Spanning forty years, Family Pictures follows the conflict between husband and wife, over a beautiful autistic child. Randall is both angel and demon. His father, David, a coolly rational psychiatrist, wants him placed in an institution; his mother, Lainey, insists on keeping him at home. Yet it is not just David and Lainey who are struggling to come to terms with a difficult and unpredictable child; there are five other children in the family, each of them coping with the dramas and rifts surrounding them, each of them affected by Randall.