PublicationsTopic index of systematic reviewsKnowledge pagesEBD
Supporting pupils with emotional and behavioural difficulties (EBD) in mainstream primary schools
This page contains the findings of systematic reviews undertaken by review groups linked to the EPPI Centre

The findings below are taken from a systematic review of research to assess what is known about the effectiveness of different strategies relevant to supporting children with EBD in mainstream primary classrooms.  The aim is to facilitate teaching and learning for all pupils.[2]  The review is based on studies published up to 1999.  A subsequent review [3] searched the literature from 1999 to 2002, but found no conclusive results.

  • Behavioural strategies such as the use of rewards for good behaviour were found to have positive effects on reducing disruptive and off-task behaviour.
  • One programme teaching children a self-instruction technique to monitor their own behaviour was effective.  Other strategies using similar cognitive-behavioural techniques, which take account of the capacity of individuals to understand and reflect on their behaviour, require further evaluation.
  • A range of cognitive-behavioural strategies for reducing aggression or improving social skills was found to have immediate positive effects but no long-term effects.
  • Changing seating arrangements for pupils from groups to rows had a positive impact on time on task.
  • The use of Circle Time as a way of improving behaviour needs more evaluation.
  • Issues considered to be important in relation to implementing strategies were: (according to teachers) simplicity and acceptability, consistency across the school and avoiding 'top-down' implementation; and (according to children) consulting and listening to children.

One review [4] attempted to investigate the relationship between EBD and speech and language difficulties (SLCD), and determine whether interventions aimed at one would have any effect on the other. Three types of intervention were identified:

  • Didactic interventions, which use behavioural modification alone to improve communication skills on the one hand or behavioural skills on the other.
  • Hybrid interventions, which teach communication or behavioural skills within a range of contexts and are of more generic application than didactic interventions.
  • Pharmacological interventions, which employ drug therapy to improve communication and behaviour outcomes.

Most of the didactic and pharmacological interventions were aimed at children with autistic spectrum disorders. Positive outcomes were found for most of the interventions, but the results were small scale and of low weight of evidence, so are not generalisable.

The report recommends that the planning of services for SLCD and EBD should be considered jointly, across professions and service providers. There is a good case for more extensive involvement of speech and language therapists in child and adolescent mental health teams across the UK. Similarly it is appropriate for all children presenting with delayed speech and language development to have access to support for their behaviour as appropriate.

A study of population inclusivity [1] found that at primary school level, the impact of inclusion of students with EBD on outcomes for other children can sometimes be negative.


1. The impact of population inclusivity in schools on student outcomes  (2005)

2.Support for pupils with emotional and behavioural difficulties (EBD) in mainstream primary school classrooms: a systematic review of the effectiveness of interventions (2003)

3. Supporting pupils with emotional and behavioural difficulties (EBD) in mainstream primary schools: a systematic review of recent research on strategy effectiveness (1999 to 2002) (2003)

4. The interaction between behaviour and speech and language difficulties: does intervention for one affect outcomes in the other? (2009)

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