Educating a student with Spina Bifida A Research Paper By Gina Dunn Spina Bifida is mysterious to many educators because

it is physical disability that many educators have heard of but may not face in their classrooms in terms of educating a student with the disability. Spina Bifida may appropriately be defined as an incomplete closure of the spine. The closure of the spine occurs at week 8 of the gestational development of a baby and the incomplete closure occurs when there is not sufficient folic acid in the mother. There are three broad types of Spina Bifida, but regardless, most babies born with the condition will require multiple surgeries to correct spinal, foot or leg problems over their life. Surgeries will begin with hours after birth and continue through childhood. The surgeries and recovery from surgeries will interfere with academic attendance and performance. Educational accommodations prior to surgery will need to be made so that the student does not academically suffer during recuperation time. The three broad types of Spina Bifida are: Lipomeningocele - a lipoma or fatty tumor is covered by skin and located over the lumbosacral spine. Meningocele the protective covering of the spinal cord is pushed out in a section of the spinal column. Myelomeningocele both the spinal cord and its coverings are out of position.

The most common, yet most severe form is Myelomeningocele and will be the form of Spina Bifida addressed in this paper. A common complication of babies with Spina Bifida develop hydrocephalus. Hydrocephalus is an accumulation of fluid on the brain, and if not drained, fluid buildup may cause brain damage, seizures and/or blindness. Hydrocephalus may be relieved, or
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avoided, by a shunt being placed in the brain to drain the fluid away from the brain. This procedure is one of the countless surgeries faced and is performed within days of birth. Often, a student with Spina Bifida is identified with their educational weaknesses rather than their strengths. A large population of those with Spina Bifida have average intelligence and strong verbal abilities. These two strengths lead to good social skills and the ability to get along well with others. Often, Spina Bifida students are the social butterfly of the classroom/school building. Some common learning problems encountered are: Poor eye-hand coordination Hearing or speaking but not necessarily understanding (comprehension) Poor attention (attention/distractibility) Restlessness/Fidgety (hyperactivity) Poor Memory for verbal and visual interactions Disorganized Poor reasoning/problem solving skills

Having a student with Spina Bifida in an inclusive elementary classroom presents unique learning and teaching moments for everyone in the classroom. An educator needs to understand the individual dynamics their student faces on a daily basis. Interviews with the student,

parent(s), physicians, occupational therapist(s), physical therapist(s), and any other appropriate service provider should occur prior to the start of the academic school year. Setting the classroom to be the least constrictive set up will make for the most conducive setting for the student in question. Ensuring that the student will be able to maneuver their wheelchair and
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walker around the classroom will be a necessity. Under the Section 504 of the Rehabilitation Act and the Americans with Disabilities Act, school buildings are equipped for students with disabilities by having ramps and fully functioning (and currently inspected) elevators throughout the building. Location of the students desk, is a priority so that mobility devices are within reach for those (i.e. student, teacher, Paraeducator, therapist) who require accessibility to them in an emergency. Placing the student near the teacher may also help reduce distractibility and assist with attention deficit issues. Location of the classroom is also important in case of an emergency evacuation. An established evacuation system will be required prior to the start of the school year. During the summer, prior to the beginning of the academic year, the teacher should work with the student to find their comfort zone in discussing their Spina Bifida while at the same time earning the trust of the student and establishing a safe teacher-student relationship. On the first day of school, during introductions, read the books What Can You Do? Inspiring Kids to Play by Kevin Arnold Haring and/or Spinabilities: A Young Persons Guide to Spina Bifida by Marlene Lutkenhoff and Sonya Oppenheimer. After reading the book(s), allow students to ask questions that will be within the student with Spina Bifidas comfort zone. An Individual Education Plan (IEP) will be appropriate in the majority of situations concerning students with Spina Bifida. At the bare minimal, a student with Spina Bifida should enter Kindergarten with a 504 Plan. The areas of academic weaknesses that are most prominent for those with Spina Bifida are mathematics, reading, writing and memory. Teaching a student with Spina Bifida does not need to be a daunting task. It is a matter of implementing teaching

