The purpose of the study is to test the hypothesis of no difference in the adjustment of children with congenital and acquired orthopaedic disabilities. A second aim is to determine the factors which may contribute to any differences in their adjustment. Forty children aged between eleven and sixteen years participated in the investigation. They were divided into congenital and acquired groups according to the development of the handicap. The results revealed that cases of acquired group had lower self-esteem, felt less happy, less autonomous, more anxious and more hypochondriac when compared with cases of the congenital group. The findings of marked differences in adjustment among congenital and acquired defect groups gives no support to the hypothesis. It is found that the congenital group experiences fewer adjustment problems than the comparison group with acquired defects. The impact of a physically handicapped child on a family may be damaging and may sometimes be catastrophic. A few families may be bound more firmly together by the experience, but in several, the stress imposed far outweighs the benefits. The demand that physically handicapped children make on society is also very substantial. Despite the apparent changes in the public's attitudes toward the handicapped, services available are still far short of the ideal. In the Isle of Wight survey (Rutter et al, 1970) dissatisfaction with the services available was expressed up to 80 per cent of the families studied irrespective of the severity of the handicap of the child. Little mention is made of the nature of the handicap itself.(ABSTRACT TRUNCATED AT 250 WORDS)