Children of Parents with Learning Disabilities

A learning disability is a permanent life-long condition which affects the way a person understands information and how they communicate. This means they can have difficulty:

• Understanding new or complex information;
• Learning new skills (particularly new skills);
• Coping independently.

Around 1.5 million people in the UK have a learning disability. It's thought up to 350,000 people have a severe learning disability.

There is a wider group of parents with learning difficulties, who do not have a diagnosed learning disability and who would not generally fit the eligibility criteria for support services in their own right. Parents with learning difficulties may face a wide range of barriers to bringing up their children successfully, and often recognise that they need practical support and help to enable them to learn to be the best parents possible.

Historically IQ testing was used as an assessment method in an attempt to categorise degrees of learning disability, however, modern assessments use a broader approach to assess strengths and needs, and are part of a person-centred approach to care and support planning, leading to a person-centred plan describing what is important to and important for the individual to live a good life with as much choice and control as possible.

The additional support needed by parents with learning disabilities can include the support with:

• Meeting a child's developmental needs, as well as their own;
• Personal care of the child;
• Preparation of meals and drinks;
• Attending to the child's health needs;
• Parental involvement in indoor and outdoor play;
• Promoting the child's education; and
• Helping to identify potential risks to their child(ren).

Where a parent has a learning disability it is important not to make assumptions about their parental capacity and capabilities. Having a learning disability does not mean that a person cannot learn new skills. Parents with learning disabilities can be 'good enough' parents when appropriate and timely support is put in place.

Some parents with learning disabilities will only need short-term support, such as help with looking after a new baby or learning about child development and childcare tasks. Others, however, will need on-going support. Most may need support at various different points throughout their family's life cycle.

If services fail to coordinate effectively, parents with learning disabilities are at risk of falling through the gap between the provision of services for children and the provision of services for adults. As a result, some parents may miss out on support services that they need in order to prevent problems from arising or escalating. Early help and Family Support services should be considered at an early stage in order to prevent future harm to the child and to promote the child's welfare. Consideration should also be given to wider family support that is available.

The context in which people with learning disabilities parent their children is one that has been dominated by the perception of risk and the assumption that their parenting will not be good enough. However, parents with learning disabilities can be 'good enough' parents when appropriate support is put in place. Adults with learning disabilities may need support to develop the understanding, resources, skills and experience needed to meet and respond to the needs of their children. This will be particularly important if they are experiencing additional difficulties such as domestic abuse, poor physical or mental health, substance misuse, social isolation / discrimination, poor housing, poverty or have a child with special needs or disabilities.

Neglect through acts of omission rather than commission can be a frequently stated concern; ultimately it is the quality of care experienced by the child which determines whether the parenting capacity can be regarded as good enough and whether or not a Referral should be made for an assessment by Children's Social Care.

Women with learning disabilities may be Adults at Risk and targets for men who wish to gain access to children for the purpose of sexually abusing them.

Children may have to take increasing responsibility for caring for themselves and, at times, for their siblings, parents and other family members. A referral to the local Young Carers Support Group may be appropriate. See Barnsley Young Carers for further information.

A learning disability is a lifelong condition, and parents may need long-term support, which will need to change and adapt as the developmental needs of a child changes as they grow. Assessments must therefore consider the implications for the child as they develop throughout childhood and will need to re-evaluate the child's circumstances from time to time. Children may exceed their parent's intellectual and social functioning at a relatively young age. 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 developing a long-term strategy 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, but the assumptions cannot be made that their capabilities will automatically extend to caring for 2 (or more) children. New circumstances, in particular those which may bring new pressures, should be considered in terms of impact for the whole family.

Whilst there must be focus on the needs and wellbeing 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, this 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.

