Part 4: Specific support needs and concerns 138 National Guidance for Child Protection in Scotland 2021 Version 1.0 September 2021 4.43 Provisional national statistics indicate there are 23,446 adults with learning disabilities known to local authorities across Scotland. It has been estimated that there may be 5,000 parents in Scotland with learning disabilities. The Scottish Learning Disabilities Observatory is developing a national data picture. 4.44 An estimated 40-60% of parents with a learning disability do not live with their children. The children of parents with a learning disability are more likely than any other group of children to be removed from their parents’ care. This is often due to the context of risk. For example, parents with a learning disability are often confused by services and disproportionately affected by poverty, social isolation, stress, mental health problems, low literacy and communication difficulties. 4.45 Contextual factors can interact with systemic factors including lack of: • strategic leadership • worker expertise and understanding • inter-disciplinary co‑operation • sufficient, tailored and sustained support 4.46 Late recognition of risk and episodic child protection in crisis is neither fair nor effective. By contrast, effective child protection addresses need early and entails assessment, support and planning which: • has a focus on the child’s needs in connection with the needs of each parent and the strengths and gaps within the family network • ensures that parents understand and are involved with what is happening, the reasons for meetings, accessible information, and involvement of advocacy as required • includes targeted specialist assessment and co‑ordinated, multi-disciplinary support plans • looks ahead to long-term needs and different situations, including predictable life transitions • is flexible, including a range of assessment methods and support services, some of which are ‘at home’ and can be adjusted to changing needs • is step-by-step, applying appropriate assessment tools and support in order to grow parenting skills on an on-going basis. Some specific, pre-birth considerations are included in the section on pre-birth support 4.47 A practice insight on this topic has been drafted to illustrate and explain key practice considerations, offer a resource, prompt reflection and signpost selected sources. It can be found in the Practice Insights supporting document alongside this Guidance. Resources and References – Parents with learning disabilities Impact of mental health or health problems on children 4.48 Poor parental health (for both mothers and fathers, both mental and physical) can be a contributor to mental health problems in children and young people. The stigma associated with mental health problems means that many families are reluctant to access services because of a fear about what will happen next. Parents and carers may worry about being judged, and that they will be deemed incapable of caring for their children.