Nurture approaches

Searches on 12 September 2026 sought original nurture-group evaluations, whole-school comparisons, recent reviews, implementation descriptions and direct pupil accounts. Searches deliberately included controlled, null, mixed, reintegration and burden terms. Seven material sources were retained: two developer identity descriptions, one systematic review, two controlled non-randomised studies, one uncontrolled mixed-method study and one qualitative study. These are seven source records, not seven independent efficacy trials.

The 2016 Northern Ireland report and its 2020 journal article concern the same evaluation. The former was located but not fully retrieved; it is a companion lead, not another independent replication. Older Scott–Lee and Reynolds studies were located as leads or review-covered evidence, not counted as independently re-extracted primary trials. The search does not establish that every relevant publication has been found.

Original publisher or university text was used for retained findings. Jones's original review was accessible through extensive indexed publisher text, including methods, tables and limitations; direct PDF retrieval returned 403. Other retained empirical papers were read through public full-text publisher or repository pages. The review distinguishes accessible full text from unavailable files; no inaccessible methods were inferred. Access limits remain explicit in the search register (internal editorial record).

A generic nurturing interaction, a defined nurture group, a whole-school framework and a locally named room need different records. A shared word, theoretical influence or activity does not make them equivalent. The Nurturing Relationships Approach studied by Nolan is not established here as the current National Nurturing Schools Programme. Colley's funded multi-component project is not a test of warmth, emotion coaching, staff training or a nurture group in isolation.

Theory can justify asking about security, continuity and relational context. It cannot identify the cause of an individual pupil's difficulty or prove that changing attachment mediates a programme effect. The Boxall Profile is an adult-completed measure of social, emotional and behavioural development used in this literature; its use for selection or progress monitoring does not establish causality. The reviewed sources do not supply a universal recipient-led threshold for entry, success or exit.

S01 — Current developer description of nurture groups¹

• Identity and version: nurtureuk, 13 March 2026 description of nurture groups; not an audited manual edition.
• Source role: Developer identity and intended provision; promotional efficacy language is not adopted.
• Population and setting: Primary and secondary school pupils; no recruited sample.
• Intended and actual delivery: Proposed 6–12 pupils, two staff, part-time participation, continuing class membership and usual full return within four terms. No actual dose distribution is supplied.
• Comparison and other support: No comparison; support elsewhere in school forms part of the intended connection.
• Outcome and reporter: Describes aims and examples, not a controlled outcome dataset.
• Delivery as intended (fidelity (delivery of the approach as intended)) and adaptation: Invokes nurture principles; does not verify that any local provision or historical trial matches the current description.
• Burden and unwanted effects: Staffing and timetable commitments are evident; no systematic adverse-effect assessment.

Use in A024: Naming and planning only. The proposed timescale cannot override a pupil's access needs or justify either indefinite withdrawal or abrupt removal of support. Current identity does not certify an older edition.

S02 — Current whole-school developer description²

• Identity and version: nurtureuk whole-school webpage, accessed 12 September 2026; describes the National Nurturing Schools Programme as 18 months.
• Source role: Developer programme identity, not independent efficacy.
• Population and setting: Schools; no evaluated cohort on this page.
• Intended and actual delivery: School culture, teaching and nurture principles; programme includes Boxall Online access. Actual uptake is not reported.
• Comparison and other support: No comparator; teaching and organisational change are combined.
• Outcome and reporter: Broad benefit claims lack a corresponding controlled dataset on the page.
• Delivery as intended (fidelity) and adaptation: Local development is anticipated; no study-specific fidelity record.
• Burden and unwanted effects: Staff and organisational time required; no complete burden or harms analysis.

Use in A024: Establishes that whole-school provision has a distinct identity. An award, subscription or training completion is not a pupil outcome. Neither S04 nor S06 automatically validates this current product.

S03 — Jones, Wood-Downie and Golm, 2025 review³

• Identity and version: Children and Youth Services Review 173, 108278; January 2023 search of six databases; narrative synthesis of 14 quantitative studies.
• Source role: Review of defined nurture groups; not a fresh primary trial.
• Population and setting: School-age populations, predominantly primary; heterogeneous samples.
• Intended and actual delivery: Classic and adapted groups; delivery and measurement varied.
• Comparison and other support: Six studies lacked controls; comparison support was usually poorly described; no randomised trial included.
• Outcome and reporter: Developmental Boxall findings were more consistent than diagnostic sub-strands; adult ratings predominated. Long-term evidence was limited.
• Delivery as intended (fidelity) and adaptation: Variant descriptions and statistical reporting were inconsistent; differences between variants do not establish equivalence.
• Burden and unwanted effects: Grey literature excluded; attrition and limited follow-up constrain conclusions. No reliable pooled harm estimate.

Use in A024: Replaces the historical headline rating with a limited evidence picture. Exploratory age, baseline or gender findings are not allocation rules. Publication year does not mean searches continued through 2025. Review-covered studies are not silently promoted to independently verified primary records.

