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Am Fam Physician. 2005;71(11):2206

The Committee on Children with Disabilities of the American Academy of Pediatrics (AAP) has released a clinical report recommending that children with special needs receive care at home—not in a group home or institutional setting. The full report, “Helping Families Raise Children with Special Health Care Needs at Home,” is available on the AAP Web site (;115/2/507).

The report facilitates permanency planning (i.e., securing a permanent family environment and long-term relationships with caring adults) for persons with special needs. It is geared toward meeting the U.S. Department of Health and Human Services’ goal of having no person 21 years or younger with special needs living in a group home or institution by 2010. Because some families are unable to care for their children at home, the AAP suggests acceptable alternative living situations, such as families who already have children with special needs or parents who work in the health care industry. The Committee also gives suggestions for parents and physicians on how to provide an optimal living situation, home modifications, and transportation to fit each child’s needs; how to find faith and community-based support; and how to help these children transition into adulthood.

Physician-specific recommendations developed by the AAP Committee include the following:

  • Address each child’s need for and the availability of appropriate education, including later transition services. Physician advocacy may be necessary to ensure that the patient receives adequate service from the school and to decrease the parents’ burden.

  • Identify which support services would most suit each child’s needs, and help families gain access to these services through referral to social service agencies.

  • Lobby for increased funding for family support by working with legislators.

  • Assist in training caregivers for children with special needs.

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