Like all parents, parents with intellectual disabilities want to give their children a safe, loving and healthy start in life. At the same time, parenting in this group often goes hand in hand with major challenges and a heightened risk of unsafe situations. ‘Parents with intellectual disabilities are overrepresented in child protection, especially with children under the age of one,’ says Zijlstra.

This prompted Zijlstra to examine what might explain this and how we can better support these parents. The results nuance the still prevalent idea that the intellectual disability in itself explains unsafe parenting situations.

Not the disability, but the accumulation of problems

Zijlstra mapped the risk factors among expectant Dutch parents with intellectual disabilities who had already been made subject to a child protection measure during pregnancy. In the Dutch case a court can decide to involve child protection services during pregnancy or decide in advance that after the birth a baby cannot live at home temporarily. ‘In these families, the safety of the unborn child was therefore already at stake,’ Zijlstra explains.

Her file analysis shows that many of these parents face multiple problems at the same time, such as a limited social network, poverty and adverse experiences in their own childhood. ‘It is mainly risk factors within the family and in the collaboration with services that are associated with the child’s safety after birth,’ says Zijlstra. ‘The intellectual disability on its own does not explain the unsafe situation.’

Three risk profiles

But this is not a homogeneous group. Zijlstra distinguishes three risk profiles among parents with intellectual disabilities:

1. Families in which both parents have an intellectual disability but with relatively few additional problems.
2. Parents with an intellectual disability who face a substantial accumulation of problems.
3. Single mothers with a small or absent social network.

Families in profiles 2 and 3 are more likely to face more intrusive child protection measures. ‘Different combinations of risk factors go together with different trajectories in child protection,’ Zijlstra notes. ‘This supports the finding that the intellectual disability on its own does not explain the unsafe situation.’

Existing support falls short

According to Zijlstra, targeted, timely and context sensitive support is essential for these parents. ‘You cannot just hand these parents a leaflet on parenting and hope for the best.’ Her analysis of the existing support on offer in the Netherlands shows that there are few interventions tailored to this group and that their effectiveness is limited or insufficiently studied. ‘That is concerning,’ Zijlstra says. ‘We have a high number of parents with intellectual disabilities in child protection, but appropriate support is often lacking.’

New intervention: Safe Start

To help bridge this gap Zijlstra examined the effectiveness of a new Dutch intervention, Safe Start (Dutch: Veilige Start), in nearly twenty families. The intervention was developed with and for expectant parents with intellectual disabilities and provides support from pregnancy into the child’s early years.

She calls the first results ‘cautiously encouraging’. The intervention appears applicable in families with multiple complex problems, is valued by parents and professionals, and is associated with a clear decrease in the likelihood of out of home placement.

‘Not whether they can, but what they need’

‘The overrepresentation of children of parents with intellectual disabilities in child protection is not simply a reflection of these parents’ disability,’ Zijlstra concludes. ‘We need to look at the system, in which appropriate and effective support is insufficiently available.’

‘The question is not whether parents with intellectual disabilities can raise their child well enough, but what they need to make sure it will go well enough.’

Thesis details

Annick Zijlstra, 2026, 'Supporting Today, Preparing Tomorrow’s Parents. Understanding and Improving Early Support for Expectant Parents with Intellectual Disabilities'. Supervisros: Prof. B. Orobio de Castro en Prof. M. van Nieuwenhuijzen.

Time and location

Friday November 6, 10.00-11.30, Agnietenkapel, Amsterdam (subscription link)