2. Agenda
Meet Sonia and her family
What is Spina Bifida?
Cause of Spina Bifida
What are some of the characteristics of
Spina Bifida?
Types of Spina Bifida
Symptoms of Spina Bifida
The need of the child
The need of the family
How parent can help his/her child?
How they will respond to those needs
in the preschool room setting
Meeting the needs in the child care
center
Discuss the child special need.
Professionals that the child might need
Teach classmates how to help a child
with a physical disability
Impact of Spina Bifida in young
children
Impact on Families
What are the most common types of
therapy?
Strategies to include Sonia
Modification
What to do in kindergarten for Sonia
to be inclusive
Teach concept
Other adaptive learning environment
that can be used teaching strategies to
parents
Teach order of Events
Agencies in local area
Things to remember...
Bibliography
3. Sonia is 7 years old and she is new to the center. She has Spina Bifida and uses a wheel
chair. She also has a shunt to lesson fluid on the brain. Sonia is good at language skills.
Sonia’s parents speak English and French. They arrived to Toronto newly and they need
help from the teacher. Finally, her parents are interested in sports and entertainment
programs.
4. It is a birth deficiency in which the backbone and spinal canal do not adjacent before
birth. Also it is a neural tube defect in which bones of spine do not completely form;
resulting in an incomplete spinal canal. The condition is a type of Spina Bifida.
Video : http://www.youtube.com/watch?v=6Ii_v3t9hpU
Centers for Disease Control and Prevention, 22 June 2012,
5. No one knows completely what cause SB. Scientists stated that it is most likely due
to a combination of inherited (genetic), environmental and nutritional factors.
Lack of folic acid during the pregnancy has a higher chance of giving birth to a baby
with SB. However, experts recommend for women of reproductive age to make sure
their folic acid intake adequate.
If a woman gives birth to a baby with SB, she has a higher-than-normal risk of
having another baby with SB too (about 5% risk).
Treating Epilepsy or Bipolar disorder have been associated with higher risk of
congenital defect birth such as SB, and some medication as well.
Women with diabetes are more likely to have a baby with SB, compared to other
females.
Benghafner March 7th, 2008 ,The C.A.M. Report
6. Difficulties with bowel and bladder
control may occur. This symptom is
dependent on the location of the lesion
on the back.
Other conditions such as latex
allergies and possible skin breakdown
from lack of feeling are also
associated with Spina Bifida.
Developmental delays may occur and
learning disabilities are possible.
May cause learning problems such as
difficulty paying attention, and
expressing or
Understanding language. Organizing,
sequencing, and processing of
information in
Reading and mathematics may also be
affected.
Mobility may be affected. How much
movement your child has in his/her
legs
depends on where the lesion is on the
back. The higher the lesion, the lower
the chance is of walking independently
Rlbates, September 4, 2007, Sutured for a living
8. Spina bifida occulta: Visible indications
of SB occulta can sometimes be seen on
the newborn's skin above the spinal
defect, including:
An abnormal tuft of hair
A collection of fat
A small dimple or a birthmark
Skin discoloration
Meningocele: in this rare form, the
protective membranes around the spinal
cord (meninges) push out through the
opening in the vertebrae.
Myelomeningocele: tissues and nerves
are exposed, making the baby prone to
life-threatening infections.
Neurological impairment is common,
including:
Muscle weakness, sometimes
involving paralysis
Bowel and bladder problems
Seizures, especially if the child
requires a shunt
Orthopedic problems
Sharon Ennis, october5, 2009, Spina Bifida: The Journey
9. Help the child feels that she is needed
and belongs to the classroom
environment.
Encourage and support the child's
independence such as self-sufficiency,
self- reliant, and self-control.
Know how the equipment works
(crutches) and ask her to show us how
we can help even her peers too.
Stress the things that the child can do,
not the things he cannot do.
Let the child know that many people
with physical disabilities lead useful
and happy lives.
