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Finland's 2022 Para Report Card on Physical Activity for Children and Adolescents With Disabilities includes a summary of results and grades for 10 physical activity indicators and highlights how these grades are interpreted by stakeholders. The disability classification was based on the UNICEF/Washington Group on Disability Statistics measure, Generalized Anxiety Disorder (GAD7) measure, or education status. Data between 2017 and 2021 were reviewed by 24 physical activity specialists using benchmarks adapted for data on disabilities from the Active Healthy Kids Global Alliance. The grades were assigned as follows: Overall Physical Activity, C+; Organized Sport, C; Active Play, D; Active Transportation, B; Family and Peers, C+; School, B; Community and Environment, C−; Government, A−; sedentary behavior and physical fitness were graded as incomplete. Stakeholder focus-group discussions highlighted the need for multidisciplinary cooperation and increasing competence of specialists working with children to promote a physically active lifestyle for all children. [ABSTRACT FROM AUTHOR]

This study aims to measure inequalities in the distribution of functional difficulties and their different domains among youth aged 15–29 years in Egypt, according to selected socioeconomic characteristics (e.g. wealth quantiles and education level of the head of the household). The data come from the nationally representative survey, 'Household Observatory Survey', with 10,405 persons aged 15–29 years representing the study sample population. The survey identifies individuals with disabilities using the Washington Group Short questions. Inequalities in disability distribution have been measured by the concentration index (CI). The results indicate that functional difficulties have been concentrated among the poorest youth and households headed by illiterate persons. Rural areas have the highest concentration of disabilities among youth, with the lowest wealth and the lowest educational level of the head of the household. The CI suggests the existence of socioeconomic inequalities in all functional difficulties except for seeing difficulties. Understanding which factors more substantially contribute to inequalities is critical for advancing policies devoted to enhancing the quality of life for individuals with disabilities. [ABSTRACT FROM AUTHOR]

The International Classification of Functioning, Disability, and Health for Children and Youth outlines body structures and functions and activities and participation to fully describe elements that support or detract from participation. While flourishing has gained attention in recent literature, research also points to the role of functional difficulties among autistic youth in influencing participation. Clearly, function is a multi-dimensional and complex construct and likely consists of both indicators of flourishing and functional difficulties. We used data from the National Survey of Children's Health (NSCH) from 2016 to 2020 to identify aspects of flourishing functional difficulties to achieve the following aims: (1) Investigate the factor structure of flourishing and functional difficulties among autistic youth ages 10–17 years; and (2) examine the extent to which child variables (i.e., sex, age, race, ethnicity, autism severity, poverty) are associated with flourishing and functional difficulties. Autistic children (n = 2960) between the ages of 10 and 17 years were included. We used confirmatory factor analysis followed by a multivariate general linear model (GLM) to examine the association between child variables and factors. Results indicated a six-factor structure (medical conditions, instrumental activities of daily living, activities of daily living, social competence, behavioral control, and school motivation) with good model fit (root mean square error of approximation = 0.08 [p = 0.926], comparative fit index = 0.94, Tucker–Lewis index = 0.91). Multivariate GLM showed that child factors were differentially and significantly associated with factors of functional difficulties and flourishing. Current findings suggest that 16 items measured by the NSCH result in a six-factor structure of flourishing and functional difficulties among autistic youth. A comprehensive approach to capture function among autistic youth must assess aspects of flourishing and difficulties. [ABSTRACT FROM AUTHOR]

Objective: This study examined students' perceived levels of coping and need for help, and the relationship with their risks and protective factors during the early stages of the COVID-19 pandemic in Israel. Participants: A sample of 4,710 university students responded anonymously to an online questionnaire. Methods: The risk and protective factors assessed were: specific COVID-related functional difficulties, levels of social support, and trust in the university authorities and the government in handling the crisis. Results: The most frequent COVID-19 related difficulties were: worry for the health of family members (64.4%) and difficulties with online learning (63.2%). Almost half of the students (47.3%) reported that they needed at least a little help. Hierarchical regression analyses for coping and need for help showed that COVID-related difficulties predicted lower levels of perceived coping and a higher need for help. Conclusions: Universities need to build specific services for students to provide concrete support throughout this continuous health crisis. [ABSTRACT FROM AUTHOR]

