The film begins with Mr. and Mrs. DeBolt traveling from their home in California to New York, where they will adopt their 19th child, a blind and physically disabled teen named "J.R." The adoption process for J.R., his integration into the family, and his struggle to develop sufficient physical strength to climb the staircase inside the family home are used as a unifying device for telling the story of how the DeBolts became involved in the adoption of "special needs" children and showing how the family approaches the challenges of raising their unusual family. During her first marriage Dorothy had five biological children with Ted Atwood and adopted two children from Korea . After her husband's death, she adopted two boys from Vietnam (she relates in the film that many are surprised to learn that she didn't ascertain before the adoption whether the children were from North Vietnam or South Vietnam). Following Atwood's marriage to Bob DeBolt, who had one biological daughter from a previous marriage, the couple went on to adopt 10 more children from Korea, Vietnam, the United States, and Mexico — the last was adopted after the initial film was made and is not included in the "19 kids" of the title. The film introduces the adopted children, shows many details of how they accomplish everyday tasks and household chores, portrays special family events, and includes interviews with some of the older children and with Bob's biological daughter. The DeBolts' web site notes that five members of the production crew lived with the family for 2½ years while filming the movie.
Kim Atwood, Marty Atwood, Mike Atwood, Mimi Atwood, Noel Atwood, Stephanie Atwood, Anh DeBolt, Bob DeBolt, Dat DeBolt, Dorothy DeBolt, J.R. DeBolt, Karen DeBolt, Ly' DeBolt