The paper attempts to provide a theoretical and empirical perspective related to the issues, problems and challenges of enhancing social functioning among children with cognitive disability in Tanzania. Specifically, the study reviews three theories, namely empowerment, inclusive and ecological with a view of finding the challenges associated with the enhancement of children with cognitive disability. The study is a literature review based on survey from books, scholarly articles and other relevant sources seeking explanations on the enhancement of social functioning among children with cognitive disability. The reviewed literature were summarized, analysed, and synthesized. The findings reveal that, the theories used in social work practice have diverse and different foci of analysis and intervention. This is largely because addressing a social problem there are many variables and uncertainties in social work practice. Because of that, there is no one single objective “reality” in social theory and practice. Secondly, whereas theories such as the ecological describes the influence of different subsystems in the changing individual behaviour, other behaviours such as discrimination and social exclusion among people with disabilities do not seem to change. The study further reveals that the assumptions of the inclusive theory of developing positive social relationships (e.g. friendships and acquisition of social skills) have not been successful because of existence negative attitudes among societal members which are influenced by false beliefs about people with cognitive disability. The study concludes that, whereas the theories help social workers to understand complex human behaviour and social environment which influence their clients’ lives and the nature of social problems, there are no theories which help in understanding African realities. The study observes that, negative social environment and attitudinal change have a negative impact in facilitating positive behavioural change in as far as enhancing social functioning among children with cognitive disability. The study recommends that more research be conducted to address the existing prohibiting factors. It is further recommended that concerted be made among different actors including policy interventions to raise awareness of local communities.