Hello. We are the Association for Child and Adolescent Mental Health, or ACAMH for short. Hello, everyone. Thank you so much for joining us today. My name is Cathy Creswell. I'm a professor of developmental clinical psychology at the University of Oxford, and I'm really delighted to be able to chair this session on behalf of the RE-STAR team. Hopefully, you all know that RE-STAR stands for Regulating Emotions Strengthening Adolescent Resilience. And this conference this morning is an opportunity for us to all hear about the fantastic work that has been going on for just over four years, led by the RE-STAR team, to really make exciting progress, taking us from discovering new things to help us understand mental health challenges in the context of autism and ADHD, taking us from that discovery work all the way through to intervention development. So we're going to get a rapid tour through all of that fantastic work this morning, led by many members of the team, including some of the fantastic youth research advisors who've been really integral throughout the whole project. So throughout this project, I've been the chair of the steering committee, and it's been just such a pleasure to be able to see the work develop and see how well the team have worked together, and particularly, as I mentioned, that central role of young people throughout. So I'm really looking forward to seeing you all together presented so we can see how it all fits together and how it's really moved things forward. So just before I hand over, I just want to flag up that on the bottom of your screen, you should be able to see a chat box. And it's great to see so many of you have already started to introduce yourselves in there. Please do use the chat to introduce yourselves to network with other members. And you'll see there's over 300 people on this call today. So a really great chance to identify other people who you might have lots in common with. But if you have questions for the speakers, if you could use the Q&A box, which is a bit further to the right along the bottom of the screen, that will be fantastic because that will mean we won't miss any of your questions. So please do use the Q&A box as the speakers are talking. We may not be able to get through all of your questions, but after each talk, we hope that we'll be able to pick out some of those questions and possibly be able to come back to some more a bit later on, depending on how we do for time. But so chat for networking, Q&A for questions for the speakers. But without further ado, I'm delighted now to hand over to the chief investigator of the project, Professor Edmund Sonuga-Barke. And I'm sure Edmund doesn't really need any introduction to any of you. He's obviously a world-renowned developmental psychologist who has done a huge amount of work studying the causes, course, and consequences of mental health and neurodevelopmental conditions, and has done particularly influential work around neurodevelopmental conditions such as ADHD. So he obviously was so brilliantly placed to lead on this work. And I'm delighted to hand over to Edmund now. Thanks very much, Edmund. Thanks, Cathy. That's very kind of you to say all that. Yeah, good, working. So yeah, hello, everybody. I'm going to tell you about RE-STAR. Our overall goal in RE-STAR is really understanding mental health challenges in autism and ADHD. It's really been quite an adventure. And I think more than in most talks, it's important, I think, that I establish where we started and how we changed and what inspired the changes in terms of our focus and our science. So that's what I'm going to take you through. So subtitle a multidisciplinary adventure in participatory translational science. It's part of a large investment from the UK government. 35-- somebody said 37 the other day, actually, so maybe 35 or 37 pounds million invested in adolescent mental health. I think we are one of seven programmes of research. Ours, obviously, our specific focus being on neurodivergence and mental health in adolescence. So where do we start? Well of course, was the call for applications came in, and we made an initial offer, which was really trying to discover the role of emotion dysregulation in the mental health risk of neurodivergent people. And then to use that, our answers to that to drive obviously therapeutic innovation, so explicitly translational piece of research. However, the-- oh, sorry. Oh, OK. OK, yeah. Sorry about that. So that initial rationale really comes from we know that, for instance, adolescence is a period of depression risk in neurotypical people that's elevated in neurodivergent people. And in particular, it's sort of concentrated in neurodivergent people with emotion regulation difficulty. So that was the source of our initial focus. And then we would-- the idea being that we would then intervene early in adolescence to strengthen emotion regulation and cut depression. That was our sort of initial hypothesis. But of course, UKRI specified two other preconditions for this research. And they told us that we had to be multidisciplinary, and we had to involve young people in a more than lip-serving way at the core of what we do. And we took those very seriously, and particularly in multidisciplinary area, we really worked to integrate science and the arts. And of course, people in the arts very often, particularly in, say, applied theatre, have a very strong tradition of authentic youth participation. So it was crucial for us that we had someone like Sylvan Baker, who is the co-director of RE-STAR, coming from a central school of speech and drama, bringing all his expertise and his commitment to authentic participation of young people. And, of course, there was no choice then, but to really take this seriously and bring the neurodivergent people into the heart of our research process. And we'll talk about that happened. So together, we created what I like to call a band of neurodiverse adventurer scientists. And of course, when we got together, we changed the narrative. It was a very strong feeling in the group, that overall group that we needed a different perspective and that we needed to integrate what's called neurodiversity concepts into our research. And I didn't really know what that was, to be honest for Just an ordinary, boring scientist. So I had to think about it. We had to think about, what could that mean? What would a neurodiversity-informed science look like? First of all, of course, we all know neurodiversity concept as a sort of a rights-based self-advocacy movement promoting lots of good stuff. Started with autism, of course, and then other neurodevelopmental problems started to take that lead, reinterpret neurodivergence in a different light to promote a whole range of good stuff, the dignity and value of neurodivergent people, empowerment, self-esteem, et cetera, et cetera. Ultimately, looking also as well as the needs, but also the Positive things that neurodivergent people bring to their community and society more generally. But it struck me quite early on that, actually, good though that is, it's not really about science. And it struck me that, actually, the neurodiversity movement, a neurodiversity perspective also offered a different perspective on the science. How did it do that? Creating a paradigm. And what do we mean by a paradigm? So Thomas Kuhn was the philosopher of science who first termed the notion of a paradigm in science. Basically, a paradigm provides a set of assumptions about what you're studying, in this case neurodivergence, autism, and ADHD. Now, these assumptions, of course, constrain your theories and your research questions. They constrain what's a reasonable and sensible question. If you assume something kind of underlying assumptions or one set of things, then you ask certain questions. If you're through another set of things, you ask other questions. So what is the current paradigm within the study of autism and ADHD? What has been the dominant paradigm? That's obviously the next question. What are the assumptions? That means implicit in the disorder paradigm, which is the dominant-- has been the dominant paradigm. And that really is, put it simply, that ADHD and autism are discrete, singular disorders caused by brain dysfunction creating impairment. And so we can visualise that like this. So at the core of the explanation is brain dysfunction. That then leads to disorder, in this case, illustrate it with ADHD. And that then creates impairment. So that's a very simple paradigm for the study of ADHD and autism. In terms of intervention, the translational imperative is that you focus on the brain dysfunction, very simple logic, trying resolve, correct that, reduce ADHD, and resolve impairment. So that's the kind of classical model of causes and intervention for neurodevelopmental conditions. And in the ADHD field, Russell Barkley presents the classic sort of model, whereby executive dysfunction created by alterations within particular brain systems reduces inhibitory control, executive dysfunction, creating a whole pattern of cognitive difficulties. That's the classic model. And our initial hypothesis, which I described at the beginning, was very much within that framework that autism, ADHD lead to depression via deficits, internal deficits in emotion processing and control. But this paradigm is not delivering benefits. If you look at the levels of therapeutic innovation in those fields based on psychological science or neuroscientific work, they're very, very limited. So cognitive training, neurofeedback, both make a lot of sense from the disorder dysfunction model I just described. But actually, when you look at the trials, there's almost no evidence that they work, at least in terms of impacting that core brain dysfunction leading to reduced symptoms and impairment. So the question then becomes-- sorry-- can we develop some new ideas by taking a different perspective that might be more fruitful in terms of developing interventions that can help autistic and ADHD people. And I kind of represented this point of view in an editorial I wrote in 2023, which really was inspired by all of my colleagues in RE-STAR terms of thinking through what a paradigm flip, that changing from the disorder paradigm to neurodiversity paradigm, might do in terms of reinvigorating translational science, new ideas, new methodologies, and hopefully, new interventions. Well, actually, new interventions in terms of RE-STAR, as you'll hear later. So what would that flip entail? Well, once you take a neurodiversity perspective, you bring in some alternative assumptions. You no longer talk about brain dysfunction, obviously. You talk about atypicality of brains, differences between individuals within the general population across a big spectrum. You talk about differences in thinking and being and acting and not disorder. And you talk of course, about not the resolution of impairment that's caused by brain dysfunction, but rather the notion that individuals development is stifled by non affirmative settings. Creating a spiral of decline. So it's that mismatch between the individual in their neurodivergence and the environment within which they're placed. So this is a flip of paradigm. It's not a statement of fact, but our goal is to create new ideas and new hypotheses. So that's the role, I think, the kind of neurodiversity perspective in science. And what does that do? Well, first of all, it changes where you target your interventions. We've talked about realigning individuals to their environments to create what we call an arc of growth. Because it also changes what you study, much more focused-- not so much focus, at least in isolation on the brain, much more focus on the environment, that mismatch between the individual and the environment. So it changes what we do. So you reject the concept of disorder dysfunction within this paradigm. Doesn't mean it doesn't have value. It just means within this scientific paradigm, we're not really focused on that. We're more focused on this alignment or misalignment, affirmation or non affirmation of neurodivergent individuals. But it also changes what you do. It also, as we've already talked about, encourages really deep participation and places that insights and experiences of neurodivergent people at the core of the study. And we've been working and thinking hard about this. And we developed, together with our youth researcher panel, which I'll introduce in a minute, a model really for participatory-- what we call participatory translation or science. And we've published a paper on this in the British Journal of Psychiatry. So everybody working together towards a common goal, inspired by the notion of intentionality that, really, Silvan brought to the table, flattening the power hierarchies, all challenging stuff, of course. Opening expertise by science to expertise by experience. And I also think leavening the neurotypical science with the neurodivergent mind, something that's not really focused on bringing those skills and those perspectives and those styles of thinking. But importantly, British Journal of Psychiatry, for such an unusual paper for them, the editor chose this as the best paper of the year. So we're very, very happy with that, highlighting you know how these ideas are getting some traction. So what is the youth researcher panel? They're really the fulcrum of this approach and a group of young people with ADHD, autism diagnoses is just the names of the individuals? And what have they really contributed? They've contributed to every level, really. So developing new ideas, creating new methods, collecting data. You'll hear about this as we go through, but also leading the dissemination. And that's been incredibly successful for us. They've also been centrally involved in building our intervention Place Positive, identifying the components of the intervention, improving its design, testing the feasibility of that intervention, and then facilitating, please God, the intervention itself, the implementation of the intervention. The process that we set out in the BJP, really, I guess, is a first attempt to say, how can you place neurodivergent people at the heart of the science, went through a series of stages. So of course, obviously, we assembled this team of all the talents, the names you just saw, carefully identified-- we had a lot of applications, actually, to be part of the study. So it was important to build the right team with the right people. Obviously, setting ground rules, establishing trust, and developing a shared vision. Just as an aside, the investment that my colleagues made in this process, both sides, the young people and also the academic researchers, have been absolutely phenomenal. This doesn't happen on a couple of weekends a year. This happens kind of continuous energy, effort, and enthusiasm over the four-year period. I think we estimated-- I can't remember what the numbers were, but we tried to estimate the numbers of hours of this process from all the different stakeholders. Quite extraordinary. And I'm so grateful to everybody for that. Obviously, I'm building confidence to co-create. None of our Y-RPers really had experience of research at all. And so that whole process of giving them the skills and the confidence so they could fully be involved in the process, and then somehow building on that initial progress to ensure continued growth. A crucial part of this whole thing, of course, is duty of care for everybody involved, actually. Everybody was stepping outside their comfort zone, both the academic researchers and the young people, and we were very focused on the scaffolding and the skills training and the duty of care that we had to put in place. I think we have a copy of it actually attached to the BJP paper, if people are interested. But in terms of-- that's all well and good, putting the structural bits in place, but what about those more intangible elements? How can you make this work? So many characteristics are important, again, to everybody involved, not just academic researchers and not just the youth research panel. It's got to be open to New ideas because we really didn't know where we were going, actually. That's the nature of co-created work if it's genuine. Tolerance for uncertainty, shared passion, common goals, respecting each other for who they are and the knowledge they're bringing to the table, valuing different evidence, different sorts of evidence. Interesting one, we had lots of interesting discussions about inductive versus deductive science and stuff, but we're all-- I think we're all still friends. Building trust, obviously, crucial, again, for the whole team. Adapting to the needs of all the individuals, tailoring rewards, and ensuring continuity and coherence of the process. And it's really great that actually a lot of the young-- the youth researcher panel have been with us through the whole process, and that's been absolutely wonderful. And I guess it says that they're valuing-- the youth researcher panel are valuing what we're doing, which is even more important, perhaps. So I guess the question for us is, how do we apply these two aspects of this neurodiversity sort of inspired science to our particular problem, which is mental health in neurodivergent people. And that's what we're going to talk about today, how we applied it, what we learnt, and how that informed our approach to developing a new intervention we call place positive. So this last slide, if I can get to move on. So obviously, the big question if we're saying that this misalignment is key between the individual and the environment, the question is, what bits of the environment are important, and what characteristics of the individual are important? So that's obviously our science focus in this case. And then, well, there's an obvious thing to do when you've accepted the deep participatory principle, is let's ask young neurodivergent people and then work with the youth researcher panel to explore the implications of what they say. And that's exactly what we've done. Yeah, thanks very much. Thanks, Cathy. And we're going over to Steve, I think, next, after one or two questions, if we've got time. And he's going to tell us what bits of the environment are important and which bits of the individual, based on our discussions with young people. Thanks, Cathy. Brilliant Thanks so much, Edmund. Yes we have got time for a quick question. And just a reminder to use the Q&A for any questions that you have. But one question to get you started that's come in is, has the research looking looked into the family home as part of the environment and its impact on mental health? So our focus has been almost entirely on the school. I mean, I don't want to steal Steve's thunder, because he's going to tell you why we did that, but just to say it was. So obviously, we realised that's an important-- the home is an important concept, an important contributor to mental health, and people are bringing a lot of stuff with them to school. We understand that. And we discussed it. But I think in the end, we decided that to do our job properly, we really need to focus on one aspect of this. Although, obviously, the next steps might be to explore the family context as a source of initial trauma or stress or whatever that then feeds into the or modifies the impact of the school experience for neurodivergent people. I'm trying to stay away from the concept here so Steve can introduce it. But yeah, so I think that was a kind of strategic decision on our