Physical · Spina Bifida

What is it?

Spina bifida is a congenital malformation which affects the brain, nerves and spinal cord.

What causes it?

The exact cause is not yet known. It is thought that genes and the environment are part of the cause. The incidence of spina bifida has lessened in recent years as more women take folate supplements during pregnancy.

Incidence

Approximately 1 in a 1000 babies have spina bifida.

Medical Considerations

The severe forms are less common. There are two types:

• Meningocele: Fluid leaks out of the spine and pushes against the skin but there are usually no other symptoms
• Myelomeningocele: This is the most rare and severe form of spina bifida. The nerves are often damaged, which can cause problems with walking, continence, and coordination. The student may have little or no feeling or movement in the legs, feet, or arms.

Characteristics

It can make walking or daily activities hard to do without help. The disease can have mild or severe forms. Each person with the condition faces different challenges and may require different treatments. The mild form more common and does not need treatment. Most people with this type do not realise. In its more severe form there can be other issues:

• Fluid buildup in the brain causing seizures
• intellectual disability
• sight problems, or
• Scoliosis: curvature of the spine
• Motor problems: the ability to move, use tools, read and write

Support

Students may have difficulty with concentration and as a result may struggle to keep pace in class. They may appear fidgety and impulsive and struggle to organise themselves. Provide additional support during instruction and in planning tasks.

Further Information

Spina Bifida Association

Lesson Preparation & Materials

• Adapt materials to provide lower emphasis on written responses.
• Highlight key points and vocabulary on handouts.
• Include a variety of activities during each lesson.
• Provide extra materials and duplicate copies to minimise the weight of a student’s school bag.

Teaching Strategies

• Write key points on the board and supplement with verbal instructions.
• The provision of a laptop for personal use may enable students to keep up more ably with peers. Students should be seated near a power outlet.
• Investigate the practicality of speech-to-text and text-to-speech software. Assistive technology specialists may be able to evaluate the student’s needs.
• Simplify complex directions.
• Verbal skills are usually stronger than nonverbal skills especially if there is a timed component. Provide alternate activities.
• Reading and spelling is usually stronger than reading comprehension and maths skills. Provide support.
• In many cases reading skills will be an area of strength. Be sure that word decoding skills do not mask a lack of understanding.
• Test the student’s ability to make conclusions and draw inferences from text. Provide explicit instruction and techniques such as underlying key points.

Feedback & Assessment

• Some students may require understanding regarding completion of homework as therapies outside of school hours may be time consuming. A private area needs to be provided in many cases to enable catheterisation and other necessary personal care.
• Some students will need to carry fluids or medications. Access the student’s health care plan.
• Promote independence as much as possible. Ask the student if they would like help and how they would like that help. Avoid simply ‘jumping in’ to help.
• Special provisions may be required for assessments. These may include extra time, alternate presentation, a reduction in the number of questions or the use of a laptop or writer.
• Give frequent short quizzes rather than long tests. Provide choice or alternative options for assignments.
• Professional Learning for all school staff should provide information about the condition and strategies which can assist the student in accessing all areas of school life.
• Provide visual aids and organisational outlines. Have student review key points verbally.

Classroom Management

• Physical accommodations may include ramps, wide doors for wheelchair access and modifications enabling access to general areas such as toilet block, bus bays and the school canteen.
• Specialty areas such as science labs and technology rooms may require changes to enable students to work without disadvantage.
• Students may need allowances to leave slightly early from classes and/or arrive late to enable movement though less crowded corridors.
• A visual daily schedule may be useful. Time may also be allocated to attend to personal needs
• Preferential seating should include unencumbered access to the doorway.
• Timetabling considerations may enable student to access ground floor classrooms where possible for lessons and extra-curricular activities.
• Risk Assessment planning should be undertaken to consider excursions and fire drills.

Peers & SLSOs

• Practical Tasks may require additional support and supervision.
• Peers may assist with note taking and movement around the school eg. open doors.
• Assign student tutors or learning partners.
• Use teamwork with a range of responsibilities to suit student strengths.

Have I...

• Provided assistive technologies?

• Arranged for special provisions in assessment tasks – writer, extra time, separate supervision?

• Adapted assessment materials to include multiple choice and short-answer questions?

• Audited the classroom for physical or sensory issues?

• Issued materials prior to the lesson for student to preview?