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Severe congenital impairments in one child will affect the whole family, possibly for a generation if the child remains at home as an adult. Disability acquired in adult life will affect both partners as roles are gained or relinquished. For children this may result in a loss of parenting. The adjustment process to any psychological or personality changes may be very painful, particularly if children have no one outside the family to provide informed support. Acquired illness or disability in children may have enormous consequences for siblings, the health of the parents and the whole fabric of family life, often resulting in family isolation. In some Asian families, the feeling that the extended family unit is self sufficient and able to provide care may conflict with the ideal of increasing independence fostered by the professionals, and limit the possibility of support from social workers or psychologists. The extended family may reduce the need for statutory support. The expectation that care will be provided to old people by their daughters or daughters-in-law may be frustrated if the younger generation of women are disabled or otherwise engaged, resulting in possible family strife or rejection.