View Working Together View Working Together
 
  View Hertfordshire Safeguarding Children Board website

6.11 Children of Parents with Learning Disabilities

Contents

  1. Introduction
  2. Definition of Learning Disability
  3. Recognition and Screening of Parental Learning Disability
  4. Impact of Parental Learning Disability
  5. Multi-Agency Working
  6. Pre-Birth Need for Multi-Agency Support
  7. Post Birth Need for Multi-Agency Support
  8. Consultation and/or Referral to Children's Services
  9. Assessment and Planning
  10. Parental Considerations as Part of the Assessment, Planning and Support Process
  11. Multi-Agency Case Management
  12. Flowcharts


1. Introduction

The increasing awareness of families where one or both parents have learning disabilities has resulted in an increase in the number of referrals made to all agencies related to parenting issues. Research evidences the need to increase effectiveness of assessment, communication and joint working between professionals from different agencies if parents are to be adequately supported and children protected.

Hertfordshire's Protocol for the Assessment of Parents with Learning Disabilities provides the basis of multi-agency work for families where a parent / carer may have a learning disability.


2. Definition of Learning Disability

For the purpose of these procedures, the definition of 'learning disability' is based on that set out in the White Paper 'Valuing People' (2001):

  • A significantly reduced ability to understand new and complex information, to learn new skills (impaired intellectual functioning [IQ < 70]), with;
  • A reduced ability to cope independently (impairment of adaptive and social functioning);
  • Which started before adulthood, with a lasting effect on development.

This is considered a 'pervasive' definition of learning disability and must be differentiated from a 'learning difficulty', which describes a range of conditions such as dyslexia that can lead to special educational needs.


3. Recognition and Screening of Parental Learning Disability

It is not always clear whether or not a parent / carer has a learning disability, but the following information (if available) may help its identification:

  • Reference to medical records can sometimes provide evidence;
  • Reference to educational records (where it is less than five years since leaving school) can provide evidence of a learning disability e.g. an Education, Health and Care Plan;
  • Personal history involving attendance at special schools;
  • Severe difficulties with literacy or numeracy (verbal reasoning often masks this difficulty);
  • Enquiries made of the Learning Disability Register maintained by Adult Care Services.

When a learning disability is suspected, practitioners should use the initial screening questions outlined in flowchart 1 overleaf (Referral to Learning Disability Team and Specialist Learning Disability Services).

The learning disability services are composed of health (SLDS) and social (CLDT) services working in partnership. The criteria for these services are based on different needs:

  • SLDS criteria are based on diagnosis of pervasive LD, as per definition above;
  • ACS criteria relate to vulnerability and risk in relation to health and safety, autonomy, management of daily routines, involvement in family and wider community life.

Following consideration of the initial screening tool consultation may be sought via the duty officer of the Community Learning Disabilities Team (CLDT) where professionals are unsure if parents (or prospective parents) meet eligibility criteria for the service.


4. Impact of Parental Learning Disability

The ability of parents with learning disability to provide a reasonable standard of care will depend on their own individual abilities, circumstances and the individual needs of the child.

The issues which most frequently give rise to concern in relation to parents with learning disabilities arise from a lack of skills, understanding or knowledge of the child's needs, rather than deliberate abuse. Consequently learning disabled parents may need considerable support to develop the understanding, resources, skills and experience to meet the needs of their child.

Such support is particularly important if they also experience additional stressors e.g. having a disabled child, domestic violence, poor physical or mental health, substance misuse, social isolation, poor housing, poverty or a history of growing up in care.

Children of parents with learning disabilities are at increased risk from inherited learning disability and more vulnerable to psychiatric disorders and behavioural problems.

Such increased stressors, when combined with parental learning disability, may lead to concerns about the care of children.

Learning disabled parents are sometimes targeted by individuals who may pose a risk to children and the children could in these situations be vulnerable to abuse and neglect.

Appendix 4 of the Hertfordshire Protocol for the Assessment of Parents with Learning Disabilities provides further details of research and of the links between neglect and parental learning disability.

Professionals should be alert to the possibility of significant harm and signs of neglect in children cared for by parents with learning disabilities. Children who may be more vulnerable are:

  • Unborn babies or infants under one year old;
  • Toddlers;
  • Children with a disability or special educational needs;
  • Children in a caring role;
  • Children experiencing domestic violence;
  • Parents with a history of violence or sexual abuse.

Click here to view Flowchart 1: Referral to Learning Disability Team & Specialist Learning Disability Services (reproduced from Protocol for the Assessment of Parents with Learning Disabilities)

Due to the increased vulnerability of this group of children they may require a rapid multi agency response to assess parent's learning disability and potential for adequate parenting.

The impact of the level of Learning Disability of parents needs to be formally addressed at appropriate stages in the management of a case of chronic neglect

Ultimately, regardless of whether or not the parent has a learning disability, the quality of care experienced by the child determines whether or not a referral should be made for assessment by Children's Services.


5. Multi-Agency Working

Effective working between professionals supporting parents with learning disability and those supporting children is at the core of effective systems to protect children. Each service will have its own criteria for prioritising referrals. This must not become an obstacle to co-operation at an early stage.


6. Pre-Birth Need for Multi-Agency Support

It is important to jointly assess the needs and plan any support for learning disabled parents as early as possible.

Where the prospective mother is known to the CLDT or it is known that she has a learning disability the GP and midwife should make referrals to the CLDT for an assessment of

  • The pregnant woman's needs and capacity for self care; and
  • Her ability to provide adequate care for the baby.