Abstract Background Persons with disabilities experience higher risks of mortality as well as poorer health as compared to the general population. The aim of this study is to estimate the correlations between functional difficulties across several domains in six countries. Methods National census data with questions on disability from six countries (Mauritius, Morocco, Senegal, Myanmar, Vietnam, and Uruguay) was used in this study. We performed logistic regressions to assess the extent to which having a functional difficulty in one domain is correlated with having a functional difficulty in each of the other domains and report weighted odds ratios (ORs) overall and within age-groups (‘18–44’ years and ‘45+’ years). Models adjust for age, sex, and location (rural or urban). Sensitivity analyses around different choices of predictors and response variables were conducted. Findings For all countries, reporting a functional difficulty in one domain was consistently and significantly positively correlated with reporting a functional difficulty in other domains (overall) and for each of the two age-groups considered - ‘18–44’ years and ‘45+’ years. All ORs were greater than one. Cognition, mobility, and hearing were the domains that were the most correlated ones with other domains. The highest pairwise correlations were for i/ hearing and cognition; ii/ mobility and cognition. Results were robust to changing the severity thresholds for functional difficulties. Across countries, Uruguay, the only high-income country among the six countries under study, had the lowest correlations between functional domains. Conclusions There are consistent positive associations in the experience of functional difficulties in various domains in the six countries under study. Such correlations may reflect barriers to social services including healthcare services and resources (e.g. assistive devices) that may lead to an avoidable deterioration of functioning across domains. Further research is needed on the trajectories of functional difficulties and on structural barriers that people with functional difficulties may experience in their communities and in healthcare settings in particular. This is important as some functional difficulties may be preventable.

Background: Persons with disabilities experience higher risks of mortality as well as poorer health as compared to the general population. The aim of this study is to estimate the correlations between functional difficulties across several domains in six countries. Methods: National census data with questions on disability from six countries (Mauritius, Morocco, Senegal, Myanmar, Vietnam, and Uruguay) was used in this study. We performed logistic regressions to assess the extent to which having a functional difficulty in one domain is correlated with having a functional difficulty in each of the other domains and report weighted odds ratios (ORs) overall and within age-groups ('18–44' years and '45+' years). Models adjust for age, sex, and location (rural or urban). Sensitivity analyses around different choices of predictors and response variables were conducted. Findings: For all countries, reporting a functional difficulty in one domain was consistently and significantly positively correlated with reporting a functional difficulty in other domains (overall) and for each of the two age-groups considered - '18–44' years and '45+' years. All ORs were greater than one. Cognition, mobility, and hearing were the domains that were the most correlated ones with other domains. The highest pairwise correlations were for i/ hearing and cognition; ii/ mobility and cognition. Results were robust to changing the severity thresholds for functional difficulties. Across countries, Uruguay, the only high-income country among the six countries under study, had the lowest correlations between functional domains. Conclusions: There are consistent positive associations in the experience of functional difficulties in various domains in the six countries under study. Such correlations may reflect barriers to social services including healthcare services and resources (e.g. assistive devices) that may lead to an avoidable deterioration of functioning across domains. Further research is needed on the trajectories of functional difficulties and on structural barriers that people with functional difficulties may experience in their communities and in healthcare settings in particular. This is important as some functional difficulties may be preventable. [ABSTRACT FROM AUTHOR]

The International Classification of Functioning, Disability, and Health for Children and Youth outlines body structures and functions and activities and participation to fully describe elements that support or detract from participation. While flourishing has gained attention in recent literature, research also points to the role of functional difficulties among autistic youth in influencing participation. Clearly, function is a multi-dimensional and complex construct and likely consists of both indicators of flourishing and functional difficulties. We used data from the National Survey of Children’s Health (NSCH) from 2016 to 2020 to identify aspects of flourishing functional difficulties to achieve the following aims: (1) Investigate the factor structure of flourishing and functional difficulties among autistic youth ages 10–17 years; and (2) examine the extent to which child variables (i.e., sex, age, race, ethnicity, autism severity, poverty) are associated with flourishing and functional difficulties. Autistic children (n = 2960) between the ages of 10 and 17 years were included. We used confirmatory factor analysis followed by a multivariate general linear model (GLM) to examine the association between child variables and factors. Results indicated a six-factor structure (medical conditions, instrumental activities of daily living, activities of daily living, social competence, behavioral control, and school motivation) with good model fit (root mean square error of approximation = 0.08 [p = 0.926], comparative fit index = 0.94, Tucker–Lewis index = 0.91). Multivariate GLM showed that child factors were differentially and significantly associated with factors of functional difficulties and flourishing. Current findings suggest that 16 items measured by the NSCH result in a six-factor structure of flourishing and functional difficulties among autistic youth. A comprehensive approach to capture function among autistic youth must assess aspects of flourishing and difficulties.

