There is great diversity among the population of people who have spina bifida. Depending on the level of the spina bifida lesion, there may be paralysis and loss of sensation of some degree below the affected area. Some children will be ambulatory, a few will walk without assistance, and others will require bracing and a walker or crutches. Some children who walk when they are younger will find that using a wheelchair for most activities makes sense as they grow so they can keep up with their friends. Some children with spina bifida will first start using a wheelchair for mobility when they are just a few years old. Some children will find that a manual chair fits their needs. Other children who use a manual chair when they are quite young may find that a power wheelchair gives them more independence of mobility when they get a little older. Most children with spina bifida who use a wheelchair can learn to transfer themselves (with or without assistance) from the wheelchair to floor and back, wheelchair to other seats and back, etc. This should be encouraged as much as possible. Advice on this should be sought from your physical or occupational therapist. It is important that small children who use a wheelchair do not spend all of their time in the wheelchair when other children are playing or working on the floor. Being down on the floor encourages social inclusion, as well as involvement in the same activities as other children.