I cannot recommend this slim monograph highly enough to anyone working with people who have the disorders of neurological development that give rise to what we term mental handicap, mental retardation, or learning disability. It is tightly argued, well written, and thought provoking and bears reading much more than once.

Psychiatrists are still the dominant medical profession working with people with learning disability, a fact of history that has been slow to change. Lothian has recently closed its large institution, one of several in Scotland that had around 1000 beds at …