S04 — Sloan and colleagues, Northern Ireland, 2020⁴

• Identity and version: Journal report of the 2014/15 nurture-group comparison; companion to the 2016 commissioned evaluation.
• Source role: Non-randomised matched-school study; adjusted multilevel comparisons.
• Population and setting: Reported total 384, chiefly ages 5–6; 30 group schools and 14 comparison schools. Selection and baseline characteristics differed.
• Intended and actual delivery: Funded established/new groups, full-/part-time variants; advisory and psychology support. Exact received hours and adherence are not established here.
• Comparison and other support: Schools meeting programme eligibility criteria but without nurture provision; not an equal-attention comparator.
• Outcome and reporter: Teacher ratings on the Boxall Profile and Strengths and Difficulties Questionnaire (SDQ), measuring developmental and emotional/behavioural difficulties, favoured groups; SDQ total g=−1.303, 95% confidence interval (CI) −1.696 to −0.909. Child enjoyment favoured groups; attendance p=.101, literacy p=.230 and numeracy p=.822 did not.
• Delivery as intended (fidelity) and adaptation: Exploratory delivery comparisons do not show equivalent efficacy. Outcome denominators varied.
• Burden and unwanted effects: No systematic recipient-harm assessment; withdrawal from ordinary lessons needs local review.

Data qualification: Figure 1 labels controls n=88, while control baseline Boxall/SDQ is 86 and the reported total is 384. Keep these denominators separate. Signature-group Boxall data decline from 232 to 197; established-group from 63 to 56; controls from 86 to 84. These are measure-specific availability counts, not one complete-case trial flow. The displayed developmental Boxall CI and prosocial CI contain apparent typographic anomalies; they are not silently repaired or used as headline estimates.

Interpretation: Outcomes may be encouraging without proving that group membership caused them. Baseline adjustment does not eliminate unmeasured selection or expectancy. In particular, the article must not translate a favourable enjoyment score into verified attendance improvement, academic progress, attachment repair or sustained independent regulation. Lower baseline scores and subgroup interactions remain exploratory.

S05 — Vincent, 2017 direct pupil and stakeholder accounts⁵

• Identity and version: Author manuscript, doi:10.1080/13632752.2017.1290882; “Beehive” provision in one English primary school.
• Source role: Qualitative implementation and experience, principally interviews.
• Population and setting: Key Stage 2; 13 pupils, five class teachers, three group staff and three parents over 2014/15–2015/16.
• Intended and actual delivery: Three consecutive afternoons weekly, mixed activities, class connection; differentiated continuing support during reintegration.
• Comparison and other support: No comparator; examples included in-class support and play therapy.
• Outcome and reporter: Participants described social, confidence and engagement changes; attainment was not tested. Pupil assent was sought; paired walking interviews supported participation.
• Delivery as intended (fidelity) and adaptation: Local part-time model; qualitative themes do not isolate active components.
• Burden and unwanted effects: Supported transitions were described; no systematic harms sampling or account of all eligible/non-participating pupils.

Use in A024: The study provides direct experience unavailable from a staff score alone. Small, selected accounts cannot establish prevalence of benefit or universal acceptability. Its examples of touch, incentives or developmental interpretation are not adopted as necessary components. Receipt of other support prevents assigning every reported change to the group.

S06 — Nolan and colleagues, whole-school comparison, 2023⁶

• Identity and version: Nurturing Relationships Approach; publisher date 1 April 2023, while PDF footers say 2022.
• Source role: Non-randomised comparison of three selected “ready” schools with three matched waitlist schools.
• Population and setting: Primary ages 6, 8, 9; teacher data 149/173, parent 136/161, child 99/112. No youngest-group self-report.
• Intended and actual delivery: Half-day all-staff training; two-day training for two leads per school; annual 1.5-hour sessions and educational psychologist (EP) action-plan support. Actual adherence unreported.
• Comparison and other support: Ordinary instruction/waitlist; other comparison training could not be excluded.
• Outcome and reporter: At 21 months teacher SDQ favoured intervention, while parent SDQ and child wellbeing did not show between-group benefit.
• Delivery as intended (fidelity) and adaptation: No integrity data; teacher raters changed. Analysis used pupil-level analysis of covariance (ANCOVA) and analysis of variance (ANOVA), statistical comparisons of group outcomes, without a reported correction for pupils being grouped within schools.
• Burden and unwanted effects: Approximately 40% participation; ten school movers withdrew; parent missing data excluded. Harms not systematically reported.

Interpretation: Distinct reporters and instruments answer different questions. The null child result is not proof of no benefit, but it must remain visible and cannot be replaced by teacher enthusiasm. The report's table also contains secondary-school rows; this primary article's analysed n=322 is not increased by those rows. Selection of especially ready schools, consent loss and small school count limit generalisation.