part, really focus on the school, because this is what young people told us was important, which Steve will say. Thank you. And I think we've got time for another question. There's a question. Did you just look at mainstream schools? And I guess we may hear more about this, but also special schools and units. Yeah, so our focus was very much on mainstream schools. So one of our criteria in terms of inclusion of individuals was that they were in mainstream schools. So that's obviously got limitations. But again, it's a kind of strategic tactical decisions about whether you spread things widely initially, this is the first step, hopefully, in more studies, or whether you focus in on a particular set of questions. And in the end, that was the way we went. We focused in on the mainstream schools. There are those issues around obviously special educational facilities, but there are also issues about people not in school, people who either been excluded or not attending. And this is a really crucial part of the story as well. Again, it just wasn't possible, possible for us to deal with that within the resource envelope and the time we got available. Thanks very much. And I think that does take us really nicely onto Steve's talk. So I'm delighted to introduce Doctor Steve Lukito, who's a postdoctoral research associate working on the RE-STAR Research Project programme at King's College London. Steve has over 10 years of research experience in the broad area of neurodevelopment, with particular focus on autism and ADHD-related topics. And I understand that Steve has been particularly prioritising, making sure that the research reflects the experiences of the neurodivergent community. So we're really looking forward to hearing from you. Steve. Thanks very much. Thank you, Cathy. Hi, everyone. My name is Steve, and I'm one of the research associates at RE-STAR Research Programme, who has been part of the band of adventurer scientists that Edmund mentioned earlier from the beginning of 2021. And it's a privilege for me to present in this conference today. So yeah, where did we start exactly? So yes, OK, that's great. Can everyone see the slides moving? Perfect. So yeah, we really started by co-creating an interview schedule with our neurodivergent young research panel. This was a vital in providing bridging between our research team and the research participants. So although we are experienced in scientific research, and some of us are neurodivergent ourselves, and we don't necessarily have the lived experience of young people who are still at school. So what you see on the left here are the different sections of the semi-structured interview schedule that we co-produced with our Y-RPers This incorporate different creative activities, whether it is artwork that the young people bring themselves into the interview session, expressing their emotions, or props, such as the video vignettes that you can see here on the right-hand side and the emoji cards that our Y-RPers have to create that help young people to talk about their emotional experience. The interview itself-- [VIDEO PLAYBACK] - Starting with some fields, they are all talking about things they are interested in. But when I talk about what is important to me, they don't seem to care or want to listen. They continue talking as if I wasn't there. [END PLAYBACK] So this is an example of the vignette that Marty, one of our Y-RPers members, have created. And this helped prompt some of the discussions that we had with the young people in terms of their experiences. The interview itself took place with 57 young people who are autistic and/or with ADHD. So this is a large number of people for an interview study by qualitative study and standard. And through this interview study that was led by the lovely Doctor Georgia Pavlopoulou that you will meet later on, we see that our young people describe a range of upsetting events that they experience through their surroundings. And these comprise themes such as social dislocation or conflicts with others. So these are experiences such as being bullied, being ignored, or being recipients of other people's anger or unjust punishment. So there's also a theme around internalised self-doubt, loathing, embarrassment, or in other words, stigma, having mismatching sensory surrounding, and also the experience of hiding themselves or through self and from others, and for fear of negative consequences. These are really best expressed through quotes from the young people. Some of them can face subtle differences between young people. And with autism, ADHD, or both, you can see that some of these themes branch out into subthemes, which are different between the groups of people with different diagnoses. And yes, let me just present some of these quotes here. So I didn't know why these people didn't like me. I feel like I don't have a concrete group friend-- concrete friend group at all. It really does hurt me sometimes. So this is from a young person who's 15 and autistic, and conveying some of the issues around being invisible and being dismissed. And some of the more contrasting quotes, for example, from a group of people with ADHD or autism. For example here, I'm trying to focus something, and then there's noises in the background. They will really irritate me. So this is conveying a state of overstimulation, which is typically experienced by young people with autism, whilst people with ADHD experience more of the understimulated kind of experience where they encounter lessons or doing something which is boring and just switch off. Another quotes that we can present to you for example here, I'm just scared that I'm going to say the wrong thing. I'm scared that they are going to be like, you lied to me. So this is conveying some of the unsafe, provoking interaction from other people. Well, this is confirmed by a young person with ADHD. And here, I feel like I've disappointed myself and disappointed other people. So this is more to do with stigma attached to autism. So yeah, what do we make out of it? So from this study, which we called My Emotions and Me, we gather new insights into the source of emotion dysregulation in autism and ADHD. Autistic and ADHD young people experience a wide range of seemingly frequent upsetting events and encounter, which they're experienced with more intensity. That's what we get from our interviews. And our findings led to a co-created hypothesis that we will present in a minute. Oh, yes, and we share these findings through our recent disseminations. For example, papers that you can see here led by Georgia and also through a public engagement event in 2022 that really conveys the experience of the young people, My Emotions and Me. Yes, so the co-created hypothesis is that the accumulation of high levels of common, upsetting events, intensely felt, creates emotional burden, a source of significant unhappiness in itself, and a potential risk to mental health in the long run. So, as Edmund said earlier, we focused in school, and this is a setting that young people brought up a lot in the interview, contrasting to the home or other environments where they often brought up as a place where the young people could have a break from the stressors that they experienced at school. So while such findings, qualitative findings illuminates the lift of neurodivergent young people in their day-to-day experience, it remains ultimately limited in scope to 57 young people's accounts. And for this reason, we examined this experiences in a larger scale. We created an instrument called my emotions in school, or MESI, that allows us to investigate the experience of upset through a survey. The themes from the qualitative interviews that you saw earlier inform the development of MESI. And so there are 25 items. Each represent commonly upsetting events, or call it CUE here, and within each item, we ask how often the CUE occurs. So this is frequency and how upsetting they would find-- they would cause if they occur. So within our model, each CUE produce emotional burden through the multiplication of their frequency and intensity of upset they cause. The MESI increase item representing difficulties, interactions between individuals with their peers and teachers, and difficulties around environmental stressors among others. So we embed this in a survey. And what have we found from this study, which involves 735 secondary school students? It was a revelation. So emotional burden is carried approximately twice in those with elevated autistic and/or ADHD traits. And this includes those who have the diagnosis of the conditions compared to those without. So you can see this from the chart. Those with both ADHD and autism experience a little bit more of this emotional burden. But the difference is between the neurodivergent groups are slight and non-significant. What you notice , people with ADHD and autism experience similar burden, but actually, the triggering events of importance, differ between the two groups. So I am now going to turn-- now turning to you, especially those of you with the lived experience of autism and/or ADHD, be it because you are autistic or have ADHD, or because you are teachers or parents of Autistic and/or ADHD children with the lived experience of seeing the differences that young people are experiencing through their daily life. So what might be the top upsetting events for ADHD or autistic students? So I'm just going to share with you s-- thank you, Susie. So now I need to share the slides. Yes. So I'm sharing with you the Mentimeter. So it's a bit of an interactive part of this presentation here. What are the top triggers, do you think, for ADHD students? So you can use the QR code here to access our survey. Oops. OK, yes, we can see already, not being allowed to do things that help you manage your emotions is number one according to yourself. Being accused of something you didn't do. I'll give you a little bit of time as it's changing still. Let's see if it is of settling to a-- that's superb. It looks like we are probably sort of plateauing. So I'll stop there, because we're going to ask you the same questions for the autistic students. So the top three, it seems to be not being allowed to do things to help manage emotions, being accused of something you don't do, being asked to stop doing something you really enjoy. So I'm going to ask you the same questions for autistic students. What do you think are the top triggers for autistic students? You can continue responding to the first bit of the survey or Mentimeter activities if you like, as well, if you're joining a bit late. That's brilliant. And so I'm going to go back to our Zoom. Susie, you can share back the-- let's have a look at our Zoom again quickly. So the top triggers, according to yourself, for ADHD students are not being allowed to do things that help you manage your emotions, being accused of something you didn't do, and being asked to stop doing something you really enjoy. So that's the top three. Whilst for autistic students, a chaotic and noisy environment and last-minute change of plan, staff do not understand feelings of reaction, that's the thing that you think will trigger autistic students at the most. And so what we have found through our own survey, when we look at the students ratings of their top triggers. For students with ADHD, being accused of something you didn't do, staff treating you unfairly, and asked to do something really boring are amongst the top three. But all the things that you've mentioned earlier are also part of the top 10 of those trigger. Whilst for Students with autism, pressure to do well, being in a chaotic environment, not getting or understanding others, and so on are part of the things that really trigger them. Susie, you've done very, very well. So what have we found when we ask-- when we do a bit more analysis on this to see what specifically triggers an emotion in ADHD and in autism? We can see that relationship with teachers being under stimulated is are among a few triggers for children with students with ADHD, whilst relational stuff with other peers are things that are triggering for autistic students. We also include a few-- so these are scientifically interesting. And we're also presenting with you here-- to you here some of the items that differentiates between neurotypical and neurodivergent students. And this is mainly driven by the harsh burden they impose on the neurodivergent students. I just want to remind you that although we find this group differences-- and this is interesting scientifically-- there are 24 items that made up the computation of burden in the MESI, and only up to items really differentiates one group with another between neurotypical and neurodivergent students as well. So there are significant overlap in terms of the burdensome events amongst group, including those with both autism and ADHD, and between the neurodivergent and neurotypical students alike. So that's the message of this slides here. So our research shows the importance of environments in the emotional experience of young people. And this is also what we experience. This also what they experience at a deeper neural level. Using experimental approach, and we investigated how school environment affects how emotional cues are experienced, represented by the teacher on the right here. So what you can see on the right-hand side is the brain neural signature to do with that experience. Brain signals naturally oscillates. And the image you see on the right are changes of these oscillations over time. The darker the colour blue here, the more reduced the oscillation is. But interestingly, this indicates more engagement. The experience is for the young people. So I can't talk much about this as we are just still finalising the analysis. But you can see some potential differences across groups and conditions in the yellow boxes here. So suggesting some modulation of these signals by environmental conditions and also the diagnosis of the young people. I should also add that these studies were very much influenced by the Y-RPers Without them, we wouldn't be focusing on the impact or the influences of the environments on the emotional experience, or that we would be investigating what experience inside emotion as an experience or within person in the study. So most importantly, our cross-sectional analysis showed that emotional burden is positively associated with mental health problems, in this case, depression or anxiety. You can see from the diagram on the top here, both emotional burden and emotional regulation difficulties were independent predictors of the degrees of mental health problems across individuals. And those with higher emotional-- this means that those with higher emotional burden and emotional regulation difficulties had more mental health problems. Now, interestingly, at the school level-- and this is based on more limited data that's provided by the schools-- we find that emotional burdens also appear to be associated with school absence, although this is not statistically-- strictly not statistically significant, but it is approaching there, whilst emotional regulation deficits or difficulties did not at all. So this is similar pattern for school levels of overall absence and persistent absence as well. So we are onto something, that emotional burden does have a place of importance in the way we think about mental health in young people, especially those with autism or ADHD. What we found interesting is that how pattern of predictions of emotional burden and emotional regulation deficit also applied for loneliness and self-esteem. And so out of these studies, we extend our hypothesis. Emotional burden, as a source of significant unhappiness in itself, combines with emotional regulation deficits to create mental health risk in the long run. So we've extended our initial hypothesis, as that showed at the start, autism and ADHD are associated with increased risk of poor mental health mediated by emotional dysregulation deficits in neurodivergent adolescents. We've now extend this mainstream hypothesis by adding emotional burden. So this is a dual process model. And how we examine this hypothesis is outlined in a registered protocol for longitudinal study we published in 2025. So how are we doing with time? I just have a few more slides, if that's OK, Cathy. So understanding the mechanistic role of emotional burden and emotional regulation deficits as mediator of mental health requires a longitudinal investigation. And this is because we need to follow the progression of these variables over time. At the moment, we think that MEMO is relatively longer follow up study in three phases. So the first phase has been completed involving three time points and followed by the phase Ii and phase III, which will capture transition time post secondary school for some adolescents. So there is a complexities around how the longitudinal data is being analysed. And this will help you to understand our finding in the end that I will present. The analysis, what we can illustrate here, is that using emotional burden questionnaires across three time points, the important step here is to separate two aspects of emotional burden characteristics statistically, those that are common across the time point, which we call the stable me, or a trait that is stable. And also so this is how I am generally. And what's left after controlling those is part of me, which is changeable over time, which could be a target for intervention. So we have to do this not only for the emotional burden construct, but also for the depressions or mental health construct. We also separate trait and state of this. And by doing so, we are able to see how stable traits in one and characteristics related to the other, and how do changing states in one characteristics relate to another? For example, here how emotional burden might affect depression or the other way around. So if you remember, our original hypothesis is that EB emotional burden trait mediate the link between neurodivergence and depression, anxiety trait. So you can see it through that more complex diagram in this way. But there are two kinds of things that we're investigating, and one of them is how neurodivergent-- how emotional burden trait mediate the relationship between neurodivergence and depression trait, and secondly, how a changing states of emotional burden mediate the link between ADHD or autism and changing depression states. Now our findings so far-- this is the first interim result-- shows that neither emotional burden or emotional regulation deficit state mediates changes in mental health over time. However, emotional burden and emotional regulation deficits mediate some of the neurodivergence and mental health links across students. So those with depression, anxiety also experience higher emotional burden or emotional regulation deficits. Somewhat surprising finding is that ADHD is linked to reduce anxiety and depression over time. We are currently conducting data collection for the phase II and hoping to look into the pattern of emotional burden and emotional regulation and mental health across longer time points to see how this pans out when we look into longer time. Yes, in summary, emotional burden in school is driven by both frequency and intensity of common upsetting events. Neurodivergent young people experience twice the level of emotional burden in school as their neurotypical peers. Sorry. Emotional burden is associated with mental health symptoms across individuals, and