This case study describes the 2-year process of moving a young child with severe disabilities and complex medical needs from a special school setting to a special class in a regular education setting. The child had Marshall-Smith Syndrome, characterized by respiratory, pulmonary, and skeletal abnormalities, and developmental delays due to the coexisting condition of "failure to thrive." The account reviews the initial efforts to place the child in a public school program at age 3, the literature on least restrictive environment, the boy's background, the residential facility and its educational services, and initial rejections from the public school system due to his parents' lack of local residency. The importance of whether the child was labeled severely/profoundly handicapped or trainable mentally handicapped and the effect of this labeling on his qualifying for specific educational services are discussed. The conflicting interpretations of the Illinois School Code, the influence of the Advocacy and Guardianship agency, and his eventual placement in a self-contained class for severe and profoundly handicapped students within a community elementary school are then described. Further discussion notes problems raised by the presence of a residential facility for children with severe disabilities and complex health needs in a community embracing inclusion. Appendices provide supporting letters and documents. (Contains 16 references.) (DB)