We thank those who took the time to provide feedback on the recently published clinical report from the American Academy of Pediatrics (AAP) about out-of-home placement for children and adolescents with disabilities and for their interest, comments, and care of children and adults with disabilities. We recognize and support the national goals for decreasing the number of children not living in home settings.

We absolutely agree that almost all children receive the best care in family settings with appropriate access to all community services and experiences, including school, recreation, travel, and relationships with others inside and outside the family. Our clinical report indicates this belief, and it is codified in an earlier AAP statement. For children with extraordinary medical, nursing, and personal care needs, the supports that they and their families need for life maintenance and safety, let alone development and socialization, may be extensive and may not be...

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