<p>My first involvement with people with learning disabilities came during the 1970s, when I worked in a large hospital. Since then, there have been changes in terms of both the philosophy and the provision of services. But perhaps the most crucial form of progress that has taken place has been in the recognition of the individuality of each of the clients – many of whom, having been inmates of the kind of institution in which I was required to work, would have been known by various labels. Some of these labels would be in the ‘clinical’ language of the day, others would be ‘titles’ bestowed by staff as a consequence of an individual’s behavioural or physical characteristics. Some staff, and for a while myself included, ‘justified’ this practice as the ‘harmless’ use of ‘nicknames’. But these monikers would not have been chosen out of a need to dignify the recipient, and they would not have been labels requested by the individuals themselves.</p>