Disability has received limited attention on the global data and social policy scene. There are few global data portals or indices tracking the socioeconomic situation of persons with disabilities. Global social policy initiatives tend to focus on disability benefits, while other social policies may impact the situation of persons with disabilities. The absence of internationally comparable data and tools to measure disability could explain this lack of attention until recently. Given progress with respect to measuring disability, this article set out to find out if human development indicators can be disaggregated by disability status using census and mainstream survey data and, if they can, consider what such disaggregation reveals regarding the socioeconomic situation of persons with disabilities and derive implications for social policies. Disability status is measured through self-reports of functional difficulties (e.g. seeing, hearing). For 19 low- and middle-income countries, the median prevalence stands at 13% among adults aged 15 years and older, and at 28% among households. We could disaggregate a range of human development indicators across disability status for all countries. There are consistent inequalities associated with disability, particularly in terms of educational attainment, employment population ratio, multidimensional poverty, and food security. At the same time, we find that not all persons with functional difficulties experience deprivations. Results in this article on the prevalence of functional difficulties and their association with socioeconomic deprivations show that disability should be central to social policies globally. More data collection, research, and policy work are needed to curb the inequalities associated with disability. [ABSTRACT FROM AUTHOR]

The aim of this study is to describe the occurrence of signs of depression and anxiety among adolescents from 26 low- and middle-income countries and explore the extent to which these are associated with difficulties across other functional domains. We analyzed randomly selected, nationally representative data from 26 countries with a total sample size of 123,975 adolescents aged 10–17 years. Data on functional difficulties, including signs of depression and anxiety, were collected by the Child Functioning Module, an instrument validated to identify the population of children with disabilities through household surveys. We estimated percentages and 95% confidence intervals of adolescents with difficulties across 11 domains of functioning, and of signs of depression and/or anxiety. We used multinomial regressions to estimate the association between difficulties in the different domains and having signs of depression only, signs of anxiety only, and signs of both depression and anxiety, relative to not presenting signs of depression or anxiety. In total, 5.5% of adolescents were reported to have had signs of anxiety, 3.1% signs of depression, and 2.3% co-occurring signs of anxiety and depression. Compared to adolescents without functional difficulties, those with difficulties in one or more domains were three times more likely to have signs of depression and anxiety. The likelihood of presenting signs of depression only or signs of both depression and anxiety was significantly higher across all domains, and the highest among adolescent with difficulties to self-care and communicating. The likelihood of presenting signs of anxiety only was significantly higher across all domains except seeing and hearing, and the highest among adolescent with difficulties communicating and accepting changes. Adolescents with functional difficulties in all domains analyzed, across different contexts, are more likely to experience depression and anxiety signs than those without such difficulties. Increasing the availability of population-level data on adolescent functional difficulties, including those related to depression and anxiety, is important in promoting inclusivity, participation, and the right of children to equal opportunities. [ABSTRACT FROM AUTHOR]

Early childhood development (ECD) is a crucial determinant of adulthood capabilities. This paper investigates the current ECD status among young children of 3–4 years of age in Bangladesh and its relation to various socio-demographic and familial factors using data from the latest round of the Multiple Indicator Cluster Survey (MICS). Results from the logistic regressions confirm many existing findings for developing countries and draw new insights specific to the country. Physical and mental disabilities hinder all types of early development. Enrolment in pre-school education programmes, the presence of children's books at home and parents' engagement in certain learning-stimulating activities are crucial for development in literacy-numeracy and learning. Development in the physical domain is fundamentally associated with wealth status. Failure to attain adequate social-emotional development can be largely attributed to domestic hostility toward children and mothers' experience of functional difficulties. [ABSTRACT FROM AUTHOR]

