Children with complex disabilities require comprehensive, coordinated and integrated services. However, parents often find themselves navigating fragmentary service systems—a process that may be more difficult when children exhibit behavioral problems such as hyperactivity and inattention. Such problems are more common among children with disabilities. Thus, the present study examined the familial and economic impact of service integration and child hyperactivity among 111 families involved with a children’s treatment network over 2 years. The most dysfunctional families over time were involved with low-integration teams and had children who were highly hyperactive. Children who were hyperactive and their parents had the highest levels of service utilization at baseline, though these patterns reversed or disappeared over time, respectively. Family functioning was also associated with higher service costs for parents, over time. Results highlight the importance of considering the impact of child hyperactivity and inattention, even when children are receiving services for other primary diagnoses.