Starting Kindergarten After Spina Bifida: Caroline’s Story

Five-year-old Caroline is a fearless, social butterfly according to her mother, Claudia Miller. “She’s extremely talkative and friendly with other kids,” said Miller, who credits some of Caroline’s outgoing nature to spending time around other children during her physical therapy sessions.

Caroline was born with spina bifida, a birth defect in which the spine and spinal cord don’t form properly. For the last two years, her personality and social skills have played a role in her development as she worked with physical therapists on her legs and core muscle strength to improve her walking.

Caroline began physical therapy at TIRR Memorial Hermann Pediatric Outpatient Clinic shortly before her third birthday. “We decided to enroll her in therapy after it was recommended by her doctor to look into TIRR Memorial Hermann’s pediatric services,” said Miller.

Working to Stand On Her Own

When she began her physical therapy, Caroline had difficulty standing up straight on her own without assistance. “She tended to arch her back a lot in order to help her stand up straight, so we worked on balance and gait training,” said Jan Kugelmann, PT, DPT, Physical Therapist at TIRR Memorial Hermann Pediatric Outpatient Rehabilitation. “We would use kinesiology tape on her abdomen to improve her postural alignment.” The tape provided support and stability to muscles and joints that were restricting and helped to relax muscles in order for her posture to improve.

“She absolutely loved going to therapy because the therapists customized her treatments to be fun,” said Miller.

Making Therapy a Family Affair

Therapy sessions have tremendously helped Caroline improve strength in her legs and core. She is now more independent and can help her mom around the house and with her baby brother. When at home, the Miller family does additional exercises with Caroline to continue the care received while in therapy at TIRR Memorial Hermann. This month, Caroline will be heading to kindergarten. “By having Caroline engaged in therapy, she will now be able to stand and be at the same height as her classmates without having to look up at them,” said Kugelmann.

TIRR Memorial Hermann Pediatric Outpatient Rehabilitation program provides intensive and specialized services to children in an outpatient setting. The program treats a variety of diagnoses including developmental delay, spina bifida, brain injury, spinal cord injury, cerebral palsy, cancer and genetic conditions. To learn more about the TIRR Memorial Hermann Pediatric Outpatient Rehabilitation services visit

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Ali Vise