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This case report highlights the importance of the role of the family in supporting a young person with a developmental disability. The young person discussed has a complex neurodevelopmental disorder with co‐morbid physical health problems. Her family have coped with a number of events in CR's life, ensuring that she has always had their support and understanding. At the time of transition there is a risk of failure to understand the complexities of the role of the family in CR's life. The implications will be discussed.

A review of the literature regarding the use of the Mental Capacity Act (MCA) of 2005 with young people with intellectual disability indicated an absence of publications on this topic, yet clinical practice suggests that services are grappling with complex issues in this area. This article aims to focus on the principles of the MCA and to explore its application to young people with intellectual disabilities.

The key principles of the MCA are reviewed and its application to young people with intellectual disability are explored through case studies.

The MCA is applicable to 16‐18 year olds with intellectual disability and services require training and support in its implementation. Issues of adaptation of communication to convey complex matters and appropriate preparation for assessment are especially pertinent.

The article explores the application and relevance of the MCA to young people with intellectual disability in clinical practice.

The purpose of this paper is to assess whether a tier four mental health of child and adolescent intellectual disability service was meeting the complex needs of children and families by evaluating performance on key characteristics of a “model service” identified by the Royal College of Psychiatrists in 2004.

Questionnaires assessed all areas of a “model service” for parents and children, and were sent to the 68 consecutive referrals received within an 18 month period. A postal survey response rate of 42.6 per cent (parents) and 11.7 per cent (children) was achieved, and the final sample was found to be representative of the consecutive case series as a whole.

The service showed excellent performance on all indicators, suggesting it is operating a “model service” as experienced by service‐users themselves.

Issues raised included the need for families to have greater information prior to assessments; clearer explanation of the limitations of the service when families are first seen; and review at the completion of intervention to highlight continuing treatment needs.

The paper may assist in the development of CAMHS for children and young people with learning disabilities.