Habilitation of the child with spina bifida and myelomeningocele.

• Experience with 45 children with spina bifida and myelomeningocele shows that an active and hopeful approach starting at birth can usually prevent years of nursing care in bed. Remarkable degrees of self-sufficiency have been achieved in such activities of daily living as dressing, hygiene, eating, and ambulation, despite paraplegia, surface anesthesia in the lower extremities, incontinence, and in some cases intellectual retardation. Progressive renal damage can be prevented by conscientious management. Early removal of the myelomeningocele is advised in order to prevent meningitis and the possibility of further disability or death. Immediate steps toward habilitation not only prevent physical complications but improve the emotional attitudes of the patient and his family. The results have justified the efforts.