longitudinal studies showed that stable, emotional burden traits mediate the relationship between neurodivergence and mental health symptoms. And so that's what I can tell you. I realise it's quite a lot in one sitting. And the next part of the presentation would be delivered by Georgia, who will talk about what helps in this case. Wonderful. Thanks very much indeed, Steve. We'll move straight on. But Steve, there are lots of interesting questions in the Q&A. So if you have an opportunity to type answers to those, I'm sure that would be really fantastic. Thanks so much. So we'll go straight on to Doctor Georgia Pavlopoulou now, who is an associate professor in mental health, neurodiversity, and implementation science at UCL's Division of Psychiatry Brain Sciences. And thanks ever so much, Georgia. Over to you. Thank you so much. It's such a pleasure to be here. I've been part of this adventure since 2020 when we first applied as RE-STAR. So we have been hearing today about the importance of hearing from young people themselves, learning from them about what supports or hinders emotional regulation and shifting. One of the suggestions that we've heard today is shifting from this kind of neuro disorder, thinking and doing into neurodiversity thinking and doing. In that context, it's is super important to hear, of course, from young people. So autistic and ADHD also, ADHD young people often experience emotional burden. And there is a dearth of research right now on emotional regulation efforts. We have so much about emotional dysregulation, how that might lead to different problems, how this might connect with deficits in terms of thinking or understanding their own emotions, and so on. But we don't often hear from neurodivergent young people themselves about their preferences, about what works, about what kind of strategies they might be already using. And we don't hear often what is useful in terms of the context of the upsetting experiences, a contextual approach, if you like, to emotion regulation. The RE-STAR team wanted to change that. And we worked with 57 adolescents to understand from their perspective about what works for them. Next slide, please. So the current knowledge base is really having a very limited attention to the youth perspectives. Earlier, Steve presented pieces of our earlier work. And if you can see in the drawing I'm sharing here, this young person has named their work The Complex. So very often, autistic and ADHD or ADHD people are considered complex in terms of their behaviours, in terms of their expressions. So very often, the way people experience emotion is considered from the outside, not from the inside, from adult-led, medicalized often interventions. There is a neurotypical lens about how people experience emotions, how people recognise their emotions, and strategies about what helps. And very often, we assume deficit when it comes to people who have diagnosis or traits of autism, ADHD, or both. Next slide, please. So when it comes to current interventions about emotion regulation, so very often, the focus is on control in ways that look at the person and the responsibility of the person, very often ignoring the contextual side of things. So typically, interventions include skills-based therapy, teaching the person how to breathe, how to regulate, how to cognitively reappraise their emotions. Many, particularly autistic and ADHD people, have been subject of behavioural modification programmes. Very often the assumption is that they need to learn better social skills or other skills in order to regulate themselves. And nowadays, particularly in the UK context, there is an emphasis into zero tolerance policies and compliance-focused school interventions. Oops. We can go back to my slide. Any of you using zones of regulation? I suspect many of you will be familiar with that. It's so interesting because zones of regulation is-- and I have used it in the past as well. But interestingly, it's not evidence based. It doesn't have evidence that it works. It gives professionals a sense of control that we're saying to people, oh, this is how you feel, then this is what you do. But so very often, we're asking the student to it out for themselves. They're not feeling well. They're on the yellow zone. We ask them to go out, play air guitar, do wall push ups, whatever is on the yellow line of the plan, and come back and manage the same difficult environment. There's some interesting stuff happening with my slides. OK, let's take it. Next slide. Thank you. Previous slide, please. And of course, that has an effect because so very often, autistic and ADHD students will be isolated in terms of many interventions are pretty harsh, are consequence based. And we know students might have been restrained or isolated. That has been a lot in the recent reports and news as well. Next slide, please. So we worked in RE-STAR in our neurodiverse team, academic and youth co-researchers, we worked together to explore how neurodivergent adolescents prevent and manage upsetting emotional experiences. We wanted to hear from first accounts, their personal perspectives, and we focused on strategies that they use in daily life across home and school contexts. And we used a range of approaches in order to get at the heart of their own experience. Next slide, please. In order to do that, one of the many very important aspects, it was to use creative, community-based participatory methodologies that will allow young people to bring their perspectives. We had to be adolescent friendly, but also neurodiversity friendly and informed in terms of our approach. Very often, we didn't rely on the spoken words. We allowed people to know the agenda in advance, to know the questions in advance. We met with them, we inculturate them into the topic, and we offered them different options. Interviews were personalised and multimedia. They could bring photos to answer the different questions. They could draw pictures. They could write poems. They could take video of themselves. They could write stories. They could use LEGO modelling or clay modelling and so on. And we saw that these really contributed into the richness of the results, because it allowed young people to think, to take their time, to process the questions, and to bring the answers in a format that really worked for them. Next slide, please. So you can see a sample of what the young people have been bringing. In terms of deepening youth participation and co-production, when we talk about emotions, it's not an easy topic for many neurodivergent people because of alexithymia, because of different aspects of processing. So young people gave us really good feedback in terms of the methods and the personalised engagement that we allowed at RE-STAR. Next slide, please. So we worked with young people and lots and lots of credits to the team, particularly to the youth co-researchers who worked with them to create ground rules, to look at the safety and the duty of care for working together. We partnered with young people to co-design the interviews and the creative tasks. We reflected. We generated new insights. We co-delivered interviews, and we analysed interviews of 57 autistic, ADHD, and ADHD adolescents, asking them what helps? What helps to manage school-induced emotional burden? Next slide, please. So we have recently, in October, published that paper. it's open access. Later, one of my colleagues can put it as well on the chat for you. So participants emphasised on being treated with kindness, well, all of them. We have more than 400 quotes where people are talking about how in terms of preventing emotional dysregulation, anger, sadness, big negative emotions, being treated with kindness really matters. Feeling accepted as their authentic self, which very rarely they have an opportunity to do in the school context really matters. Loyalty in friendships was particularly prominent in the ADHD group. They spoke a lot about the importance of friendship, about the importance of contributing to friendships, and others being loyal to them, the sense of justice, the sense of connectedness. And for the autism group, it was really important to have opportunities to connect with themselves and their inner world, as well as with others via shared interests. If you can click again on that slide, we can see the different themes. There's an overarching theme about connections and acceptance over being told what to do. It's a good time, I guess, to think about what young people have been saying, because recently, we had-- I think it was yesterday, the Senate reform was published, and the word inclusion was mentioned in the document 166 times. But what does inclusion may involve? What does good living my best life at school might look like for young people is something that we rarely hear. And I'm so privileged to be part of the RE-STAR to hear from young people directly themselves, speaking about how it helps them to manage emotions, and it helps them to prevent emotional dysregulation when they feel connected, when they feel accepted, and when there are people at school who get it, who understand it. And so very often, people told us that, unfortunately, it's only that one learning support assistant, that one counsellor, that one pastoral care person that really gets it. And that shared understanding is not obvious in across every setting and across all members of staff, which often can have devastating consequences for them. Next slide, please. So participants in our study stress that belonging is reported to reduce emotional intensity of daily frustrations at school. If they feel that they are accepted, if they feel that their opinion matters and they gave lots of quotes and examples that you can read in our paper, they mentioned that they're in a better place to manage any kind of adversity or lack of planning or unpredictability that may pop during the day. So to experience belonging, neurodivergent students mentioned that they need others to attend their particular inner experience sensory, emotional, cognitive, without judgement and without rushing to quick fixes. The people who have been really helpful, according to young people, are those who bring curiosity and that pause and listen from young people what they need in the moment rather than telling them, this is the fidget toy, this is what you need to do kind of quick fixes. If you click one more time, Susie, on the slides. Again, connection, acceptance, and being supported. Next slide, please. So when we think about what helps to prevent students from becoming upset and dysregulated, a topic that was particularly relevant to autistic participants is about self-care. They spoke about the proactive value of practicing self-care and being allowed to have quiet time, time for themselves, to do their own reading in depth. So for some of them, it was meditation or breathing, listening to music, sensory resets. For some of them, that sensory reset had that element of drinking water or movement, natural engagement with nature, as well as creative expression. Now, you can imagine if you are a practitioner in many contexts and in the UK, going to the toilet or drinking water in zero tolerance behavioural places, that's not really going to be in favour. There are planned bathroom times, for example. And there are many assumptions about why autistic people might-- autistic students might be choosing specific things or not. They spoke a lot about the importance, again, that's specific to the autistic subgroup about familiar and sensory calming activities and quiet and solitary routines. Remember, they don't want to be lonely, but often they want to be alone to reset. That has been pretty important. Next slide, please. So self-care for autistic participants has been rooted in sensory regulation. Many have mentioned meaningful distraction and emotional grounding. Our participants not only recognise what worked for them, but also spoke about these routines as being essential for them to navigate the daily demands that teachers and school staff have on them, particularly when the day schedule might feel unpredictable, overstimulating, or activities might be socially challenging. They feel better equipped to act on these demands in a way that feels and looks regulated when they had time to engage with self-care. Next slide, please. Now, again, autistic and all ADHD participants spoke about the importance, in terms of preventing emotional dysregulation and negative experiences, of affirmation, of people believing them, of people checking in with them. What is happening? What is their perspective? What is their kind side of the story of whatever might be happening? People giving reassurance, particularly people in authority position and peers offering reassurance and support in a curious way, not in a pre-decided way, not in a one-size-fits-all way. Particularly, autistic participants spoke about being listened to that makes such a difference. Check-ins from trusted adults and peers so that they don't freak out and they don't feel that others are just checking in a controlling way. Reassurance, emotional validation, and predictability. Safety and predictability was mentioned a lot. People have been considering it very important to know about what's going to happen to them next and if there's any changes. When it comes to ADHD participants, it was emphasised that, again-- sorry, I think we need to go to the next slide, please, Susie. Yeah. When it comes to ADHD participants, autonomy really matter. So if I can briefly give you an overview, when we talk about autism and ADHD, it has been super important, co-regulation, in terms of our findings, this is what the young people have been telling us. Co-regulation has been important for ADHD folks, but they also really, truly value autonomy and being able to take their own action and having options, being giving options, not being told what to do, but having somebody who's curious to work it out with them, choosing their own coping strategies, having a chance to disengage with whatever is upsetting, and coming back, without this being labelled as refusal or avoidance. And positive distractions are highly valued in terms of managing themselves during periods of upset. It's impossible to always be proactive. Sometimes things will go bad. And it's really important for ADHD participants to have freedom to act independently and to have others who are curious about what the person might be needing. Next slide, please. Letting it out. Well, not always pleasant, I guess, for members of staff or family members, but having a chance to let it out, to cry, to steam, to do things your way, as well, lots of physical gestures to externalise emotions. Sometimes that included intense physical, vocal, and gestural kind of expressions and lots of crying, sometimes yelling has provided relief, as reported by the young people. Even if it doesn't fully solve the underlying problem, it seems that once people have let it out, they are more able to go back, reflect and see what's happening next, and try to recuperate and get over the upsetting experience. Let's go to the next slide. I think for me, that's one of the favourite topics that came out that we found working with the team because it's very often, I guess, forgotten. And judging from my own professional practise, so very often, I like to have the control. We are preoccupied with very mainstream, neurotypical kind of regulation support. And young people have been saying to us that, give me a chance. Don't think of deficits and how to fix me. Let me draw from strengths within. And please do help me to leverage my own strengths proactively and reactively. Young people spoke a lot about the importance of experiencing environments where they don't feel that they are a failure, that they are a deficit, that they are broken. They spoke about the experience of sense of achievement, and some of them gave very simple examples the teacher or some familiar person having written reminders or photographies of moments that they have done really well so that they can remind themselves that they are not a failure, that they are strong enough to give it a go into whatever challenge is ahead of them. And also that is interconnected with the sense of building positive self-image. At some point, we're going to put on the chart one of our first papers that Steve beautifully presented. And very often, these neurodivergent students spoke about a sense of hating themselves, not believing in themselves, and not exactly ruminating, mostly imagining very negative things about the future based on their experience. So learning from previous experiences and building a positive self-image has been super important. Cathy, I'm going to take one more minute, if that's OK. Let's go to the next slide. Let's summarise key interpretations. So based on our results, emotion regulation is not an external thing or something that just people need to be taught. It's context sensitive, and it's very relational the way young people have presented it. So actively managing emotional burden using relational, environmental, and personal strategies. I gave you a flavour. You can read the paper for more about what the young people have been talking. And it has been very important for them not to see themselves as emotionally deficient, but to build on existing strengths. Next slide, please. So again, remember, autonomy, loyalty, sense of achievement, sense of strength and independent action, very much valued from the ADHD folks. And autistic folks seem to value more predictability, consistency, safety in the relationship with the other, co-regulation, structured self-care, structured opportunities for self-care. Next slide, please, and I think that's going to be my last one. Implications for practise then, how do we take it from that? We worked with the RE-STAR team, including our youth co-researchers, and we did member checking about how to interpret our results. Prioritising kindness sounds simple, but it's not easy, especially in very busy working environments. Predictability, positive identity, offering personalised, low-stakes support, facilitating self-care, educating ourselves, educating the peers and the staff about neurodivergence in ways that are not based on deficit neuro disorder narratives, and providing neurodivergent role models, was also mentioned as something really positive for people leveraging our strengths. Thanks for your attention. Thank you so much. And next, you're going to hear from Jane. I don't know if you have time for one or two questions, and then my colleague Jane is going to tell you about school action. Great. Thanks ever so much, Georgia. And I can see lots of comments on how much this is resonating with people in the chat. There's just one question that came in, I think, while-- oh, a couple of questions now, but we'll see how we do. You mentioned zones of regulation. For those who are not familiar, can you just say a little bit about what that is? Yes. So I haven't used it for years now, but from what I remember, we are supporting students to understand a bunch of emotions. And it's kind of a colour-coded approach. So green is calm, and yellow, I don't know, is getting a little bit upset. And then orange is you're getting quite upset. It has this kind of colour-coded stuff around emotions. And very usually, someone who is doing pastoral care, sometimes a NOT, sometimes a speech language therapist with a teacher, they work out into some activities. So if you are in your yellow