methods to the daily routine. With the aid of a 1:1 Paraeducator spreads the workload out over the course of the day. The following techniques can make daily instruction most beneficial for all involved. With a visual checklist to solve word problems handy, students should solve word problems daily to help overcome the problem solving deficit at hand. Teach student to highlight math operational signs when working on math problems. Visual schedules displayed in sight of student assists in staying organized and learning organizational skills. Using a one-notebook binder system will assist student in organizing their work in one place. Teaching keyboarding skills on an adapted keyboard will assist student with handwriting process. Encourage students to read books that teach lessons, such as morals and social skills. Use graphic organizers for paragraphs and essays for writing skills and organization skills. Teach fact and opinion to reduce the gullibility that those with Spina Bifida often tend to be. Socially, students with Spina Bifida will stand out from their peers. There are ways to minimize the stigma and ease the isolation pain. Typically, those with Spina Bifida face

incontinence and need to be catherized and wear diapers/pull-ups/pads for bowel accidents. Many individuals living with Spina Bifida are able to change their own catherizations by the start of Kindergarten. If an individual is unable to change their own catherizations, though rare,
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accommodations may be made in advance of the beginning of the school year to work with the school nurse. The student will have scheduled times to step out of the classroom for a bathroom break with the school nurse. Scheduling those visits (as best as possible) may occur enroute to a special so the students dont necessarily see the student leave the classroom. If the

diaper/pull-up shows then discretely have the student fix their clothing so the others in class will not see. Keeping spare clothing in the classroom and in the nurses office will assist when there are accidents or clothing not fitting well arises. The main special a student with Spina Bifida will not be able to participate fully in is physical education and that is the ideal time to schedule O/T or P/T. The other specials are great ways for the students to unite as a community. Creating an awareness of space for those with Spina Bifida is imperative. Physical therapy may provide this and perhaps the class may be involved in this therapy as well. The therapy would involve rolling, turning, somersaulting and may be fun and beneficial for all the students while providing necessary therapy for a particular student within the classroom. Having speech therapy serviced in the classroom and involving fellow students may eliminate isolation and avoid further stigmatizing the student for having to leave the classroom for services. If done in a community setting the other students may not even realize what is occurring if all are involved in the therapy service. Two final benefit of speech therapy being held in the inclusive classroom is it can diminish social stigmatization of leaving the classroom for additional services and open the door to provide Right to Intervention (RtI) to fellow classmates who are on the brink of needing speech therapy services.

The only other activity that can pose a dilemma for the classroom would be outdoor recess time. Typically, school playgrounds are not conducive for those in wheelchairs or with walking devices used by those with Spina Bifida. Creating a recess buddy/buddies is a way to provide socialization time that can include the entire (or part) of the class. A recess

buddy/buddies can be selected from a hat/jar and then an activity is planned for that days recess time. Recess buddy activities may include: Use of the I-Pad for fun educational applications Wii games on the television Art project such as play dough sculptures or drawing or coloring Co-Reading to build up on reading skills for both students Puppet theater for entertaining dramatic play and role playing

Allowing teaching/learning moments so the student learns how to live with the fidgety behavior will be important. A teacher will need to perform a functional behavior assessment within the first few days of school and at home to establish the behavior routine of the student. Once the behavior assessment has been performed in school and at home then the IEP team may meet to create a behavior plan that will assist the student at school and home. Building attention skills will be necessary and can be incorporated into almost the entire day. Simple actions, such as observing the sounds and sights while traveling from one classroom to another classroom may assist with attention building. Spina Bifida within itself poses a variety of life and educational challenges for the individual and their family. A school can set the tone for the relationship through the delivery of educational services to assist the student in facing the educational and social challenges they

face. Welcoming the challenge and refusing to delve into the negative will benefit the student, family, school, and community at large while assisting the student to fulfill their desired destiny in the future. Teaching a student with Spina Bifida can be a rewarding challenge that many educators will not obtain but should be willing to embrace. The experience can truly enrich many lives!

References 1. 2. 3. 4. 5. 6. 7. 8. 9. Bifida Association of America. Reprinted in 1995. www.easterseals.com. Understanding Spina Bifida article. www.education.com. Spina Bifida. Article. Government of Alberta Education. Spina Bifida. Article. Jones & Jones. Comprehensive Classroom Management. Tenth Edition. 2013. Mercer, Mercer, Pullen. Teaching Students with Learning Problems. Eight Edition. 2001 Lollar, Donald, J., Ed. D. Educational Issues Among Children with Spina Bifida. Revised April 2001. Lollar, Donald, J., Ed. D., Learning Among Children with Spina Bifida, Published by the Spina www.suite101.com. Teaching the Child with Spina Bifida. Article