PG27. Learning Disability (Parenting Capacity)

Parental learning disabilities do not necessarily have an adverse impact on a child's developmental needs; however, it is essential to assess the implications for each child in the family. Learning-disabled parents may need support to develop the understanding, resources, skills, and experience to meet the needs of their children. Such support is particularly necessary where the parent/s experience the additional stressors of:

• Social exclusion;
• Having a disabled child (see Disabilities Procedure);
• Experiencing domestic abuse (see Domestic Abuse Procedure);
• Having poor mental health (see Mental Illness (Parenting Capacity) Procedure);
• Having substance misuse problems (see Parents who Misuse Substances Procedure);
• Having grown up in care (see Living Away from Home Procedure, Foster care and Living Away from Home Procedure, Residential care).

In most cases, it is these additional stressors, when combined with a parent's learning disability, that are most likely to lead to concerns about the care their child/ren may receive. If a parent with learning difficulties appears to have difficulty meeting their child/children's needs, a referral should be made to the local authority children's social care, who have a responsibility to assess the child's needs and offer supportive and protective services as appropriate.

Please note that a learning disability and a learning difficulty are different. A learning disability significantly affects a person’s intellectual functioning and ability to learn new things, which has an impact on everyday activities. A learning difficulty affects specific areas of learning, such as reading or solving maths problems, without impacting overall intelligence.

A learning difficulty is a problem that the individual faces in learning, such as ADHD, dyspraxia and dyscalculia and does not affect an individual’s intellect.

For further information, see the Mencap website which explains further and Learning disability - applying All Our Health - GOV.UK.

Where a parent has enduring and/or severe learning disabilities, children in the household are more likely to suffer significant harm through emotional abuse, and/or neglect, but also through physical and/or sexual abuse. See Recognising Abuse and Neglect Procedure

Significant harm is defined in Recognising Abuse and Neglect Procedure, Concept of significant harm as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and/or emotional harm (through abuse or neglect) which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

The following factors may contribute to a child having suffered, or being more likely to suffer, significant harm:

• Children of parents with learning disabilities are at increased risk of inherited learning disability and more vulnerable to psychiatric disorders and behavioural problems, including alcohol/substance misuse and self-harming behaviour;
• Children having caring responsibilities inappropriate to their years placed upon them, including looking after siblings (see Young Carers Procedure);
• Neglect leading to impaired growth and development, physical ill health or problems in terms of being out of parental control;
• Mothers with learning disabilities may be targets for men who wish to gain access to children for the purpose of sexually abusing them.

Local authority children's social care, vulnerable adult's services and other agency services must undertake a multi-disciplinary assessment using the Assessment Framework (see Referral and Assessment Procedure and Appendix 4: Triangle chart for the Assessment of Children in Need and their Families for a summary and diagram of the Assessment Framework), including specialist learning disability and other assessments, to determine whether or not parents with learning disabilities require support to enable them to care for their children. Such an assessment will also assist in determining whether the level of learning disability is such that it may impair the health or development of the child, particularly if an adult with learning disabilities is to be the primary carer.

All agencies must recognise that their primary duty is to ensure the promotion of the child's welfare, including their protection from any risk of harm.

Practitioners should not assume that having a learning disability means a person cannot learn new skills. Parents with learning disabilities can parent appropriately when the right support is put in place in a timely way by professionals or extended family.

Local Safeguarding Children Partnerships are responsible for taking full account of the challenges and complexities of work in this area by ensuring interdisciplinary/agency protocols are in place for the coordination of assessment and support, and for close collaboration between all local children's and adult services.

Local authority vulnerable adult services should ensure that the eligibility criteria for service provision are such that parents with learning disabilities who need help to care for their children can benefit from support provided under the NHS and Community Care Act 1990.

Children and Adult Services have a role in supporting both the parent and the child/ren. Local Protocols may have been developed around how Children and Adult services work together. The Working With Parents programme (Research in Practice) has an example protocol that may be of interest.

