What Teachers Should Know

Spina bifida is a birth defect in which part of the spine does not form normally before birth, leaving an opening in the back. As a result, the spinal cord and nerves may be damaged.

There are three types of spina bifida:

1. Spina bifida occulta is the mildest form. “Occulta" means "hidden," and the defect is covered by skin. There is no protrusion of the spinal cord or its coverings. Most children with this type don't have any problems, though some may develop symptoms as they get older.
2. Meningocele involves the meninges, the membranes that cover and protect the brain and spinal cord. The meninges push through the opening in the back, forming a sac called a meningocele. Since the spinal cord is not involved, there is little or no nerve damage. Some children will have mild disability.
3. Myelomeningocele is the most severe form of spina bifida. It happens when the meninges and the spinal cord push through the opening in the back. This causes nerve damage and is associated with more severe disabilities. Most people mean myelomeningocele when they say someone has spina bifida.

Problems that can happen with spina bifida include:

• hydrocephalus (fluid buildup in and around the brain) that requires a shunt to drain the extra fluid. Teachers should be aware of symptoms of shunt malfunction, which include headache, nausea or vomiting, and decreased physical or mental abilities.
  
• paralysis, depending on the location of the opening (the higher on the spine, the more severe the paralysis)
  
• bowel and bladder control problems
  
• poor eye–hand coordination, which can make it hard to do things like writing
  
• attention deficit hyperactivity disorder (ADHD) or other learning problems

Students with spina bifida may:

• use splints, casts, leg braces, canes, crutches, walkers, or wheelchairs
  
• need extra time moving around classrooms, between classes, and through the school
• need special seats and desks or tables, as well as assistive technology and extra space for wheelchairs or other equipment
• have learning difficulties and problems with memory, attention, comprehension, and organization
• need extra help and time to do assignments
• miss class time due to medical visits or surgeries
• need frequent bathroom breaks
• be allergic to products that contain latex (natural rubber)
• have specific accommodations listed in an individualized education plan (IEP) or 504 education plan

What Teachers Can Do

Most children with spina bifida have normal intelligence, but some may have learning difficulties. Every child with spina bifida is different, and students' specific abilities can vary widely. Understanding the extent of a student's condition will help you identify strengths and weaknesses in the classroom.

You may need to modify the classroom environment to meet your student's needs. Accommodations will depend on the student's impairment and the classroom. The student's specific needs should be listed in an IEP or 504 plan.