Working with Learning Disabled Parents

Where a parent has a learning disability it is important not to generalise or make assumptions about their parental capacity. Research shows that a learning disability does not prevent adults from being able to care and safeguard their children and / or unborn baby. However many parents with learning disabilities are likely to need on-going support to develop the understanding, resources, skills and experience to meet the changing needs of their child. Such support is particularly needed where they experience additional stressors such as having a disabled child, domestic abuse poor physical health and/or mental health, substance misuse, social isolation, poor housing, poverty or a history of growing up in local authority care. Such increased stressors, when combined with parental learning disability, are likely to lead to concerns about the care of children.

Children of parents with learning disabilities may also present with learning disabilities (socially acquired or inherited) and may be more vulnerable to emotional or behavioural difficulties.

Parents with learning disabilities may be vulnerable in their local communities and could be targeted by individuals who may pose a risk to children. They may need support to manage these risks and to increase their awareness.

In all cases it is important that practitioners from children's agencies and adult agencies work together using a Think Family approach to ensure the full needs of the child and parent are considered. At all times the welfare of the child remains paramount.

For many parents with learning disabilities, significant levels of support are required from a non-abusive and capable relative, such as their own parent or a partner, or through appropriate services to ensure that their children's health and development are adequately maintained.

All agencies and practitioners should refer to the Derby City and Derbyshire Thresholds Document (see Documents Library, Guidance Documents) to identify the level of need and the appropriate assessments and interventions. Most families are likely to require support and co-ordinated services through an Early Help Assessment. See Providing Early Help Procedure.

Children's practitioners will need to check with Adult Learning Disability services (health teams) and Adult Social Care to see if the parents are known to them; if they are not known a referral to services is likely to be needed. This should be done at the earliest point to ensure that appropriate assessments and interventions are completed in a timely way to add to understandings of family needs. Adult services can provide valuable input to children's assessments in relation to their care.

It is important for all practitioners to remain child focused and gain a clear understanding of the individual child's experience of life being mindful not to collude with or be over sympathetic with parents / carers. It is however essential that all practitioners remain sensitive to the parent's position, being supportive rather than critical, to minimise their sense of discrimination. The well-being of the parent has a direct impact on their relationship with their child and also their relationship / engagement with services. Practitioners in children's services should also consider the use of assessment tools for parents with a learning disability, such as Parent Assessment Manual (PAM) and seek support with this if needed.

There should be a discussion about the best way to establish services and support for the parent/s. Referral to Advocacy should be offered in recognition of good practice guidance.

Practitioners in children's and adults services must proactively work together to ensure there is a full understanding of the parent's needs, the potential impact of this and how to optimise their ability to care for their baby or child.

If there hasn't previously been an assessment of the parent's learning disability an assessment is likely to be needed to establish the degree and impact of the learning disability. Consideration should also be made of the need for a fuller assessment from adult specialist learning disability services to ascertain psychological, functional and communication difficulties, and the effect of this on their ability to parent and the support that would be required for the adult to be able to effectively care for their baby or child.

Adult service practitioners should check whether the adult with whom they are working is a parent and whether there are children in the household as part of their initial and on-going assessment. Adult services practitioners should always be alert to the impact that a learning disability has upon one or both parents' capacity to meet the needs of a child and take appropriate steps to ensure the child and their family are effectively supported. This may be through an Early Help Assessment, or where there are serious or complex needs or Child Protection concerns via a referral to Children's Social Care. See Providing Early Help Procedure and Making a Referral to Social Care Procedure. 

All practitioners should work within the principles of the Mental Capacity Act (see Mental Capacity Act: Making Decisions). Parents with learning disabilities should be presumed to be able to make their own decisions and all practical steps should be undertaken to support them in this. In particular they should be meaningfully supported to effectively participate in any assessments and meetings regarding their child. All practitioners should also work within the confines of the Equalities Act ensuring that reasonable adjustments are made in their approach to working with a parent with a learning disability. This may require the involvement of an Advocate. This may also require assessment and guidance from Speech and Language Therapists, Occupational Therapists, Clinical Psychologists or other practitioners from Adult Learning Disability Health Services.

It is essential that practitioners regularly review the situation of the child and the impact that their parent's learning disability is having upon them. Advice should be sought from the designated lead for child protection if necessary.

When adult service providers change support package, or are unable to provide a service, or withdraw service from a household where there are children, all services working with the family should be informed. Adult services should also be informed of changes to service provision from children's services.

