'Letting the Future In' for children with learning disabilities

Topics: Child sexual abuse and CSE Deaf and disabled children

Helping children with learning difficulties move on from sexual abuse

We developed Letting the Future In for children with learning disabilities (LTFI-LD) as a therapeutic intervention to support children and young people with learning disabilities who have been sexually abused.

LTFI-LD is based on Letting the Future In (LTFI), our service which supports children who have experienced sexual abuse. LTFI-LD has less emphasis on cognitive behavioural theory than LTFI and more focus on creative therapies such as artwork, drama and therapeutic play. We’ve piloted LTFI-LD in four NSPCC teams.

The University of Bristol conducted a formative evaluation of the pilot to inform our ongoing development of LTFI-LD and our plans to roll out the service to a greater number of teams in the future.

The evaluation determined whether:

  • children and young people found LTFI-LD helpful
  • practitioners considered the approach effective and user friendly
  • carers reported that LTFI-LD improved their understanding and ability to respond to their sexually abused child.

It also identified any barriers to the effectiveness of the LTFI-LD approach and developed an evaluation design that could be used if the programme were to be tested further.

Authors: Tricia Jessiman and John Carpenter
Published: December 2018

Key finding

Practitioners with previous LTFI experience were able to deliver a similar service for children with learning disabilities with training and support.

To make sure practitioners were able to support children with learning disabilities we provided ongoing training and expert consultation from Respond (an organisation specialising in work with adults and children with learning disabilities) for complex cases.

Additional findings

Practitioners used a range of approaches to suit each individual child’s needs.

Practitioners found it helped to use plain and literal language with plenty of repetition. They also recommended using trial and error to find an approach that worked for each child.

More time is needed to deliver LTFI to children with learning disabilities than other children.

Practitioners found the LTFI therapeutic work takes longer with children with learning difficulties than it does for other children. This is particularly because it takes longer to gain trust, engage with children at the start and help children express their feelings and emotions. Practitioners also spent time engaging with other agencies to secure appropriate support and services for children.

Carers valued the flexible approach the NSPCC took to meeting their child’s needs and felt their child had benefited from the service.

However, carers felt they would need more support in the future, particularly around teaching their child about healthy sexual relationships. Practitioners found work with carers took longer than expected as carers sometimes needed support for their own needs before they were able to focus on the needs of their child.

LTFI-LD helps young people make positive changes.

There was limited feedback from young people but those who responded to the feedback survey reported that they liked spending time with the practitioners and felt that they helped them make changes to their life. Both practitioners and carers supported this view and felt the therapeutic relationship was important in bringing about change.


"We wouldn’t have been without it. I’m very impressed that they could even try. Yes, nobody else wanted to step up. There is nothing out there."



Jessiman, T. and Carpenter, J. (2018) Therapeutic intervention for children with learning disabilities affected by sexual abuse: formative evaluation of a developing service. London: NSPCC.