This paper examines to what extent household surveys and censuses in low- and middle-income countries include disability questions and the types of questions under use. We found that only 31% of 734 datasets between 2009 and 2018 from 133 low- and middle-income countries have at least one disability-related question. Of the surveys reviewed, 15% of the datasets have functional difficulty questions that meet international standards, i.e. Washington Group short set or other functional difficulty questions. Meanwhile, the most asked disability question "Do you have a disability?" is problematic as it does not produce meaningful and internationally comparable data. We recommend the adoption of functional difficulty questions for all surveys and censuses to track the progress of the implementation of the 2030 Agenda for Sustainable Development as well as the Convention on the Rights of Persons with Disabilities. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has created a sense of threat, and stress that has surged globally at an alarming pace. University students were confronted with new challenges. This study examined university students' functional difficulties and concerns during COVID-19 pandemic in two countries: Israel and Ukraine. Additionally, it examined the similarities and differences in prediction of COVID-related concerns in both countries. Two large samples of university students were drawn from both countries. Results showed that students' main functional difficulties in both countries were: worries about their family health status and their learning assignments. In both countries, COVID-related functional difficulties and stress associated with exposure to the media added a significant amount of the explained variance of COVID-related concerns after controlling for background variables. In conclusion—while the level of exposure and difficulties may differ by country and context, their associations with students' concerns seem robust. Additionally, repeated exposure to media coverage about a community threat can lead to increased anxiety. [ABSTRACT FROM AUTHOR]

Background: Adverse childhood experiences (ACEs) are commonly observed in the general population and often have lasting neurological and physiological effects. Previous studies have found links between exposure to ACEs, headaches, and functional difficulties in adults. However, little is known about the mechanisms through which exposure to ACEs is associated with headaches among children. Objective: To examine the association between exposure to ACEs and headaches in children, and whether functional difficulties mediate this association. Methods: Data for this cross‐sectional secondary analysis study came from the 2017–2018 National Survey of Children's Health. The sample analyzed in this study was 40,953 children who were between ages 3 and 17 years. We adjusted for the complexity of the sampling design and used structural equation modeling to examine the mediating effect of functional difficulties in the association between exposure to ACEs and headaches. Results: Based on parent reports, we found that 4.1% (1697/40,953) of the children reported frequent or severe headaches, and 9.5% (3906/40,953) were exposed to three or more ACEs. About one in four children (23.4%; 9601/40,953) had at least one functional difficulty. The results show that exposure to ACEs was directly positively associated with functional difficulties (β = 0.16, p < 0.001, 95% CI = 0.15–0.17), and functional difficulties were in turn positively associated with headaches (β = 0.17, p < 0.001, 95% CI = 0.12–0.22). The Sobel test of indirect effect showed that functional difficulties partially mediated the association between exposure to ACEs and headaches (β = 0.027, p < 0.001, 95% CI = 0.022–0.029). Also, older children and children with brain injury were more likely to report experiencing headaches. Conclusions: The findings from this study suggest an association between exposure to ACEs and headaches among children, and functional difficulties partially mediate this association. [ABSTRACT FROM AUTHOR]

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Objective: A lack of understanding of the causes of attrition in longitudinal studies of older adults may lead to higher attrition rates and bias longitudinal study results. In longitudinal epidemiological studies of Alzheimer's disease and related dementias, high rates of attrition may cause a systematic underestimation of dementia prevalence and skew the characterization of the disease. This can compromise the generalizability of the study results and any inferences based on the surviving sample may grossly misrepresent the importance of the risk factors for dementia. The National Institute on Aging outlined a National Strategy for Recruitment and Participation in Alzheimer's Disease Clinical Research to address this problem, providing evidence of the magnitude of this problem. Method: To explore predictors of attrition, this study examined the National Alzheimer's Coordinating Center (NACC) Uniform Data Set, a repository of observations of older adults spanning 11 years, using survival analysis. Four samples were examined: the full sample (n = 30,433), the alive subsample excluding those who died (n = 24,231), the MRI sample [participants with complete MRI data (n = 1104)], and the alive MRI subsample [participants with MRI data excluding those who died (n = 947)]. Results: Worsening cognitive impairment, neuropsychiatric symptoms, and difficulty with functional activities predicted attrition, as did lower hippocampal volume in the MRI subsample. Questionable co-participant reliability and an informant other than a spouse also increased risk of attrition. Discussion: Special considerations exist in recruiting and retaining older adults in longitudinal studies, and results of baseline psychological, functional, and cognitive functioning should be used to identify targeted retention strategies. [ABSTRACT FROM AUTHOR]