zone, what can you do proactively not to get into the orange zone? And it has a range of activities. That might work for some people. But I think what we're really missing is, for one, we don't have clear evidence that this is working. And it's important to embrace evidence-based approaches when it comes to school mental health. And for two, very often, the solutions about being in the orange or being-- or getting back into the green zone come from adult neurotypical perspectives and are asking you to go out of the class, jump on the trampoline, or play with the kinetic sand and come back and tolerate that very environment that was very difficult for you, that very environment that maybe people have bullied you, or maybe you feel lonely or the teacher has misunderstood you. Hope that makes some sense. Mm-hmm. Thank you. And I guess on a similar note about strategies for sensory-- for emotional regulation, there's a comment that there seems to be a push for using sensory walk-in cupboards in schools for emotional regulation. What do you think? Well, I wonder who's-- it could be reasonable, but for who? Is it for members of staff to have a sense of control that this is what we do here for to help people regulate? Has the student council, has students themselves spoken about what works and what conditions that works, or it might not work for some people? I guess much of what I have been learning in the RE-STAR is about whose voices we're privileging. How do we work with young people rather than on or for? So I guess a good measure, a good audit for us is to check if whatever we're putting in place is co-produced, if you like it, with the young person to check in that it really works for them. Mm-hmm. Thank you. And just one-- oh, no, actually I better move this on. But there are a couple of questions in the Q&A. So if you have a chance, Georgia, to have a look at those, it's possible to type answers in there. Or otherwise, we can try and come back to them later on. Thanks very much for a wonderful talk. And now I'm delighted to introduce Professor Jane hurry, who is the professor of the Psychology of Education at UCL Institute of Education. And Jane's focus has very much been on how the educational outcomes of young people are shaped by their mental health, and how schools can maximise well-being and mental health in their pupils to promote positive outcomes. Thanks ever so much, Jane. Hi, everybody. OK, so you've heard quite a lot about the importance of listening to young people in terms of thinking about how we support them in their emotional lives. And we took that one stage further. We also were asking teachers. So the issues with-- oops, sorry, I've punked us on too far. The issues with school-based action on mental health is, first of all, that there's not a strong evidence base, just generally, never mind the neurodiverse populations. And what there is focused on student competencies. There's far too little on the perspectives of the young people themselves. I'm using, by the way, neurodiverse here as my shorthand for, in this case, autism and ADHD. And so there's far too little on their perspectives. And we've heard how that means that we miss stuff. And also, too little on the perspective of school staff. And since we're thinking maybe about changing environments in schools, obviously, school staff's perspectives are going to be important too. And in terms of the research base, implementation issues in the real world are virtually ignored. Here we go. And so what I'm going to talk to you about what we did in this part of the RE-STAR project was we started off with two focus groups, one of school staff. And I'm using teachers as a shorthand for school staff. That was included, learning support assistants, heads of year, deputy heads, sencos, and counsellors. We had so a group of teachers and a group of students in mainstream school who had diagnoses of either autism, ADHD or both. And we spoke to those guys over a period of eight months. So we met them roughly about once a month. Then we moved on to doing a survey to see if the sorts of things that were coming out of our focus groups could be generalised to a larger canvas. So we surveyed about over 100 teachers in over 70 schools and over 100 students with autism or ADHD. So what did we find in the focus groups? In the focus groups, we found, first of all, that teachers and students on the whole were raising similar issues. And I'll talk a little bit more about the issues that they raised in a minute, but there's two things I'd like to pick out to highlight just in this very brief talk. The first one is that they're coming at this from different perspectives. Teachers are relying on observing behaviour in terms of the kids, of course. They did report on their own feelings, but the students are reporting their feelings. So that's a big issue in terms of understanding what the perspectives are. And another thing I just want to highlight was in that-- oh, start the video. Sorry, I don't know why that went off. Sorry. So the other thing was that in one of the sessions with the school staff, with the teachers, we presented them with examples of the kids' feelings, a bit like what you've seen earlier on in this presentation. And that was extremely powerful. We only presented a few things and then we opened it up for discussion. It was powerful because, first of all, it got people to talk lots about things. And they reported that it really made a difference to their understanding of the positions of these young people. And these particularly are impressive because these school staff, these teachers were already people who were quite knowledgeable in this area. So I'm saying that kind of picking up that thread that Edmund talked about at the beginning about the importance of the arts, if you like, in terms of communication. Sadly, not something I'm using very heavily in my presentation. OK. So what I'm going to-- so in terms of what came out of the focus groups, in terms of the findings, we did transcripts of all the discussions, we coded them, and then we grouped them into themes. And in terms of promoting healthy school and emotionally healthy school environments, these four themes that you can see on the screen are the ones that came up. And they're not really surprising, given what we've heard before in this set of this RE-STAR presentation. And they also match quite well to other forms of guidance, nice guidance, DFE guidance and so forth. So they're not going to surprise you all that much. Number two, positive approach is an agency. So the agency would be the ability of the kids to say what was happening to them. And the whole school collaboration and action would include behaviour policies, behaviour policies which sometimes restricted all those things that Georgia has just been talking about. Kids weren't allowed to have a wee quiet time or whatever. OK, now, in the last one, improving staff relations, training, and supervision, supervision didn't mean we were watching the staff, but more, it's used in that clinical sense of supporting staff in their experiences. And we added in a theme for emotion regulation interventions. We did that because it's such an important thread of the mental health research story, but it didn't come up very strongly as a theme in our focus groups. And it didn't come up so strongly as a theme because one of the things that was strong was an emphasis, both from staff and students, that the one size did not fit all. So a very, very-- reflecting back to Georgia's chat. OK, so we used the focus groups to construct a survey. We set out a load of statements based on the coding system from the focus groups. And then we went over that with our RE-STAR team, with the youth research panel. And we also had another group of practise experts that we met over several sessions to reduce all these statements that we'd created from the focus groups and add to them and reduce them down to the most important issues for schools. And that ended up with about 10 school actions per-- action statements per theme, as the ones above, plus a couple were related to the emotion regulation interventions, and another load of items on barriers and enablers. And so the survey, it meant people had to rate things for all these items from low to high. And we had matching surveys for students and staff. So they were the same context-- content, but slightly different wording. I've given you just a sample of examples of the survey. I'm not going to go into them, but really, what I'm trying to show you here is that we quite unpack things in the statements that we gave, and we also had expanded examples for each statement. And the reason for that the folks that were working on developing this survey wanted to reduce ambiguity. But it also means that there's quite a lot of information, potentially for people using these surveys to inform them about school actions. OK, so the first thing that emerged from the survey was that it confirmed that we had, in fact, captured the most important school actions. I say that because for teachers, they were rating these school actions very to extremely important. So the average rating was over four with a maximum of five. And the students were also rating it important but not quite as important. And we also had open responses. We asked people to say, oh, well, what sort of things do you think are important, in case we hadn't captured all this in the school actions? And actually, the open responses substantially just elaborated survey actions. In terms of agreement between teachers and students, there was a large correlation, but not of 0.55, but not total correlation. So they agreed quite a bit, but they didn't agree entirely. Now, we had a go at trying to conceptualise this information in a reduced form. And so we analysed whether there was any difference in importance between the different themes we generated. And you'll see if you look at the blue bars here across the different themes, which are shown at the bottom, there wasn't any significant difference. Pretty well, all the themes were considered equally important. However-- I'm trying to send this on to the next one-- there were items within each of those themes that were on the tops of both the student and the staff lists. And here they are in this slide. These are the items that both students and staff had in their top quartile. And again, they're big doorstep issues which we have been hearing about already. Maybe you might be interested to see at the bottom there that school staff care was considered to be very important by both students and staff. But it's a load of other things. Things they disagreed on. So there were quite a few disagreements. For the kids-- to give you an answer on this-- they were kind of looking at things that were going to affect their day-to-day experience, and they felt that those were the things that they weren't-- they thought were more important than the teachers thought. In particular, maybe that understanding of people's understanding of difference, their ability to relate to other kids and that kind of thing. For teachers, the things that they tended to pick as more important than the students did, those were more related to systems and the relationships staff had with various members. I will just draw your attention to the last item on the more important for teachers list. That's the emotional regulation interventions for neurodiverse students. They thought that was much more important than the students did. We'll return to that. Now, going on to implementation, so we asked them to rate each statement on whether it was important and then on the degree to which it was implemented. And you can see from if you compare the blue and the green bars, the blue being importance and the green being implementation, both for staff and students, implementation was lower than importance, which is not very surprising. That's what everybody finds more generally. But another interesting thing was that both for importance and for implementation, students gave significantly lower ratings than teachers. So if we're thinking about implementation in particular, teachers thought they were doing a bit better than the students did, significantly so. Now, what's the relationship between importance and implementation. Well, for staff, the association was strong. Things that were rated importance were also more likely to be implemented. For students, there wasn't a relationship. There wasn't an association between what they thought was important and what they rated as happening. And this probably shouldn't surprise us, the staff are in control largely of the school actions. And I'm not going to dwell on the slide because of time. These are the things that the students and staff agreed about in terms of implementation. And the yellow ones are the ones that they both thought were important. The additional ones, only one of the additional items not highlighted in yellow, safe options for unstructured time, were ones that were in the top 15 for students in terms of importance. The others were all driven by the teachers. So how did they disagree on implementation of school actions? Well, in this case, generally speaking, the kids were feeling that the things that reported-- sorry. They thought that the staff were doing rather well, things were helping the staff. And the teachers rather felt that the kids were doing rather better in terms of the implementation action. The teachers thought that they weren't giving excessive pressure and there were lots of reasonable adjustments. The students didn't experience that. The staff thought that they did accept student differences, not that the students didn't feel that so much. And there's also the interesting item of addressing bullying, which the teachers thought they did better on than the students. And I'm going to pick that up in the next slide particularly. So addressing bullying, and the full wording in the statements was mindful of particularly at-risk students. Now both teachers and pupils thought this was very important. It was right up at the top of both of their lists for importance. And this is rather useful because there's all the evidence about social and emotional learning interventions in schools, the strongest evidence for effectiveness is in anti-bullying actions. So that would seem to be a useful strand to follow. However, the teachers and students didn't agree about implementation. Teachers rated this third out of 39 for implementation. Students rated it 23rd. Now, this is the last bit I'm going to tell you about the survey, the next two slides. These are school actions in the last two years. Specifically, we had open questions asking both students and teachers what they'd seen in their experience in the last two years in terms of emotional support. Well, from the student perspective, optimistically so, most students had reported some support. It might have been quite light, but they had experienced it and most of them found it helpful. The vast majority had found the support they'd received helpful. In terms of coding their comments, rather light comments about what they'd experienced, the most common thing that they'd experienced was strategies to manage their emotions. And they'd always seen these as helpful, so they were valued. They'd also experienced most frequently personalised support, often, as Georgia had talked about, quite light touch. So check-ins, how you're doing, listening a little bit. There were a few that had had counselling experiences, but the majority was this check-in, and they'd always found that helpful. Teachers, now those would also be a bit of personalised support quite a lot. But they found all of the teachers support that they'd received helpful. But some of them also said that there was an inconsistency in that some teachers were great and other teachers weren't great. And again, that was something that was talked about quite a lot by both staff and students in the focus groups. Only four of the kids mentioned a named intervention. Zones of regulation was one of them, and that was mentioned as unhelpful to that. Two of the kids found the intervention they were given really helpful, and two found them really unhelpful. So there's a bit of a story there that, again, going back to one size fits all probably. I'm just pushing it on, with any luck, to the teachers. So first of all, the teachers responses about what they'd been doing in the last couple of years were mostly covered by the survey items. When I say mostly, really, almost completely. There were a few bits and pieces which are interesting, but mostly covered by the survey items, which again, is confirming that these survey items are quite a good capture of what schools consider important and what they do. We specifically asked teachers if they had adopted an existing intervention in the last two years, and over half of the teachers did report that. But the interventions we-- so they listed them. By the way, the top one that was mentioned at least 10 times was zones of regulation from the conversations we've had. So they all focused on student competencies, and they were typically based on books or materials that are available online. They were not interventions that have been evaluated in peer-reviewed journals, not one. Last slide here is about enablers and barriers. And they're exactly what you might expect. Leadership, staff training, and applicability for all students were enablers. Barriers largely about resourcing. So that would be staffing and money and also support from external agencies. So nothing new here but useful to remember. So what are the implications? This is my last slide. First of all, the survey provides a detailed list of actions to enable whole school approaches. So they're quite broad. And these surveys could be used, for example, for auditing, for measuring and monitoring the effectiveness of interventions. The second thing that the whole school approach is-- surprise, surprise-- that are about adapting environment and supporting student competencies. I say surprise, surprise because we already know that. But I'm underscoring for you the fact that teachers and students really pushed adapting into environments. Most of the items actually were in that area. Teachers and students didn't always agree. We need both of their perspectives. And these two stakeholders were not well aligned with mental health researchers who focus on the student competencies and evidence-based intervention. Now, this item, in my view, is huge, because what we're seeing here is that you've got a whole industry of research and potentially some of the mental health practitioners who are looking at what they think is the right thing, evidence-based interventions. But when you go to schools, it's not happening. And of course, the whole thing about this one size fits all and the students dislike of interventions for emotion regulation fits to this. And the final one, resource limitations, support nudges. Now actually, Georgia talked about a lot of the nudges, like positive approaches, being nice to people, having slight check-ins, those kinds of things. Some of these things are useful for everybody. OK, very quick blether there. Over to you, Cathy. Wonderful. Thank you very much indeed, Jane. And I think people are going to be really excited to see where the next sessions build on everything that you've described and the others have described to talk more about intervention, practise, and policy. We've got time for one or two