Some adaptation of the activities may
be necessary. Of course anything
involving use of the legs may have to
be done sitting down
Zivka Nikolic, January 28, 2012, There are only benefits of inclusion; there is not any negative
effect!
10. Provide information and emotional
support to the mother to learn more
about children who have Spina Bifida
Get information and find clinics or
health care providers who are expert in
Spina Bifida
Provide resources for the mother to get
help about feeling
Be consistent and clear when
disciplining the child
Help her to use the correct words and
phrases to express her need.
Help the child through the steps to
solve problems when she is upset.
Give the child a limited number of
simple choices.
BA Haller, July 5, 2009, Experimental surgery may hold hope
for children with spina bifida
11. Consistent and active treatment is
important to your child’s development,
so please make every effort to attend
all sessions in a treatment block.
Become active in your child’s therapy
following through with home
programming and asking questions
whenever you have concerns.
Maintain contact and speak regularly
with your child’s health care team
Keep your child’s team informed of
any changes.
Communicate your concerns and goals
for your child with his/her therapists.
Encourage your child to try new
things.
It is important to provide a strong
social support system for your child.
Being the parent of a child with
Spina Bifida requires a lot of
attention and energy, so be sure
to take time for yourself and look
after your own needs as well.
Keep in touch with family and
friends – seek out their support
when needed.
Take advantage of community
resources and services available
to you and your child.
The better informed you are as a
parent, the better prepared you
will be to get the best services
from medical, educational, and
community programs
Keep in touch with family and
friends – seek out their support
when needed.
12. Adapt learning activities to be
inclusive for the child with Spina
Bifida
Provide tools for the child with motor
disabilities can use for grasping,
holding, transferring, and releasing.
Make sure the materials are age
appropriate for all children in room to
use.
Provide materials of different textures
such as play dough, fabric swatches,
ribbon, corrugated cardboard and
sandpaper to stimulate the sense of
touch
We will make sure activity areas are
well-lighted, and I will add lamps if
needed.
Work with parents and specialists to
choose special exercises for the
child, and encourage the whole class
to do some of them as part of a large
group activity.
Add tabs to books for turning pages.
Place tape on crayons and markers
to make them easier to grip.
Secure paint brushes into a glove, or
provide paint brushes with large
knobs on the ends.
Consider buying scissors that open
automatically when squeezed, or
scissors that do not require children
to use finger holes.
Plan activities to encourage all
children to move all body parts.
How they will respond to those needs
in the School age room setting
13. The environment :
Children learn through the
environment
Gather as much as information we
can about the child with special need,
and learn about typical modifications
that can be made.
Working closely with parents,
professionals will be an excellent
resource to get suggestions and to ask
questions.
Modification of the environment
would be beneficial for the child in
special needs and even for her peers
Plan together:
Set a goal in collaboration with parents,
consultant, and caregivers to be a part of
the team who develops the child`s
Individualized Education Plan (IEP).
Meeting together to plan goals and
needs of the child, and discuss about
activities, exercises, and support needed
to reach goals in closely collaboration.
These goals should always match the
child’s disability by discussing ideas and
plans with the family.
14. Make it easy to move around in play areas
by arranging furniture and equipment with a
wide aisle so the child can move around
more freely.
Providing a safe place for walkers,
crutches, or canes so other children do not
trip over them; using heavy, stable furniture
and equipment that cannot be easily knocked
over.
Moreover, work together with the parents
to come out with a comfortable ways for
child to sit, a corner with two walls for
supports, a chair with a seat belt, or a
wheelchair with a large across. These are
some ways we could help.
Benghafner March 7th, 2008 ,The C.A.M. Report
15. Applaud and encourage helping
behaviors, and also teach them
to encourage their classmates to
do as much as possible on her
own.
Teach children to assist children
with disabilities when need
Teach children how to offer
help respectfully
Encourage them to ask if the
child wants help first, and to
take “no” as an answers.