• Does the child take on inappropriate roles and responsibilities within the home?
• Does the parent/carer neglect their own and their child's physical and emotional needs?
• Does the learning disability result in chaotic structures within the home with regard to meal and bedtimes, etc.?
• Is there a lack of the recognition of safety for the child?
• Does the parent/carer misuse alcohol or other substances?
• Is the parent/carer able to protect the child from being exploited or from dangers outside the home?
• Does the parent/carer's learning disability/cognition and learning needs have implications for the child within school, attending health appointments etc.?
• Does the parent/carer's learning disability result in them rejecting or being emotionally unavailable to the child?
• Can the parent/carer apply learned knowledge to a different context?
• Does the child witness acts of violence or is the child subject to violence?
• Does the wider family understand the learning disability of the parent/carer, and the impact of this on the parent/carer's ability to meet the child's needs?
• Is the wider family able and willing to support the parent/carer so that the child's needs are met?
• Does culture, ethnicity, religion or any other factor relating to the family have implications on their understanding of the learning disability and the potential impact on the child?
• How the family functions, including conflict, potential family break up etc.
• Has there been a change in circumstances which might impact on the capacity of the parent/carer? For example, another child in the family?
• Is the parent/carer vulnerable to being exploited by other people e.g. financially, providing accommodation?
• Does the parent/carer have difficulty developing and sustaining relationships or have relationships that may present a risk to the child?
• Does the parent have a limited understanding of the child's needs and development including pregnancy, childbirth, and caring for an infant?
• Does the parent/carer have poor parenting experiences from their own parents as a child?
• Does the parent/carer have difficulty accessing health care and other support for themselves or the child?
• In relation to pregnant women, should a Prebirth Assessment be arranged? Where pre-birth involvement is a result of the mother's learning difficulties causing uncertainty as to her ability to meet the needs of the child once born, the Court of Appeal in D (A Child) [2021] EWCA Civ 787 stressed the importance of effective planning during the pregnancy for the baby's arrival, and of taking adequate steps to ensure that the mother understands what is happening and is able to present her case.

Professionals undertaking assessments must recognise that a learning disability is a lifelong condition. Assessments must therefore consider the implications for the child as they develop throughout childhood and will need to re-evaluate the child's circumstances from time to time. Children may exceed their parent's intellectual and social functioning at a relatively young age.

Where a parent with learning disabilities appears not to be able to meet the needs of their child a Referral should be made to Children's Social Care in line with the Referrals Procedure.

Children's Social Care, will undertake a multi-disciplinary assessment using the Assessment Framework triangle, and include input from Adult Services and other relevant agencies. Specialist learning disability and other assessments should be considered as a means to determine whether or not the parents require additional support to enable them to care for the child or whether the level of learning disability is such that it will impair the health or development of the child. Assessments involving families affected by parental learning disability should always include specialist input concerning the impact of learning disability.

All agencies must recognise that their primary concern is to ensure the promotion of the child's welfare, including their protection.

Children and Adult Services have a role in supporting the parent and/or 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 maybe of interest.

However, this is what should be considered in terms of who should take on the lead role:

• Where there are no welfare concerns but adults need assistance with routine tasks of looking after children, Adult Learning Disability services should take the lead on assessment and care planning (as per the Care Act eligibility criteria);
• Where parents need ongoing support such as with a child in need or early help support, Adult Learning Disability and Children's Social Care will jointly co-ordinate assessment and care planning;
• Where there are safeguarding concerns, Children's Social Care will lead assessment and planning with input and support from Adult Learning Disability services.

It is important for support needs to be recognised at the early stages of the parenting experience. If possible, identification of needs should start when a pregnancy is confirmed.

It is particularly important to avoid the situation where poor standards of parental care, which do not, however, meet the threshold of significant harm to a child, subsequently deteriorate because of a lack of support provided to the parent. It is vital to recognise low levels of need, which, if unaddressed, are likely to lead to difficulties for parents and undermine children's welfare.

Where Section 47 enquiries conclude that there is no actual or likely significant harm it will be important that action is taken to prevent future problems arising.

'If any worker has concerns about a child whose parents have Learning Difficulties and Disabilities, an Early Help Assessment/CAF (see Working Well with Children and Families Lancashire) should always be undertaken and consideration given to making a referral to Children's Social Care where appropriate. Where a child is considered to be at risk of Significant Harm, a referral must be made using the Making a Referral to Children's Social Care Procedure'.

The case of A Local Authority v G (Parent with Learning Disability) [2017] EWFC B94 explored the question of whether the parenting that can be offered is 'good enough' if support is provided. However, this obligation does not extend to support that is tantamount to substituted parenting.

The case identified 5 key features of good practice in working with parents with learning disabilities:

• Accessible information and communication;
• Clear and co-ordinated referral and assessment procedures and processes, eligibility criteria and care pathways;
• Support designed to meet the needs of parents and children based on assessments of their needs and strengths;
• Person-centred support where required;
• Access to independent advocacy.

