At the early stages of the development of integrated services, a study that examined the views of children and their carers on being missing from education is drawn upon to highlight two key issues that connect with the integration agenda: identifying the object of intervention and altering frames of organizational relevance. It is argued that if the proposed national outcome framework for England is to be meaningfully achieved (being healthy, enjoying and achieving, making a positive contribution, staying safe and achieving economic well being) within new service configurations, children's problems can no longer be fragmented into objects of organizational or professional expertise. Organizational relevance must adjust to enable the service user's (in this case children's, young people's, and their parents'/carers') framing of problems to be communicated, heard, and responded to. Three cases are presented for illustrative purposes, which show (i) the continued fragmentation of the service user's problem into objects of organizational relevance and (ii) the impact of this fragmentation on outcomes for children. Following presentation of the cases, a policy discussion is offered, which highlights a number of factors that undermined agencies' efforts to offer a joined-up and holistic service in this particular local context. The study draws links between this particular local context and issues of national relevance and concludes that, for the families in this study, problems presented to agencies continued to be framed according to organizationally relevant concerns and practical realities. This process occurred in spite of efforts by children, young people, and their parents/carers to steer diverse professionals involved with their lives down a more individually relevant path. Copyright © 2006 John Wiley & Sons, Ltd.