Shropshire, Telford and Wrekin SEND Team Position Statement (20/03/2025): Learning Disability Assessment Pathway - Children 0-18 years

The Department of Health and Social Care defines a learning disability as “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 (Valuing People - A New Strategy for Learning Disability for the 21st Century - GOV.UK (www.gov.uk)).

The difference between learning disability and learning difficulty

• A learning disability affects a person’s global learning and intellectual ability and requires ongoing support from others to enable the person to function in most aspects of day-to-day life.
• A learning difficulty affects one or more specific areas of learning, it does not affect the intellectual potential of the person. It can be overcome through changes to learning styles, the presentation of information, or giving people more time to understand and complete tasks.

Learning disability assessments

Learning disability assessments seek to determine whether an individual has:

1. a significant impairment of intellectual functioning.
2. a significant impairment of adaptive behaviour (communication, daily living skills, socialisation and motor skills); with
3. both impairments arising before adulthood.

Current position in Shropshire, Telford and Wrekin

There is currently no commissioned learning disability assessment pathway in Shropshire, Telford and Wrekin. However, some professionals will identify/apply the ‘learning disability’ descriptor to a child’s health record.

• The Child Development Centre have recently moved to using the term Early Childhood Development Disability (ECDD) in their early years assessments as a means to identify those who may be identified as having a learning disability later.
• Community Paediatricians may convert GDD (Global Development Delay) / ECDD descriptors to learning disability for children on their caseload; for example, those attending Severndale and the Bridge School who are open cases with Community Paediatrics for medical needs. A significant number of children and young people who attend the Bridge or Severndale are not open to a Community Paediatrician.
• The BeeU LD service will conduct learning disability assessments with some of the children and young people referred to them for behaviour/mental health support. Children and young people need to meet the service criteria and LD assessments will only be competed where it is clinically indicated (i.e., a better understanding of cognitive strengths and difficulties is required to inform clinical decision-making or decisions around transition pathways). Most of the children referred to the BeeU LD service without a diagnosis, will not be offered an LD assessment.
• GPs can apply learning disability descriptor codes in relation to clinical diagnoses that NHS England deem should automatically be included on the learning disability register, for example Down’s Syndrome and some other genetic conditions (Improving identification of people with a learning disability: guidance for general practice (england.nhs.uk)).
• Learning disability assessments are not included in the choice options (‘Right to Choose’) under the NHS Choice Framework (Your choices in the NHS - NHS (www.nhs.uk)).

Shropshire, Telford and Wrekin Integrated Care System recognise that the absence of a commissioned learning disability pathway is a significant gap impacting health inequality in the learning disability population.

There are many children and young people who are currently unable to receive the learning disability descriptor and therefore unable to access Learning Disability Annual Health Checks and other services where diagnosis is required.  This will include:

• Children and young people attending Southhall and Haughton schools in Telford
• Children and Young people with a variable cognitive profile attending Severndale in Shropshire
• Children and young people attending hubs attached to mainstream schools
• Children and young people with complex needs attending mainstream schools

Furthermore, the absence of a locally commissioned learning disability pathway means that there is inadequate data about the size and needs of the local learning disability population, and this impacts the effective planning and delivery of services.

The development of a commissioned learning disability pathway is a priority on the ICS Learning Disability and Autism Strategic Priorities Document (also known as the “LDA Road Map”).

To download a PDF version of the above statement click on ICS Position Statement.