Encourage children to find creative
ways to include a child with physical
disability in their play activities
Teach classmates how to help a child with a
physical disability
Parenting Blog,June 23, 2011, Physical Therapy: Warning Signs and What Parents Can Do from KidsCare Therapy
16. Spina bifida can happen anywhere along the spine if the neural tube does not
close all the way. The backbone that protects the spinal cord does not form and
close as it should. This often results in damage to the spinal cord and nerves.
Spina bifida might cause physical and intellectual disabilities that range from
mild to severe. The severity depends on:
The size and location of the opening in the spine.
Whether part of the spinal cord and nerves are affected.
Sharon Ennis, october5, 2009, Spina Bifida: The Journey
17. Spina Bifida affects the entire family. Meeting the complex needs of a person
affected involves the whole family and can be challenging at time. However, finding
resources, knowing what to expect, and planning for the future can help.
BA Haller, July 5, 2009, Experimental surgery may hold hope for children with spina bifida
Video: http://www.youtube.com/watch?v=2LyPOZf-6rw
18. The goal of therapy is to help your
child to maximize mobility and to
become as independent as possible at
home, in school, and in the
community.
Therapy involves: increasing strength,
balance, and flexibility through
exercise
preventing orthopaedic problems with
exercise and ositioning devices
recommending equipment to help with
independence, walkers, wheelchairs,
equipment increasing independence
with Activities of Daily Living
(ADL’s) such as dressing,
eating and toileting increasing
independent use of tools such as
scissors, pencils, cutlery, toothbrush.
Occupational Therapy and Physiotherapy
are the main therapies needed for
children with Spina Bifida.
Occupational Therapists and
Physiotherapists will often work as a
team in caring for your child.
bathroom equipment modifying
household
Parenting Blog,June 23, 2011, Physical Therapy: Warning Signs and What Parents Can Do
from KidsCare Therapy
19. As an ECE in order to help Sonia to move
around throughout the day we will use the
prompt and fading technique to help her
learn new skills, to built independence, and
self-esteem.
Also I will make sure that the physical
space are removal of barriers for her to have
traffic flow . Materials, toys, and equipment
will be accessible for indoor and outdoor for
wheelchair or crutches, appropriate size
toys, shelves at child level.
Safety and safe risk taking by being
responsive all the time, by understanding
child feelings, treating her as an equal
being rather than isolate, cognitive and
communication.
20. Name of prompt : Environment
Types prompt Examples ECE BODY
POSITION
Environment
prompting
Providing verbal
pictures, labelling
materials in the
room and cue cards
Full and partial
Least to most prompt is used when the child has the
skills but doesn’t do it on request.
Prompting and fading :Goal –Sonia will stand
up and move around when asked independently
Benghafner March 7th, 2008 ,The C.A.M. Report
21. Type of prompting Example ECE body position
Full prompting Put crutches in her
hand
In front of the child
Partial prompting Put the crutches in
front of her hand in
her own personal
space
Behind /beside the
child
Type of
prompt
Pointing
prompting
Example
Pointing to
the crutches
ECE body
position
Parenting Blog,June 23, 2011, Physical Therapy: Warning Signs and What Parents
Can Do from KidsCare Therapy
22. Types of
prompting
Example ECE body position
Full prompting Giving full step by
step instruction
without gesture
In front of the child
Partial prompting Giving partial
instruction and
waiting to see if the
child will do the
task
Behind or beside
the child.
Gestures prompting Asking questions
ADMIN, MARCH 20, 2011, What is Verbal Behavior?
23. Prompt: Modeling
Types of
prompting
Example Body positioning
of the ECE
Full Prompting Using verbal
instruction when
doing the task
together
In front of the child
Partial Prompting Using verbal
instruction to
pretend to do the
task
Beside/behind the
child
24. Prompting and fading :Goal –Sonia will stand up and
move around when asked independently
Types of
prompting
Example Body
positioning of
the ECE
Full
prompting
Hand over hand- The
child requires full
physical assistance to
carry out the task
In front/or behind
the child
Partial
prompting
The child requires
partial physical
assistance by touching
the arm, elbows and
wrist
In front or behind
the child
Benghafner March 7th, 2008 ,The C.A.M. Report
25. By providing specific classroom
devices and altering the classroom
environment, we will help Sonia to
achieve success in the classroom.
