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Home :: FAQ :: Minor Adult Child Claims

What is the fifth of the six “functional domains”?

The fifth domain is “caring for yourself”.  This domain considers how well a child maintains a healthy emotional and physical state, including how well a child satisfies her physical and emotional wants and needs in appropriate ways.  This includes how the child copes with stress and changes in the environment and whether the child takes care of her own health, possessions, and living area (20 CFR 416.926a(k)).

The regulations provide that a preschooler without an impairment should want to take care of many of her own physical needs (e.g., putting on shoes, getting a snack), and also want to try doing some things that she cannot do fully (e.g., tying shoes, climbing on a chair to reach something up high, taking a bath).  Early in this age range, it may be easy for the child to agree to do what her caregiver asks.  Later, that may be difficult for the child because she wants to do things her way or not at all.  These changes usually mean that the child is more confident about her ideas and what she is able to do.  The child should also being to understand how to control behaviors that are not good for herself (e.g., crossing the street without an adult) (20 CFR 416.926a(k)(2)(iii)).

The regulations provide that a school-age child without an impairment should be independent in most day-to-day activities (e.g., dressing and bathing), although she may still need to be reminded sometimes to do these routinely.  The child should begin to recognize that she is competent in doing some activities but has difficulty doing others.  The child should be able to identify those circumstances when she feels good about herself and when she feels bad.  The child should begin to develop understand of what is right and wrong, and what is acceptable and unacceptable behavior.  The child should also begin to demonstrate consistent control over her behavior, and be able to avoid behaviors that are unsafe or otherwise not good for her.  At this age, the child should begin imitating more of the behavior of adults she knows (20 CFR 416.926a(k)(2)(iv)).

Social Security regulation 20 CFR 416.926a(k)(3) sets forth some examples of limited functioning in this domain that children of different ages might have.  The examples do not apply to a child of a particular age; rather, they cover a range of ages and developmental periods.  In addition, the examples do not necessarily describe “marked” or “extreme” limitation in the domain.  Some examples of difficulty children could have in caring for themselves are: 9i) continues to place non-nutritive or inedible objects in the mouth; (ii) often uses self-soothing activities that are developmentally regressive (e.g., thumb-sucking or re-chewing food); (iii) does not dress or bathe age-appropriately; (iv) engages in self-injurious behavior (e.g., suicidal thoughts or actions, self-inflicted injury, or refusal to take medication), or ignores safety rules; (v) does not spontaneously pursue enjoyable activities or interests; or (vi) has disturbances in eating or sleeping patterns.

A claimant would have no limitation in the ability to care for herself if no problems were alleged in this area and no deficits were observed by any treating sources.