Skip to content

Nurture Groups

Evidence rating
Cost rating
Review: March 2017

Note on provider involvement: This provider has agreed to EIF’s terms of reference, and the assessment has been conducted and published with the full cooperation of the programme provider.

Nurture Groups – Classic Boxall Model is a short-term intervention grounded in Bowlby’s attachment theory, which aims to address barriers to learning arising from unmet attachment needs.

It is a targeted programme, intended for primary school children who have difficulties coping in mainstream classes and may be at risk of underachievement. 

Nurture Groups are underpinned by six core principles: (1) Children’s learning needs to be understood from a developmental perspective. (2) The classroom offers a safe base from which to learn. (3) The importance of nurture for the development of self-esteem and wellbeing needs to be recognised. (4) Language is a vital means of communication. (5) All types of behaviour are a form of communication. (6) The importance of transition points in children’s lives needs to be recognised.

EIF Programme Assessment

Evidence rating

Nurture Groups has preliminary evidence of improving a child outcome, but we cannot be confident that the programme caused the improvement.

What does the evidence rating mean?

Level 2 indicates that the programme has evidence of improving a child outcome from a study involving at least 20 participants, representing 60% of the sample, using validated instruments. 

This programme does not receive a rating of 3 as its best evidence is not from a rigorously conducted RCT or QED evaluation.

What does the plus mean?

The plus rating indicates that a programme’s best available evidence is based on an evaluation that is more rigorous than a level 2 standard but does not meet the criteria for level 3. 

Note: The most common version of Nurture Groups is the Classic Boxall Model. Several variants of the Classic Boxall Model for Nurture Groups do, however, exist. The EIF evidence rating is not applicable to these variants.

Cost rating

A rating of 4 indicates that a programme has a medium-high cost to set up and deliver, compared with other interventions reviewed by EIF. This is equivalent to an estimated unit cost of £1,000–£2,000.

Child outcomes

According to the best available evidence for this programme's impact, it can achieve the following positive outcomes for children:

Supporting children's mental health and wellbeing

based on

Enhancing school achievement & employment

based on
Nurture Groups

Key programme characteristics

Who is it for?

The best available evidence for this programme relates to the following age-groups:

  • Primary school

How is it delivered?

The best available evidence for this programme relates to implementation through these delivery models:

  • Group

Where is it delivered?

The best available evidence for this programme relates to its implementation in these settings:

  • Primary school

The programme may also be delivered in these settings:

  • Secondary school

How is it targeted?

The best available evidence for this programme relates to its implementation as:

  • Targeted indicated

Where has it been implemented?

United Kingdom

UK provision

This programme has been implemented in the UK.

UK evaluation

This programme’s best evidence includes evaluation conducted in the UK.

Spotlight sets

EIF includes this programme in the following Spotlight sets:

  • School-based social & emotional learning
Nurture Groups

About the programme

What happens during delivery?

How is it delivered?
  • Nurture Groups is delivered five times a week, with each session being approximately 2.5 hours' long, led by two practitioners, to each group of children.
What happens during the intervention?
  • Children who are found to be at high risk of social, emotional, and behavioural difficulties based on an assessment on the Boxall Profile are selected into the programme. Social and developmental targets for each student in a Nurture Group are then devised on the basis of the Boxall Profile.
  • Children are removed from their mainstream classrooms for a portion of the day and placed in Nurture Groups, where they are provided with an accepting and warm environment which helps develop positive relationships with both teachers and peers.
  • The aim of the intervention is to provide children with a carefully planned, safe environment in which to build an attachment relationship with a consistent and reliable adult. Children spend the majority of the school week in the Nurture Groups, receiving highly structured and supported learning experiences, but where possible, rejoin their mainstream class for registration, assembly, break, lunch and home time.
  • Children typically attend Nurture Groups for between two and four terms, after which they can reintegrate into their mainstream class on a full-time basis.
  • Activities undertaken include emotional literacy sessions, news sharing, group activities, curriculum tasks, and nurture breakfast.

What are the implementation requirements?

Who can deliver it?
  • The first practitioner who delivers this programme is a teacher with QCF-6 level qualification.
  • The second practitioner who delivers this programme is a Nurture teaching assistant with QCF-3 level qualification.
What are the training requirements?
  • The practitioners have three days of programme training. Booster training of practitioners is recommended.
  • During the training, practitioners will learn how to use the Boxall Profile Online; are provided with all the materials needed to implement the programme, and receive a training handbook. Practitioners also receive training focusing on attachment theory and child development and learning.
How are the practitioners supervised?
  • It is recommended that practitioners are supervised by one host agency supervisor qualified to QCF-6, with 20–40 hours of programme training.
  • It is recommended that practitioners are supervised by two programme developer supervisors, qualified to QCF-6, with five to 10 hours of programme training.
What are the systems for maintaining fidelity?
  • Training manual
  • Other printed material
  • Face-to-face training
  • Fidelity monitoring
Is there a licensing requirement?

There is no licence required to run this programme.

How does it work? (Theory of Change)

How does it work?
  • Replacing missing or distorted early attachment improves children and young people's behaviour, wellbeing, and academic attainment.
  • Nurture Groups aim to replace these early attachments by immersing students in an accepting and warm environment which helps develop positive relationships with both teachers and peers.
  • In the short term, children and young people have improved self-esteem, behaviour, and school attendance.
  • In the longer term, children and young people have improved academic attainment, well-being and mental health.
Intended outcomes

Supporting children's mental health and wellbeing
Enhancing school achievement & employment
Preventing crime, violence and antisocial behaviour

Contact details

Lea Verlaguet
Operations Coordinator
[email protected]

Becky Hug
Policy and Public Affairs Adviser
[email protected]

Nurture Groups

Nurture Groups

About the evidence

Nurture Groups’ most rigorous evidence comes from one QED study which was conducted in the UK. This study identified statistically significant positive impact on a child outcome. 

