Learning Difficulties / PAMS

PAMS

A significant number of staff have been trained by Dr Sue McGaw in relation to working with and assessing parents with Learning Disabilities utilising the Parenting Assessment Manual and Software (PAMS). Dr McGaw is a recognised world expert in this field.

Learning Difficulties

Why have a programme?

It is not known how many parents there are with learning difficulties in the population. However, it is generally acknowledged that their number is significant and steadily rising and that they ‘represent a sizeable population whose special needs as parents have not been fully understood. Many professionals show a commitment to helping and supporting parents with learning disabilities, wherever possible, to ensure their children gain maximum opportunity to remain in their parent’s care. However, parents with learning difficulties are far more likely than other parents to have their children removed from them and permanently placed outside the family home. The English national survey found that 48% of the parents with learning difficulties interviewed were not looking after their own children (Emerson et al, 2005).

Parents with learning difficulties can often be ‘good enough’ parents when provided with the ongoing emotional and practical support they need. It is our experience that social workers and other professionals are seeking the best for their clients however, they receive little training in this area and have few resources available to them when trying to marry together different needs in what is often a very complex situation.

There are also barriers to the provision of support for parents with learning difficulties including unrealistic attitudes about parents with such difficulties. Social workers and other professionals can find undertaking assessments with such parents difficult as both the child and the parents have needs, which may seem to be at odds with one another and also parent’s often lack understanding, which may sometimes be seen as deliberate obstruction or denial. Polarisation between upholding the rights of the parents and those of the child is usually artificial. Parents with learning difficulties also want to protect the welfare of their children and are more likely to be able to do so if they are assisted and supported at critical stages.

Supporting parents to develop parenting skills and to overcome issues in their lives that were negatively impacting on their ability to be ‘good enough’ parents is crucial as to promoting a positive outcome as is retaining a clear focus on child protection and the paramount needs of the child.

Learning difficulties can be viewed by professionals as a problem in its own right; this may be true when the level of disadvantage is overwhelming but for most parents learning difficulties complicates parenting rather than making it impossible, often it impacts on other problem areas but should not be an automatic bar to parenting.

When offering assessments we are concerned that they are not overly prolonged and that the child’s welfare is always paramount in considering whether or not an assessment should commence or continue. We are also concerned to ensure that  parent/s fully understand any concerns about their parenting and to give them the opportunity to develop strategies to offer good enough care, which may include offering them and evaluating their use of appropriate support services.

Assessment Process

When assessing parents with learning difficulties it is an absolute imperative that the methodology used is appropriate and that a needs led assessment is also conducted in respect of the parent, as they will almost always need support which is more often than not provided by the extended family.

We conduct assessments on the basis of the welfare checklist, the framework for assessment and other children in need/protection assessment protocols; but we add to this assessing the actual strengths and weaknesses of learning disabled parents through conducting early and specific psychological and other assessments (cognitive but not necessarily and never just IQ tests) and other testing to gain the best view we can of what are the complications of assessment and how best to assess and assist. Psychological assessment is very important to this process but we do not view such assessment as sufficient on its own. It is suggested that we provide a sixteen week assessment.

It is important that this identification of strengths and weaknesses is not seen as a simple matter of relying on indicative testing. The identification of the problem of understanding, communication and parenting should also include an identification of what support and training a parent could benefit from in order to offer good enough parenting and which would also offer direct benefit to the child. This is then used to evaluate the probable outcome if such services were offered and utilised.

It is vital that there is careful planning of the assessment process and the parents understanding by identifying the parameters i.e. exactly what is being assessed and milestones i.e. what is expected of the parent/s. This has to be done very carefully in order that we know for sure the parent/s understand the concerns and the assessment process.

Parameters are the specific focus of the assessment and will vary according to the specifics of each assessment. They may include capacity to change, ability/commitment to engage, putting the child’s needs first, what would be the situation if appropriate therapeutic or other interventions were offered and accepted and acceptance of the need to tackle problem areas. We can then adapt parenting assessment models such as the manual for assessing parents with a learning difficulty and others in order to assist the parent/s understand and engage in the process and assess their ability and commitment to learn, change and move forward towards a positive outcome for the child.

Milestones are the areas of engagement and progress required from a parent both during the assessment and beyond. These may include putting into practice advice given by Jamma and others, always being available for the child when possible, being open to change and having the capacity to change and offer good enough parenting.

Care Standards legislations require residential assessment centres to provide support and guidance whilst undertaking assessments. Consequently we are required to perform these tasks in parallel and accordingly whilst providing support and guidance we are also assessing the needs of a child and their parents and gaining evidence to assist in the making of decisions in the best interests of the child, which is of course the primary requirement. Although these parallel functions may seem to clash we do not find meeting them difficult as we work on the premise that the most important function we perform is assessment. We do need to offer parents insights into the problems they experience but also crucially assess whether they can benefit from solutions. This means that we offer interventions, which we hope, would be helpful but only at a level that does not prevent or interfere with our primary focus of providing evidence on the child’s future care, with any therapeutic or supportive benefit derived by the parent/s as incidental.