Children of Parents with Learning Difficulties/Disabilities

A learning disability is a permanent life-long condition usually identified in childhood and which has been diagnosed by a qualified  health professional or a multi- disciplinary team.

A person with a learning disability might have some difficulty:

• Understanding complicated information;
• Learning some skills;
• May have care and support needs.

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

Please note a learning disability and learning difficulty are different.

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

There is a far wider group of parents, who may not have a diagnosis 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 and help everyone work more successfully 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.

Parents with learning disabilities or difficulties may struggle to adapt to their child's changing needs as they grow; they may find it difficult to prepare meals and drinks or make sure that children get to health appointments; they may struggle to support their child in school or with play and they may find it harder to understand who or what may cause harm to their child.

Where a parent has a learning disability it is important not to make assumptions about how well they can look after their children and keep them safe. A full assessment should be completed with the support of other professionals. Having a learning disability does not mean that a person cannot learn new skills. Parents with learning disabilities can look after their children well when they have enough support to help them to do this.

Children of parents who have a natural network of supportive people (family, friends, neighbours, community resources) who can step in to help out are likely to do better than children and parents who are isolated. Family networks should therefore be explored as part of any assessment and planning.

If services do not inquire about the network of support (family, friends, neighbours) around parents and children then existing support and how this is helping the family may be overlooked. Where parents do still require services to support them and should 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. 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 wellbeing.

The context in which people with learning disabilities have 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 look after their children and keep them safe when they have the right level of support from their wider network and support services. Adults with learning disabilities may need help to understand what their children need from them as parents; learn new skills to help them to care for their child, understand where to get help if they or their child needs it; and to gain confidence and experience in caring for their child as they grow. This will be particularly necessary if they are experiencing additional difficulties such as domestic abuse, poor physical or mental health, having a disabled child, drug and/or alcohol misuse, social isolation / discrimination, housing need or poverty.

Children and parents with a strong family network who can step in to help when things get difficult are more likely to manage these challenges and keep children safe.

Practitioners often worry that children of parents with a learning difficulty or disability may be neglected due to things that the parents don't do, e.g. children going without good food or regular meals if a parent struggles to prepare food; children missing health appointments if a parent finds reading letters difficult. When parents have a good level of support these issues can often be overcome however if there are worries that a parent's learning disability or difficulty is impacting on their child's safety then a referral to Children's Social Care should be made.

Similarly, 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 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, which will need to change and adapt as the developmental needs of a child changes as they grow.

Parents with a learning difficulty or disability may struggle to understand assessments and plans that are written about them and their children. Presenting information about what the worries are and what the plan is to address the worries in a simple words and pictures format can help the parents and the child to better understand why services are involved and what will happen next.

Assessments must therefore consider the impact of the parent's learning difficulty or disability on their child as their child grows older. The child's circumstances and how well parents are managing should be re-evaluated as the child develops and grows as children may be able to learn and understand the world and relationships better than their parents from a relatively young age.

Landlords can hold vital information regarding their tenants. Where the property the child resides is rented from a social housing provider, a representative should be contacted for any relevant information they may hold in relation to the tenancy and, where applicable, invited to any multi-agency safeguarding meetings.

Where the property is a private rented tenancy, checks can be made with the Durham County Council’s Private Landlords’ Team for any relevant information. This team can also carry out checks with Environmental Health and the Council’s Anti-Social Behaviour Team, Neighbourhood Wardens for any relevant information. A check is also recommended to the Durham County Council Housing Solutions Housing Advice Team for whether the household have recently made contact for advice regarding homelessness or threats of homelessness.

To understand how a parent's learning disability or difficulty may affect their ability to look after their child or keep them safe, practitioners need to be aware of the signs that suggest that a parent is struggling, or the child is being affected. The following indicators may suggest that this is the case and should be explored in any assessment so that plans can be put in place to help the parent and the child:

• Children are taking on a caring role in the house, e.g. looking after themselves, their brothers or sisters or their parents;
• Parents may not fully understand what their child needs from them and how these needs change as the child grows, e.g. from pregnancy through to caring for a baby, infant and beyond, which can affect the way that they look after themselves and care for their child;
• Children's and / or parents' needs aren't being met, e.g. they may be going without good food, the children may be missing school or health appointments, parents may not understand how to play with their child;
• Routines are affected, e.g. bedtimes and mealtimes happen at different times or not at all;
• Children may be poorly supervised. A parent with a learning disability / difficulty may not know where their child is or who they are with, or they may be more trusting of people who want to take advantage of or harm their child;
• Parents may turn to drink or drugs to help them to cope, which can get in the way of them being able to look after their child well or keep them safe;
• A poor relationship between the parent and the child, e.g. children may feel rejected if a parent with a learning disability or difficulty doesn't spend enough time with them, show them enough affection, or if they act harshly towards their child. Children's behaviour can become more difficult to manage as a result of this;
• Some parents who have a learning disability of difficulty may be the victim of violence in their relationships or use violence to try to manage behaviour so children may be caught up in this or become frightened by it;
• Relationships with the wider family and friends (the family network) may become strained which can lead to arguments or family breakdown;
• Some parents with a learning disability or difficulty may find it hard to make relationships in the first place and this may mean that they are more isolated;
• Parents with a learning disability / difficulty may be vulnerable to having other people take advantage of them, e.g. taking their money, moving in with them;
• Parents may not fully understand what their child needs from them and how these needs change as the child grows, e.g. from pregnancy through to caring for a baby, infant and beyond. Women who are pregnant may benefit from a pre-birth assessment. 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;
• Some parents with a learning disability or difficulty may have grown up in families where their needs as children weren't met, which may then affect their ideas about how to raise their own child, e.g. harsh parenting.

