Children with myelomeningocele often experience restricted play and recreational opportunities because of limited mobility and physical limitations. This inactivity decreases the potential for normal development in all spheres and can exert a negative impact on self-esteem. For the infant and toddler with myelomeningocele, recreational therapy enhances opportunities for environmental exploration and interaction with other children. For the school-aged child, recreational therapy provides opportunities for participation in adapted sports and exercise programs, which can result in long-term interest in personal fitness and health. Recreational and physical fitness goals include socialization, weight control, and improved fitness (e.g., flexibility, strength, aerobic capacity, cardiovascular fitness, coordination). Recreational therapy is helpful for promoting independence with adult living skills and often is used to assist the patient with shopping for and purchasing personal items, use of public transportation, and development of appropriate leisure activities.