Chronic health problems can have an effect on children in virtually every domain of their lives. Individuals from a wide range of systems influence the course of development for children with chronic medical conditions, including family members, neighbors, and community residents, as well as professionals in the health and educational systems. Child development is strongly influenced not only by interactions that occur within systems (e.g., parent-child relationship, physician-child relationship), but also by the quality of interactions between systems (e.g., family-health provider relationships, parent-teacher relationships; Kazak, Rourke, & Crump, 2003;Pianta & Walsh, 1996). Collaborative practices among professionals and family members can be critical in planning interventions and sustaining effective care for children with chronic health needs (Power, DuPaul, Shapiro, & Kazak, 2003). This chapter describes numerous impairments associated with chronic health conditions and systemic factors that influence the level of competence and impairment experienced by these children. The chapter highlights the importance of understanding cross-system linkages and promoting collaborative practices among professionals, family members, and community 7