Behavioral interventions for older adults can reduce difficulties in performing daily activities, hospitalizations, and mortality risk. The success of behavior change interventions, however, can be affected by a participant's readiness to adopt changes. This study evaluates whether socioeconomic conditions, particularly financial strain affording food, are associated with readiness to change. We conducted a cross-sectional, descriptive study of baseline data from disabled older adults (N = 147) participating in an intervention to reduce physical disability. Readiness to change score was rated at the start of the intervention by interventionists as either pre-action (precontemplation = 1, contemplation = 2, preparation = 3) or action (=4). Participants reporting high financial strain affording food were more likely to have high readiness at the start of intervention; the association of this specific socioeconomic condition with readiness may be an important consideration in implementing interventions to reduce disability. [ABSTRACT FROM AUTHOR]

As the rates of obesity are steadily increasing, the relevance to occupational therapy (OT) is increasing accordingly. There is limited OT-focused research internationally, particularly relating to the functional and social implications of obesity and none within an Irish context. This was the first research of its kind at a national level and aimed to explore the daily functional difficulties experienced by a group of adults attending an Irish weight management clinic. A mixed methods study design was deployed, and the two phases were combined to form an overall picture of the daily functional difficulties experienced. Of the 26 participants included in the study, 21 completed the quantitative phase, and 19 of those completed the follow-on qualitative phase. Mean body mass index (BMI) of those involved in the quantitative phase was 52.6 (range 39-69). Of the 21 respondents, nine were partnered, and 10 were unemployed. A large number of participants ( n = 16) were reported to experience comorbidities alongside their weight, and the number of comorbidities experienced varied between one and seven. A significant correlation was found between a greater number of comorbidities and a greater level of functional difficulties and a lower perceived health-related quality of life. Interestingly, there was no relationship between BMI and both functional difficulty and perceived health status. The presence of a vicious cycle and interdependency between factors was seen to be an over-riding, dominant theme throughout the qualitative interviews. The issue of a vicious cycle was reinforced in the quantitative measures where community participation in particular was reported to be an area of neglect due to the interaction of emotional difficulties, physiological difficulties, environmental barriers and societal attitudes. The complex interaction and incremental worsening of factors was also seen to be a major barrier to effective implementation of the advice given by the weight management clinic into everyday occupational performance. The findings indicate the complex interaction that exists between the consequences of obesity and their impact on health and well-being. Understanding of such interactions will have important implications for OT practice as addressing these factors on a continuum rather than in isolation may lead to greater success with weight-loss interventions and also with occupational re-engagement. [ABSTRACT FROM AUTHOR]

Objective: Patient activation, the patient's knowledge, skill, and confidence to manage his or her health, is an important indicator of future health and use of health care resources. Understanding factors associated with patient activation in an older population with functional difficulties may inform care in this population. This study aimed to determine whether patient activation is associated with depression, chronic conditions, family support, difficulties with activities of daily living (ADLs) and instrumental activities of daily living (IADLs), hospitalizations, education, and financial strain.Methods: (N=277), We administered surveys measuring patient activation, financial strain, depressive symptoms, family support, and chronic conditions to an older adult population. We tested association through multivariate linear regressions controlling for race, sex, and age.Results: Patient activation is significantly (p<0.05), positively associated with family support and self-rated overall health, and significantly (p<0.05), negatively associated with depressive symptoms and difficulties with ADLs and IADLs. We found no association between patient activation and financial stress, hospitalizations, and education.Conclusions: Older age, depressive symptoms, and difficulties with ADLs and IADLs were associated with decreased patient activation.Practice Implications: Developing interventions tailored to older adults' level of patient activation has the potential to improve outcomes for this population. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the prevalence of chronic conditions and functional difficulties of American Indian/Alaska Native (AIAN) children with special health care needs (CSHCN). We conducted bivariate and multivariable analysis of cross-sectional data on 40,202 children from the 2009-2010 National Survey of Children with Special Health Care Needs aged birth through 17 years, including 1,051 AIAN CSHCN. The prevalence of AIAN CSHCN was 15.7 %, not significantly different from the prevalence of US white CSHCN (16.3 %). As qualifiers for special needs status among AIAN children the use of or need for prescription medication was the most frequent (70 %), compared to the lower rates of need for elevated service use (44 %) and emotional, mental, or behavioral treatment/counseling (36 %). Asthma (45 %), conduct disorder (18 %), developmental delay (27 %), and migraine headaches (16 %) were significantly more common chronic conditions among AIAN CSHCN compared to white CSHCN, as were functional difficulties with respiration (52 %), communication (42 %), anxiety/depression (57 %), and behavior (54 %). AIAN CSHCN were also more likely to have 3 or more chronic conditions (39 vs. 28 %, respectively) and 3 or more functional difficulties (70 vs. 55 %, respectively) than white CSHCN. Results indicated a greater impact on the daily activities of AIAN CSHCN compared to white CSHCN (74 vs. 63 %). Significantly greater disease burden among AIAN CSHCN suggests that care must be taken to ensure an appropriate level of coordinated care in a medical home to ameliorate the severity and complexity of their conditions. [ABSTRACT FROM AUTHOR]

