Changes in Medical Practice Towards the Child with Spina Bifida: Implications for Schools

Up to 15 years ago, Spina Bifida Cystica and its complications was the second most common physical handicap in childhood, but has declined in incidence, occurring about 5.9/10,000 births in the UK. Similar reductions have been noted in other parts of the world. Several different causes are responsible for the fewer numbers of children, but changes of surgical management known as selective treatment is particularly important.

The small number of children initially denied surgery tend to be severely physically handicapped and often intellectually impaired, but most children treated without delay are physically less disabled and often within the normal range of intelligence. Such improvements in status has resulted in more children attending ordinary schools though some may have subtle learning difficulties which should be systematically sought for. There will be a corresponding decrease in the number attending special schools.