a totaly housebound family due to a child's disability (unless they are totaly bedridden or have something like an extreemly compromised immune system such that it precludes public contact) is a very rare circumstance these days. disability advocates and service providers want these kids out in the world so they get exposed to different environments vs. the walls of their homes/rooms.
ds receives services from one of the very few in home occupational therapy program-it in large part was made 'in home' not because of kids/parents being homebound but because of the extreemly rural nature of where we live which compounded with at times very severe weather could prevent a parent from being able to transport their child to regular, on-going o.t. (another goal of the program is to have children/parents learn to do o.t. using available household items vs. getting the mindset that only with all the 'fancy' stuff at the o.t. centers it can be accomplished).
even though ds's therapy is technicaly 'in-home', he and the other participants do regular off site o.t.. during the summer months this can be at the ymca, the local lakes or public parks. during the winter months it is more difficult, but (at least for ds and the kids that live right near us) thanks to some indoor facilities at a local university that are open to the public we still manage to do about 59% offsite (indoor pool, indoor rock climbing walls, indoor ice rink).
most insurers won't consider paying for in-home services (if they are even available in a region) without extremly extenuating circumstances-and generaly that would not include a person finding it difficult to do because they had additional children absent a childcare provider to leave them with.
We are talking about if the Gosslins had multiple children with disabilities. They would be housebound any family would. I'm not saying they would never leave but it would be a production with 8 kids. We are in Philadelphia it is available in home. We also have free Septa transportation.