Plagiocephaly and Developmental Delay: A Systematic Review

Martiniuk, Alexandra; Vujovich-Dunn, Cassandra; Park, Miles; Yu, William; Lucas, Barbara R.

doi:10.1097/dbp.0000000000000376

Cited by 71 publications

(55 citation statements)

References 42 publications

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“…This study showed that plagiocephaly in babies/infants is more strongly associated with the motor skills area and less with the social area, as shown by previous studies [27]. In the first test, the infants showed a significant developmental delay in all areas, with a global development coefficient of 64.3, which was lower than two standard deviations of the norm [29].…”

Section: Discussionsupporting

confidence: 77%

“…In previous studies, a significant neurodevelopmental delay was observed in children with deformational plagiocephaly, although no definitive relationship between the severity of deformation and the degree of developmental delay was found (the psychomotor development index was only affected by congenital anomalies) [41]. On the other hand, a systematic review showed a positive association between plagiocephaly and developmental delay in 13 of 19 studies, including four of five studies with a "strong" methodological quality [27]. Moreover, this delay was less frequent in studies with children more than 24 months of age, and motor skill development was the most commonly affected area, similar to the results of our study.…”

Section: Discussionmentioning

confidence: 92%

“…A recent systematic review suggests that immediate referral to early intervention services, such as physiotherapy, ameliorates motor delays [27].…”

Section: Discussionmentioning

confidence: 99%

“…In the literature, most studies on infants with plagiocephaly focus on analyzing the effectiveness of the application of different physiotherapeutic techniques via a healthcare professional [26,27]. However, no studies have investigated the usefulness of complementing this therapy with home protocolized exercises performed by the infants' relatives.…”

Section: Introductionmentioning

confidence: 99%

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A Prospective Study of Cranial Deformity and Delayed Development in Children

et al. 2020

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Plagiocephaly, the most common form of cranial deformity, has become more prevalent in recent years. Many authors have described a number of sequelae of poorly defined etiologies, although several gaps exist in their real scope. This study aimed to analyze the effects of physiotherapy treatments and cranial orthoses on the psychomotor development of infants with cranial deformities, complemented by protocolized postural exercises applied by the family. This prospective study on different developmental areas included a sample of 48 breastfeeding infants aged 6 to 18 months who presented with plagiocephaly (flat head syndrome). The Brunet–Lézine scale was used to perform three tests for assessing the psychomotor development of infants, thus offering a measure for global development. The results suggest that plagiocephaly is a marker for the risk of delayed development, particularly in motor and language areas. This delayed development could be improved with physiotherapy and orthopedic treatment, complemented by interventions by the infants´ relatives.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 92%

“…A recent systematic review suggests that immediate referral to early intervention services, such as physiotherapy, ameliorates motor delays [27].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Prospective Study of Cranial Deformity and Delayed Development in Children

et al. 2020

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“…Since the adoption of the Back to Sleep campaign in 1992 in USA, the prevalence of positional head deformity in early infancy has increased significantly, and the condition now occurs in one of every 60 live births, which have constituted a frequent issue of international concern . Infants with positional head deformity may lead to significant cosmetic and functional consequences, even to psychological consequences . Positional head deformity is caused by external pressures on the rapidly developing skull from prolonged exposure to one position.…”

mentioning

confidence: 99%

Effect of helmet therapy in the treatment of positional head deformity

Wen

Qian

Zhang

et al. 2019

J Paediatrics Child Health

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Aim: Most positional head deformities can be treated conservatively with postural correction training or a head orthosis ('helmet'). We aimed to investigate whether infants with helmet therapy have cosmetic improvement in head deformity. Methods: A total of 376 infants at age 2-40 months who were diagnosed with mild-moderate-severe positional head deformity were enrolled. Among these infants, 101 infants were treated with helmet therapy or postural correction training. After matching by infant's age and time of therapy, three retrospective cohort studies of 56 infants were conducted for infants with plagiocephaly, brachycephaly and asymmetrical brachycephaly, respectively. The cephalic ratio (CR), radial symmetry index (RSI), cranial vault asymmetry (CVA) and cranial vault asymmetry index (CVAI) were compared between two groups before and after treatment. Results: Before treatment, no significant differences in CR, RSI, CVA and CVAI between groups were found. After treatment, compared with the postural correction training group, the helmet therapy group had significant improvements in CR, RSI, CVA or CVAI (Plagiocephaly: P CVA = 0.017, P CVAI = 0.028; Brachycephaly: P CR = 0.002; Asymmetrical brachycephaly: P RSI = 0.002, P CVA < 0.001, P CVAI < 0.001). Moreover, there was no significant difference in head circumference growth between the groups. Conclusions: Helmet therapy may be more effective in the treatment of mild-moderate-severe positional head deformity than postural correction training in infants. And helmet therapy may not hinder head circumference growth.

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Incidence of Nonsynostotic Plagiocephaly and Developmental Disorders

Lynch,

White,

Rabatin

et al. 2024

JAMA Pediatr

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ImportanceThis is the first population-based study quantifying the incidence of nonsynostotic positional plagiocephaly and/or brachycephaly (PPB) in infancy and its association with developmental disorders.ObjectiveTo report the incidence of PPB before age 1 year, the incidence of craniosynostosis, and the percentage of children with PPB diagnosed with a developmental disorder by age 7 years.Design, Setting, and ParticipantsThis was a retrospective, population-based cohort study of children in the Rochester Epidemiology Project (REP) born in Olmsted County, Minnesota, from January 1, 2008, through December 31, 2012, with follow-up through age 7 years. Data were analyzed from March 2021 to April 2024.ExposurePhysical examination detecting cranial deformity.Main Outcomes and MeasuresThe primary outcome was the incidence of PPB. Secondary outcomes were the incidence of craniosynostosis and the percentage of children with PPB diagnosed with a developmental disorder by age 7 years.ResultsOf 9909 infants (5084 [51.3%] male; 9205 [92.9%] born at term and 704 [7.1%] born preterm) included in the study, 575 had PPB, for a PPB incidence of 5.8% (95% CI, 5.3%-6.3%). The incidence of PPB was 5.3% (95% CI, 4.8%-5.8%) in term infants vs 11.8% (95% CI, 9.4%-14.6%) in preterm infants. The incidence of craniosynostosis was 0.16% (95% CI, 0.09%-0.26%). A developmental disorder was known or suspected in 4.2% (95% CI, 2.7%-6.2%) of infants at the time of PPB diagnosis; among 402 infants with PPB and follow-up through age 7 years, 30 (7.5%; 95% CI, 5.0%-10.7%) had a confirmed developmental disorder by 7 years of age. The prevalence of autism spectrum disorder (ASD) in children with a history of PPB who were followed up to age 7 years was 2.2% (9 of 402 children).Conclusions and RelevanceThis study found that only a small percentage of the infants had positional head deformity significant enough to be documented and/or referred for subspecialty evaluation, and only a small subset of these children went on to have a developmental disorder in childhood. This information is helpful for counseling families about their child’s developmental risk at time of PPB diagnosis.

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Plagiocephaly and Developmental Delay: A Systematic Review

Cited by 71 publications

References 42 publications

A Prospective Study of Cranial Deformity and Delayed Development in Children

A Prospective Study of Cranial Deformity and Delayed Development in Children

Effect of helmet therapy in the treatment of positional head deformity

Incidence of Nonsynostotic Plagiocephaly and Developmental Disorders

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