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This article examines the history of permanency in relation to children with developmental disabilities in the US. Family support policies which focus on maintaining children in their own home and also include a community based continuum of care, imply that non family based care is acceptable for some families. The family support movement is urged to embrace the permanency perspective, which focuses on quality relationships. Perceived obstacles to the implementation of permanency are discussed and rebutted. The article concludes with recommendations that all levels of government co-operate to ensure all children are supported in natural, adoptive, or foster families.