Group education combined with home-based support increases parenting capacity. Supported parenting should include:

• Accessible information;
• Advocacy;
• Peer support;
• Multi-agency and multi-disciplinary re/assessments;
• Long-term home-based and other support.

A learning disability is a lifelong condition, and parents may require long-term, ongoing support, which will need to adapt to meet the child's developmental needs as they grow. Assessments must therefore consider the implications for the child as they develop throughout childhood. Services will need to re-evaluate the child's circumstances, and clear plans should be in place on how this will be achieved. The impact of support over time should also be measured, given the short-term nature of interventions. Consideration should be given to what will be expected to happen when support or direct involvement ends, and a long-term strategy should be developed to ensure the ongoing needs of children are met.

Changes in circumstances should also be assessed in terms of impact on parenting capacity. For example, a parent/carer with a learning disability may have been successfully supported to care for one child. Still, it cannot be assumed that their capabilities will automatically extend to caring for two (or more) children. New circumstances, in particular those that may bring new pressures, should be considered in terms of their impact on the whole family.

Whilst there must be a focus on the needs and well-being of children, it should be recognised that parents/carers with learning disabilities should have their needs appropriately responded to, to enable them to parent their children effectively. Parents/carers with learning disabilities can often be socially isolated, which can leave them open to other risks, including domestic abuse and coercive control. Consideration should also be given to support for parents or carers who have children removed from their care to enable them to manage their emotional response to what is a significant trauma.

For further information see Good practice guidance on working with parents with a learning disability (DH / DfES, 2007, updated 2016).

For further information, see the Mencap website which explains further and Learning disability - applying All Our Health - GOV.UK.

Training - specialist training should be available on how to assess and support parents with a learning disability. The Good Practice Guidance on Working with Parents with a Learning Disability should be an essential part of the continuation training for social workers and managers. (See Further Information).

Accessible information and communication:

Communication - communicating with parents should always be in a way they understand.

This may include:

• Local authorities have to make reasonable adjustments under the Equality Act, so they need to think about how to meet the parents’ needs, such as taking more time to explain things, and any written information should be provided in an accessible form for the parents.
• Telling parents things more than once and checking their understanding of what has been said;
• Considering in advance how best to prepare for meetings, and discussing with parents what would be helpful for them and involving the advocate in these discussions;
• Visual aids to support with parenting, such as pictures, short films;
• Specialist Support from a Speech and Language therapist, Occupational therapist, and /or psychologist who can advise on the parents’ needs and how best information can be given. They can also advise on suitable learning strategies which may enhance the parent’s ability to learn.
• Make sure the parents are not overwhelmed by the number of professionals involved in the Multi-Disciplinary Team, and make sure they understand what roles each professional is taking on. For example, having one point of contact so the parents liaise with them and information and appointments can be disseminated from this point of contact.
• Parents need to understand what an assessment is, what it is for, what it will involve, and what will happen afterwards. This information should be provided in an accessible format and may need to be repeated if there are any memory or cognitive issues.

The Family Court in XX, YY and Child H (Rev1) [2022] EWFC 10 stated that, in cases where a parent has a learning disability:

• There should be timely referrals to adult social care for a parent with learning difficulties, without a very lengthy gap after a referral;
• Parents with learning difficulties involved with children’s social care, where a child is on a child protection plan, should have their own advocate as a priority. A referral for that service should be made as soon as is practicable; and
• The support available to a parent with learning difficulties should be distilled into a simple document identifying what is available, how often it is available, timescales for its availability and who is responsible for its delivery. Such a document should be shared with children’s social care (if involved) and discussed with a parent in the presence of their advocate.

Accessible information

Information about universal services made available to parents and prospective parents should be in formats suitable for people with learning disabilities. This may include:

• Easy Read versions of leaflets, avoiding the use of jargon;
• Audio and/or visual information on CD/DVD/MP3;
• Fully accessible websites;
• Creating opportunities to tell people with learning disabilities, face-to-face, about services for parents and parents-to-be;
• 'Word banks' of words that parents can read and understand, to be used in written communications with the parents.