Spina Bifida Ambulatory

[lifelearningrn, BSN, RN]

I have an ambulatory spina bifida student who can't control his bowel/bladder that I've been changing since PK. He is now in first grade. He has been showing more signs of independence, like unbuttoning and pulling down his pants and pulling them back up and zip/buttoning after diaper changes. Is 6 or 7 a good age to start having them self change or should it be when they're older?

[ruby_jane, BSN, RN]

How dexterous is the kid? How willing is the family to get on board with the transition? Because if you're going to be transitioning the kid at school and the parent isn't doing the same at home, there will be some issues. Do you have access to an OT who can assess/make some suggestions? Good luck!

[lifelearningrn, BSN, RN]

He is really just like any other 1st grader aside from the bladder/bowel control issue.. I agree with you that I need to get the parents on board first. Thank you for your response.

[OldDude]

30 minutes ago, ruby_jane said:

How dexterous is the kid? How willing is the family to get on board with the transition? Because if you're going to be transitioning the kid at school and the parent isn't doing the same at home, there will be some issues. Do you have access to an OT who can assess/make some suggestions? Good luck!

Totally!!

[UrbanHealthRN, BSN, RN]

Definitely go for it! I'm sure he's noticed by now what the other kids can do to help themselves during bathroom time. As long as there's no developmental delay, a 6 or 7 year old can put most if not all of their clothes on. It's just a matter of working around any physical limitations.

[aprilmoss]

Back when I was in an Elementary School, I had one kid in diapers (not SB though) that we worked with at the beginning of first grade (with the help of the father). I doubt the kid could have done in kinder, but they were ready the next year. It was a boy and wet diaper changes were pretty straight forward for him. By the end of the year, he was pretty self-sufficient all around.

[scuba nurse, BSN, MSN, RN]

Does he wear diapers, or is it Pull-ups?? If diapers, see if you can transition to pull-ups, that helped my student be more independent! I then only helped if she asked for help with clothing or wiping.

[lifelearningrn, BSN, RN]

He wears diapers. It's weird, after I posted this him mom had brought him to his yearly evaluation and the MD is recommending surgery for both the bowel and bladder. Mitrofanoff and ACE. Mom isn't ready for that due to his age. Thank you all for your thoughts!