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The field of intellectual and developmental disabilities has evolved dramatically from the end of the nineteenth century, changing from dehumanizing institutional care to community-based services and supports. The University of Rochester Medical Center's response to community needs in this field began in 1947. This book describes the history of its Division of Developmental and Behavioral Pediatrics, written by the only two chiefs the division has had. The narrative traces the first effort to provide diagnostic service to parents of affected children and describes the emergence of a full program of interdisciplinary services, education of future leaders, community-based consultation, and research. It shows how the division's growth was molded by changing needs in the region and the world. It also tells the story of how a multidisciplinary program can emerge and thrive in a research-oriented medical center and serve as a bridge between a university and its community partners. Finally, it underscores the time-consuming process of program development, including building trust, acquiring needed resources, and maintaining the highest quality of programming during both good and difficult times.