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Communication is one of the challenges for children with severe and multiple disabilities due to their impairments (Turnbull et al, 2004). There is about forty percent of unknown causes of severe and multiple disabilities, but prenatal biomedical is the majority known cause of the disabilities.
Spina bifida may cause minimal symptoms or only minor physical disabilities. If the spina bifida is severe, sometimes it leads to more significant physical disabilities. Severity is affected by: The size and location of the neural tube defect; Whether skin covers the affected area; Which spinal nerves come out of the affected area of the spinal cord