questions. During your talk, there's been quite a lot of discussion on the chat about language used to talk about autism and ADHD. And so if people are interested in that, I definitely direct them to the chat, where there is a lot of different discussion. But I'm interested to hear your thoughts, Jane, based on interactions with teachers and school staff about thinking about use of language in terms of, for example, talking about students as autistic or with autism And whether there were particular considerations from teacher and school staff's perspectives around that. And again, I guess how that-- whether that aligns with the views of young people. OK, I'm happy to just have a quick say on that because the school staff, they made a point of the fact that having to rely on diagnosis was not helpful for them, especially because often behaviour policies prescribe that you can allow certain things for somebody with a diagnosis, but not without a diagnosis. And they just said this was very, very disempowering for them, having to work with kids. And they talked about the fact that you can take ages to get a diagnosis and those kind of things. So, I mean, I'm definitely of the school that these sorts of things, ADHD and autism, are on a-- they're on a continuum and that we should be recognising what's significant for the kid. And that's what the school staff were very much saying. We can't say that the kids were because the kids were already selected because they got a diagnosis. OK, thanks very much. And there are lots of questions about how people can access the research and the information. So just to direct you to some helpful comments from Dalia, just to let everyone know that you will all receive a recording and also the slides, which have references embedded within them. So do keep an eye out for that in your emails after the event. We're going to take a short break now just for 15 minutes. But please do come back and stick with stick with us. And because after the break, we're going to be moving on to hearing about the intervention that the team have developed and also hear directly from our youth researcher panel about their experiences and reflections from being involved in the process. And as you'll be able to see from the chat, they are making some really fantastic contributions to the chat today. So there's a lot to look forward to in their contributions a bit later on too. So we'll see you in 15 minutes. And thanks, everyone, for joining us, and thanks to all our speakers so far. Hi, everybody, and welcome back. Thanks again for joining us this morning. And I'm delighted to get this next part going again. Just before we start, just to remind you all to keep things going in the chat. And if you haven't been engaging in the chat so far, there's lots and lots of really interesting and important discussion going on there. And if you have any questions for Susie when she speaks, please do pop those in the Q&A. You might also be interested to have a look in the Q&A. And you can click on the section that says answered because the team have been giving some very thorough responses to various questions that have been asked. So lots and lots of really interesting information there too to have a look at. So huge thanks for that. But now we're going to go over to Susie Chandler, who's a research fellow at the Department of Child and Adolescent Psychiatry at the Institute of Psychiatry, Psychology, and Neuroscience at King's College London. And Susie has been the fantastic programme manager for the RE-STAR project. And I'm delighted that she'll be speaking to us now and telling us about the intervention that they've been working on. Thanks, Susie. Thanks, Cathy. Yeah, thanks for the introduction. So in this next section, yeah, I'm going to share with you how we've really been feeding all the discoveries from the various RE-STAR projects over the last 4, 4 and 1/2 years into the development of a whole-school intervention for use in mainstream secondary schools. So, Steve, if you could just click to the next slide, please. Thank you. You're a superstar. So this, if you like, is really the translational dividend that has come out at the end of this 4 and 1/2 years worth of work. And if you keep clicking, Steve, through this one. And the development process, the development of the intervention is really the product of a years intensive co-production with some key stakeholders, both from schools. So we've had school staff inputting on this, as well as students and clinicians and parents. And we've heard a little bit already about our youth researcher panel of older kind of kids with autism and ADHD. For this bit particularly, we wanted to throw the spotlight on our junior youth researcher panel. So these are school-aged students, 11 to 16-year-olds, in mainstream secondary schools that have been helping co-produce the intervention. So the intervention, we're calling it Place Positive at the moment, because that's really what we're trying to do, is to create a neuro-inclusive learning environment, a positive place for all children. And I guess, the tagline that we put underneath it is reducing emotional burden, unlocking educational potential for all. So that's what we're trying to do with developing this positive place. And then just running through the key principles that underline the intervention structure and the rationale. So it's multi-layered. We're both looking to, on the one hand, transform school culture, and then on the other hand, so the other important layer is around building skills and supporting students to manage those everyday kind of events and challenges, but also supporting staff to enable them to modify environments towards individual needs. It's also a very collaborative approach. So you've heard the previous speakers talking about the different perspectives from staff and students. So we've learned that it's very important for those two sides to work together on school action and also on the evaluation of change. This intervention, so Place Positive, it's not a clinical intervention working at the clinical level of mental health symptoms. It's prevention focused. So we're trying to get in earlier really, before the mental health problems emerge. So we're focusing, within Place Positive, on promoting being and really preventing or on reducing the risk of depression in adolescents. So in that sense, it's actually very practical and solution focused. It's looking to help young people navigate those everyday challenges in school life, so that, hopefully, we don't have this accumulation of emotional burden that could lead on to things like depression and anxiety. So it's very practical, it's prevention focused, and it's not a clinical intervention. We're not asking the young people to talk and think about their emotions and their mental health problems per se. On the other hand, it's a universal intervention, so it's important to say that. We're looking at applying something to the whole school, really, because there's an issue with some of the more targeted interventions that while they can be very helpful for those most in need, perhaps at that more clinical level on the one hand, they can increase levels of stigma, which is something we don't want to do. So it's a universal intervention that we hope will be beneficial to all students, but a particular benefit to those with neurodivergences. And so in that sense, it's neurodivergence informed because it's been co-produced with neurodivergent young people. And the intervention, as I've said, is it's experience driven, but it's also evidence based. So it has both-- it brings together all sorts of expertise, both from science and from experience. And then at the level of implementation, we're hoping that it will be relatively low cost and scalable due to its digital format. So moving on to the next slide, Steve, please. So I mentioned that it was multi-layered. If we can click through this slide, Steve, This just really illustrates how the different layers within Place Positive would work. So at the top, we've got the culture change activities. So one of the layers is really looking at promoting a more neuro-inclusive school culture. So again, there's that word inclusion in there. As well as developing an awareness of one's own and other people's emotions. And we would be looking to do that through assemblies and classroom activities. And then at the bottom, in that red box there, you've got the other layer, which is the practical support. So this is the skills component, if you like. And there are resources in this for students to help them navigate those everyday events, and also resources on the other hand, for teachers to help them build those affirmative and neuro-inclusive classroom environments. And we're doing that through two apps, one for students and one for teachers and through digital resources that will be available in the classroom. And then the outer layer, so on the outside we've got these blue boxes on either side. And these are resources for the school leadership teams as well as practical tips and resources for what we call Place Positive champions, who would be the people on the ground, potentially supported by mental health support teams that are just supporting the implementation of the overall whole school approach. And then the next slide, please, Steve. So in terms of the leadership support, we've been thinking about resources that would illustrate for schools. So this would all be on the digital platform. There are resources that would explain to a school all how one school could benefit from Place Positive. And we've heard some of the early findings about the outcomes and associated outcomes with emotional burden in school. There's also going to be information there for how to support staff to actually implement the stuff, but also how to support staff in reducing emotional burden more widely within the school, because we know that we need to improve staff resilience and well-being if they're going to support the kids, even though that's not our primary goal with Place Positive. It's very student focused. But we know that there needs to be some support there for staff. We've got a section on how to appoint place positive champions, what the role of a place positive champion would be. And there's an area for staff and students there. And then the final bit is kind of around integrating the Place Positive approach within the school policies. So Jane talked a little bit about behaviour policies, inclusion policies in schools. And we've got some nice case studies that suggest to schools how they might try and make those policies more inclusive. And if you can, click on, Steve, please. And yeah, the final bit was about the actual kind of activities the assemblies. So within the Place Positive champions section of the platform, there's information about what the role of the champions are as a group and the different kind of skills that the individuals within the group might need, how the groups would run, what the student and then what the staff champions would look like. And then if you do another click, Steve, I think this-- there should be-- yeah, this is just an example of what a Place Positive student champion might be doing within the school. So I know there are lots of school champion models kind of out there at the moment. And some of them, yeah, kind of operating under the Mental Health kind of umbrella. But typically, they would be providing peer support. They might represent as an inclusion ambassador, promoting positive culture and also getting kind of really involved and perhaps leading some of the student voice activities that will be informing the Place Positive approach within the school. So that might be collecting responses from both staff and students on what they think are the priorities for school change and then presenting that back in an assembly, for example. And then moving on please, Steve. So we've looked at the layers. This is what Place Positive activities might look like within a school term. So if you could just click through these please, Steve. So I'm keeping you busy. We have our little avatar called pebble in the corner giving the big thumbs up. But we have three of these cycles. I think maybe one more click that would run within a school year, so based on the three terms within a school year. So it would kick off with an assembly. So the very first Place Positive assembly would be launching the idea of what a positive place and school would be and why that's important, and introduce maybe the idea of the champions' roles. And then it would move into some class activities, which I'll show you some examples of in a moment and some staff training, which would point both the students and the staff to their respective apps, their Place Positive apps. And then as we go through the term, hopefully, the champions will be kind of working amongst the school community to collect information about what staff and students think is important in terms of supporting mental health and neurodivergence and celebrating difference, collect that together and start to put together some reflections that could be fed into the assembly at the start of the next school term. And the next slide, please. So in terms of the assemblies, some of these might be more familiar to those of you that kind of have worked within the area of school connection and belonging. So these are the three assemblies that would really target changing school culture to make the school culture more inclusive, with opportunities for connection and belonging for all kids. So these are really just some examples. And then the next slide again, please, Steve. Within the classroom, so these are the class activities that we have just developed a very early prototype of something that could be done during form time or during PHSHE lessons. So led by the teacher who would access the Place Positive digital platform on the school computer, on their desk. And then a series of activities will come up on the whiteboard in front of the class. If you could just click on there. So these would kind be introduced by Pebble, the Place Positive avatar. And then another click, they would introduce the activity. And I think this one is around emotional awareness. And Pebble would then bring a video up onto the screen, which would be a little scenario of kids having a little interaction with maybe a provocation somewhere. And then if you click again, Steve, I think at the end, the students in the class will be asked about what they've seen and how they think that people could have responded differently really, what they thought about it. So it's really a kind of tool to get those conversations going within the class around emotional awareness and understanding of others. So yeah, this particular one was on emotional awareness right at the beginning of the Place Positive programme. Thanks, Steve. Then the next slide, please. So staying within the classroom the two pure materials, we have a teacher app for teachers, a Place Positive teacher app. And it's actually kind of-- it's accessible on two levels. So we have the version that's accessible within the classroom, which then gives them access to the class activities. It also has some little reminders and tips for things to do in setting up the classroom. We also have a version for teachers, so we'll stay on this screen, which can take them into deeper learnings around the Place Positive approach. And this can be accessed outside of school, but it's compatible with the version. It's a deeper version of what they would see in school. So this is really just to give you a taster of it. The Place Positive toolkits within the teacher app are organised around six gateways, if you like, which link specific challenges, I guess, in the classroom. And so they would pick on one of those. But the very first thing, and I think this is really important, and this was kind of came out of the co-production process-- the very first thing that teachers are asked to do is actually to try and walk in the shoes of their students before they start, then going into the problem solving and seeking the skills based resources on the app. So they're asked to think about how the classroom might be experienced by the kids in their class before they then go on to think about how they can support them. So they then go into the toolkits. And once they're into the toolkits, there are little tip cards there, which you can see on the screen as you go through to the right. And then there are little audio sound bites as well that they could listen to perhaps as they're getting their classroom ready at the beginning of the day. And then at the very end, there's the kind of activation bit, which gives them little classroom goals or things they might like to try next time they're kind of going into class. Then if we can click through Steve, I think we'll whizz past. This was really just to play a little bit through the app, but I think we'll click through to the next screen here. This is just to give you a little taster of the teacher app. This is again a taster of some of the material, some of the content that's been co-produced with school staff and students in the teacher app. And I think if we click through these, Steve, because I'm conscious of time. We'll just keep going through these, and then to the next slide. So this is the toolkit supporting students to say what they need. So really trying to build agency and enhance the agency of the students through the teachers. And then the next slide, please, Steve. Responding calmly when behaviour is hard to read. So these are tips for teachers to support the students. And then coming on to the student app. So what was really interesting, very near the beginning of the development process, that students were saying they wouldn't want to be working on these skills necessarily in school, in the classroom. They'd much rather do this in their own private time, in their own safe place, not with somebody looking over their shoulder or asking them, what were their personal challenges. So the app is designed to be used outside of school, a bit like some of the linked school apps that schools currently use, like Teaching Rock Stars for time tables, where the teachers point them to the app in the class, and they do it in their own time outside of school. So at the start of the student app, the students are actually asked a kind of a mini MESI. So this is the My Emotions In School inventory that Steve presented at the very start of today. And there are just a few questions there to find out from the kids, a very short version, what it is they're particularly finding challenging. Hi, Cathy. I'm rounding up. So this is to get really into the nitty gritty of the practical side of things. And based on their responses, it then pulls up some toolkits for them. So this is a toolkit on knowing your triggers, knowing what it is in school that's triggering you. It gives them some tips and takes them through a very stepped approach for how to navigate those. But again, the key bit at the end of this is the activation component, where we're really wanting them to not just leave these kind of skills or tips and tricks they may have picked up on the app or in their head. We want them to translate into real world action. So they're sent on a little mission, and the missions start quite low level, and then they gradually build up in terms of the complexity or the competencies, so that they're actually kind of acting out the things they've learned. And