Team Approach

A team approach is an important part of the care of the individual with congenital spinal dysfunction. The multidisciplinary team often includes neurosurgery, orthopedic surgery, urology, rehabilitation medicine, physical and occupational therapy, social work, nutri­tion, and nursing.

After birth, parents and families of individuals with spina bifida need to be informed about their child's diagnosis and its implications. A prenatal visit with the neurosurgeon and other medical specialists may be beneficial. Parents often ask questions regard­ing anticipated functional abilities and limitation, including self-care and ambulation. Cautious predic­tions based on the current functional level may be given. Medical providers should be frank in their dis­cussion of the problems that the parents and child will face, but this should be done with cautious optimism. Discussions and instructions about the child's care and handling at home may require several sessions so that the family members are not overwhelmed by the

amount and complexity of the information. Families should be informed of the many issues involved and the need for seeing several medical specialists. Frequent follow-up after discharge from the neonatal unit is often necessary and typically involves visits every three to four months for a couple of years and then every six months thereafter (74).