• Climbing

• Stooping, kneeling, crouching

• Lifting

• Strength

• Working in physically hazardous situations

• Limited range of motion

• Chronic pain

• Fear of injury that might cause bleeding

These individuals must obviously avoid job situations that have physical risks for injury, which is the major vocational problem. They often miss school or are treated in ways that may not demand full academic achievement. Thus, school achievement must be carefully assessed in terms of both school records and achievement testing. In many cases, there may be limited academic skills.

The counselor should assess the person's vocational and life experiences. Often there are few to draw from. A work history is often not present for individuals who transition from school to work, so they lack work skills and an understanding of the expectations of the workplace.

Areas to assess include severity of the disorder, the orthopedic results in terms of joint immobility, and the response of the individual and the family in terms of long-term adjustment. The individual must be assessed as to his/her willingness to follow a medically appropriate treatment regime, and must maintain functional states with parental or environmental support and encouragement. In terms of specific treatment, the individual must be active without taking abnormal risks, must have an adequate supply of blood coagulant factor, must be under medical supervision (usually both medical and orthopedic), and, if possible, home treatment is preferred. In the case of joint pain, which is secondary to the primary condition of hemophilia, analgesics and anti-inflammatory drugs are often used. Once again, aspirin must not be used as it interferes with coagulation.