then if we move through, Steve, I will come through to the end before handing on to our youth researchers. So we have an early prototype of this kind of digital whole school intervention that we're quite excited about and thinking about where do we go next with it. So, so far, our findings are suggesting that reducing emotional burden in school has the potential to benefit the whole school community. And if you maybe put all of them up in one go, that'd be great. It's not just for autistic and ADHD kids, but we think it's particularly beneficial to those. And I think this really shows that a neurodiversity-informed approach to inclusive learning environments has the benefit to-- has the potential to benefit all learners. And the key bit, I guess, for this is the point that Jane touched on earlier, that this doesn't actually require a diagnosis to support the kids. It's something that could be done for all kids, and there's nobody gatekeeping who has access to these resources. Yeah, stressing that this is a very collaborative approach between staff and students. We're not pitching them against each other. We're wanting them to come and work together within this whole-school approach. And I think lots of the other kind of approaches that are out at the moment tend to work in a much more isolated way. They're either just focused on supporting the students or delivering staff trainings and not doing the two things together, or they're looking at building school belonging or connections, but they're not doing the upskilling bit at the same time. So this multilayered and collaborative approach, I think, is important. The next steps for us are really a bit more of further development and implementation in schools, so that we can really assess the feasibility and impact of this kind of approach. And I guess in the discussion panel, we might hear from some of the others on how feasible this would be within schools. But thank you very much. And I will hand over. Thank you, Steve. Wonderful. Thanks so much, Susie. And there are some questions for you in the Q&A. So if I can point you that way, maybe you can type some answers in there. That would be great. But now I'm really delighted to introduce some of the senior youth researcher panel who are going to share their reflections on the programme and their aspirations going forward. So yeah, huge thanks to Maciej, Amber, and Tiegan for joining us. And over to you guys. Thanks ever so much. Thanks. So I'll be starting. My name is Maciej. I've been involved in the project since 2021. And in Steve's presentation you could see the video, we shot early on. I was a few years younger and a few pounds lighter. I've been involved in various different studies and work packages. It's been a great experience for me, and I got to do things I hadn't expected I'd get to do, being part of a big research project, speaking at conferences, co-authoring research articles. I was late recognised as autistic as many other Y-RPers. And so this involvement has also been helpful for me to embrace my autistic identity and make me more confident speaking publicly about my experience. It's also led to other opportunities around research and advocacy. For instance, recently I was invited to develop and lead workshops for school staff about what we call an experience sensitive approach to education and neurodivergence, and a large chunk of it was informed by insights from the young people interviews, some of which I co-delivered and co-analysed. And I'd say out of the work I've been involved in here, that work on interviews was among the most rewarding and memorable. I think Amber will speak about it a bit too, and I've had a similar experience. It seemed like something really daunting at the beginning, but also something I wanted to try, and we were eased into it really well by the team. Obviously, the young people were talking about their struggles, which is not easy, but we usually had great support to a large part because we've had a lot of shared experiences. In the most recent RE-STAR-adjacent interview study that we haven't covered here, we focused specifically on students who had school attendance difficulties. And what struck me was that so many of the young people I've interviewed had a completely different experience once they changed schools. We've heard stories that I could relate to of debilitating burnout, depression, to the point of being completely unable to attend. And then once they went to schools that suited them better, many of them even flourished. They found friends and started enjoying education again. It was a story that kept repeating itself, in spite of the big variety of schools that turned out to be a better fit. These were places where they finally felt like they belonged. So I think it's a good decision that this final RE-STAR intervention is a whole school one, something that strives to change the overall school culture, to be more understanding, both for teachers and students overall while being neurodiversity informed, rather than something that only focuses on neurodivergent young people. If you give an autistic young person a social skills training, which some people think is the main thing we need, it is probably not going to make them get along with or their bullies. It's not going to make intolerable sounds and smells tolerable, or make them suddenly interested in the curriculum. One young person wrote, for us, it's like equipping a person who doesn't like the colour red with the ability to the colour red. And one naturally develops their personality and social skills in environments in which they can safely be themselves, which is often not the case for many kids in schools, neurodivergent or not, the vast difference I've seen in how young people can function, depending on whether their school genuinely sees and understands them, is another proof that more focus on the environment is the way to go forward with research that makes a positive difference in our lives. I genuinely believe this makes for better informed and more impactful neurodiversity research. I think participatory ways of working need to be more of a norm in research in this and other fields, and I'm glad to be part of this project, which really took it seriously and will hopefully inspire others to do the same. Thank you, and over to Amber. Hi. I'm Amber. I joined RE-STAR in the second wave of recruitment for the youth researcher panel. So I joined the project shortly after it had already taken shape and started. I was brought up to speed incredibly quickly, and never once kind of made to feel that my contributions didn't matter as much as someone who maybe had been there since the start. Shortly after starting, I had the opportunity to co-interview secondary school students who struggle with their low mood. And as a current PhD student, I've been involved in a variety of other research projects prior to joining RE-STAR, but interviewing was always something that felt way too scary and way out of my comfort zone to even contemplate doing. I couldn't even think of a way to ease myself into it. It didn't seem possible to even begin doing it. But with RE-STAR, I felt able to give interviewing a try. And with the support of RE-STAR, Georgia, who's here, and Myrtle, who is not, because they were so flexible and accommodating and we had the opportunity to practise and prepare beforehand. I felt able to push myself out of the comfort zone just enough to do it. [CHUCKLES] And likewise, presenting, that was also something that felt completely out of my realm of possibility, which was something I obviously absolutely had to get over, considering I was doing a PhD and I was planning and still am planning on staying in academia, kind of lecturing and even research conferences and things like that. That was all presenting was a skill I needed to develop. And thankfully, RE-STAR has given me the space to slowly warm up to presenting as I am today. So overall, RE-STAR has been incredibly important to me in helping me develop my academic skills in an environment that I felt safe in. I would also like to touch on the Place Positive intervention. Personally, I found secondary school to be absolutely miserable. I wasn't diagnosed with autism until I was 17, so after I had left secondary school, I never received any support. During my first year of secondary school, my parents actually approached the school because they were concerned, because I would emotionally explode when I got home from school, and I spent a lot of time in tears back then. Looking back, this was likely because I'd been masking so hard at school all day and was just completely exhausted. Obviously, we didn't know that at the time. I spent most of the day just completely dissociated. When my parents approached the school, they were told to do a parenting course, which was largely focused on discipline. So instead of recognising that school was causing immense emotional burden, the problem was placed onto my parents being bad at discipline and placed on me as needing to be disciplined. This was the one and only time my parents sought help for mental health at school, and I was then left to fend for myself. So something like Place Positive would have meant that I was given the tools I needed to help myself that, like Susie said, wasn't gatekept behind a diagnosis or behind staff's decision as to whether to give it to me or not. And staff would have had the awareness and tools to change the environment, so I would have felt safer even without a diagnosis. With the intervention being a school-wide approach, students and staff will feel the benefits regardless of access to a diagnosis. And I think it's also a really important additions to schools, because it's important to remember that home is not always a safe space for students. Some students don't have an emotionally safe home to return to after struggling at school, so making school feel safe and supportive then becomes that much more important. Yeah, I'll hand over to Tiegan now. Thank you. So I am Tiegan. I joined the RE-STAR project at the beginning as part of the first cohort. And I'm first going to share some reflections on the intervention and then move on to some of my personal reflections. So I think this intervention comes from the accumulation of all we've learned from this project. And the shift in thinking we have shown is needed. Moving away from the solution should be solely on the individual. Instead, a lot should be on the environment and the people around them. Neurodivergence can easily live in a world that can be challenging for them or create a burden. And so this intervention shows how this can be changed. So a school environment isn't so challenging, including sensory inputs, communication, and amount put on someone in a day. However, also recognises the safe spaces for young people, including home and healthy spaces need to be protected. The young person has a space to decompress in. As we heard from some young people, it was the exhaustion of a speculation, but I would come out when at home of a blurring of the two spaces when homework needed to happen at home. It also doesn't isolate or point anyone out, as this intervention is designed in a way that anyone can feel supported as what can help neurodivergence can also help neurotypicals. For example, we all need regular breaks or benefit from the impacts of hobbies. There are ways people can individually support themselves, but this is done in a way that is tailored. No one size fits all like some interventions, and they can do it in a time or place that's safe for them, as we know, school isn't safe for everyone. I know this intervention would have benefited for me, and I can see how it could have played a key part in people properly supporting me. On a personal level, I could provide you with so many highlights of this project and examples of what it has provided me with on a personal and a professional level. It's opened up so many opportunities and learning for me, many of which I had never imagined being part of or experiencing for years ago. I've been part of co-design and co-create interview schedules and materials, engaging directly with young people through interviewing and supporting equipment usage, analysis, and so many forms of dissemination to give a brief overview. It's also helped give me a wider range of understanding of the different perspectives that go into these elements, and what I can contribute to them. Even at times I've struggled to understand the concepts due to being well supported, I could still engage. I started at this project at 19 years old, so I'd just started out my career officially and had recently been diagnosed as autistic and dyslexic. So this is a great space to learn more about neurodiversity through hearing others' experiences and the academic sharing past research. This meant I could feel more confident in being autistic and embracing what that means for me. It also led to me seeking an ADHD diagnosis, something I first had considered in secondary school and was officially diagnosed with last year. This exploration of neurodiversity is something I hope to carry on after this project through further projects and research. On wider reflection, I hope this project shows it's possible for lived experience individuals to be part of projects in a research capacity, and has given neurodivergent people a strong voice that carries on afterwards. Thank you. Wonderful. Thank you all very much indeed. As you can see, there's a lot of very positive reactions coming in to hearing your reflections. So huge thanks and great, Tiegan, that you're going to be joining us now for the panel discussion. So I'll now just bring in the other members of the panel. And I'll just ask each of them to introduce themselves. So, Tiegan, you obviously have just said a bit just now, but I don't know if you want to share a little bit more about your-- is there anything else you want to say as part of an introduction that you haven't said already? Kind of, yeah. So yeah, you all know me now. I'm also a lived experience consultant, advocate, and trainer based on my experience of neurodiversity and adoption. So quite well versed in understanding, the comorbidity, I would say, between adoption and neurodiversity. And I'm doing more and more, I think, on that element as well and trying to advocate recent report coming out saying 62% of adoptees identify as neurodivergent. But yeah, it's been really amazing to be part of this project. Great. Thanks so much. Susana, can I go to you to introduce yourself? Sure hello, everyone. Thank you for the opportunity to be here today. I've learned so much already. So my name is Susana Castro Kemp. I am an associate professor at UCL and currently the director of the UCL Centre for Inclusive Education. Thank you. And James. Hi, everybody. I'm James. I'm one of the regional clinical leads for Place2Be, a children's mental health charity, and recently was given the wonderful job of being SCMD as an inclusion lead. So this is incredibly interesting for me. I'm diagnosed with ADHD. I have a child who's ADHD and dyslexic and another one who's autistic. And so I've got a personal vested interest in learning more about this for my own two children, too. Thanks very much, Paul. Thanks, Cathy. Morning, everyone. I'm Paul. I'm the head of policy and public affairs at Autistica. So we're an autism research and campaigning charity. We're focused on working with autistic people, funding research, and shaping national policy. I've only recently joined autistica back in December, so like other panellists, this session has been so useful to me and I really, really appreciate the invite today. Thank you. And Ruth. Hi, everyone. Really, really lovely to be here. And as you can see from my blobby background, I work at the Council for disabled children, which is part of National Children's Bureau. I'm currently a programme lead in the education team. I've only actually worked at CDC for a little while, just a couple of years. For the 20 something or so before that, I have been a teacher, a senco, and advisory teacher for children with more profound learning difficulties. So all of my life has been spent in schools and around schools up until the last year or two. And I suppose one of the things that's brought me to the work I do now is an observation over those 20 odd years of a real funding within the education system of school cultures, curriculum, numbers of children who can be there thriving and happy, and an increase in the number of children who we perceive as not fitting. And then in the last couple of years also have become a-- well, haven't become a parent, I mean, parent for a long time, but my 16-year-old now daughter has been struggling with an awful lot of the sorts of things that we've been hearing about this morning. So have become an expert sort of by experience in that way as well. So really interesting to hear from everyone this morning and learn more about some of the things that we now have some evidence to show are working. So really happy to be here. Thanks very much. And last but not least, Lucinda. Hi. Thanks, Cathy. So I'm Lucinda. I am a psychology teacher and have been in education for a very, very long time. I also have three now adult children with a variety of neurodivergent things going on. So a bit of ADHD and autism and dyslexia. I have had the privilege, and it really has been a privilege of sitting on the steering committee for RE-STAR and seeing this project the whole way through, and also interviewing. So I have a podcast as well, and interviewing some of the people that we've heard of as we've gone through the project and seeing the change that has happened. So yeah, that's me. Great. Thanks very much. And some of the links to your podcasts have been popped in the chat. So if people have a flick through the chat, they'll be able to find links to have a listen as well. So great. So I just want to start by asking the panel how they feel RE-STAR discoveries could inform future educational or health policies. So I'm going to go to Susana first of all with that question. Sure, thank you. This is so interesting to me because all my research has been focused on sound policy over the years. And this morning, hearing this research and the experience of those of you who lived with lived experience, it's just so, so timely, given the release of the white paper yesterday, as Georgia said. And there's so much potential at the moment to effectively change policy and practise because of the launch of the white paper. And some of the things suggested in policy yesterday align perfectly with some of the findings that we heard this morning. So things like, for example, the recognition of the value of a broader curriculum much more focused than expressive arts, for example, the value of multi-agency working, the value of involving children and young people in matters that affect them, finally, the talk around having inclusive systems beyond just inclusive education, which is something that I personally have been advocating for a very long time. So this mandatory need for coordination between sectors, education and health, to ensure that children experience life, not just school, but life as a whole as positively as possible. And I think this shift in policy reflects a shift in our understanding of special educational needs and disabilities towards a much more biopsychosocial understanding that the problem isn't within the individual. The problem is in the goodness of fit between