In this study, the long-recognised and well-documented problems faced by families who have a young child with a moderate or severe handicapping condition are re-examined and service provisions designed to support such families are reviewed. Major deficits in both service provision and applied research are highlighted and some of the traditionally-held views of these families are questioned. A problem-centred approach to evaluation is offered as an alternative method for applied research and service development in this area. This procedure is used to evaluate the Portage Home Teaching approach, a relatively new service model which uses parents as the major change agents for their handicapped children. Comparisons are made between the frequency of child, parent and family problem indicators experienced by families receiving a Portage service and general surveys of this client group carried out in the UK. The data indicated similarities between all three groups on endogenous child variables especially degree of handicap, physical health, hospitalisation, additional handicapping conditions and death rate. However, in the cases of parent variables (physical and mental health, care and management demands) and family variables (e.g. divorce, separation, sibling disturbance, harsh parental management and social isolation) clear differences emerged, those families receiving a Portage home teaching service having a lower problem incidence than families in the comparison samples. An examination of service outcome data suggests that some external variables, notably, frequency of child deaths, severity of handicap and SLD school placement are related to high service demand, although so social class or home teacher effects could be established. The existence of a small group of high service demand families, who are likely to require an intense level of support, is noted. Data collected on the everyday problems of all the Portage families are also examined. In the case of educational, family, Portage service, agency and interagency problems, qualitative differences, in terms of the problem referrer, the person who was the focus of the problem and the agreed strategy for change emerged. This information is used to (a) generate a new advanced training curriculum for home teachers and (b) to design a new in-service training programme for Portage personnel. Finally, a number of avenues for future research is suggested and, at a service level, the possibility of using a systematic problem solving procedure as a means of empowering parents is considered.