This paper aims to review current knowledge concerning the development of prenatal attachment, the impact of demographic and pregnancy variables, and the implications for care and well-being of the foetus. The studies suggest that level of prenatal attachment, as assessed by questionnaires, typically increases throughout the course of pregnancy. It is likely that higher levels of social support are associated with increased levels of prenatal attachment but more research is needed into the association with this and other psychological variables. There is little evidence concerning the impact on prenatal attachment of procedures carried out as routine antenatal care or about the effects of high risk or surrogate pregnancies. An important area of emerging research involves investigating the implications of low levels of prenatal attachment and risk to the foetus. More research is needed into the relationship between prenatal attachment and how women care for themselves and their developing baby in terms of healthrelated behaviours. The current conceptual framework of the majority of prenatal attachment studies which focus on measuring levels rather than style can be considered over-simplistic. Greater integration with theoretical perspectives such as the development of maternal representations of care-giving would be beneficial.

In line with Valuing People Now: A New Three-year Strategy for People With Learning Disabilities (Department of Health, 2009), this article details a service evaluation for a learning disability-child and adolescent mental health service (LD-CAMHS) in Chesterfield, North Derbyshire. The aim of the project was to produce a set of quality standards in order to ensure service users' needs are met. Semi-structured interviews were conducted with seven children between the ages of 11 and 17 years, with moderate to severe learning disabilities. Four themes were derived from a thematic analysis; the experience of the service, communication, impact of the work carried out, and difficulties encountered. It was recommended that staff working within the service should ensure communication is at a level appropriate for the client; offer a welcoming approach; provide an open approach; and offer a reasonable choice of location. This article provides suggestions for how other LD-CAMHS teams could use these standards for their own purposes.

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A paper was presented at the Trent SIG Group for Learning Disabilities, in June, 2006. Below, the paper has been expanded upon and takes into account the feedback provided from the psychologists present.