Abstract
The objective of this article is to describe problems affecting special education services in developing countries where economic challenges have harsh consequences on health, education, and welfare and force difficult ethical choices. Special education efforts in Ecuador and 2 projects serving children with special needs are used as examples to describe inherent problems and give inspiration toward potential solutions. Relevant questions regarding future research are raised with the explicit purpose of facilitating appropriate and sustainable special education models that offer preventive as well as rehabilitative services to children with special needs.