OBJECTIVE: The Family Hardiness Index (FHI) has been used to glean insight into the functionality of the family unit (in terms of family commitment, confidence, challenge, and control) as a potential factor influencing outcomes of care for ill children. A potential consequence of care giving is the loss of time or performance in other aspects of the care giver's life (for instance work or academic productivity). METHODS: We measured family hardiness and productivity using validated instruments that provide index measures for each; family hardiness index (FHI) and work productivity and activity index (WPAI) in 60 families presenting to a pediatric neurology clinic. The FHI score was used to stratify families into three groups: low hardiness (FHI < 40); medium hardiness (FHI=41-50), and high hardiness (FHI=51-60). Participating families were dichotomized into two groups based on WPAI: families whose caregiver reported a WPAI decrement, and families whose caregiver reported no WPAI decrement. Relative odds were calculated using chi-square test of association (univariate) to determine the association of FHI with WPAI. The odds of reporting a WPAI decrement were calculated for each FHI strata compared with the highest FHI stratum. RESULTS: The relative odds, 95% CI (p = value) of reporting a WPAI decrement in the low (FHI ?40) and medium (FHI 41-50) strata compared to the high (FHI 51-60) stratum were 3.4, 0.3 to 35.0 (p = .29) and 1.3, 0.3 to 5.4 (p = 0.73), respectively. CONCLUSION: Recognizing factors associated with disease burden may allow providers of epilepsy care to offer families additional supportive services that may be associated with important indirect consequences of disease, such as productivity. Although not significant, our results suggest that family hardiness might be useful for this purpose, however further validation studies are needed. The influence of seizure severity and therapy type on productivity should also be determined using a multivariate approach.