1..9 Parental Learning Disability
Definition of Learning Disability
Some people with 'learning disabilities' prefer to refer to themselves as having learning difficulties; other people have difficulties in learning but do not meet the core criteria for an individual to be described as 'learning disabled'.
The term 'learning disability' does not describe a homogenous group. However, for the purposes of these procedures, 'parental learning disability' refers to adults who are or may become parents / carers for children and who meet the 3 core criteria which describe an individual as 'learning disabled':
- Significant impairment of intellectual functioning: i.e. individuals with an IQ of 69 or below (ref: British Psychological Society and legal system) -this is not a hard and fast rule; overall IQ scores can be subject to interpretation either way for a variety of clinical reasons -interpretations of psychometric test scores are the remit of a chartered psychologist;
- Significant impairment of adaptive / social functioning: i.e. how an individual copes with every-day demands of community living; impairment of adaptive / social functioning might be considered to be present if s/he needs assistance with survival (eating, drinking, clothing, hygiene and provision of basic comforts) or with social problem solving and social reasoning;
- Age of onset before adulthood: in order for an individual to be considered as 'learning disabled', impairment i.e. of intellectual adaptive / social functioning usually needs to have been present before the age of 18 years.
Recognition of Parental Learning Disability
It is not always clear whether or not a parent / carer has a learning disability, but the following may help its identification:
- Reference to medical records can sometimes provide evidence;
- Reference to educational records (where it is less than 5 years since leaving school) can provide evidence of a learning disability e.g. an Education, Health or 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 Services (Social Care).
Impact of Parental Learning Difficulty
The ability of learning disabled parents to provide a reasonable standard of care will depend on their own individual abilities, circumstances and the individual needs of the child.
Learning disabled parents may need 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 abuse, poor physical or mental health, substance misuse, social isolation, poor housing, poverty or a history of growing up in 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 assume the responsibility of looking after their parent and /or siblings, one or more of whom may be learning disabled.
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.
Pre-birth need for Multi-Agency Support
It is important to assess the needs and provide support for learning disabled parents as early as possible.
The GP and midwife should make referrals to the community team for people with learning disabilities (CTPLD) for an Early Help Assessment of the pregnant woman's needs and capacity for self care and to provide adequate care for the baby. This assessment should consider strengths and the nature of any support available from family and partner.
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, a referral should be made to Children's Social Care in line with the Pre-Birth Procedure.
Subsequent assessment should be in accordance with pre-birth procedures, but the involvement of CTPLD is essential.
Post Birth of Child
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.
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 Social Care in line with normal procedures.
The response is the same as for any other child, using the Assessment Framework Diagram (pictured below) to consider the extent of vulnerability of the child/ren. Additional specialist assessments may be helpful in determining how best to help support parents. The paramount consideration will be the welfare of the children.
Assessments of learning disabled parents will need to integrate specialist assessment functions provided by the CTPLD, adult social services and health. Validated assessment tools are available to use for this purpose (see McGaw S & Newman T. What works for parents with learning difficulties, Barnardo's).
Additional support to child protection professionals in the way of consultation and/or supervision should be made available from specialist adult services both within Children's Social Care, CTPLD and elsewhere in health in particularly complex cases.
Parents with learning difficulties 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.