Teaching the Student with Spina Bifida.

Rowley-Kelly F, Reigel DH, eds. Baltimore, MD 21285-0624, Paul H Brookes Publishing Co Inc, 1993, paperback, 470 pp, illus, $35.

The focus of this text is the child with spina bifida and the educational experience. It is written for all professionals working with children with spina bifida, but specifically for those involved in the educational setting. The contributing authors work in a wide variety of disciplines including nursing, physical therapy, law, neurosurgery, psychology, speech therapy, occupational therapy, and teaching. The authors' purpose is to share with educators the potential problems involved with teaching a child who has spina bifida and the means of addressing these problems to ensure maximal educational opportunities for each child. The editors focused on this goal and developed a text that provides great insight into the unique medical and educational concerns of students with spina bifida.

The text is divided into four sections. The first section addresses health care issues, explaining the initial defect and problems such as hydrocephalus, Arnold-Chiari malformation, tethered cord, and orthopedic problems. In this section, one chapter is devoted to providing information on physical management, including use of adaptive equipment, mobility in the educational setting, creating a functional environment, and involving the child in the routines of the school. Another chapter deals with specific health care needs that could occur in the school setting. The second section addresses the neuropsychological evaluation of the child's learning ability and how to develop strategies to teach abstract concepts, math, language, and perceptual motor skills. The third section addresses social and family issues as well as rights and resources available to ensure the child with spina bifida a high-quality education. This section explores issues such as social and emotional development, social awareness and disability awareness, parent-school partner relationship, and planning for transition to adulthood and serves as a guide to rights and resources. The final section of the book deals with school outreach programs.

The information provided in this text reflects the growing population of people with spina bifida and the new laws governing education and accessibility. It also demonstrates the educational system's recognition of the many problems involved with this disability, as well as the need for the educational and the medical communities to work together. Of special note is the section of the book that deals with the evaluation and development of abstract concepts and math skills. Physical therapists, stymied in their treatment program for a child with spina bifida, would do well to review these chapters. Does the child, for example, understand the abstract concepts included in instructions such as "Always put your crutches first when you go down each step"? This text addresses how to recognize these deficits and how to work more effectively with these students.

This practical book is full of illustrations, references, glossaries, and sample forms. In addition, the chapter format divides topics, making it easy to find a topic of your choice. Whenever possible, numbered lists are used to further clarify material. An index is also included for easy reference.

I would recommend this book to physical therapy practitioners who work in clinics and schools and deal with clients who have spina bifida. It would also be of special interest to therapists working in transdisciplinary settings. This is a book that you will want to share with others on your team.

Marie Staight, PT Orlando Pediatric Multi-Therapy Clinic Orlando, Fla