The conclusions that can be drawn from this study are limited by methodological issues pertaining to non-blind data collection, and the treatment condition not being modelled at the level of assignment. A programme receives the same rating as its most robust study, and so the programme receives a level 2+ rating overall.

Study 1

Citation: Reynolds et al (2009)
Design: QED
Country: Scotland
Sample: 221 children across 32 schools, aged between five and seven years
Timing: Pre-test and six months post-test
Child outcomes: Improved self-esteem
Improved academic attainment
Other outcomes: None measured
Study rating: 2+

Reynolds, S., MacKay, T., & Kearney, M. (2009). Nurture groups: A large‐scale, controlled study of effects on development and academic attainment. British Journal of Special Education, 36(4), 204–212.

Available at

Study design and sample

The first study is a quasi-experimental design, conducted in Glasgow. Selection and matching of control and treatment schools and children, was based on a three-stage process. In the first stage, all 116 schools in Glasgow were divided into bands based on two factors:

  • Number of pupils on the roll (ie school size)
  • Socio-economic status (included eligibility for free school meals and for clothing grants).

Each of the 58 schools where Nurture Groups were already being implemented, were then matched to one or more potential control school(s) in the same band. In the second stage every pupil in primary one and primary two in all 116 schools was assessed using precise ratings on an audit of need designed for the study. This resulted in the identification of 16 schools that were a close match for schools with Nurture Groups in terms of school criteria in stage one and the pupil criteria in stage two.

Finally, in stage three, children in the selected control schools, and those in the schools with Nurture Groups, were assessed on the Boxall Profile. Children were selected as controls if they sufficiently matched the profile of the pupils in Nurture Groups.

The sample included 221 children across 32 schools. 16 (117 children) schools were allocated to the treatment group where Nurture Groups were conducted, while the other 16 (14 children) schools served as matched controls without Nurture Groups. Children in the sample were aged between five and seven years.


Four measures were used to assess change in academic attainment, and emotional/behavioural functioning. The first three measures included:

  • The Baseline Assessment for Early Intervention which assessed academic attainments.
  • The Strengths and Difficulties Questionnaire (SDQ) which was used to assess behavioural development.
  • The Behavioural Indicators of Self-esteem (BIOS) which was used to assess self esteem.

All of these measures were reported to have good levels of reliability and validity. The fourth measure used was:

  • The Boxall Profile. This measure was designed specifically for the intervention, and was completed by Nurture Group teachers or mainstream classroom teachers.

Because the Boxall Profile was specifically designed for this intervention, and is therefore closely aligned with the outcomes targeted by the intervention, findings from this measure were not regarded as being as robust as the findings from the first three measures.


Findings indicated that children attending Nurture Groups showed significant gains in academic attainment (p < 0.001) as measured on the Baseline Assessment for Early Literacy. Significant gains were also found for social and emotional development on all five constructs of the Boxall Profile. These findings were however not reflected on the SDQ which demonstrated no significant findings. On the BIOS measure children attending Nurture Groups showed significant improvements in behaviours relating to self-esteem.

More Less about study 1

Other studies

The following studies were identified for this programme but did not count towards the programme's overall evidence rating. A programme receives the same rating as its most robust study or studies.

Cooper, P., Arnold, R., & Boyd, E. (2001). The effectiveness of nurture groups: Preliminary research findings. British Journal of Special Education, 28(4), 160–166 - This reference refers to a quasi-experimental design, conducted in the UK.

Cooper, P., & Whitebread, D. (2007). The effectiveness of nurture groups on student progress: Evidence from a national research study. Emotional and Behavioural Difficulties, 12(3), 171–190 - This reference refers to a quasi-experimental design, conducted in the UK.

Gerrard, B. (2006). City of Glasgow nurture group pilot scheme evaluation. Emotional and Behavioural Difficulties, 10(4), 245–253 - This reference refers to a quasi-experimental design, conducted in the UK.

O’Connor, T., & Colwell, J. (2002). Research Section: The effectiveness and rationale of the ‘nurture group’ approach to helping children with emotional and behavioural difficulties remain within mainstream education. British Journal of Special Education, 29(2), 96–100 - This reference refers to a quasi-experimental design, conducted in the UK.

Sanders, T. (2007). Helping children thrive at school: The effectiveness of nurture groups. Educational Psychology in Practice, 23(1), 45–61 - This reference refers to a quasi-experimental design, conducted in the UK.

Seth-Smith, F., Levi, N., Pratt, R., Fonagy, P., & Jaffey, D. (2010). Do nurture groups improve the social, emotional and behavioural functioning of at risk children? Educational and Child Psychology, 27(1), 21–34 - This reference refers to a quasi-experimental design, conducted in the UK.

Sloan, S., Winter, K., Lynn, F., Gildea, A., & Connolly, P. (2016). The impact and cost effectiveness of Nurture Groups in primary schools in Northern Ireland. Belfast: Centre for Effective Education, Queen’s University Belfast - This reference refers to a quasi-experimental design, conducted in the UK.

Published March 2024