Professor Malcolm MacLachlan:

With Down's syndrome, the diagnosis is easy because the condition has a genetic cause but the way in which it expresses itself changes hugely across different people. That is really the essence of a family-centred approach. We find out what is required by that individual. Of course there is an element of assessment.

That is normal good clinical practice, but it is distinct from the legal requirement for an assessment of need. We always conduct assessments as part of routine clinical practice to work out what is in the best interests of the person and the family. We cannot just go by a diagnosis even when we have one, given that it does not tell us what the individual and the family need.