What would your occupational therapy approach be with this client? A 20-YEAR-OLD woman has a rare genetic disease that means she is regularly mistaken for a child half her age. Michelle Kish, from Illinois, USA, was born was Hallermann-Streiff syndrome, a condition so rare that at the time of her birth there were only 250 known cases worldwide. Her symptoms include distinct round, childlike facial features and a form of dwarfism that means Michelle only comes up to just above her sister’s waist. But despite requiring round-the-clock medical care, Michelle has flourished into a warm, bubbly adult, who loves playing on her iPad and hanging out with her dog Piper. Michelle now dreams of following in her sister Sarah’s footsteps and finding a boyfriend - ideally a long-haired man who is in touch with his emotions.