Children With Spina Bifida - What Teachers Need to Know

What is spina bifida, you ask? Well here are some basics that will help increase your understanding of this type of physical disability that affects some children in mainstream and special education settings.

Spina bifida is a type of physical disability. Along with cerebral palsy, it is one of the most common congenital disabilities. (This means it is a type of physical disability which occurs before the birth of the child, rather than occurring due to problems with the birth process, or after birth, as with some types of physical disability).

Spina bifida affects around one in 1600 births (although some statistics put this at around 1 in 100 births).

Spina bifida is often associated with another condition called hydrocephalus, which is where cerebrospinal fluid builds up within the skull and causes pressure on the brain of the child.

Spina bifida occurs when part of the spinal column does not form perfectly, and part of the spinal cord protrudes outside the vertebrae of the spine, leaving it exposed rather than safely nestled inside the protective boney vertebrae.

Often the part of the body which is controlled by the central nervous system (and spinal cord) below the area where the cord has been affected will be limited in terms of movement control and sensation. This is because the nerves which come from the spinal cord are affected, as well as the cord itself. Unlike a spinal cord injury which often results in a severing of the spinal cord, there may be some retention of the functioning of the cord beyond the level of the lesion. So a child with spina bifida may have some sensation and movement control in the body beyond that area controlled by the level of the lesion.

What causes spina bifida? Well the exact causes of spina bifida are still not fully understood. However it is known that both genetic and environmental causes play a part in spina bifida. One of the causes of spina bifida that can be addressed simply and easily before a pregnancy occurs is folate levels in the mother. Low levels of folate are known to increase the chance of spina bifida occurring in the developing fetus. By increasing awareness of folate's importance prior to and during pregnancy, the incidence of spina bifida has decreased over time.

Teachers do not need to know or consider the causes of spina bifida for individual students, as this has no bearing on teaching strategies. Issues such as level of folate consumption by the mother prior to pregnancy may have a part in whether a child develops spina bifida, but teachers should be aware of the need for extreme tact and care in any conversations which relate to folate with parents of children who already have spina bifida. For some parents, the guilt associated with 'did I cause this because I didn't have enough folate in my diet' is harrowing and unnecessary, and should be avoided from a teaching perspective, as they are irrelevant and potentially very disturbing to a parent.

Teachers of children with spina bifida need to be aware of the individual needs of their student. Spina bifida affects different children in different ways, due largely to the variation in level of the lesion on the spinal cord. Typically a lesion which occurs lower in the spinal cord will be associated with higher levels of sensation, mobility and physical independence for a child with spina bifida.Teachers need to consider issues such as:

• toileting and continence needs
• ability to be independently mobile (in an electric or manual wheelchair, or using crutches, a walker or without aids)
• potential problems linked with low or no sensation of the limbs (watch for contact with hot or sharp surfaces, as well as pressure sores due to poor positioning, imperfect clothing alignment etc)
• problems related to hydrocephalus (an associated condition which often occurs along with spina bifida)