This assessment should consider strengths and the nature of any support available from family and partner.


7. Post Birth Need for Multi-Agency Support

Where evidence of a learning disability is present in one or both parents, the paramount consideration of all the agencies will be the welfare and protection of the child(ren) with each service providing assessment and support directed at the family members identified as the primary focus of that service's provision.


8. Consultation and/or Referral to Children's Services

If there are support needs or concerns arising for the prospective care of the unborn baby, please refer to "Continuum of Needs" and the Pre Birth Appendix in Multi-Agency Pre-Birth Protocol HSCB for guidance when professionals are unsure whether to make a referral to Children's Services or to initiate a Common Assessment.

Named Children's Social Workers are also available in each of the 5 Safeguarding Assessment Teams to provide consultation as appropriate and contact details can be found in the Multi-Agency Pre-Birth Protocol HSCB.

Staff in CLDT should also refer to Flowchart 2: Checklist for Community Learning Disability Staff flowchart

Pre-Birth

If any professional or agency has any concerns about the capacity of the pregnant woman and her partner to self-care and/or to care for the baby, it should be discussed with the line manager / supervisor, recorded and a referral should be made to Children's Services in line with pre-birth procedures as set out in Multi-Agency Pre-Birth Protocol HSCB.

Some parents with learning disabilities may not recognise that they are pregnant, and this should be considered if there are suspicions that a parent is concealing or has concealed a pregnancy.

Post-Birth

If any professional or agency has any concerns about the capacity of the parent(s) to self-care and/or to care for the child, a referral should be made to Children's Services in line with these procedures.


9. Assessment and Planning

Where a parent meets the CLDT's threshold criteria, all assessments (CAF, pre-birth, Assessment and Section 47 Enquiry) must involve CLDT and be in accordance with the Framework for the Assessment of Children in Need and their Families. The focus should include all parents / carers, regardless of their intellectual level and include the parent / carer's ability to:

  • Recognise the child's needs, including emotional needs;
  • Place needs of the child before their own;
  • Anticipate the child's needs;
  • Adapt to the growing and changing needs of the child;
  • Learn and retain information (including consideration of different learning styles);
  • Use available support for themselves and their child(ren).

The Parenting Assessment Manual (PAM) may be used as part of the multi-agency assessment of the parents (see Appendix 2 of the Protocol for the Assessment of Parents with Learning Disabilities) for more information).

Specialist assessments may also be appropriate e.g:

  • Cognitive functioning;
  • Functional / living skills assessment;
  • Emotional factors.

Child Protection Plans should clearly focus on how to achieve better outcomes taking into account:

  • The specialist assessments above;
  • The way the parent(s) / carers are able to understand and learn.

Additional support to child protection professionals in the way of consultation and/or supervision should be sought from specialist adult services both within CLDT and elsewhere in health in particularly complex cases.


10. Parental Considerations as part of the Assessment, Planning and Support Process

Key meetings should be kept short to cope with the parent(s)' attention span. Notes and plans may need to be adapted to be comprehended by the parent(s).

Consideration should be given to parents' needs for an independent advocate and/or a facilitator during the assessment phase.

Suitable methods for providing advice and helping to set routines should be identified e.g:

  • The parent may find it easier to learn in her/his own home to maximize transference of learned skills;
  • Tasks broken down into small steps;
  • Use of practical demonstrations and concrete examples;
  • Instruction / information to match the parent's level of understanding and comprehension and include pictorial material;
  • Provide more time for each process and task;
  • Written agreements may be helpful, but will need to be very clearly written.

The number of people involved in the network of support should be limited to avoid confusion and inappropriate intrusion.

The professionals involved must be clearly identified and communication pathways developed to facilitate a cohesive, coordinated service, that is supportive to all those involved.

Parents / carers with learning disabilities are likely to require long term support to be able to meet their child's needs. Where this cannot be provided within the family or community, the parent is likely to require support from professionals. Working Together to Safeguard Children 2010 para. 9.56 (now archived) refers to a study that concluded group education combined with home based support increased parenting capacity.


11. Multi-Agency Case Management

To ensure effective working professionals must consider:

  • Early communication and referral if it is suspected that a parent (or prospective parent) has a learning disability;
  • Regular meetings should be held;
  • Involving Speech and Language therapists when communication has been assessed to be a problem.

Multi-Agency Work as Part of the Child Protection Process

Joint working is essential as part of the child protection process (assessment, Child Protection Conference decision making, Core Group planning and provision of support) and should take place from outset. This is to ensure appropriate services are provided by all agencies, needs are addressed, visits co-ordinated to avoid duplication and to prevent professional conflict.

The East of England Joint Protocol on Supervision Orders and the Multi Agency Pre Birth Protocol HSCB (2010) set out the managerial responsibilities in respect of all agencies.

Children's Services Lead Social Worker is responsible for case co-ordination.

Where parental health and/or social needs are identified, the CLDT should identify lead health and/or social professionals to support the parents.

Each service should consult with or advise colleagues in order to facilitate case management.

For cases that do not fit criteria for Learning Disability Services consultation and advice about assessment and intervention is available from the Hertfordshire Parenting Network.


12. Flowcharts

Click here to view Flowchart 1: Referral to Community Learning Disability Team & Specialist Learning Disability Services (reproduced from Protocol for the Assessment of Parents with Learning Disabilities)

Click here to view Flowchart 2: Checklist for Community Learning Disability Staff (reproduced from Protocol for the Assessment of Parents with Learning Difficulties)

End