Finland's 2022 Para Report Card on Physical Activity for Children and Adolescents With Disabilities includes a summary of results and grades for 10 physical activity indicators and highlights how these grades are interpreted by stakeholders. The disability classification was based on the UNICEF/Washington Group on Disability Statistics measure, Generalized Anxiety Disorder (GAD7) measure, or education status. Data between 2017 and 2021 were reviewed by 24 physical activity specialists using benchmarks adapted for data on disabilities from the Active Healthy Kids Global Alliance. The grades were assigned as follows: Overall Physical Activity, C+; Organized Sport, C; Active Play, D; Active Transportation, B; Family and Peers, C+; School, B; Community and Environment, C-; Government, A-; sedentary behavior and physical fitness were graded as incomplete. Stakeholder focus-group discussions highlighted the need for multidisciplinary cooperation and increasing competence of specialists working with children to promote a physically active lifestyle for all children.

This study examines how regions of origin are related to immigrant health status in the USA. This paper uses the National Health Interview Survey to examine health status differences between East and Southeast Asian immigrants and immigrants from other regions. The models control for duration, socioeconomic factors, and behavioral factors. Two health indicators are examined: self-reported health and functional difficulties. Results from ordered logit regression analyses demonstrate that some of the regions of birth do significantly predict differences in health for immigrants. Specifically, immigrants from Central America and the former Soviet Union do exhibit significant health disadvantages when compared with immigrants from East and Southeast Asia. The duration effect was positively related to functional difficulties but not to self-reported health status. Overall, economic resources and education typically have a strong relationship to the measures of immigrants' physical health. It was also found that drinking is persistently associated with better measures of physical health while smoking appears to have the opposite effect. [ABSTRACT FROM AUTHOR]

Determining disability prevalence is a growing area for population statistics, especially among young adolescents. The Washington Group on Disability Statistics is one source of reporting disabilities through functional difficulties. Yet, young adolescents self-reporting through this measure is in its infancy. The purpose of this study was to carry out an intra-rater test-retest reliability study on a modified set of items for self-reporting functional difficulties. Young adolescents ( N = 74; boys = 64%; age M = 13.7, SD = 1.8) with special educational needs in Finland completed a self-reported version of the Child Functioning Module in a supervised classroom. The second administration took place two weeks later. Intraclass correlation coefficient (ICC) and Kappa ( k ) statistics were used to test the reliability of the items, and interpretation took place through Landis and Koch, and Cohen, respectively. The majority of items had substantial or moderate agreement, although there was only fair agreement for self-care (ICC = 0.59), concentration (ICC = 0.50), and routine changes (ICC = 0.54). Kappa statistics of behavior control were interpreted to be large ( k = 0.65), and seeing ( k = 0.49), walking ( k = 0.49), and speaking ( k = 0.49) difficulties were moderate. The majority of the items in the self-reported version of the Child Functioning Module can be used in a scale format, although some caution may be required on items of self-care and concentration when used as a dichotomous variable.

Wilson's disease is a rare inherited disorder of copper metabolism that results in abnormal accumulation of copper in the body. The symptoms appear between 6 and 40 years of age, resulting in functional limitations. A 17-year-old male was referred to the occupational therapy (OT) department with functional difficulties. The objective of the case study was study the effect of family centered intervention in the adolescent with Wilson's disease. It is a single case study. The patient presented with difficulty in self-care and communication skills. Informed consent was taken from mother. Family-centered approach was used while planning OT intervention. Various adaptations utilizing local resources were provided using procedural and pragmatic clinical reasoning. Based on the ICF model, it was observed that the patient had limitations in participation due to body structure and environmental structures, which improved from mean of 4 to 1. Parent's satisfaction level has improved from total of 5 to 13 on Canadian Occupational Performance Measure scale. The use of ICF model to evaluate functional difficulties and resolving problems has improved parent's satisfaction. Thus, the intervention has also improved quality of life of the child. [ABSTRACT FROM AUTHOR]