For optimal outcomes, children belong in homes.

Children Belong in Homes In the Clinical Report “Out-of-Home Placement for Children and Adolescents With Disabilities,” Friedman and colleagues review options for placing children with disabilities in congregate care settings. However, the report omits discussion of the best interests of the child in selecting out-of-home options and fails to review and prioritize noninstitutional models of care. When families of origin are unable to provide adequate care, children with disabilities retain their right to receive care in the least restrictive setting. Like all children, children with complex disabilities benefit from family and community life. Therefore, it is a national priority to reduce the number of children and youth with disabilities aged 21 years and under living in congregate care residencies. It is also a national priority to increase the proportion of people with disabilities who participate in social, spiritual, recreational, community, and civic activities to the degree they wish. This clinical report undermines these important priorities by lowering the bar to institutionalizing children. The report does not address the negative impact of institutional care on growth and development of children with disabilities beyond a few narrow medical outcome measures.