This article summarizes literature about paraprofessionals who assist children or families in the areas of mental health, education, or early childhood education, and focuses on three main questions: How effective are paraprofessionals?; what are the common and appropriate roles and responsibilities of paraprofessionals?; and what qualifications, training, and supervision are needed for paraprofessionals? Implications are inferred for a burgeoning new form of paraprofessional services: attendant care in community based mental health services for children. Lessons from existing literature can help mental health administrators and clinical supervisors at state and local levels to select, train, supervise, and evaluate attendant care workers.