James is a three year old with moderate factor VIII deficiency. He is not yet in school. James loves to play with his toy car. He would like to be a doctor when he is grown, or so say his parents! James has two bleeding episodes a month on average. He visited the clinic one time in the last year but not receive any infusions. James lives with his father, Bobby James, and his mother, Sheela. He has two sisters; Precious Yllana, age seven, and Ashley Natalie, age five. Neither sibling has a bleeding disorder. James’ father earns $56 a month working as a computer technician. His mother keeps the family’s rural home, which they rent. His family can read and write English.