Classroom adjustments: Spina bifida

In this episode, we showcase some adjustments teachers can make in the classroom to support students with spina bifida. A congenital abnormality of the spine and sometimes the brain, spina bifida can range in severity from slight functional impairment to severe physical and intellectual disability. Students with spina bifida are individuals who may have a variety of learning needs. Some students may have difficulties with executive functioning and memory, while others may find gross and fine motor tasks challenging and may experience personal care challenges, including significant continence issues.     

Year 5 student Josh wears orthotic braces that immobilise and support his ankles. He says he doesn’t let this get in his way and really pushes his body to its limits. Josh loves goalkeeping during a game of soccer, but laments that he can’t ride a unicycle. His mum Sue explains that in addition to the physical challenges, Josh can also struggle with planning and organisation skills. Primary school teacher Katie Kligerman talks about the positive impact teacher led physical exercise has made in the classroom. Paediatrician Dr Catherine Marraffa outlines why it’s important for students with spina bifida to always wear shoes and socks.    

Top five takeaways

• Spina bifida can affect the part of the brain that controls executive functioning, so some students may find it difficult to plan, organise and recall details. To support students to remain focused and on task, break tasks into small manageable chunks and check for understanding before moving onto the next activity. Additionally, providing a checklist or a tick box, may assist the student to remember what they need to do for that lesson.     
• Build breaks into your daily routine that involve age-appropriate movement – for example, rocking, rolling or marching for younger students and mindfulness practices for the older students.
• Writing can be challenging for students with spina bifida as the condition may affect fine motor skills. Allowing students more time to complete a task when the focus is on handwriting is one adjustment. Further adjustments include the use of assistive technology. When writing is not the core skill being learnt, modify the work so that the student with spina bifida is required to do less handwriting but is provided with an alternative way to demonstrate their learning. These may include tasks that can be completed via a computer, an app, or another alternative technology. The development of a student’s fine motor skills may also be supported through creative pursuits that are age appropriate such as sewing, knitting or threading,
• Adjust the physical space in the classroom, in consultation with an OT, to suit the mobility needs of the student with spina bifida – whether they are using an electric wheelchair or other mobility aides. Ensure there’s easy access in and out of the room and building. Inside the classroom, make sure surfaces are flat, there are no trip hazards, and provide the student with a height adjustable desk to accommodate their wheelchair as needed.
• Students with spina bifida are at risk of developing injuries as they may not have full sensation in their lower body. Reduce the risk of students being harmed by doing a risk assessment of the different environments in which the student learns, particularly during outdoor activities, by ensuring they always wear shoes and socks. Remind students to avoid sitting on hot surfaces such as metal seats, which may cause burns.

Discussion starters

• Why is it crucial to remind a student with spina bifida to have scheduled bathroom breaks?
• What steps can I take to support limited executive functioning in students with spina bifida?
• What physical adjustments do I need to make in the environment to support the mobility of a student with spina bifida?
• Why is it important to carefully consider the seating arrangement of a student with spina bifida?
• How can I adjust my lesson to support a student with spina bifida who is experiencing difficulty with tasks requiring fine motor skills?

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Approximately 25 minute run time.

Credits

Interviewees

Katie Kligerman, Primary School Teacher, Collingwood College

Dr Catherine Marraffa, Deputy Director Neurodevelopment and Disability Stream Leader – Intellectual Disability and Autism, and Honorary Fellow, Murdoch Children’s Research Institute

Josh, Year 5 student

Sue, Josh’s mum

Thanks also to

Jennifer Callaway, Office Manager, Spina Bifida Foundation Victoria

Host/Producer

Serpil Senelmis, Written & Recorded

Producer/Audio Engineer

James Brandis, Written & Recorded

Further resources

Find further resources at Spina Bifida Foundation Victoria, Spina Bifida Foundation Australia and the NCCD Portal. Download a transcript of the podcast episode.