As has been well outlined in the two chapters regarding spina bifida/myelomeningocele (SB), SB is a still quite common and often severely disabling birth defect that is typically associated with bowel and bladder complications, complete paralysis, and other congenital defects , as well as varying degrees of anomalies in the brain. SB affects many aspects of early and later development, impacting opportunities for academic achievement and vocational success, as well as ongoing independence. It is often associated with neurodevelopmental changes, such as Chiari II malformation or acqueductal stenosis, that can result in hydrocephalus [2–5], leading to the need for shunting. Medical management of the conditions associated with SB (e.g. shunting, catheterization) influence the developmental process of cognitive and psychological functioning into adolescence and adulthood.
As both chapters discussed, SB is associated with significant variability in medical, motor, cognitive, psychosocial, academic, and functional adaptation throughout the lifespan. Complications of SB can range from minor physical problems to severe physical and mental disabilities. Generally, the degree and severity of the primary central nervous system (CNS) insult and its potential secondary CNS insults (e.g. hydrocephalus) lead directly to the set of deficits, such as motor functioning and attention orienting , that can be seen as early as infancy. This chapter aims to synthesize information shared in the previous two chapters, by reviewing the core deficits and strengths across the lifespan for individuals with SB, and to highlight issues pertinent to assessment, diagnosis, and intervention.