S07 — Colley and colleagues, 2026 mixed relational package⁷

• Identity and version: Phase 2, Oxfordshire 2023–2025; four primary schools; published 9 July 2026.
• Source role: Uncontrolled mixed-method evaluation funded by the delivering Mulberry Bush organisation.
• Population and setting: 57 pupils in two cohorts (28/29), selected by schools; 20 staff interview participants. One secondary school withdrew and was replaced.
• Intended and actual delivery: Groups plus training, leadership development, emotion-coaching input and outreach. Actual schedules: two schools four afternoons; two three mornings. Replacement school supplied one year.
• Comparison and other support: No control; multiple components and school changes confounded.
• Outcome and reporter: Staff-rated Boxall changes favoured post-test; within-person r=.68/.27. Suspension trajectories were mixed. Family views were staff-reported, not direct interviews.
• Delivery as intended (fidelity) and adaptation: No independent adherence estimate; local delivery varied.
• Burden and unwanted effects: Staff time and post-group concerns reported; no direct pupil harms dataset.

Use in A024: Contemporary descriptive evidence, not an independent causal demonstration. Suspension changes cannot be assigned to the package: one school's count rose 12→21→29, while another's later fall coincided with a cohort leaving. The nominal three-afternoon description in the introduction must not replace the actual schedules in Table 2. Phase 1 is not counted again as this sample.

The evidence does not permit a single verdict on whether a young person feels safe, belongs, learns more and attends more. Each requires its own information. A staff-rated developmental scale may reflect useful observations but is not a direct measure of consent, trust, dignity or curriculum access. Less disruption does not prove that a pupil is no longer distressed.

The reviewed qualitative material gives some pupils a voice, while the whole-school study preserves a child-reported null comparison. Neither supplies a representative account of people who decline provision, leave early, communicate without speech, experience substantial intellectual disability or need extensive adjustments. Generalising beyond the studied ages and settings should remain an explicit limitation rather than an assumed adaptation success.

For local review, document what the pupil wanted, what adults delivered, which communication methods were available and which ordinary opportunities were lost or retained. Ask about discomfort, stigma, fatigue, pressure, unwanted touch or disclosure, and continuity when staff change. These are proposed review questions, not adverse events established by the studies. Record disagreement among pupil, family and staff instead of averaging it away.

The following fields make a specific evidence or implementation record comparable with other Atlas profiles. They do not supply missing study data or replace the source-specific judgements in this entry.

• Identity and version: Name the component or programme, its edition or protocol where relevant, and the purpose being evaluated.
• Source role: Separate direct comparative evidence, descriptive implementation findings, guidance, theoretical support and firsthand experience.
• Population and setting: Retain the studied age, communication/access characteristics and setting. State when an intended application lies outside them.
• Intended and actual delivery: Record the planned components, frequency and duration (dose) separately from what was received, by whom, and with what support or interruptions.
• Comparison and other support: Name the actual comparison and concurrent changes. If there is no comparison group or condition (comparator) or it is unreported, say so rather than supply an assumed usual-care condition.
• Outcome and reporter: Record the outcome, time point and reporter. Keep the young person’s account separate from someone else’s judgement on their behalf (proxy report), and access or participation separate from task performance.
• Delivery as intended (fidelity) and adaptation: Record whether the core components were delivered and describe adaptations; distinguish an adapted application from the protocol tested.
• Burden and unwanted effects: Record time, effort, practical access, cost or workload where known, alongside refusal, fatigue, distress, restriction and other unwanted consequences. Unreported burden is not evidence of no burden.

Source-recovery history remains in the editorial archive. Detailed historical manual editions, individual received doses, fidelity and adverse effects are incompletely reported in several studies. Longer-term transfer after group exit, recipient-defined benefit and many access profiles remain uncertain.

An editorial check does not replace subject-specialist or recipient review. Those reviews have not been completed for this profile.

1. 1.

   nurtureuk (2026). Nurture groups: the original inclusion base, especially “How does a nurture group work?”.

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2. 2.

   nurtureuk. Whole-school approach to nurture, “Making it work in your setting”, accessed 12 September 2026.

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3. 3.

   Jones, B., Wood-Downie, H., & Golm, D. (2025). The effectiveness of Nurture Groups at supporting social and emotional outcomes: a systematic review, §§2.1–2.4, 3.2 and 4.1–4.3; original indexed publisher text.

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4. 4.

   Sloan, S., Winter, K., Connolly, P., & Gildea, A. (2020). Northern Ireland nurture-group evaluation, §§3–5, Figure 1 and Tables 2–7; doi:10.1016/j.childyouth.2019.104619. Companion 2016 report record is the same evaluation, not another trial.

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5. 5.

   Vincent, K. (2017). “It's small steps, but that leads to bigger changes”: evaluation of a nurture group intervention, manuscript pp. 4–17, especially methods and reintegration; doi:10.1080/13632752.2017.1290882.

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6. 6.

   Nolan, A. D., Hannah, E. F. S., Lakin, E., & Topping, K. J. (2023). The impact of an elementary whole-school nurturing approach, pp. 11–21, Table 1 and methods/results/limitations; doi:10.25115/ejrep.v21i59.4527.

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7. 7.

   Colley, D., Dennis, L., Knipe, E., & Gaciu, N. (2026). The impact of introducing relational approaches into four primary schools, Participants, Tables 2–5, RQ1–RQ3, positionality and funding statements.

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