Children of Parents with Learning Difficulties/Disabilities

A learning disability is a permanent, lifelong condition.

Mencap defines a learning disability as a reduced intellectual ability and difficulty with everyday activities – for example, household tasks and socialising - that affects a person for their whole life.

A person with a learning disability might have some difficulty:

• Understanding complicated information;
• Learning some skills (particularly new skills);
• May have care and support needs.

A learning disability is different for everyone, and a full assessment is needed to identify a person’s strengths and difficulties.

Some parents may have other issues which would be described as neurodiverse, such as Autism, Asperger Syndrome, Dyslexia, Dyscalculia and Attention Deficit Hyperactivity Disorder. Learning Disabilities may cut across some of these conditions, but not necessarily.

Neurodivergent parents may require additional specialist support, such as support with communication and interaction with others.

There is a far wider group of parents who may not have a diagnosis or would fit into the neurodiverse group and would not generally fit the eligibility criteria for support from a Learning Disability Adults team. However, the parent may be able to receive support from another Team within Adult Social Care or a Health provision, such as a specialist Multi-disciplinary Autism Spectrum service or complex needs team within Adult Social Care. Diagnosis and support from other services can be invaluable, helping everyone work more effectively with the parent(s). A multi-agency approach is therefore essential when supporting parents with learning disabilities.

Parents with learning disabilities may face a wide range of barriers to bringing up their children successfully, and they may also recognise that they need support and help to enable them to learn to be the best parents possible.

Historically, IQ testing was used to categorise degrees of learning disability; however, the current multidisciplinary assessment uses a broader approach to assess strengths and needs and should be part of a person-centred needs assessment/plan. It is also about the parent(s) being fully involved in the assessment and consulted throughout the process.

Practitioners should not assume that having a learning disability means that 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.

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 the support services they need to prevent problems from arising. Early help and Family Support services should be considered at an early stage to prevent future harm to the child and to promote the child's welfare. Consideration should also be given to the wider family support available.

The context in which people with learning disabilities have children 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 to meet the needs of their children. This will be particularly necessary if they are experiencing additional difficulties such as domestic violence and abuse, poor physical or mental health, having a disabled child, substance misuse, social isolation/discrimination, poor housing or poverty.

Neglect through acts of omission rather than commission is a frequently stated concern; ultimately, the quality of care the child experiences determines whether the parenting capacity can be regarded as good enough and whether a referral should be made for an assessment by Children's Social Care.

Similarly, women with learning disabilities may be Adults at Risk and targets for men who wish to gain access to children for sexually abusing them.

Children may end up taking 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.

A learning disability is a lifelong condition, and parents may need long-term ongoing support that will need to change and adapt to meet a child's developmental needs as they grow. Assessments must therefore consider the implications for the child as they develop throughout childhood, and services will need to re-evaluate the child's circumstances, with clear plans in place for 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 2 (or more) children. New circumstances, particularly those that may introduce 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.

• Does the child take on roles and responsibilities within the home that are inappropriate for the child’s age? If so, consider referral to Young Carers’ services.
• Does the parent/carer neglect their own and their child's physical and emotional needs?
• Are good routines in place within the house, such as mealtimes, bedtimes, etc?
• If the child is registered at school, do they attend regularly? Or are there concerns around persistent or severe levels of absence?
• How is safety managed for the child?
• Is the parent/carer able to protect the child from being exploited or from dangers outside the home?
• Does the parent/carer have any other issues which need to be addressed, such as mental health issues, substance misuse, difficult childhood experiences, etc?
• 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 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/friendship group 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, domestic abuse issues, etc.
• Has there been a change in circumstances which might impact 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 know how to discipline the child appropriately?
• Does the parent/carer have difficulty accessing health care and other support for themselves or the child?
• In relation to pregnant women, should a pre-birth assessment be arranged? Where pre-birth involvement is a result of the mother’s learning disabilities 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.

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

Children's Social Care will undertake a multidisciplinary assessment using the Assessment Framework triangle and include input from Adult Services and other relevant agencies in a timely manner.

Cognitive and Multidisciplinary assessments are essential to determine whether 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 child's health or development. Assessments involving families affected by parental learning disability should always include specialist input concerning the impact of a parent’s learning disability.

All agencies must recognise that their primary concern is to promote 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 may be 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 support in the medium to long term 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 that support needs are recognised at the earliest opportunity. If possible, identification of needs should start when a pregnancy is confirmed.

It is particularly important to avoid the situation in which 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 for 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.

The case of A Local Authority v G (Parent with Learning Disability) [2017] EWFC B94 highlighted 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 five key features of good practice in working with parents with learning disabilities:

• Accessible information and communication;
• Clear and coordinated 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, particularly in relation to child protection cases. This should be at the earliest opportunity.

The case also highlighted the need for a 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  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;
• Taking more time to explain things, and any written information should be provided in an accessible form for the parent;
• 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;
• Hands-on approaches, such as role-play, modelling, and filming tasks being completed;
• Visual aids to support parenting such as pictures, short films;
• 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;
• 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.

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:

• There should be timely referrals to adult social care for a parent with learning difficulties, in their own right, 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 disabilities in their own right 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.

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 based on 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 (Working Together with Parents Network) 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 coordination 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 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 at supporting local authorities in developing local policies and protocols for 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

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 that look at the experience of the parent with learning disabilities when visited by a social worker and in court.