The case also highlighted the need for specialist training on dealing with parents with a learning disability, emphasising how best to work with the parents and how to deliver the right support.

Accessible information and communication

Communication - communicating with parents in a way they understand.

This may include:

• Local authorities have to make reasonable adjustments under the Equality Act so  it is essential to recognise the parent's communication needs, for example taking more time to explain things, adjusting the language used, providing information in a pictorial or easy read format or separating information to provide one piece at a time;
• 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 whether they would like an Advocate to support them to prepare for the meeting and take part in it;
• Hands-on approaches, such as role-play, modelling, and filming tasks being completed;
• Step by step pictures showing how to undertake a task;
• Repeating tasks regularly and providing opportunities for frequent practice;
• Use of 'props', for example, containers which will hold the right amount of milk.

Parents should be told, in plain language, what any assessment is, what it is for, what it will involve, and what will happen afterwards. They may need to be told more than once, for example, a parent may need to be reminded what happened at the last meeting.

Leicestershire County Council v Amy & Ors (Re Lack of Multiagency Approach to Deaf Parents) [2024] EWFC 364 (B) - the judgment cites several relevant cases in relation to how courts and local authorities should work with deaf parents. A Local Authority v G (Parent with Learning Disability) [2017] EWFC B94 - the principles in Re D and other relevant cases were applied, and found to establish the following:

• 'Parents with disabilities can often be 'good enough' parents when provided with the ongoing emotional and practical support they need;
• The concept of 'parenting with support' must underpin the way in which courts and professionals approach parents with learning difficulties;
• Courts must make sure that parents with learning difficulties are not at risk of having their parental responsibilities terminated on the basis of evidence that would not hold up against parents without such difficulties. To that end parents with learning disability should not be measured against parents without disability and the court should be alive to the risk of direct and indirect discrimination;
• Multi-agency working is critical if parents are to be supported effectively and the court has a duty to make sure that has been done effectively; and
• The court should not focus so narrowly on the child's welfare that the needs of the parent arising from their disability, and impacting on their parenting capacity, are ignored.

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 and any plans, avoiding the use of jargon;
• Audio and/or visual information of plans, agreements;
• Fully accessible websites;
• Creating opportunities to tell people with learning disabilities, face-to-face, about services for parents and parents-to-be.

Good Practice Guidance on Working with Parents with a Learning Disability identifies the following:

• Self-directed learning can bring about long-term improvement in parenting skills;
• Group education combined with home-based intervention is more effective than either home-based intervention or a group education programme on its own;
• Parents with learning disabilities value both advocacy services and those which support self-advocacy;
• Good co-ordination and communication between children's and adult services is key to effective interventions;
• Preventative approaches are key to safeguarding and promoting children's welfare;
• Interventions should build on parents' strengths as well as addressing their vulnerabilities;
• Interventions should be based on performance rather than knowledge and should incorporate modelling, practice, feedback and praise;
• Tangible rewards may promote attendance at programmes, rapid acquisition of skills and short-term commitment;
• Other methods of engagement are needed long term;
• Intensive service engagement is more effective than intermittent service engagement;
• Programmes should be adapted to the actual environment in which the skills are needed in order to enable parents to generalise their learning;
• Teaching should be in the home if possible and if not, in as home-like an environment as possible;
• Factors in the family's environment which promote children's resilience should be identified and enhanced;
• The importance of family ties (for most – though not all – parents and their children) should be recognised and no actions taken that damage such ties;
• Interventions should increase the family's experience of social inclusion rather than cause or contribute to their social exclusion.

Good practice guidance on working with parents with a learning disability (England)

Working Together With Parents Network run by Research in Practice, part of the NCB family, is a free-to-join network that supports professionals working with parents with learning disabilities and learning difficulties and their children.

Working With Parents Programme - resources aimed to support local authorities when developing local policies and protocols around working with parents with a learning disability or learning difficulty. It includes an example protocol alongside other supporting documents - Underlying Core Concepts and Key Contextual issues.

A Local Authority v G (Parent with Learning Disability) [2017] EWFC B94

Babies in Care Proceedings: What do we Know about Parents with Learning Disabilities or Difficulties? - Nuffield Family Justice Observatory

Parents and Carers with Learning Difficulties (Anna Freud)

The role of adult social care for parents with learning disabilities when a child is no longer in their care - there are two insightful videos which look at the experience of the parent with learning disabilities when being visited by a social worker and when in court.