Learning Among Children with

Recently, the incidence of spina bifida has appeared to be decreasing in most areas. Emphasis on medical advances has been maintained with the advent of magnetic resonance imaging (MRI), bladder augmentation, new orthotics, shunt materials, etc. Still the children, adolescents, and young adults with spina bifida are often struggling to find their way toward substantive education, gainful employment, and autonomy in daily living. Initially, this issue for spina bifida children and parents was survival; followed by orthopedic problems, and bowel and bladder incontinence. As these young people as a group continued to experience dependence problems, professionals and parents placed emphasis on the emotional dependence that was often evidenced within the families. Paralleling these developments has been a continued effort to understand the neurological sequelae of spina bifida, including hydrocephalus and Chiari malformation. Along with these difficulties, on the positive side, these young people are often socially adept and good with words. As preschoolers, they are often hard workers with courage and motivation. They do not begin with as many difficulties early, but these may come as more independence is expected. These early strengths set the stage for expectations of normalize