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The number of parents with a learning disability is growing rapidly, as the closure of institutions and the rise of community living encourage this population to take on roles that were previously denied to them (DoH, 2001). People with a learning disability are seen as people first, with the right to be a parent and raise a child, a valued role in society. The rise in the number of parents with a learning disability can also be attributed to the discontinuation of enforced sterilisation and increasing opportunities to form relationships in which consensual sex is accepted and supported (Martin & Ticktum, 1987). Accordingly, the research on the ability of parents with learning disability to provide adequate parenting is expanding. However, research on the effect on the child of having a parent with a learning disability is still limited. This article will first look at the literature on factors affecting the ability of parents with a learning disability to care for their children adequately. The effects of having a parent with a learning disability will then be considered, and finally the implications for clinical practice will be outlined.

The dementias are important disorders of ageing which result in cognitive and functional decline, behaviour change, increasing dependency and premature death. Alzheimer's disease and other dementias are at least as prevalent in older people with learning disabilities as in the general population. In addition, people with Down's syndrome have high rates of early onset Alzheimer's disease. Assessment of dementia in people with learning disabilities is confounded by pre‐existing cognitive and functional impairments and high rates of comorbid disorders. This paper discusses assessment of dementia in people with learning disabilities from a clinical perspective, with reference to the current evidence base.

Much of the discussion of capacity to consent has focused on how capacity can be assessed. However, in focusing on the assessment of capacity of people with learning disabilities, information from studies of human judgement and decision‐making in the general population has been ignored. This paper reviews the main factors that affect an individual's capacity to consent and examines the integration of research into these factors in the general population with that of people with learning disabilities. A person's capacity to consent is considered to be affected by three main processes: comprehension (ability to understand and retain information), decision‐making (ability to weigh up information and reach a decision) and communication (ability to communicate the decision made). The difficulties people with learning disabilities may have in these processes are discussed, and possible ways of overcoming these limitations are suggested.

Psychosocial interventions are a core part of the service structures of mainstream mental health services. Research and clinical services for people with learning disabilities have often adopted a broadly psychosocial perspective. However, there is surprisingly little literature that considers psychosocial intervention for people with learning disabilities who have mental health problems. This paper describes the structure of psychosocial intervention and then considers the evidence base that is available to develop this approach for people with learning disabilities and mental health problems.

Changes have occurred in the pattern of services for people with learning disabilities and mental illness and/or challenging behaviour over recent years, with the development of a variety of service models across the UK. In SE London, residential services are based predominantly on a supported housing model and the strong philosophical premise that people should not be excluded from a community residential service because they have complex physical, behavioural or mental health needs. Local services, therefore, are supporting individuals with a wide range of need. This paper describes the development of specialist mental health and challenging needs services in support of this model. The issues raised are outlined, together with a list for action and priorities to overcome the difficulties encountered, including the maintenance of an effective infrastructure.

Services for people with intellectual disabilities in Greece can be described as versatile and based on both old and new structures, old, over‐crowded institutions co‐existing with new, alternative structures for independent living. Distinguishing features of the support system are limited financial resources, a strong orientation to medical categories in psychiatry and lack of specific services. There are still many people with intellectual disabilities being treated in mental health services. The gap in services is filled by informal networks, which face a crisis because of the increasing participation of women in the labour market. One of the major deficiencies of the present system is the lack of any sound knowledge of how many people with intellectual disabilities there are, who they are, how they cope with their disabilities and what services they use. This article gives an overview of the current situation.

There is increasing awareness of the needs of people with learning disabilities from different ethnic communities. This paper focuses on the impact of ethnicity on the presentation of mental health problems. The main aim of the paper is to inform those planning and delivering mental health services for people with learning disabilities of the current evidence, in order to enable their practice to improve health outcomes for people from minority ethnic communities.

This article examines the prevalence of mental disorders in a community and clinic population of adolescents with learning disabilities in one catchment area (in the UK). A two stage cross‐sectional survey was used. Measures included screening by parental report (Developmental Behaviour Checklist), adaptive behaviour (Vineland Survey Scale) and clinical interview (ICD 10 childhood disorders).Seventy‐five adolescents aged 12‐19 years old participated in the study. 50.7% screened positive for mental disorders, mainly in the disruptive and anti‐social domains. Almost all of those were found to have an identifiable ICD10 mental disorder. The most common diagnoses included pervasive developmental disorders, hyperkinetic disorder and emotional disorders. Male participants as well as those with autism were more likely to be reported as cases. Caseness was associated with lower adaptive level, presence of autism and family history of mental disorder.Rates of psychopathology are high in adolescents with learning disabilities. There are continuing difficulties in diagnostic ascertainment primarily due to mediation by developmental factors. Further research is necessary in order to clarify continuities of mental disorders in this population and to develop effective interventions.

This chapter traces the history of intellectual disabilities by exploring significant historical periods and personalities who impacted the disability field and specifically the area of intellectual disability. Like other documented histories, the purpose of this chapter is to instruct and inform readers about the historical underpinnings of the labels, practices, and programs related to intellectual disability that are in effect today. While this chapter is not intended to be prescriptive in how the information presented here is to be interpreted, we are acutely aware that historical accounts are often interpreted based upon contemporary ideologies, knowledge, and practices. As such, as a historical account, this chapter is no exception. Current belief and practices about intellectual disabilities indeed influence the choices that, we as the chapter authors, made about the relative importance of the events that we select to highlight in this chapter. Nonetheless, this account reflects the events and personalities who, in our estimation, transformed and/or advanced the field of intellectual disability. We open with a brief prologue of the representations of the intellectual disability in popular culture and its potential impact on perceptions of persons with intellectual disability.