An examination is made of factors that contribute to handicap in children with impairments. Handicap is seen to be caused by a complex coalescence of factors which can be divided into three groups associated directly and indirectly with the presenting disability. It is argued that, for there to be a reduction in the level of handicap experienced by the impaired child, then consideration must be given to intervention in all aspects of the contributing factors and not just in the treatment of the impairment itself.