SPINA BIFIDA
FACT SHEET
A cleft spine, which
is an incomplete closure in the spinal column. According to Individuals with
Disabilities Education Act (IDEA) 1991; all children and youth with
disabilities are entitled to receive instruction in Physical Education.
CHARACTERISTICS
Spina Bifida Occulta
·
This is the mildest form. There is an opening in one or more of the vertebrae (bones)
of the spinal column without apparent damage to the spinal cord. Approximately
40% of Americans may have it, but because they experience little to no
symptoms, very few of them ever know that they have it
(http://www.nichcy.org/pubs/factshe/fs12txt.htm).
Meningocele
·
A moderately severe form of spina
bifida in which the meninges protrude, causing a bulge under the skin. The spinal cord remains intact. This form can be repaired with
little or no damage to the nerve pathways.
Myelomeningocele
·
Most Severe Form and also the most
common complex congenital (present at birth) abnormality. A portion of the spinal cord itself protrudes through the
back. In some cases, sacs are covered with skin; in others, tissue and nerves
are exposed.
Spina Bifida Manifesta
·
The combination of Meningocele and
Myelomeningocele. This occurs in approximately one out of every thousand
births.
(http://www.kimber.cjscreations.com/ksbpics.htm)
Common
Characteristics:
·
Muscle Weakness (in the feet, ankles
and/or legs)
·
Paralysis below the area of the spine
where the incomplete closure (or cleft) occurs.
·
Loss of sensation below the cleft
·
Loss of bowel and bladder control
·
Hydrocephalus (fluid build up that
causes accumulation of fluid in the brain. This can be controlled by
“shunting”. Shunting relieves the fluid build up in the brain lessening the
chances of brain damage, seizures, or blindness.)
·
Growth Deficiency
·
Difficulty with learning
·
Difficulty with paying attention
·
Difficulty with expressing or
understanding language
·
Difficulty grasping reading and math
·
Difficulty in locomotor and mobility
movements
·
Difficulty with fitness levels (Obesity
is common)
·
Motor Difficulties in the arms and
hands with perhaps some slowness in performing certain tasks.
·
Possible Seizures
·
Latex Allergies
CAUSE
·
Present at Birth (congenital)
·
Inefficient amounts of Folic Acid in
the mother’s diet while pregnant.
ETIOLOGY
·
This birth defect results from the
failure of the vertebrae to close completely around the part of the spinal cord
that it is supposed to protect. This occurs during the first three months of
pregnancy.
·
Spina bifida is a congenital
malformation however the causes are still unknown.
·
Taking folic acid before conception and
during the first few weeks of pregnancy may help reduce the risk of spina
bifida.
PROGNOSIS
·
Spina bifida doesn’t deteriorate
·
Hydrocephalus can be controlled by a
surgical procedure called “shunting”
·
The child should learn to manage their
bowel and bladder functions.
·
Those with a history of hydrocephalus
experience learning problems
·
Early intervention can help
considerably
IMPLICATIONS
FOR PHYSICAL EDUCATION
·
Be aware of weather conditions –
extreme conditions (Cold or Heat) can have an adverse affect on the individual
and their learning. Maintain Steady and ambient conditions
(http://www.nichcy.org/pubs/factshe/fs12txt.htm).
·
Be aware of Latex Materials. It is
common for a child with Spina Bifida to be allergic to latex.
Ø
Be aware of latex equipment like:
Balloons, Rubber Bands, Elastic in clothing, Beach toys, Koosh Balls, Diapers,
Art supplies, gloves, elastic bandages, adhesive tape, Band-Aids.
RECOMMENDED
ACTIVITIES
·
Mobility Skills (Using crutches,
braces, or wheelchairs)
·
Emotional and Social Development
Ø
Encourage children within the limits of
safety and health, to be independent and to participate in activities with
their non-disabled peers.
·
Bladder Management Program
·
Modify equipment and curriculum for
inclusion purposes
·
Early Intervention can help
considerably
·
Work on Physical Fitness
Ø
Develop good cardiorespiratory fitness
early in life.
·
Cooperative Activities
Ø
Increase self-esteem,
self-consciousness and self-image
Ø
Increase Peer Awareness
ASSESSMENT
SUGGESTIONS
·
Denver Developmental Screening Test II
Ø
http://www.denverii.com/
Ø
http://www.fpnotebook.com/PED59.htm
Ø
http://www.uvm.edu/~cdci/pedilinks/pediatric/tools/ddstII.htm
·
Hawaii Early Learning Profile (HELP)
Ø
http://www.vort.com/profb3.htm
·
Pediatric Evaluation of Disability
Inventory (PEDI)
Ø
http://www.med.unc.edu/wrkunits/syllabus/distedu/childas/publish/refsupp/pedi.pdf
Ø
http://www.nemc.org/rehab/pedi_inf.htm
·
Observe
Ø Social interactive signals between the child and caregiver (learn
about the child’s communication styles,
behavior management procedures, and the child’s responses to the environment)
Ø Observe the child in a pre-established free play environment.
Observe the physical, motor, and interactive abilities.
§
Look for visual pursuits,
muscle, tone, gross motor patterns, functional mobility, and fine motor/hand
function.
§
With formal assessments
look for: reflexes, development of equilibrium and balance reactions, and
development of gross motor and fine motor patterns.
EFFECTIVE
TEACHING STRATEGIES
·
Modify equipment, and the
environment.
Ø
larger racket, Velcro band
to help student hold racket, larger
ball, larger target, smaller field, less distractions, softer balls, slower down the activity,
modify the rules (ex: two bounces in tennis).
·
Use developmentally
appropriate equipment
·
Set up Exercise Routines
·
Use large bright and to the
point visual aids
·
Having repetition in activities and
verbal instructions/demonstrations
·
Setting up routines
·
Modeling organization
·
Teaching organization (have the
students think to themselves how they can stay organized and what they can do
to be more organized)
·
Teaching the concept of time and
performing activities in steps, providing exercises that work on sequence
·
Developing games for the students where
they work on solving problems
·
To increase the lack of attention give
short assignments or chores that can be done successfully. This will increase
the child’s concentration.