The normalization principle, the movement for self-reliant living, and implementation of support-payment systems for persons with disabilities, plus enforcement of the "Services and Supports for Persons with Disabilities Act", have encouraged a tendency toward the deinstitutionalization of children with severe motor and intellectual disabilities (SMID). The present review describes the current situation, including problems with community services supporting the life of such children. Although mothers, who are the main caregivers of these children, can draw on an increasing number of in-home support services to assist them, informal social resources, such as sympathetic relatives, rather than formal societal ones, such as medical and welfare services, are thought to help in reducing their burden. The present study proposes the need in the future for good consultants for such care-giving mothers and for supportive measures to facilitate equitable participation in caregiving by family members in addition to mothers. Furthermore, the present review argues for the importance of family participation and emphasizes its key role in facilitating collaboration among relevant institutions so that children with severe motor and intellectual disabilities can continue to live at home. Some of these children have to live in residential care for various reasons, such as their high dependence on medical treatment and the ill health of their caregiving family members. Very little research has been reported on community services to support the life of children with severe motor and intellectual disabilities. The present review indicates that this shortcoming should be rectified with future research on this topic.
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