This special edition explores the serious genetic disorder, Lesch-Nyhan Disease (LND), which is characterized by severe dystonia, spasticity, speech impairment, renal disease, varying degrees of cognitive deficit, and, especially, compulsive self-injury. The information provided is based on experience at the Matheny School and Hospital (New Jersey) and reflects that institution's philosophy of individualized treatment and development of skills necessary to self-direct one's life, regardless of the degree of disability. In the first section, an overview of LND is provided in tandem with a column of observations and comments by staff at the school about a specific case. Later sections focus on self-injurious behavior, health care, adapted equipment, speech/communication/feeding, education, and leisure/recreation. (Contains 11 references.) (DB)