KFF Health News Apr 4 2025 Alanys Ortiz reads Josephine Senek's cues before she speaks. Josephine, who lives with a rare and debilitating genetic condition, fidgets her fingers when she's tired and bites the air when something hurts. Josephine, 16, has been diagnosed with tetrasomy 8p mosaicism, severe autism, severe obsessive-compulsive disorder, and attention-deficit/hyperactivity disorder, among other conditions, which will require constant assistance and supervision for the rest of her life.