By providing a desk for her where
she can easily maneuver around the
classroom and have enough space to
sit comfortably.
We may need to provide a special
desk for her or rearrange some of the
classroom supplies to provide easy
access to the materials.
Scheduling to accommodate
anything imperative in the last minute
Amanda, July 31, 2013, Classroom Decor: The 'CUTE' Conversation
26. To help Sonia to be inclusive in
learning environment, we will
divide the class into learning station
so she will feel comfortable and
succeed in this new environment.
We will set up the desks or tables
in a way of all the student can
negotiate.
Also we will implement activities
which will promote inclusion and
integration among her peers to
encourage group work and
structured partner activities.
Cody Laplante, February 27, 2013, Inclusion Takes the Special out of
Special Education
27. Active learning: Effectively use to
develop cognitive skills among children
such as problem solving and critical
thinking, and improve student’s
understanding.
Collaborative/cooperative learning:
student work together in small groups
to accomplish a common learning goal.
Critical thinking: It brings the activity
together and enables the student to
question what knowledge exists.
Discussion strategies: Engaging
students in discussion deepens their
Learning and motivation by propelling
them to develop their own views and
hear their own voices. A good
environment for interaction is the first
step in encouraging students to talk.
Patti Richards, Demand Media, April 8,2006 The Effects of Behavior Modification in an Inclusion Classroom
28. During birthday party: this is a great
opportunity to see for yourself which
children interact best with your
child. The children that want to sit next
to the birthday boy or girl are good
candidates for future play
Ask your child’s teacher: if there is a
friend who likes to talk with your child
then try to connect with him to build a
friendship out of school.
Find another child with special needs:
Wouldn’t it be nice to find a fellow friend
who is going through the same issues and
might have similar interests?
ADMIN, MARCH 20, 2011, What is Verbal Behavior?
29. Experience learning: an approach of
educational of focus on learning by
doing. ECE role is to design direct
experience that include preparatory and
reflective exercises.
Games/experience/simulations:
Games and simulations enable students
to solve real-world problems in a safe
environment and enjoy themselves
while doing so.
Humor in the classroom: Enhance
student learning by improving
understanding and retention.
Inquiry guided learning: Encourages
students to build research skills that can
be used throughout their educational
experiences.
Learning community: Communities
bring people together for shared
learning, discovery, and the generation
of knowledge
ADMIN· JULY 22, 2011, How Can Visual Supports be Used in the Inclusive Classroom?
30. Where there located?
P.O. Box 103, Suite 1006
555 Richmond Street West
Toronto, Ontario M5V 3B1
Toronto & GTA: 416-214-1056
Toll Free: 800-387-1575 (Ontario Only)
Fax: 416-214-1446
Email: provincial@sbhao.on.
What they are doing?
“To build awareness and drive education,
research, support, care and advocacy to help
find a cure while always continuing to
improve the quality of life of all individuals
with spina bifida and/or hydrocephalus.”
http://www.sbhao.on.ca/programs-services/care-
and-support/parent-support
Spina Bifida & Hydrocephalus Association of Ontario, april 5 2014.
31. Spirit of our organization that has been
committed for over 30 years to making a
positive difference in the lives of people
with SB&H, an association of volunteers
providing a comprehensive range of help
to parents, families, youth and adults
with SB&H.
Breakthrough because of our spirited
and sustained mission of research,
awareness, care and advocacy our
organization will steadily break through
barriers and continually improve the
quality of life and ensure fair treatment
and social justice for all individuals with
SB&H.
Hope within our organization dedicated
to ongoing therapy, medical care and
surgical treatments to minimize further
neurological damage and through our
determined commitment to Spirit,
Breakthrough & Hope a cure will be
found.