the environment and individual characteristics, and we just haven't paid enough attention to that over the years in policy and in practise. And I think the findings from RE-STAR clearly show the potential of doing so. We know the emotional burden at schools is a reality for many children. I think sometimes-- I dare say for most children at the moment-- so we all recognise that schooling needs to change. And I am thinking that some of the tools developed in the scope of this project may be particularly useful. In light of the white paper released yesterday, where there was a clear commitment to support access to tools for measuring belonging, for example, and school experience more generally. So I think this can be very useful for policy makers and for bridging policy and practise. Also, in terms of training, yesterday, the white paper, I was very pleased to see that there is the intention to support staff and workforce training beyond just the traditional areas send and diagnosis, but training on inclusion. Of course, implementation here will be key. But the principle is there, and I think that's absolutely fundamental and, again, very well aligned with what was said here today. And we know these changes at the education level, when focused on belonging, do have implications for long term health. We saw that in Edmund's talk, and we also see this in-- I also see this in my own research where we compared policy across different jurisdictions. So we know that when there is a focus on belonging, well-being and reducing emotional burden, that the experience of schooling is perceived as more inclusive. We know that, so we really need to action these policies now with effective tools. I was also very pleased to see yesterday that the government seems to be keen to do this while harnessing the potential of digital technology. So I think Place Positive is timely in that respect as well. And I do hope further research can be developed on how this tool can help enact some of the new policies, as there is so much potential, for example, for enhancing and making the most of communication between teachers and children and actioning things in the moment when they need to be actioned, and overcome some of the bureaucracy that we all know too well. So I think the potential for policy-- for bridging the policy to practise gap via Place Positive and the findings of RE-STAR is absolutely immense. And so I wanted to congratulate the panellists for this excellent, outstanding piece of work. And I've learned so much today as well from those of you with learned experience. So thank you for giving me the opportunity to be here. And I'm also very happy to comment further on any specific points you may have. Thanks very much, Susana. Paul, can we go to you now for any thoughts on how the RE-STAR discoveries may inform future educational or health policies? Yeah, absolutely. I'll try not to repeat too much of Susana's, because I agree with tonnes of that and obviously agree with the fact that this is such a timely session with the white paper coming out yesterday. There is loads of other bits going on in policy land as well. You've got the children's being and schools bill going through the Lords. You've got an independent review into mental health, ADHD and autism. Hopefully, I'm crossing my fingers here, we'll soon see the development of a new autism strategy, and then, obviously, the white paper yesterday. I'll focus on the white paper in particular, but forgive me for brushing through it as quickly as I can. It's like 120 pages. But the briefest summary that I think is relevant to lots of this stuff is the changes to HCPs and the shift towards more day-to-day support in schools through what they're going to call individual support plans or ISPs. And it's not clear how but they're talking about there'll be some legal requirements to those. Ofsted will inspect schools on their assessments and provision of support through ISPs. But I saw a couple of comments in the chat about this. So it's just to say that the influence RE-STAR can have on those proposals absolutely hasn't missed the boat. It's more the start of the next stage of a much longer process. The government's kind of preparing the ground for the changes that will take effect in 2030. So firstly, there's a 12-week consultation that's open on the proposals and other solutions. But secondly, and I think the really key bit for this work is the government have hinted at a plan to draw up a set of evidence-based interventions and resources that can inform schools when they look to put support in place in the individual plans. So for me, that's clearly just opening a brilliant door to initiatives like RE-STAR and providing the platform to make this support just much more widely available. So yeah, definitely not at the end of the process with the white paper. And there's a massive opportunity to embed stuff like this in it, which will be really useful. Brilliant. Thank you. Yeah, and thanks to both of you for highlighting some of the key aspects of the white paper, because as you say, it's extremely well timed having this event today. Ruth, can I go to you with the same question? Yeah, of course. And yes, echo everything that Susana and Paul have said there. And like them, yesterday when I read through the white paper, I felt very hopeful for the most part. And I think for those of us who've been in inclusion for a long, long time, it's sort of astonishing to be at a point where everyone's talking about it and it's on radio four every day, and it's become really high profile. So I do think we're at-- I hope we're at a tipping point. I feel like we are, and that gives me great hope. I think in terms of some of the detail, yes, that focus on lots of even just the headers, that idea about narrow to broad, which I think is exactly what we're talking about, the need for universal approaches and the real call for that, rather than that need for an HCP or a diagnosis. And I think Amber nailed it beautifully when she talked about feeling safer without a diagnosis. I thought that was a really fantastic way of articulating what we know is needed. And I think there was a lot of that echoed in the white paper. So that felt good. I think, as Paul said, I like the use of policy land. It does feel a bit like that. Other things that I would speak to are the-- would include the recent report that's come out from the behaviour hubs around the shift. We're seeing more and more schools shifting towards more relational restorative behaviour policies and away from zero tolerance, no excuses policies, which I think in terms of this programme and the RE-STAR work is massively important because for me, as a long time practitioner, I think I truly do believe that most teachers and practitioners that we've engaged with at CDC through our belonging matters programme, and all those that I have worked with over the years have really wanted to do this stuff. I think this is what teachers want to be able to do, but I think the agenda has been pushing them in the opposite direction. So I think anything that we can do to empower teachers, I think a slight caveat would be and lots of practitioners that we've engaged with have said this, what's going to go aspect. Are we going to be given a little bit of space to focus on this? And I think that's definitely an important caveat to bear in mind. But I do feel hopeful, and I feel that the RE-STAR work has almost landed at the perfect time. Really, this conference has sort of landed at the perfect time with the sorts of shifts that we're hearing about, so yeah. Absolutely. Thanks very much indeed. I'm going to go to James now with the question more focused on practitioners. So, James, it'd be great to hear your thoughts on what you feel the most important discoveries from RE-STAR are from a practitioner perspective. Yeah, well, in some ways, it's similar, because for 30 years, we've been a place to be working in schools, supporting mental health, and championing and supporting schools for the whole school approach, because we've always known that just doing the work in the room with the one child that's got to a certain point of escalated mental health need isn't going to change the tide or affect the culture. And they then leave that room for the rest of the week and go back into the environment and the places where they're learning. So we've always tried to be much more holistic. I think people are right, there's a tipping point, there's a mass awakening that's happening. But then what happens is you get the mass flooding of resources as in overwhelm. I mean, just last week where I live, we had a letter come out to all schools saying, no more referrals to ADHD and autism for assessment because it's just three or four years waiting list, and we can't deal with it. So there's something for me around-- there's always a place for when somebody's mental health gets to a point of need, they will need something more. But early intervention and prevention and working within the networks of adults, but also empowering young people themselves is the way forward. And I think the discussions and the learning around regulation, co-regulation, but also the limits and ways that we can support people around interoception and what's working and what isn't working is really, really important. What we can't do here is introduce another thing for the professional adults in this setting to have to do without, like Ruth was saying, well, how do we fully resource that which is what looks amazing for this, or what is this replacing? Because you end up with overwhelmed, dysregulated, quite often neurodivergent, diagnosed or undiagnosed adults trying to deal with more and already overwhelmed. So the more support we can do and the simpler we can make this, and the more capacity that the government or the people can put into this, because it's the implementation that, I think, is always going to be the deciding factor, really. And practitioners are on a similar journey. We're having lots of conversations within our organisation about how we become more of a place where people who are neurodivergent can belong and work. And often, strangely, I think at that level, when we're talking about adults as employees and staff, we're sometimes having more advanced discussions. And we see it, we see it-- we see it more fully. It makes sense that we need for these people to be effective within the workplace. They need to feel they can belong. So we're changing everything from our recruitment practises to EDI steering groups. And yet, sometimes there seems to be a lag when we think about children and young people. And the last thing I'd say is about two weeks ago, we launched children's mental health week. Once again, the timing was brilliant, all about belonging. And when thinking about Place Positive, I think we need to broaden out as much as possible the concept of place and ensure that we aren't too biassed towards that being bricks and mortar, a place you can belong in a group, in a society and a culture and also in a physical space. But I think that's the bit that I'd really love people going into this and learning about it, to be thinking as broadly and not narrowly as possible. Thanks very much, James. And Ruth, did you have any further comments, thinking about this from a practitioner perspective? Yeah, thank you, James. I really appreciated all of that. And I think this theme of breadth is coming across a lot this morning. I thought about this quite practically in terms of what my experience and what I see and what I have seen going on in classrooms. And I think to reiterate that point about teachers particularly needing to be supported to deliver this kind of work is really important. And I was really excited to see that part of the RE-STAR that Susie just shared was around children and young people having digital tools to share, what is it about the environment that you're finding overwhelming? What's upsetting you? And I think what we have to do in schools, particularly is to support staff so that when they're hearing from the children and young people who know best what needs to change, that they can change those things. Because I think there's nothing harder than being a practitioner who would like to make the changes that are needed and isn't supported to do so. I think the role of school leadership teams and SENCos is absolutely vital. I think we give teachers the tools, but then we really, really have to build a support network from that whole school approach that supports them. So I would definitely want to lay evidence to that. I think also one of the really, really key bits of learning, I think we just can't hear it enough, and particularly from our young people, and it's so brilliant to hear it again today is that emotional burden can look like coping, pleasing, falling, masking and all these words that we could use. And there is a real need for practitioners to understand that as a response, compliance isn't a sign that all is well. And I think we have an entire system or education system anyway built around that belief that children who are sitting passively listening and absorbing information, that is a good thing. And I think what we hear when we hear from the young people who've spoken today and young people more generally, and certainly at CDC, is often a big red flag. So I think there's lots of implications for initial teacher training and continuing professional development. I know there is some mention of that in the white paper, but I'd be interesting to see the detail of that. And I also really do feel, especially having heard Tiegan and others this morning talking about the power that co-design has, I think we need to start bringing children and young people into the co-design of what they think teachers need to have included in their training, because I think often, it's very straightforward mindshift actually. We need to do big things, but we need to do small things as well. So I think there's some real messaging here, from what we've heard this morning about how teachers would like to be and should be trained. Great. Thanks very much. And actually, that takes us really nicely onto my next question, which is about particularly focusing on schools and school structures. So, Lucinda, if I could come to you next, it'd be great to hear your thoughts on how well the place positive intervention might fit within current school structures. So thanks, Cathy. I'm going to echo a lot of comments that have already been made. But the things that sort of struck me, particularly about, when Susie was talking, were the fact that what it seems to do is take existing structures that are already in place and slot into those. So as long as it's done with sensitivity, actually putting in an additional assembly-- it wouldn't be an additional assembly, but it would be fitting into your assembly structure is not actually that difficult to do. And again, it was quite nice to see talking about culture shift. And I think one of the biggest barriers might be that some schools don't recognise they need to make the culture shift. But where they do, it seems like something that would be relatively easy to implement, but there's a lot of-- I mean, someone commented on PSHE and I'm making sure it doesn't replicate that. From what I can see, it doesn't seem to replicate that, or it would slot in nicely with some of the PSHEs that might replace an existing PSHE slot. So that's for those of you who are not teachers, that's Personal Health Social, the E can stand for Economic and Education. You can have an extra E in there, but essentially, that's a statutory thing that has to happen in schools. So I kind of feel like it sounds like it's very easy. The other thing that I thought was really nice is when in terms of teacher training, what quite often happens is we have an inset day. At the beginning of term, you have an inset day and you feel all really enthusiastic, and I'm going to implement all of these wonderful things in my lesson. And you do it once, and it's really hard work because it's new and it's not your habit. And then you feel a bit overwhelmed and you just slip back into your old habits and whatever the wonderful thing was that you learned on your inset day is gone. And what was really nice was seeing that there's actually that continuation, having an app or having that oh, I don't quite know what to do, or I've tried this. That kind of underpinning support and network felt like something that would be then fairly easy to implement. So I really liked that sort of ongoing. It wasn't just a one-off. I often talk about people take these things as zones of regulation is probably a really good example, if they take something and then I always describe it as up sparkling it so make something that's quite complicated, something that's quite nuanced and make it into this a very simple, very brightly packaged thing that teachers can implement that just doesn't work. And it just felt like this was really grounded in what was already going on or might already be going on in schools. So that was really nice to hear. And I think the only thing that struck me, and I know from sitting on the panel and talking to and the interviews that I've done with the RE-STAR team and as a parent and as a teacher, what's really stood out is the idea of walking in the shoes of the young people we're talking about, there's a real emphasis on that, really understanding it. And I once did some inset training with a group of teachers, and I was thinking about this as people were talking, and I basically I put them into threes and I made them-- one person had to learn a number that another person was saying. The third person was talking over them. I was banging the door, turning the lights off, and made them swap their shoes from their left foot to the right foot. There was so much going on. And so in the end, the teachers that were trying to learn the number one of them stood up and walked out of the room. One of them started screaming. And I was like, you can see how this is actually happening. Suddenly they had empathy with-- OK, it was a particular scenario, and it was very contrived, I suppose. But it was understanding their empathy. And I think that's what's really struck me about the whole process here, is as someone who doesn't have autism, who doesn't understand ADHD, doesn't understand-- I mean, I have children who have it. They try and explain it to me. And we quite often don't get each other. It has really helped me understand how those young people in my classroom, for example, might be feeling. And I think that's been really helpful. And if that's part of the training as well, I think that's going to be really, really good. So yeah. Thanks very much. Looking forward to it. James, is there anything you'd like to add from think about things in terms of school structure? Yeah, I mean, circling back to the white paper, there was a mention in there when I read through it-- I need to take a deeper look and read later today-- around an encouragement towards multi-academy trusts, but no date on this, but the movement towards that. And that's something that I think would be really important to think about in regards to how this fits in, because that can massively affect the school structure, culture, behaviour model, whether they've got space within the curriculum, what's planned in. So things like PSHE, some schools are quite keen for things to fill those slots. Others have it mapped out, and there's no room for that to fit. And