The cause of learning disabilities can have its roots in genetic factors, infection before birth, brain injury at birth, brain infections or brain damage after birth. A learning disability may be mild, moderate, severe or profound, but it is a life long condition. Traditionally, scores on standardised intelligence tests have been used to define learning disability. However difficulties arise over how to classify those with borderline IQs (70 to 85), and individuals who exhibit different ability levels across the components of IQ tests. The department of Health's definition of learning disability emcompasses peopl with a broad range of disabilities.
'Learning disability includes the presence of:
* a significantly reduced ability to understand new or complex information, to learn new skills (impaired intelligence); with
* a reduced ability to cope independently (impaired social functioning);
* which started before adulthood, with a lasting effect on development.
The most recent research estimates that there are 985,000 people in England with a learning disability, equivalent to an overall prevalence rate of 2% of the adult population. Estimates of the number of adults with learning disabilities who are parents vary widely from 23,000 to 25,000.
It is important not to generalise or make assumptions about the parenting capacity of parents with learning disabilities. Parental learning disability is not correlated with child abuse or neglect, although there is evidence that children may suffer neglect from omission where parents are not adequately supported or where there was no early intervention. In most cases where physical or sexual abuse occurs it is the mother's male partner who is responsible. A study of Serious Case Reviews found that in 15% of cases parents had a learning disability.
Parents with learning disabilities will need support to develop the understanding, resources, skills and experience to meet the needs of their children. Such support is particularly important when parents experience additional stressors such as having a disabled child, domestic violence, poor physical and mental health, substance misuse, social isolation, poor housing, poverty and a history of growing up in care. It is these additional stressors when combined with a learning disability that are most likely to lead to concerns about the care and safety of a child. A study of children living with learning disabled parents who have been referred to local authority child's social care services highlighted the need for collaborative working between children's and adult's services and support for the family that lasts until the children reach adulthood. There are many examples of positive practice in supporting parents with learning difficulties.
Parental learning disability may impact on the unborn child because it affects parents in their decision making and preparation for the birth. Many women with learning disabilities are poorly informed about contraception and the significance of changes in their menstrual pattern and, as a result, may fail initially to recognize their pregnancy. The quality of the women's ante-natal care is often jeopardized by late presentation and poor attendance. When women with learning disabilities do attend ante-natal care they may experience difficulty in understanding and putting into practice the information and advice they recieve.
For new born babies to thrive they need love, adequate nutrition, sleep, warmth, and to be kept clean. Mothers with learning disabilities may not know what is appropriate food for the baby and developing infant and experience difficulty in establishing a beneficial routine. Health checks may be missed and when the baby is unwell a mother with learning disabilities may not recognise the seriousness of the illness. As the infant develops and becomes more mobile, parents with learning disabilities may not realise the importance of supervising bath times and ensuring the infant is protected from potential dangers within the home. The ongoing support and advice from their wider family and health workers will be essential to ensure parents adapt to their babies changing needs. The infants cognitive development may be delayed due to an inherited learning disability. However, the environment can still make a difference; children brough up in a warm and stimulating environment will have better outcomes than those with inherited learning disabilities that are not. Mothers with learning disabilities may experience difficulty in engaging with and providing sufficient stimulation for the infant's development and learning. For example, a learning disability may curtail parents' ability to read simple stories to their children and result in a restricted repertoire of nursery rhymes and other songs. Finally, babies and infants may be left with unsafe adults because parents fail to recognise the threat they pose, or lack the self confidence to prevent them having access to the child. Babies and young children can be supported by the presence of a non- abusive, caring adult, other responsible adults such as grandparents involved in the care of the child, on-going support for the parent, stable home, adequate finances, and harmonious family relationships.
The impact of parental learning disability on children becomes more evident during middle childhood. Children's health may suffer because of a lack of hygiene and a poor diet. Health problems may not be recognised or adequately dealt with, for example dental and doctor's appointments may be missed. Learning may also be affected. Parents with literacy and numeracy problems will have difficulty in helping with school work and encourage learning. Children's school attendance may be erratic or frequently late. Parents' own poor school experiences may mean they are reluctant to attend school events, and they may experience difficulty in understanding and putting into practice the advice teachers give them. A learning disability may affect parents' capacity to set boundaries and exert authority as their children reach middle childhood; a situation that can be exacerbated if the child is more able than their parent. Children's self image and self esteem may be affected if parents do not understand the importance of recognising the individuality of their children. Parental learning disabilities may also affect children's relationships within the family and with their peers. Inconsistent parenting can cause children to become anxious and uncertain of their parents' affection; emotions which will be exacerbated if parents fail to protect their children from childhood abuse. The consequences of abuse and neglect, particularly in relation to hygiene, low self esteem, and poor control over emotions and behaviour, may result in children being rejected and bullied by their peers. Finally, growing up with parents with learning disability may mean that an able child assumes a major caring role within the family, and as a consequence loses out on his or her own childhood. Positive outcomes for middle year children are associated with the provision of emotional and practical support by relatives, particularly grandparents, regular attendance at school, empathic and vigilant teachers, sufficient income, good physical standards in the home, and belonging to organised out of school activities.
Teenagers of parents with learning disabilities may be left to cope alone with the physical and emotional changes that result from puberty. Parents themselves do not fully understand the significance of puberty and they fail to educate, support or protect their children. The problems are compounded when parents need to care for an adolescent child with profound learning and physical disabilities. Physical and emotional neglect, low self esteem and inadequate supervision increases the likelihood that young people will engage in risky behaviour, such as drinking and drug taking, self harming, and early sexual relationships. When children are more intellectually able than their parents, acting effectively and setting boundaries as they reach adolescence becomes more difficult. The likelihood that education will suffer continues into adolescence. Learning disabilities can result in parents not attending meetings and other school events and not having the capacity to support teenagers through the stress of examinations. Research suggests that many children of parents with learning disabilities experience school related problems such as being suspended for aggressive behaviour, truancy, frequent punishment, being bullied and having few friends. Teenagers who are more able than their parents are increasingly likely to take on the parenting role, becoming responsible for housework, cooking, correspondance, dealing with authority figures, and the general care of their parents and younger siblings. When parents become increasingly dependent on their teenage children it may lead both parties to feel resentful and angry. For many teenagers peer friendships are a source of great support, but low self esteem and behavioural and emotional problems can make it more difficult for teenagers to make friends. Young people whose parents have a learning disability will benefit from factual information about sex and contraception, a trusted adult or peer with whom they can discuss sensitive issues, a good friend, regualr attendance at school, training or work, practical help in the home, and access to a young carers project.
To support families where a parent has a learning disability a specialist assessment will often be needed and recommended. Where specialist assessments have not been carried out and/ or learning disability support services have not been involved, evidence from inspections have shown that crucial decisions could be made on inadequate information.
Adult learning disability services, and community nurses, can provide valuable input to core assessments and there are also validated assessment tools avaliable. However, most parents with learning disabilities do not meet eligibility criteria for adult services and a lack of cooperation between children's and adults' services can create great difficulties.
A comparative study of methods of supporting parents with learning disabilities found that group education combined with home based support, increases parenting capacity. In some areas, services provide accessible information, advocacy, peer support, multi-agency and multi-disciplinary assessments and ongoing home based and other support. This 'parenting with support' appears to yield good results for both parents and children.
This information has been taken from Working Together to Safeguard Children 2010.