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, and include input from Adult Services and other relevant agencies as well as the wider family network. 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 affect the parent's ability to look after their child or keep them safe. Assessments involving families affected by parental learning disability should always include specialist input concerning the impact of learning disability.

All agencies must recognise that the child's wellbeing and safety is paramount.

It is important that services understand who is to take the lead on assessments:

• Where there are no wellbeing or safety 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 – this is only applicable to an adult who is eligible for support under the Care Act 2014;
• 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 children's safety or wellbeing is a concern, Children's Social Care will lead on the assessment and planning, with specialised input from the Adult Learning Disability Service.

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.

When parents are struggling, but this is not causing harm to their child, the aim should be to support parents and children so that things do not deteriorate any further. It is vital to recognise low levels of need, which, if unaddressed, are likely to lead to difficulties for parents and undermine children's wellbeing.

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.

Any assessment of the worries and impact of a parent's learning disability or difficulty on their child should also include questions about what works well in relation to the worries and complications (strengths and safety), who the important people are around the parent and the child and how it is that they help.

Questions to explore strengths and safety include:

• What would the children say are the things that they love most about their parents? What would the parents say that they love most about the children?
• Who would the children say that they are closest to? Who do they think are the best people around their parents? What do they like about these people and what do they do to help?
• What would professionals or wider family members say impresses them the most about the way that the parent cares for their child?
• Who are the people that the children feel safest with? What do these people do that helps the kids to feel safe?
• If we asked the children who they would want to be part of a plan to make sure that they and their parents are always okay, who would they want involved?
• What are the best ways that parents have found to help them to learn new skills? Who do they ask to help them when they feel stuck or unsure about anything?
• Who has given the parent good advice about caring for the kids?
• Who helps the parent the most with practical, day to day things?
• Who is the person that the parent can rely on the most? What are all of the ways that this person has helped?
• Have there been times where parents could have argued and fought with each other but they did not want to frighten the children, so they did something else? What did they do instead?
• When do the parents and the children get along best? What is it that the parent is doing differently when this happens? How does their child respond?
• What are all of the ways that the parents try to make sure that the children don't miss out or go without? Who can they count on to help out?

Children who have a network of supportive adults around them who look out for them and can step in to help when parents are struggling tend to do better than children who are isolated so the family's naturally occurring network of support (family, friends, neighbours) should always be explored as part of any assessment and the network should help to create plans so that children are kept safe and well now and in the future. This work can be started through the Child & Family assessment and it should form the basis of assessments and planning in Children's Social Care.

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 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 any worries, strengths and complicating factors;
• Long-term support where necessary;
• 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 specialist:

Training - specialist training should be available on how to assess and support parents with a learning disability, emphasising how best to work with the parents and how to deliver the right support. 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:

• 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 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;
• Specialist Support from a Speech and Language therapist, Occupational therapist, and /or psychologist who can advise on the parent’s needs and how best information can be given. They can also advice on suitable learning strategies which may enhance the parent’s ability to learn.

Parents need to understand what any 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. A words and pictures explanation can help parents and children understand why services are involved; what the worries are; and what the plan is to address the worries. Parents may need to be told more than once, for example, a parent may need to be reminded what happened at the last meeting.

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.

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 co-ordination and communication between children's and adult services is key to effective interventions;
• Preventative approaches are key to promoting the child's safety and wellbeing;
• Interventions should build on parents' strengths as well as addressing their vulnerabilities;
• Interventions should be based on actions rather than knowledge and should incorporate modelling, practice, feedback and praise;
• Parents may be more likely to attend programmes and learn new skills if they are rewarded for this;
• Other methods of engagement are needed long term;
• Working with services on an ongoing basis is more effective than intermittent involvement.;
• 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 networks (for most though not all parents and their children) should be recognised and no actions taken that damage such networks;
• Support should help the family to feel more included with friends, family and their community rather than getting in the way of this.

Good Practice Guidance on Working with Parents with a Learning Disability (Working Together with Parents Network)

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

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