What to do with family?
They understand how difficult it can be,
even when things are going smoothly, to face
the added challenges and concerns of living
with spina bifida and/or hydrocephalus.
SB&H provides direct service to adults,
youth, parents and guardians dealing with
the challenges of spina bifida and/or
hydrocephalus, offering information,
resources, emotional support, counselling
and networking opportunities.
For more information please contact SB&H
at 1-800-387-1575 or email
http://www.sbhao.on.ca/programs-
services/care-and-support/parent-support
32. What to do with family?
Spinal Column
Trauma/Developmental
Anomalies
Children and adolescents with
defined spinal column/cord
injuries or developmental
anomalies are treated jointly by
the orthopaedic and
neurosurgeons. Both external and
operative internal fixation
procedures are carried out and the
rehabilitation program customized
individually for each patient.
SickKids & social media: Interview with Janice Nicholson
NOVEMBER 23, 2011
Where there located?
The Hospital for Sick Children
555 University Avenue
Toronto, Ontario
Canada
M5G 1X8
General inquiries: 416-813-1500
Patient information/locating: 416-813-6621
33. Services are provided by a pediatrician,
ambulatory care nurses, physiotherapists,
an occupational therapist, a speech-
language pathologist, a social worker and a
psychologist.
has access to medical consultants in the
areas of orthopedics and urology. To
enable co-ordination of care of each child,
the Spina Bifida/Spinal Cord team
communicates with other involved
community partners such as schools
Referrals
To access this service, a pediatrician’s
referral is required and the client must reside
within the Toronto area or within an area that
cannot access a local treatment centre within
Ontario.
http://holland-
bloorview.heroku.com/floors/2/facilities/57
Spina Bifida and Spinal Cord Contact
Dulcie Styles
Clinic Secretary, Child Development
Program
Tel: 416-425-6220, ext. 3835
E-mail: dstyles@hollandbloorview.ca
Child Development Program
Tel: 416-425-6220 ext. 7050
What to do with family?
The Spina Bifida/Spinal Cord team uses a
multidisciplinary, family centred
approach. Clients are seen annually or
more frequently if necessary, in a clinic
setting by various professionals as
determined by the needs of each
client. also provides intervention and
consultation as required between clinic
visits.
•
ADMIN on MARCH 7, 2011, Holland Bloorview Kids Rehabilitation Hospital
34. Plan of Action
Who What When
Staff & Supervisor Training Staff April 13, 18, 20, 2014
Supervisor Attending workshops on Spina
Bifiad & layout of room for staff
April 1,5,7, 2014
Resource Consultant & Parents Meeting with a Paediatrician April 11, 13, 19, 2014
Resource Consultant & Parents Meeting a Social worker and
counsellor
April 12, 18, 21, 2014
Resource Consultant Meeting with Physical therapist April 1,3,6, 2014
Resource Consultant Meeting with a Paediatric
orthopaedic surgeon
April 23, 26, 29, 2014
Resource Consultant Podiatrist April 2, 4,10, 2014
Resource Consultant & parents Going to see places for
recreation programs
May 10, 13,15, 2014
Resource Consultant Finding summer camps May 21, 24, 30, 2014
35. Spina Bifida occurs in all races,
ethnic groups, scioeconomic
classes, and nationalities and in
both boys and girls.
Each child with Spina Bifida is
a unique individual with his/her
own personality, strengths,
talents and thoughts.
Children with Spina Bifida can
participate in many community
programs such as sports, arts
and crafts, music, scouts,
school, etc.
Centers for Disease Control and Prevention, December 26, 2013, Living With Spina
Bifida
36. Quiz Time
What was our child’s
name?
How many types of
Spina Bifida are there?
Name one of the
agencies that we have
told you about.
