The purpose of this report is to discuss the status and ambulatory outcome of two children with mid- to low-lumbar myelomeningocele and hydrocephalus who were treated with a Ferrari knee-ankle-foot orthosis (FKAFO). One child was a girl six years old, and the other child was a boy seven years old. The first child had used the FKAFO over two years, and the other child had used the orthosis only two weeks. Patient examination was completed in musculoskeletal and functional areas related to standing and walking. Results of examination are presented. Evaluation of the data indicated one child was doing well as fit with the FKAFO. The other child's orthosis was felt to need adjustments to increase the flexibility of the FKAFO soleplates. Possible explanations for differences in evaluations of the two children are presented and the importance of unique management decisions based on individual patient findings is advocated.