The overall goal of nursing practice with families of spina bifida children is to engage them in the process of maximizing their potential for healthy living. The birth of a child with spina bifida precipitates an avalanche of challenges to a family's health. Parental fears and anxieties following the birth must be effectively resolved. If left unresolved, they can interfere with the development of healthy parent-child and marital relationships. Families require more than only time, and the nurse is in a pivotal position to help them adapt. The nurse has extensive knowledge and skills for addressing the family's concerns effectively. Guided by a conceptual framework for practice, the nurse assesses the family dynamics and coping skills as well as the family's social support system, in order to identify family strengths, concerns, and problem areas. Nursing interventions are directed at the family's cognitive, behavioral, and affective levels of functioning. Since living with spina bifida is a family venture the nurse engages in regular meetings with the couple, thus fostering a pattern of sharing that might prevent future family problems. The nurse helps the family develop coping skills and supports to enable both the family and the child to grow as normally and healthily as possible.