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A case history of a hearing-impaired child is presented which covers a period in the child's life from 18 months of age to 13 years. A description of the original assessment and preschool program is provided, and the outcome of "mainstreaming" during the elementary school years is discussed. A position is stated which contends that the least restrictive environment for a given child should not necessarily imply "mainstreaming." Rather, decisions about school placement should be made on the basis of the individual child's needs and on the basis of the availability of continued professional support by qualified persons after the placement has been made.