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For the normal child, achievement of toilet control is an integral part of achieving self-identity and selfconceptualization. The child with meningomyelocele, however, rarely achieves this control because of the resultant neurogenic bowel and bladder. Of all the problems to which handicapped children are subject, urinary and stool incontinence is perhaps the most frustrating and socially unacceptable. Therefore, at the Birth Defects Center, associated with the University of Washington School of Medicine, interdisciplinary efforts have been focused for some years now on the medical and nursing management of the myelodysplatic child. As part of the overall care, we have initiated a program of practical management of incontinence, the goal being to assist the myelodysplastic child to attain the highest possible degree of independence in his daily living.