37. References
Centers for Disease Control and Prevention, (2012), Wikipedia, the free encyclopedia, Retrieved date: march
10, 2014 Retrieved from: http://www.cdc.gov/ncbddd/spinabifida/facts.html
Rlbates, September 4, 2007, Sutured for a living, retrieved date: march10.2014, Retrieved from:
http://rlbatesmd.blogspot.ca/2007/09/myelomeningocele-mmc-repairs.html
Sharon Ennis, october5, 2009, Spina Bifida: The Journey , retrieved date: march10.2014, Retrieved from:
http://www.yummymummyclub.ca/family/special-needs/spina-bifida-journey
ADMIN, MARCH 20, 2011, what is Verbal Behavior?, retrieved date: march10.2014, Retrieved from:
http://www.autism-community.com/what-is-verbal-behavior
Amanda, July 31, 2013, Classroom Decor: The 'CUTE' Conversation, retrieved date: march10.2014,
Retrieved from: http://rainbowswithinreach.blogspot.ca/2013/07/classroom-decor-cute-conversation.html
Cody Laplante, February 27, 2013, Inclusion Takes the Special out of Special Education, retrieved date:
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special-education
Patti Richards, Demand Media, April 8,2006 The Effects of Behavior Modification in an Inclusion
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behavior-modification-inclusion-classroom-28925.html
ADMIN· JULY 22, 2011, How Can Visual Supports be Used in the Inclusive Classroom?, retrieved date:
march10.2014, Retrieved from: http://www.autism-community.com/how-can-visual-supports-be-used-in-the-
inclusive-classroom
Sick Kids & social media: Interview with Janice Nicholson,NOVEMBER 23, 2011, ?, retrieved date:
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media-interview-with-janice-nicholson
38. References
(2011),Specific Ideas for Child Care Providers to Help Children with Physical Disabilities, Retrieved date:
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providers-to-help-children-with-physical-disabilities#.U0HaNqhdW8A
N. Scott Adzick, MD (2011) Spina Bifida Facts Video, Retrieved date: march 10, 2014 Retrieved from:
http://www.youtube.com/watch?v=6Ii_v3t9hpU
March of Dimes. (2009, August). Spina bifida, , Retrieved date: march 10, 2014 Retrieved from:
http://nichcy.org/disability/specific/spinabifida
Spina Bifida(2013)Centers for Disease Control and Prevention, , Retrieved date: march 10, 2014 Retrieved
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Spina Bifida(2009), Retrieved date: march 10, 2014 Retrieved from:
http://www.youtube.com/watch?v=CldPx9EwYAc
Living With Spina Bifida(2013) Centers for Disease Control and Prevention, ), Retrieved date: march 10,
2014 Retrieved from: http://www.cdc.gov/ncbddd/spinabifida/living.html
Mayo Clinic Staff,1998-2014 Mayo Foundation for Medical Education and Research., Symptoms, Retrieved
date: march 10, 2014 Retrieved from: http://www.mayoclinic.org/diseases-conditions/spina-
bifida/basics/symptoms/con-20035356
Christian Nordqvist,(2011)What Is Spina Bifida? What Causes Spina Bifida? ), Retrieved date: march 10,
2014 Retrieved from: http://www.medicalnewstoday.com/articles/220424.php
39. References
Lucie Westminster,(2011) Adaptations for an Inclusive Classroom, Retrieved date: march 10, 2014 Retrieve
from: http://www.ehow.com/info_8346921_adaptations-inclusive-classroom.html#ixzz2y9R8fmvc
Dawn Villarreal,(2014), Finding friends for your special needs child, , Retrieved date: march 10, 2014
Retrieve from: http://www.oneplaceforspecialneeds.com/main/library_finding_friends.html
Spina Bifida & Hydrocephalus Association of Ontario(2011), Retrieved date: march 10, 2014 Retrieve from:
http://www.sbhao.on.ca/programs-services/care-and-support/parent-support
Deborah Elbaum, M.D.,(2010) Teaching Your Child about Peers with Special Needs, Retrieved date: march
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Jessica Cook, eHow Contributor,(2012), Classroom Strategies for Students with Physical Disabilities,
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