People in the early modern period had long been fascinated by 'monstrous births' as portents, prodigies and scientific marvels, but during the eighteenth century attention began to turn to the 'problem' of children growing up with physical or sensory impairments. During the second half of the century, against the backdrop of increasing professional interest in child health, the sentimentalisation of childhood, and growing concerns about the costs of a dependent 'useless' population, 'imperfect' children became publicly visible as targets for medical, philanthropic and pedagogical intervention. Using newspapers, child rearing and medical texts, this article examines causes of, and responses to, childhood impairment. While impaired children were often viewed as a 'burden', growing confidence in methods for restoring them to 'utility' began to set apart children with impairments from other people with disabilities.