The purpose of this research was to determine family patterns which limit the optimal functioning of the child in middle childhood with Bipolar Disorder and Cerebral Palsy. To achieve this goal a thorough literature study was performed with regard to the child with Bipolar Disorder and Cerebral Palsy. The nature, causes and state of these two conditions in the family were investigated. Cresswell's combined model of research namely the "dominant-less-dominant" model of investigation was used. The less dominant part of the research was quantitative where the "Hudson scale: Index of Parental Attitudes" was used. This is a standardised questionnaire that aims to measure the attitudes of parents. The qualitative part of the research produced more information regarding the above-mentioned aspects. Unstructured interviews with the family, as well as the multi-disciplinary team currently involved with the family were conducted. The "One shot case study" was used to determine the significance of negative family patterns. This is an in-depth study of a single unit and required that the researcher become part of the family and family activities for a specific period of time. From this specific family, patterns were identified which limit the child with Bipolar Disorder and Cerebral Palsy to optimal functioning. From the results it was clear that significant family patterns exist in this family which limit the child. The research question could therefore be answered and certain themes could be identified. With regard to dimensions of family functioning, significant patterns around affection, behaviour control, value transmission, structure, communication and external systems were identified which limit the child to optimal functioning. Through this the researcher comes to the conclusion that family functioning has a significant influence on the optimal functioning of the child with an affective disorder and disability. With these results in mind, it is important that families are guided in the handling of children with affective disorders and disabilities, so that these children too, can reach optimal functioning. / Thesis (MSD (Play Therapy))--University of Pretoria, 2004. / Social Work and Criminology / unrestricted