This paper reviews underlying systems of worldwide thought, which underpin the organisation of care, support and (special) education for people with disabilities and behaviour disorders. As the world enters a postmodern age, there is no longer one central and dominant theory by which to guide action. The article reviews a range of theoretical positions, which have supported intervention for people with disabilities and behaviour disorders. It traces historical development of one institution, Ghent University, in the field of orthopedagogy in order to understand how systems of thought have developed and influenced practical action. The paper also provides a critique of existing models of care and (special) education, which sets an agenda for change.