Using the Leuven wellbeing scale in observations to assess children’s mental health and wellbeing more effectively

To kick off Place2Be's Children's Mental Health Week, I'm providing an outline of how to use the Leuven wellbeing scale to support understanding of mental health and wellbeing in early years and beyond
Using the Leuven wellbeing scale in observations to assess children’s mental health and wellbeing more effectively

It is widely known that the mental health and wellbeing of children in their youngest years can influence their future development. Poor mental health and wellbeing in early childhood can follow into adolescence and adulthood. Poor mental health and wellbeing can impact every aspect of a person’s life, including their educational outcomes, employability, relationships and can lead to substance misuse and other risk-taking behaviours.

Therefore, as practitioners, we have a responsibility and a duty of care to support and promote good mental health and wellbeing from the earliest point. It is important to integrate healthy practices towards children’s mental health and wellbeing into every aspect of your setting, from the environment you create to the activities which you provide and the relationships you build with the children and their parents/carers.

However, it can sometimes be challenging to make informed judgements about a young child’s mental health and wellbeing, as they may not be at a stage where they can express their feelings and emotions. Therefore, it's helpful to know that there are resources and tools that you can use to help guide you. This article focuses on the specific tool known as the Leuven scale of wellbeing.

The Leuven scale of wellbeing

The Leuven scale of wellbeing was created and developed by Ferre Leuven and his team, as a form of assessment to measure the wellbeing of children. The philosophy behind the scale was the recognition that when children are happy and confident (have higher levels of wellbeing), they are more likely to engage, explore and experiment with the world around them. Over time, the scale has been widely adopted within early years education to help make observational, evidenced-based assessments of children’s wellbeing.

The wellbeing scale is an observational, sliding scale from 1-5 that provides indicators and descriptions of a child’s behaviour and body language. The indicators and descriptions provide a guide for practitioners to help them to identify a child’s current level of wellbeing;

Level 1- Extremely low

Indicators would include: The child shows signs of discomfort, such as crying or screaming. They may look dejected, sad, frightened, or angry. The child does not respond to the environment, avoids contact and is withdrawn. The child may behave aggressively, hurting him/herself or others.

Level 2- Low

Indicators would include: Posture, facial expression and actions indicate that the child does not feel at ease. However, the signals are less explicit than under level 1 or the sense of discomfort is not expressed the whole time.

Level 3- Moderate

Indicators would include: The child has a neutral posture. Facial expression and posture show little or no emotion. There are no signs indicating sadness or pleasure, comfort or discomfort.

Level 4- High

Indicators would include: The child shows obvious signs of satisfaction (as listed under level 5). However, these signals are not constantly present with the same intensity.

Level 5- Extremely high

Indicators would include: The child looks happy and cheerful, smiles, cries out with pleasure. They may be lively and full of energy. Actions can be spontaneous and expressive. The child may talk to him/herself, play with sounds, hum, sing. The child appears relaxed and does not show any signs of stress or tension. He/she is open and accessible to the environment. The child expresses self-confidence and self-assurance.

How you can use the Leuven scale within your practice

The most effective and simple way to implement the Leuven scale of wellbeing is to use it alongside the observations you make of children. Making observations of children is part of daily practice and one which we are very accustomed to doing. Having a copy of the scale at the top of your observation sheet can encourage you to think about how a child is feeling.

It can also be useful to have a copy of the scale on the wall of your classroom so that it is always to hand. It can also provide children with an opportunity to consider their own wellbeing and serve as a talking point to discuss how they are feeling and how one of their peers might be feeling based on their own observations.

You can also adapt the scale to be more suited to the individual needs and communication styles of each child. You can develop your own indicators on the scale for individual children. For example, a child may have limited facial expressions or be non/pre-verbal, but you know that subtle sounds or body movements would indicate high or low levels of wellbeing.

Within my own practice, I supported a child with Profound and Multiple Learning Difficulties (PMLD). He had limited body movement, facial expressions and vocalisations. However, as I got to know the child well, I was able to distinguish a subtle tonal difference in his vocalisations. A high pitched, short vocalisation would be an indication that he was showing displeasure or was upset. However, a low pitched, longer vocalisation would be an indication that he was happy and expressing enjoyment.

It is typical for a child’s wellbeing to fluctuate throughout the day, as factors such as being tired, hungry, or feeling unwell can impact on a child’s wellbeing. The effects are short term and often alleviated through meeting their needs, such as encouraging them to rest or eat. It becomes more of a concern if a child seems to be at the low end of the scale more consistently. In this instance, continue to monitor the child and talk to parents/carers about any changes that may be happening at home. Often as a parent myself, I can forget to pass information on to my child’s teachers, so prompting parents/carers can be useful to find out more information, which may explain a child’s behaviour.


Using the Leuven scale of wellbeing alongside your observations of children can help make their mental health and wellbeing more visible in terms of bringing it to the forefront of your mind. Each time you observe a child, you will be actively looking at their wellbeing and build a picture of their mental health over time. It is not intended to be a prescriptive tool, but as a guide to encourage you to think about and reflect upon each child’s wellbeing. It prompts you to look at children’s non-verbal communication and explore what they are telling you from their body language, facial expressions, and gestures. For young children and children with SEND, they may not be able to communicate their feelings and emotions, so you have to play the role of a detective and try and find out. The Leuven scale of wellbeing can help provide you with some of the clues to follow and look out for.

You can share your observations with parents/carers to explain their child’s current stages of learning and development and the next steps that you will be implementing to continue supporting their wellbeing. Your observations of children can additionally provide evidence for referrals to other services, such as if you identify that a child could have an underlying SEND. By including the Leuven scale of wellbeing, you can enhance the quality of the information that you provide for evidence-based referrals and help direct you to what service maybe the most beneficial to the child in the first instance. Although the Leuven scale of wellbeing is mostly used within early years education, it can be adapted and used within all key stages of education.

On a final point, it is important to always be alert to any potential safeguarding concerns. Sudden or unexplained changes in a child’s behaviour or if you have ongoing concerns regarding their emotional or mental health could indicate something more is happening in a child’s life. Always follow your settings safeguarding policies and procedures if you are concerned about the safety of a child.

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Go to the profile of Letecia Knight
25 days ago

I will hold the #The Leuven scale of wellbeing in mind, when I support/work with autistic individuals and their families.

Go to the profile of Sarah Noonan
20 days ago

we use th leuven scale but i did not know the history behind it- thank you very much