<p>This article seeks to place current methods of identifying and assessing people with learning disabilities into a historical context. It suggests that, although the roles playedby service providers and users throughout history have changed, the relationship between them has always been, and continues to be, characterised by an inequality of power. This inequality has contributed to a series of restrictive and abusive practices, and to the perpetuation of an institutional model of care. The author then evaluates the appropriateness of current assessment scales.</p>