Behavioral Treatment of Ambulatory Function in a Child with Myelomeningocele

Abstract

Myelomeningocele (spina bifida) is the most common congenital CNS defect. It is characterized by septic distension of the meninges with associated neurogenic deficits and lower extremity paralysis.1 The development of improved medical and surgical techniques has resulted in dramatically increased survival rates in children with myelomeningocele.2 Dietrich reported an 86-percent survival rate out of a total of 500 patients over a 16-year period (S.L. Dietrich, MD, unpublished data, 1979). With such a high survival rate, opportunities now exist for therapists to focus on the habilitation and rehabilitation of children with myelomeningocele.3,4 Recently, biofeedback and nonbiofeedback behavioral techniques have been applied to some of the chronic problems associated with myelomeningocele that are both biological and behavioral in nature and include urinary and fecal incontinence,5–7 obesity,8 deficits in self-help skills,9 and pressure sores.10