The Welfare of Unborn Children

It is important to assess the needs of and give support to parents with learning disabilities as early as possible. Close liaison between Midwifery Services and Children's and Adults Services should ensure that either an Early Help Assessment or pre-birth assessment are undertaken whenever there is concern about the ability of a pregnant woman (with a learning disability) to care for her expected child (and jointly with her partner where applicable). See Derby and Derbyshire Multi Agency Protocol for Pre-Birth Assessments and Interventions (Document Library, Protocols).

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.

Young Carers

From an early age children may assume the responsibility of looking after their parent and in many cases other siblings, one or more of whom may have a disability. As Young Carers these children should be offered an Early Help Assessment to ensure their needs are identified and any services which are required. Young Carers who are not coping and/or have needs which cannot be met by Early Help Assessment, as they are complex or serious, should be referred to Children's Social Care.

If any practitioner or agency has any concerns about the capacity of a parent to meet the needs of their child, or where there may be serious or complex needs or Child Protection concerns, they should consult with their designated safeguarding leads and make a referral to Children's Social Care. Concerns should be discussed with a parent prior to making a referral unless it is judged that this action will jeopardise the child's safety.

See also Making a Referral to Social Care Procedure.

Where there are concerns that a child may be suffering or is likely to suffer Significant Harm, Children's Social Care will convene a Strategy Discussion / Meeting involving health, police and other relevant practitioners. See Child Protection Section 47 Enquiries Procedure, Strategy Discussions / Meetings.

In addition to considering whether or not the threshold for a Section 47 Enquiry has been met, a Strategy Discussion / Meeting may also look at appropriate multi-agency interventions early in the process and seek to minimise risk.

Practitioners working with the parents should be involved in the Strategy Discussion / Meeting.

The Strategy Discussion / Meeting should give particular consideration to:

• Ensuring that there is sufficient information about the parents learning disability on their ability to care for their child/ren and the impact on the child/ren;
• Enabling the parent to communicate effectively, sometimes this will require someone who knows the parent and their individual style of communication well. It should involve an Advocate. They can advise whether the usual method of communication can be used;
• Whether specialist advice or assessment should be sought and who from, whether advocacy is needed, who should undertake the investigation, where and how it will take place.

Given the potentially complex nature of Section 47 Enquiries it may be appropriate to hold additional Strategy Discussions / Meetings to ensure that informed decisions are made. Expertise in both safeguarding children and adult learning disabilities must be brought together to ensure that there is appropriate assessment and planning of services.

In addition to the information gathered and analysed within the Single Assessment, adult learning disability services should be requested to provide information in relation to:

• The extent of the parental learning disability;
• Their assessment on the impact of the learning disability (including psychological needs) on the ability of the adult to effectively look after and meet the child's needs;
• The parent/s views about their learning disability and the impact it has on them and their child/ren;
• What support (paid and informal) and services are needed, if any, to enable the adult to effectively look after the child/ren.

Some parents with learning disabilities are likely to require long term (continuous or at pertinent developmental stages of their child) support to be able to meet their child's needs. Where this cannot be provided within the family or community clear plans must be made. Where the Children's Social Care Single Assessment has identified long term needs of a child it is essential that appropriate services are put in place.

Parents are also entitled to be accompanied by a supporter or Advocate in meetings, for example at Child Protection Conferences or in core groups. Additional time and adapted approaches (e.g. everyday language, visual aids, brief written summaries, smaller group meetings) may be needed in meetings to ensure that they are able to meaningfully participate and fully understand the concerns about their child.

See also:

Child Protection Conferences Procedure

Implementation of Child Protection Plans Procedure

All practitioners working with families where there is a parent with a learning disability must also be mindful that adults with learning disabilities may be vulnerable to abuse or exploitation, which may be heightened by their perception of scrutiny by services in relation to their child/ren. Children's Services involvement may at times make it feel harder for parents to speak out about abuse for fear of how this might be interpreted by practitioners working with them. This heightens the need to work supportively and collaboratively with the parent(s) to facilitate their openness to share information pertinent to their own protection and the protection of their child/ren. Where there are concerns that an adult is being abused or exploited, a referral should be made to:

• Derby: Adult Social Care, Derby City Council during office hours (Monday to Friday 9am to 5pm) telephone: 01332 642855 or Careline if out of hours on 01332 956606;
• Derbyshire: Call Derbyshire 01629 533190.

If something needs to be done straight away to protect someone from abuse or harm, call the Police emergency number 999 (24 hours). Alternatively, if it is a non-emergency criminal matter, you can call the local Police on telephone number 101.

For more information about safeguarding adults see Derby Safeguarding Adult Board website or Derbyshire Safeguarding Adults Board website.