Before school starts, find out the room numbers for the classes your child will be attending. Practice how to get from the car or bus to classes, the school nurse and the lunchroom.

- School Nurse - schedule a meeting with the school nurse before school begins. Bring the medication(s) to be dispensed to school along with forms needed from your child's physician. Discuss your child’s catheterization schedule and the level of assistance needed by your child.
- Teachers - On the first day of school, find out when teachers are available for conferences and schedule an appointment by telephone or in person. Discuss the progress your child has made and point out strengths and weaknesses. If your child has an Individual Education Plan (IEP), it may be helpful to schedule a staff meeting to review the goals of the IEP and classroom modifications. Verify that teachers have reviewed a copy of the IEP.
- Meetings with school personnel (ARD meetings, etc.) - If your child receives special services, it is important to know under what category your child is eligible for these services. Generally, the most appropriate eligibility for students with spina bifida falls under Other Health Impairment (OHI). Article about OHI eligibility...

Recruit the teacher's assistance in training your child to maintain an assignment notebook. Ask the teacher to check to insure assignments are recorded accurately and to remind your child to load his/her backpack with all materials needed to complete assignments.
- Attentional skills - It may be helpful to request preferential seating in the classroom for your child. Ask the teacher to check to insure your child understands assignments before starting new ones. View attention presentation...
- Math skills - Work with your child on learning how to use money. Reinforce learning to identify coins, how to count money and how to make change. According to Dennis and Barnes (download paper...), students who develop adequate functional math skills achieve higher levels of social, personal, and community independence as adults.
- Reading skills - Read with your child everyday until he/she is an independent reader.
Download flash card reading exercises:
Reading fluency exercises...

It has been said that one's basic attitude toward work is established during the school age years. It is during this time that children learn the skills necessary for becoming useful, contributing members of society (Wong, 1999).
School attendance fosters the acquisition of social, academic, and physical skills through class work, school activities and clubs, sports and vocational training. Children who master these skills and do well in school have a higher probability of experiencing success in the job market and socially, than those who do poorly. Because children with Spina Bifida often have special health and learning needs, they may experience some or all of the following problems during the school age years:

• excessive school absences due to hospitalizations/surgeries
• limited physical accessibility due to mobility problems
• inadequate school accommodations to meet mobility needs (no ramps/elevators or classes on the first floor)
• insufficient school health services to meet health needs (no assistance with CIC, personal hygiene)
• inadequate related or instructional services to meet learning needs (insufficient Occupational, Physical or Speech Therapy
• or tutoring services, such as Content Mastery/Resource help)
• poor academic achievement due to excessive absences, learning or attention problems
• inappropriate educational placement
• a lack of required schoolwork or test modifications to overcome learning weaknesses or deficits
• ineffective social relationships due to limited participation in school/extracurricular activities
• increased dependency on parents/family members

In addition to providing children with educational instruction, school offers a respite to parents from their role as constant caregivers. Children who can separate from family and become members of a peer group are far more likely than others to become self-sufficient.
To the extent possible, family members and teachers should expect age-appropriate behavior from children with Spina Bifida and create environments that encourage participation in age-appropriate activities and enhance the establishment of relationships with same-age peers (Wong, 1999).
When children attend school their social circle expands to include a wide variety of peers and authority figures. School rules regarding attendance, authority and socially acceptable behavior, prepare the child for adulthood, specifically for employment and relationships. Peer interaction also plays a major role in the cognitive, social and emotional development of all children.
Children, who because of their disability are isolated from school, have a negative school experience, or lack the ability to interact with peers, may miss an important opportunity to expand their horizons and develop the necessary skills for successful transition into adulthood.
Parents of children with Spina Bifida and professionals who care for them may not be aware of the rights of children with disabilities. The following federal laws govern Special Education for students with disabilities, their Civil Rights and physical accessibility:

• Public Law 105-17, Individuals with Disabilities Education Act (IDEA) Amendments of 1997 (Originally PL 94-142, Education for all Handicapped Children Act of 1975)
• Public Law 93-112, Section 504 of the Vocational Rehabilitation Act of 1973
• Public Law101-336, Americans with Disabilities Act of 1990 (ADA)

IDEA defines disability as "a handicapping condition which affects the child's educational performance." This law has established 13 disability categories under which students qualify for special education services. These categories are: Autism, Hearing Impaired, Speech/Language Impairment, Visual Impairment, Deaf-Blind Impairment, Mental Retardation, Traumatic Brain Injury, Deafness, Multiple Disabilities, Other Health-impaired (i.e., ADD/ADHD, Diabetes, Spina Bifida, etc.), Emotional Disturbance, Orthopedic Impairment, or Specific Learning Disability (in writing, spelling, reading, math)
IDEA also:

• Entitles children with disabilities ages 3 to 21 years to a free appropriate public education (FAPE)
• Provides funds to states to develop and support special education programs
• Guarantees children an education in the least restrictive environment (LRE); children should be included in educational and social programs
• Specifies payment for related services at school. The following are some of those services: Adaptive equipment, Audiology, Physical Therapy, Speech/Language Therapy , Adaptive P.E., Counseling Services, School Health Services, Special Transportation, Assistive Technology, Occupational Therapy, and Social Work services
• Requires that every child receiving Special Education have a written Individualized Educational Program/ Plan (IEP)
• Establishes parental rights to question placement decisions and the right to due process when settling differences

Recent interpretations and applications of Section 504 have expanded the IDEA disabilities that qualify children with special needs for Special Education.
These conditions include: drug or ETOH addiction, dyslexia, behavior disorders, communicable diseases (AIDS, asymptomatic carriers of HIV, TB) and temporary medical conditions due to illness or accidents (limb casting causing temporary mobility limitations or use of crutches/wheelchair, eye injury/eye patch causing a temporary visual impairment).
As they currently stand, IDEA and Section 504 strengthen each other in important areas. They both:

• call for school systems to carry out a systematic search for every child with a disability in need of a public education
• have similar requirements to ensure that testing and evaluation of a child's needs are not based on a single testing instrument
• make it clear that education and related services must be provided at no cost to parents
• mandate a free appropriate public education, regardless of the nature and severity of an individual's disability
• emphasize the importance of educating children and youth with disabilities with their nondisabled peers, to the maximum extent appropriate

The central purpose of the ADA is to extend civil rights protections to individuals with disabilities, similar to those provided on the basis of race, sex, national origin, and religion.
Based on the concepts of the Rehabilitation Act of 1973, the ADA guarantees equal opportunity for individuals with disabilities in employment, public accommodation, transportation, state and local government services, and telecommunications. The Office of Civil Rights (OCR) is responsible for enforcement with respect to all programs, services, and regulatory activities relating to the operation of public elementary and secondary education systems and institutions, public institutions of higher education and vocational education (other than schools of medicine, dentistry, nursing, and other health-related schools), and public libraries.
The ADA is the most significant federal law ensuring the full civil rights of all individuals with disabilities. (NICHCY, 1999).

- Wong DL. Whaley & Wong's Nursing Care of Infants and Children, ed 6, St. Louis, 1999, Mosby.
- The Education of Children and Youth with Special Needs: What do the Laws Say? NICHCY News Digest Interim Update #ND15, October 1996.
- Basics for Parents: Your Child's Evaluation, NICHCY Publication #BP 1, September 1999.