Spina bifida is a complex condition, difficult even for a medically informed person to understand, and particularly so for lay people. On a day-to-day basis, the ordinary routine of living is disturbed and the necessity to make special arrangements to accommodate the child and his disabilities become a major consideration. During childhood the majority of patients with myelomeningocele attend outpatient clinics every three months at least so this becomes a very regular problem. In the South Wales and the GLC studies, the Malaise Inventory was used, a scale developed by Rutter et al, to obtain information about emotional and psychosomatic symptoms, including depression, irritability, worry, or physical complaints such as headaches or upset stomachs. In the GLC study a significant association was found between both bowel and bladder incontinence in the child and maternal distress, particularly in cases where the child had a urinary appliance or poor.