to preventative approaches means recognising early signs of distress, embedding universal inclusive strategies, and intervening before behaviour reaches crisis point.
Upcoming SEND reforms aim to strengthen early identification and create more consistent support across settings. These changes align with the evidence that outcomes improve when needs are understood and addressed early.
Our commitment at Words First
Across our services, we aim to:
- recognise early signals of distress
- support staff to understand the communication behind behaviour
- work collaboratively with families and schools
- provide practical, everyday strategies
- promote inclusion and belonging for every learner
When we see the whole picture, behaviour becomes understandable, support becomes proactive, and exclusion becomes less likely.
Every child deserves a learning environment where they feel safe, understood, and valued.
About Sonali Haridass
Sonali Haridass is a Speech and Language Therapist and SEMH Pathway Lead and Clinical Specialist at Words First. She graduated with distinction from the University of the Witwatersrand and began her career in a children’s hospital supporting pupils with complex communication and feeding needs. She later established her own practice in Cape Town before relocating to the UK.
At Words First, Sonali supports therapists across the organisation to develop confidence and creativity in SEMH practice while continuing her clinical work in schools. Her approach is trauma-informed and grounded in the understanding that behaviour is communication, with a focus on emotional regulation, self-esteem, and access to language.
About Linda Bresgi
Linda Bresgi is a Senior Educational Psychologist at Words First with over three decades of experience in education and psychology. Originally from South Africa, she began her career as a preschool teacher before qualifying as an Educational Psychologist.
She works across school settings providing assessment, consultation, and therapeutic support, with a strong emphasis on attachment-informed practice, collaboration with families and schools, and practical strategies that support emotional wellbeing, learning, and inclusion.