I think considering those environments as they are and thinking about how this can attune and adapt and slot in different ways is, I think, really, really useful. As the other piece that's really topical right now is around mobile phone usage, and that can be very different in different schools. It's very topical. And how and where the apps can be accessed by staff and students could be impacted by that. So I think that's something that's important to understand the different settings and how they interpret what's happening at the moment. I actually love the fact that there's an interactive tool, because I think not just it's that informative for staff and students, but it's also another form of regulation and co-regulation, being able to access and touch base and access. And I think, certainly, in those early days, where people-- like we said, it's very new. They're on a steep learning curve. There's so much going on. Often we find that children and young people being able to stay in school and access education and be mentally well is relationship dependent, not relationship enhanced. There's often one person that is the linchpin that's holding it all together, and often that person ends up burning out because they're carrying a lot of the pastoral load or they move on and there's no resilience in the system. So making sure that often-- when we're in a school, it's often our practitioner who's co-regulating the adults to support them, to co-regulate the children and young people. And it's looking at how can we make that more normalised and sustainable. And some of that is actually about putting capacity into schools, not coming up with more things for overwhelmed teachers to do. So I think this, there was so much in this that was resourcing and empowering, not is extra work, and that's the key thing. Great. Thanks very much indeed. Tiegan, I'm going to come to you next because it will be great to hear your thoughts on how the outputs from RE-STAR might best support neurodivergent young people. Great to hear your thoughts on that. Yeah, I think my first reflection is I think it, hopefully, will help neurodivergent young people not feel alone. And I think that comes from it being a whole-school approach. I think one of the things I've found personally really empowering, as I've learned about my autism, and that was quite difficult in some ways because it was 2020 when I got-- well, I got diagnosed late 2019. So then I spent the first year learning about my autism in lockdown. But actually, that was really beneficial for de-masking. But actually, one of the things I think I found most empowering is actually what everyone needs is accommodations. You're not alone in a room. Neurotypicals need accommodations as much as you. The amount of times I've been in a room and being the most popular person because I'm asking for breaks every so often, or I have an agenda when no one else in that room has an agenda, and everyone's getting antsy about when's a bathroom break or when are we going to be fed next or I have a fidget or a fan in the summer because I can't deal with the heat and everyone's like, this is amazing. And I'm like, well, you could ask for it. But they're like, but when you're a typical, we can't. Whereas I think there's something really empowering about having this whole school approach of actually-- what if actually Tommy, who's neurotypical, finds strong lights a real problem? Why can't we dim them for Tommy, actually? Because if that's going to help his learning. It's going to help his learning. And then if we also have an autistic student in that classroom who also struggles with lights, they're also going to love the fact we don't need blinding lights on every day in the middle of summer. Something I still to this day, can't understand why at school we always had blinding lights on in the middle of summer. But actually, is that real empowerment of actually having neurodivergence don't have to feel alone or all that pressure is on them of going, hi, I'm the one that needs breaks. Actually, they can go, well, we all need breaks, so-- and I think that can be really better than actually that power of that real stigmatising of anyone in this room needs help. Actually, if we're doing a whole school approach, you know there'll be other people, even if they're not standing up. I think in relation to neurodivergent young people, I think it shows in black and white the importance of taking away that pressure and expectation of neurodivergent people. It shows a reality, I feel, many of us have already been aware of. How it confirms the reality that for many neurodivergent young people, they provide a chance for those working with neurodivergent people or those who know a neurodivergent young person to step into their shoes, as people have said, and understand these experiences. I really like that example of that sensory overload for someone trying to take information. And you're saying about them running out of a room, it's like, yeah, if you step into our shoes, you'll actually realise how overwhelming this world is. And actually, as much as we can have coping mechanisms, all that, it's true. We're still too much in this world. And I think even more importantly, it's supporting this autonomy of actually, why not ask a young person what will help you? Sit them down in your office, grab a drink and talk if that's what's needed. I think for so long, and I've mentioned this in a couple of Q&A, young people have been told what will help them while young people are going, that won't help me. And it's like, yes, it will help you. And it's like, no, it won't. And actually, I remember my therapist was the first person-- because I said this breathe in for 10, breathe out for 10. I was like, I hate it. I can't do it. It drives me crackers. And honestly, it makes me more agitated than not doing it. And she's like, yeah, that makes sense. There's other things you can do. And I was like, wait, is there? She's like, yeah, most people don't like it. I don't know why it goes around. But there was instantly something like, someone's having a conversation here with me and saying, that's valid. You don't like that helping method, let's look for something else. So I think that's really important is we encouraging these conversations. And I think there's many clear messages throughout the work we've done. So I'd also say not to overthink them and use them in discussion with these young people. And actually seeing these outputs as not a start or even a middle, seeing these as a start, not an end or even a middle. All experiences are very individual. And whilst-- have I frozen? No. Can you still hear me? Yes. Yeah, yeah, you're fine. Whilst these outputs give a lot of insight to be useful, it needs to be tailored to each individual experience. Everyone experiences a room differently. I'm sure if we all put you in a room right now, you'd all think there's something more problematic than the other person. And I think the other important thing with this whole school approach is I think it finally helps teachers and actually tells you, well, how can you cope in this classroom a bit, but also how can you help your students cope? Because, I'll be honest, I think some teachers have never really been told. I remember a great example from secondary school. Well, it wasn't a great moment for either of us, but for whatever reason I was quite heavily bullied at school. I wasn't supported. So I went to a physics classroom just sobbing, and I was trying to hold it together, but you know, when you're sobbing, you can't really. And my physics teacher, he was a guy that wore shorts all year round. He instantly went, don't cry, please. Well, what do you think I did? I just ended up crying more. And you could just see the panic on his face of like, almost. I don't know what to do in this room. Eventually, I think another student said, should we just go and get another teacher? Because he just couldn't deal with emotions. But actually, someone just needed to have a conversation with him of how to deal with a student crying, even if that was like, even if you can't handle it, go and get someone that can handle it. And so I think it's great that actually it's focusing on actually that burden on teachers. And teachers are human. We're not expecting you all to know how to support or help a neurodivergent student, or know if Tommy comes in your classroom instantly, what accommodations he needs. It's about supporting you to help actually empower these young people and work together to make your classroom as cohesive as possible. So actually, you're accommodating your students, but you can also accommodate yourself. If you're having a really burnt out day, what can you do? Or if you're neurodivergent as a teacher yourself, what can you do to support yourself? And I think those, to me, are the ways our outputs can best support neurodivergent young people is it's moving away from neurodivergent young person. I've seen a lot about diagnosis and stuff. And whilst that's important, it isn't the only thing that's important. It's actually, we all have needs in this world. How can we support these needs more, and actually that young people that neurodivergent at the core because they find this world the most challenging, especially in school environments, I would say? But actually recognising that further output. And I think my final point is, I think part of that is because as a research team, not only as young people, are we neurodivergent. A lot of the academic team are, and we both recognised each other's needs throughout this project. And I think that's just come into then what we've made as a final intervention. Wonderful. Thanks very much, Tiegan. And Tiegan, do have a look at the chat, because there were a lot of very positive responses to everything you were saying there. Huge thanks for that. Paul, can we go over to you with the same question? You can. I'm not sure if you're going to get a better answer than the brilliant response from Tiegan and how they've summarised it all there. I'll try and answer with the national policy hat on a little bit and I mentioned at the start what's happening in national policy, which on the one hand is great, but actually sometimes can lead to maybe a bit of a vacuum in the short term in terms of the support that schools and practitioners can get while the reforms are being developed. And actually just lots of speculation around reforms can be really stressful for people and their families to watch unfold on the news and on the radio and in comment sections on web articles. So on just a really human level, it can be really overwhelming. So one thing I hope that young people can take from RE-STAR is a bit of reassurance and reassurance that there are people working desperately hard to improve things right now on the ground. And they're doing it in all the right ways, as we've seen from the presentations today, fully involving people who would be affected by and involved in delivering the changes to support. And as Tiegan said, not just telling people what they need and doing it on that individual basis and that there are people who want to help lots of people on the call. In terms of how the outputs themselves, can help. Firstly, you've got now that evidence model the interventions, the place positive work, the whole-school approaches. So they can inform the advice to government through the consultation I mentioned. Subsequently, they can inform any training and advice resources to support teachers and school staff. They can also inform the need for capital investment to ensure that schools actually have the environments and spaces for quiet time and meditation and other sort of elements of self-care. And just the final point is that influencing that national policy is vital, particularly in relation to funding and workforce stuff. But there are times when you can almost skip it and go straight to the direct delivery and giving the staff the resources they need and getting the support directly to young people. And I think that's where RE-STAR can help as well. Government especially going to be looking in the consultation. I've seen some questions asking if we're all going to be responding. Autistica definitely will. And you've got that evidence-based model right there that they can pluck straight away. So yeah, I hope that's a useful answer. Great. Thanks very much indeed, Paul. And Lucinda, can I come to you on the same question? I feel like this is going to be quite a challenge to follow both of those. So I've just picked three things. There are so many things that I could pick, but my first one, and I think it's been something that's been a big discussion today in the chat, and that's the use of language. I think the very beginning of the talk, Edmund was talking about the paradigm shift. And I think that's going to be really interesting for researchers as well as teachers. And yeah, I think the language that we use around this, which has been-- language is a funny thing. It takes a long time to change. But I think language for me is one thing. The other thing that I think is really important is the use of voice. So that's, again, linked to the idea of the paradigm shift, but just hearing Tiegan talk and the comments that were being made and all of the other youth researchers that I've spoken to, understanding their perspective is so important for helping teachers understand what's going on. And I think that's a real shift. And the final thing is a very brief thing, and it's come up so many times in all of the conversations. I think one episode that I actually the title of one of the episodes of the podcast we recorded, and it's just be kind. Lovely. Thanks very much. And that's a really lovely place to end the panel. Bang on time as well. So thank you all very much for your fantastic contributions, and thanks to everybody for such thoughtful contributions in the chat as well. It's really been absolutely fantastic to see how engaged everybody is. We're just going to finish up with a little bit of time to have a chance for any of the panel members really to respond to any particular issues that are outstanding. There are lots and lots of questions there, so I won't be able to go through them all, but I just wanted to give you a brief chance to pick up on anything that had been raised in the chat or Q&A that you were particularly keen to respond to. And that goes to our panel members, but also any of our speakers throughout today. There was one question about Place Positive that came up a few times that I think I've answered in the Q&A, but it was just about where can we find it? Well, we've just come to the end of the first phase of development, and the next step would be kind of implementation and having a prototype that would be accessible. And we're sort of seeking funding for that. So that's really the next step. But the big question is, yeah, when? And so presumably, you'll be evaluating that implementation. So if there are for example schools that were keen to be part of that evaluation, is there anything they can do to let you know about that? They could get in touch. Just leave their details in the chat is great. That would be great. That is our next step is really to work with schools. And we have one academy trust that is interested in partnering with us. But it's always good to hear from others and just to understand that across the breadth of schools. So please leave a note in the chat is probably the easiest thing. I will also put our email in the chat for anybody who wants to email us directly with anything. Wonderful. Thanks very much. So I'm going to hand over to Edmund in a moment just to finish this up with his final comments on the day. But before I do, just to say another huge thank you to all of the speakers and all of the panel members today. It's been a fantastic project to observe over the last 4 and 1/2 years. And huge congratulations to on all of the work that's been done. And I think as many people have said, it's obviously so timely at the moment with all of the opportunities that seem to be there at the moment, which this work aligns really closely with. So it will be really fantastic to see this as it goes forwards and into implementation evaluation. And certainly, there's so much learning beyond the intervention as well, isn't there, that's so relevant to the policy context. So massive thanks to you all and thanks. As Lucinda said, it really has been a privilege for those of us on the steering committee to be involved in a very small way. So thank you very much. I was about to hand over to Edmund. And I'm back. Oh, are you? So over to Edmund for concluding comments to the day. That's great. Thanks, Cathy, and thanks for chairing so absolutely brilliantly as always, of course. Thanks to the panel. Great discussion. And thanks to the brilliant questions actually in the chat. I'd like to make five points if I may. I think first is my immense pride to have shared this adventure with such an incredibly talented and inspiring group of people. Well, RE-STAR warriors, one and all, massive thanks to every single one of you. A special thanks must, of course, go to the warrior queen Susie. She's held it all together. Incredibly complex project. Incredibly complex people [CHUCKLES] with incredible skill, grace, and patience. So thank you, Susie. Second, we've heard from Tiegan, Maciej, and Amber how research has changed our Y-RPers' lives. But I think it's really crucial for you to all understand it's had a transformative effect on the rest of us too. I've never done a project like this, and it's really got us to challenge our own preconceived ideas, but also more deeply, to reflect on our own lives, encouraging us to be more open and perhaps more willing to be vulnerable in the context of our research. Third, that if you are brave enough, you can try and do science in a different way from other people by looking at things from a different angle, and this can be very fruitful. I think it has been very fruitful. In terms of new ideas and concepts, it's wonderful. The term emotional burden, everybody's using it now, and we've only just introduced it, so we're going to become a meme. New findings, of course, as you heard about and a new intervention. Forth, that deep participatory approaches, if properly resourced and supported, are possible and actually have been essential for what we've done in RE-STAR. Without the Y-RPers and the J-RPers, there would be no RE-STAR. While we've had a lot of positive reactions to our participatory approach, there's also been quite a lot of kickback from other researchers who think we've gone too far. Some suggesting that it undermines the rigour of our science. I think we've proved today that's not the case. Others suggested that neurodivergent people would be overburdened by this level of engagement. I think we've shown that that, with the right support and care, this is not the case either. Fifth, we need investment to bring Place Positive to life and then evaluate it, as Susie said. So if anyone in the audience is rich and wants to make the world a better place, do get in touch. Thank you very much. Is it back to you, Cathy, or? I was going to finish with your final words. So I think. That's good. Yeah, I didn't have anything further to say. So huge thanks to everyone. And we can keep the call open for a bit so that people can add anything further that they want to the chat. But thanks again and congratulations. Thank you very much. Thank you, everyone. [MUSIC PLAYING]