Therapy Plan for Spina Bifida

The early period often involves surgical closure of the spinal defect, shunt placement for hydrocephalus (if needed), and close monitoring of neurological function. Physiotherapy begins early with gentle range-of-motion exercises, positioning, and support for motor milestones. Many babies with spina bifida will need orthotic devices (braces) to support leg alignment. Occupational therapy helps with feeding, hand function, and early developmental stimulation. Parent education on skin care, catheterization, and recognizing signs of shunt malfunction is essential during this stage.

This is a critical period for establishing mobility. Depending on the level of the spinal lesion, your child may walk with braces and crutches, use a combination of walking and wheelchair, or use a wheelchair primarily. All forms of mobility are valid — the goal is independence and participation. Begin wheelchair skills training early if your child will use a wheelchair. Hydrotherapy is especially beneficial for spina bifida because it allows movement and strengthening without the challenge of gravity. Begin teaching self-catheterization readiness skills (understanding their body, participating in the routine) even at this young age. Ensure the preschool environment is fully accessible.

School-age goals focus on maximizing independence: self-catheterization, managing orthotics and wheelchair independently, handwriting or keyboarding, and playground participation. Work with the school to ensure full physical accessibility and develop an appropriate health care plan that covers catheterization, skin checks, and emergency protocols. Encourage participation in adapted sports — wheelchair basketball, swimming, sledge hockey, and handcycling are popular options that build fitness and confidence. Monitor for learning challenges, as some children with spina bifida (particularly those with hydrocephalus) may have difficulties with math, attention, or executive function. Orthopedic monitoring is important, as tethered cord, scoliosis, and hip issues may require intervention.

Teens should be taking full responsibility for their own catheterization, skin care, and health monitoring with decreasing parental oversight. Address body image, self-esteem, and social challenges — teens with spina bifida may feel isolated or different from peers. Cognitive-behavioral therapy can help manage these feelings. Begin transition planning for adult healthcare (moving from pediatric to adult specialists) and adult disability services. Explore post-secondary education options, career interests, and workplace accommodations. Ensure your teen has a current wheelchair that fits properly and meets their activity level — a well-fitted wheelchair is essential for independence and preventing shoulder injuries.

Ongoing health management is critical for adults with spina bifida. Regular monitoring of kidney function, skin integrity, shunt function (if applicable), and orthopedic health prevents serious complications. Maintain a regular exercise routine to support cardiovascular health, weight management, and upper body strength. Explore adapted fitness programs, wheelchair sports, and community recreation options. In the workplace, accommodations may include accessible workspace, flexible scheduling for medical needs, and ergonomic equipment. Ensure adult healthcare providers understand the unique complexities of spina bifida — the Spina Bifida and Hydrocephalus Association of Canada is a valuable resource for finding knowledgeable adult care providers. Maintain RDSP contributions and plan for long-term financial security.