Spina Bifida

Definition: Spina bifida (“split spine”) is a neural tube defect that is caused by incomplete development of the brain or spinal cord. Spina bifida is caused by the spine not fully closing in the first month of pregnancy. This can sometimes create an open lesion that has caused damaged nerves or spinal cord. This hole can be repaired but nerve damage is permanent so paralysis may occur. This is the most common birth defect that causes permanent disability. One out of every 1,000 births is affected by spina bifida. There are three types of spina bifida; occulta, meningocele, and myelomeningocele. Occulta is sometimes called hidden spina bifida because there is no opening in the back and the spinal cord and nerves are intact. The problem occurs because there may be a defect or opening in the vertebra. Sometimes this may not cause any problems at all. They may never even know they have spina bifida unless an x-ray is taken. However, some people experience bowel problems, back and leg problems, or brain deficits. Meningocele is the rarest type of spina bifida. It is caused by the bones not closing around the spinal cord. This causes the meninges to push through creating a sac filled with fluid. The spinal cord and nerves are rarely affected and this can usually be cured by surgery. Myelomeningocele is the most common and most severe type of spina bifida. In this type, a part of the spinal cord actually protrudes through the back. The type of neurological problems depends on the location of protrusion. It may be only small bowel problems up to total paralysis of both legs. The most common cause of spina bifida is a deficiency of folic acid during pregnancy. Some research has shown that genetics may play a part. The only treatment for spina bifida is surgery and it is never fully cured. Some problems that may also occur with spina bifida are hydrocephalus, Chiari II malformation, tethered spinal cord, urinary tract disorders, latex allergies, learning disabilities, obesity, digestive tract disorders, and psychological and sexual issues.

Implications: Teaching a student with spina bifida may require absolutely no changes. If they experience no problems as with occulta, they will require no special assistance. However, if they have medical problems such as paralysis or bowel problems, I will discuss with the family and a health professional as to what I need to watch for and how to care for my student throughout the day. As for the rest of the class, I would ask the parents if they would like to come in and discuss spina bifida with them. I feel that if the students understand it more, they will be more likely to accept the differences. If the student experiences neurological deficits, I would deal with them as they came along. My opinion is that a child should be included in the regular classroom as much as possible. If this begins to cause problems for them, I would send them to a resource room. However, in my regular classroom, I would try to have a paraprofessional to assist my student. I would work with my student to see what they have problems with and adapt my lesson plans for their benefit. If the spina bifida caused a learning disability, I would treat them as if they were no different from any other student with a learning disability. I would adapt to their deficits and gain information on how to better educate them.

Specific Technology:

Surgical shunt: A valve inserted to make cerebrospinal fluid go into the bloodstream instead of the brain

CIC: (clean intermittent catheterization) method used for problems with bladder and urinary incontinence

Assistive Technology: wheelchairs, braces, crutches, ect.

Annotated Bibliography:

American Association of Neurological Surgeons. (September 2005). Neuro Surgery Today. Spina Bifida. Retrieved April 10, 2009 from http://www.neurosurgerytoday.org/what/patient_e/spina.asp.

This website was created by a group of neurological surgeons. The information is about the definition, types, and prevention of spina bifida.

Health Scout Network. (2009). Health Encyclopedia. Spina Bifida. Retrieved April 10, 2009 from http://www.healthscout.com/ency/68/596/main.html.

This network put together a very information website on Spina Bifida. It consisted of the description, causes, symptoms, risk factors, and treatment.

Liptak, G. S. (June 2008). Spina Bifida Association. Spina Bifida. Retrieved April 10, 2009 from http://www.spinabifidaassociation.org/atf/cf/%7BEED435C8-F1A0-4A16-B4D8-A713BBCD9CE4%7D/Spina%20Bifida%20low%20litJune%202008.doc.

This was a fact sheet from the Spina Bifida Association. It was in question/ answer form, but provided good information about the condition.

March of Dimes Foundation. (2009). Pregnancy & Newborn Health Education Center. Spina Bifida. Retrieved April 10, 2009 from http://www.marchofdimes.com/pnhec/4439_1224.asp.

This foundation created a very helpful website for mothers. It describes spina bifida and how it affects children. It provided details about who might be at risk for spina bifida.

Office of Communications and Public Liaison. (December 2007). National Institute of Neurological Disorders and Stroke. Spina Bifida. Retrieved April 10, 2009 from http://www.ninds.nih.gov/disorders/spina_bifida/spina_bifida.htm.

This website provided in-depth information about spina bifida. It consisted of the definition, treatment, prognosis, and research.