While the vast majority of kids with developmental disabilities are cared for at home, pediatricians are being reminded that out-of-home placements remain an important option.

In a clinical report this month, the American Academy of Pediatrics said that doctors should be prepared to guide families whose children need more care than they are able to provide at home.

“Despite the fact that considerable progress has been made to support children with significant developmental and/or medical problems in the home setting, there continues to be a need for other options of care and living arrangements,” the report said.

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Out-of-home placements for children can include everything from skilled nursing facilities, intermediate care facilities and specialty hospitals to residential schools and medical group homes.

A variety of factors including a child’s diagnosis and needs, the level of community-based support available, financial considerations and family circumstances often go into decisions about out-of-home placements, a choice that is “extremely difficult for families to make,” the guidance indicated.

In cases where families are considering placements outside the home, pediatricians should discuss the reasons and guide families in how to select an appropriate setting, the pediatrics group said.

Nonetheless, the report indicates that a doctor’s first priority should be supporting families in caring for their children at home. Pediatricians should be well-versed in community-based options available to families with children who have disabilities and ought to be “instrumental in finding support” for parents who appear overwhelmed, according to the┬árecommendations.

“The importance of trying to support families to care for the child at home cannot be overstated. However, parents of children with significant special health care needs may, at some point, consider out-of-home placement,” the report said.

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