Embarking on the journey of caring for someone with spina bifida presents a unique set of challenges, yet early intervention opens a world of possibilities for your child's development and well-being. Here, we'll delve into the transformative power of proactive steps, highlighting the array of therapies and strategies you can implement.

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Spina Bifida Defined

If a person has spina bifida, a section of their spinal column failed to form completely, exposing the spinal cord and nerves, which may lead to complications.

This condition develops in the early stages of pregnancy, typically within the first 28 days. Symptoms range in severity, and while some people with spina bifida may have noticeable disabilities, other cases will go undetected. For more information, you can read our brief primer on spina bifida here.

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The Crucial Role of Timely Diagnosis

Routine prenatal screenings, like the mid-pregnancy anatomy scan, play a vital role in detecting spina bifida.

Early diagnosis lays the foundation for effective management. While children with the mildest form of spina bifida (spina bifida occulta) rarely need treatment, babies with more severe types (like myelomeningocele and meningocele) require immediate intervention after birth.

In some instances, interventions may take place prenatally.

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Surgical Interventions

Prenatal Surgery:

In some instances, fetal surgery may be an option. This proactive measure aims to address the spinal defect before birth, potentially mitigating neurological damage and minimizing symptoms. Studies indicate significantly improved long-term results of prenatal surgeries as compared to traditional postnatal surgeries. Typically, the earlier the intervention, the better the outcome.

Postnatal Surgery:

Postnatal surgery for spina bifida is usually performed within 24 to 48 hours of birth. In this case, the surgeon works to correct the incomplete closure of the spinal column. The procedure involves placing the spinal cord and any exposed tissues or nerves back into their correct position and closing the gap in the spinal column. While this surgical intervention addresses the issue moving forward, it cannot reverse any existing nerve damage.

Hydrocephalus:

Hydrocephalus — a condition characterized by excess fluid in the brain — is a common complication in spina bifida and is corrected surgically. In this procedure, a surgeon implants a shunt, a long, thin tube that drains fluid from the brain and carries it to the abdomen, where it’s absorbed. A neurosurgeon may perform this procedure at the same time as spine surgery.

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Therapeutic Interventions

Early childhood is a critical period for neurological and developmental growth. Children are exceptionally impressionable, their bodies and brains developing rapidly. Initiating interventions early on allows for maximal impact on motor skills, cognitive abilities, and social development.

Physical Therapy: Exercising Persistence

Children affected by spina bifida have diverse needs, and their treatment plans are equally varied. However, one thing is clear: starting a physical therapy regimen early and sticking to it consistently improves outcomes.

Physical therapy treatment may include exercises like:

• Treadmill to improve mobility.
•  Assistive devices to improve gait and posture.
• Full-body stretches to improve posture, balance, and coordination.
• Strength-based exercises to maintain and improve muscle strength.
• Practicing functional activities to improve quality of life and prevent risk of falls.

Physical therapists can also teach children and adults how to practice exercises at home. While it’s ideal to begin physical therapy at a young age, many continue physical therapy and/or exercises into adulthood to maintain their progress. It is also recommended that people with spina bifida exercise at least five times and stretch at least three times per week.

Occupational Therapy: Mastering Life Skills

Occupational therapists work with children with spina bifida to help them navigate their day-to-day life. They’ll likely look at your child’s daily schedule and identify exercises to help them maximize their independence throughout the day.

For example, an OT might teach a child how to brush their teeth, do their chores, or improve their handwriting. They can also work with the child to improve his organizational or executive functioning skills. Occupational therapists sweat the small stuff, acknowledging that the most mundane tasks help kids feel a sense of normalcy.

Behavioral Therapies: Shaping Cognitive and Social Development

Given the social and intellectual challenges associated with spina bifida,  early engagement in behavioral therapies can be transformative.

While the precise relationship between spina bifida and social development isn’t yet clear, it seems that children with spina bifida experience greater challenges in the social and emotional realms. (This appears to be particularly common among those who had hydrocephalus and, consequently, a shunt placed.)

A good therapist can help enhance their understanding of social cues, which will, in turn, foster positive interactions with the people around them. They can also provide emotional support and coping skills, given the emotional complexities that can accompany life with a disability.

Some children with spina bifida experience learning disabilities, intellectual disabilities, or symptoms of ADHD. It’s important to collaborate with educators to develop an individualized education plan as needed to ensure that they feel supported in school.

In the world of spina bifida, it’s clear that acting early yields results.  Every step taken — be it a surgical or therapeutic intervention — becomes a building block for a brighter future. Because when it comes to fostering independence, there’s no such thing as a small victory. 

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