Positional cranial deformity—the parents’ point of view

Kluba, Susanne; Lypke, J.; Kraut, Wiebke; Peters, Jan; Calgeer, B.; Haas-Lude, Karin; Krimmel, Michael; Reinert, Siegmar

doi:10.1016/j.ijom.2014.10.005

Cited by 15 publications

(9 citation statements)

References 27 publications

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“…This study has the potential to reduce parental stress and costs associated with the evaluation and treatment of plagiocephaly and to close the loop on a side effect of the Back to Sleep Campaign. Surveys have indicated that parents are faced with personal strain, distress of their child, and finial burden as stressor when 13 . Parents may also take potentially controversial actions in attempts to treat the plagiocephaly such as using infant chiropractors, specialty head rests, and other devices not validated for infants.…”

Section: Discussionmentioning

confidence: 99%

“…Surveys have indicated that parents are faced with personal strain, distress of their child, and finial burden as stressor when. 13 Parents may also take potentially controversial actions in attempts to treat the plagiocephaly such as using infant chiropractors, specialty head rests, and other devices not validated for infants. Use of some of these devices prompted the Food and Drug Administration to issue statements specifically discouraging their use.…”

Section: Significancementioning

confidence: 99%

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Parental Education for the Prevention of Plagiocephaly

Chekmeyan,

Joo,

Saini

et al. 2024

Ann Plast Surg

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Introduction The American Academy of Pediatrics Back-to-Sleep Campaign significantly reduced infant mortality from sudden infant death syndrome. As a result of prolonged supine positioning, the incidence of deformational plagiocephaly has also risen 5-fold since its adoption. We aimed to improve the current educational paradigm for new parents with the goal of reducing the incidence of plagiocephaly within the confines of the Back-to-Sleep Campaign. We hypothesized that the early addition of plagiocephaly focused education for parents would reduce cephalic index, the ratio of head width to length, used as an easily measured objective proxy for positional plagiocephaly. Methods Children were screened at their newborn visit. Premature newborns and those diagnosed with craniofacial disorders were excluded. For those enrolled, biparietal and anteroposterior measurements of the head were obtained using manual calipers to obtain cephalic index. Subjects randomly assigned to the intervention group were shown a 2-minute video and given an educational pamphlet on methods to prevent plagiocephaly. Unpaired 2-sample t tests comparing mean differences in intervention and control were performed. Results Thirty-nine subjects were enrolled as of November 2023 with variable lengths of follow-up completed. The average baseline cephalic index for subjects in the control group was 82.7 and 83.8 for intervention group. Unpaired 2-sample t tests were performed at 2-, 4-, and 6-month time points to analyze the difference between groups. At 4 months, average cephalic index for subjects in the control and treatment group, respectively, was 90.6 and 83.4 (P = 0.02). Significance Parental education at the newborn visit led to decreases in cephalic index, a proxy for positional plagiocephaly, compared with control patients. This simple intervention has the potential to reduce parental stress and healthcare costs associated with the evaluation and treatment of plagiocephaly.

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Section: Discussionmentioning

confidence: 99%

Section: Significancementioning

confidence: 99%

Parental Education for the Prevention of Plagiocephaly

Chekmeyan,

Joo,

Saini

et al. 2024

Ann Plast Surg

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“… 36 They discovered that more than 80% of parents had been affected by treatment related issues; the most commonly cited were financial cost, disputes with health insurance, concern for the child, time spent bringing the child to and from the clinic, and social conflicts. 36 Martiniuk et al reported that in their survey, parents of a child with moderate-to-severe plagiocephaly expressed sadness that they had not addressed the flat head sooner and felt sorry for their child when they were forced to wear an orthotic helmet around the clock; typical regimens require the child to wear the helmet 23 hours a day, every day, for months at a time. 42 , 43 Importantly, helmet therapy has been shown to not affect infant quality of life.…”

Section: Emotional Tollmentioning

confidence: 99%

“…Of those that could submit the costs of helmet therapy to health insurance, 36.1% reported conflicts with the health insurance company regarding the refund of costs. 36 Third party insurance companies often refuse to cover treatment for positional plagiocephaly, arguing that the deformity is purely cosmetic and that active treatments (like helmet therapy) are not substantially better than parental repositioning. 11,37 One study by Lam et al analyzed the degree of treatment compliance according to patient subgroups and found that families with public insurance were less likely to adhere to the recommended treatment than families with private insurance (80.2% versus 89.6%).…”

Section: Treatment Burdenmentioning

confidence: 99%

Practical Review of the Cost of Diagnosis and Management of Positional Plagiocephaly

Watt

Alabdulkarim

Lee

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Background: Positional plagiocephaly has garnered increased research interest since the introduction of the Back to Sleep campaign in the 1990s, and the subsequent increase in infants with cranial deformity. Research has focused on treatment outcomes and developing new modalities to address asymmetric heads. Little attention has been given to the cost of treatment and diagnosis. This study aimed to summarize the literature and provide an overview of the costs associated with a diagnosis of positional plagiocephaly. Methods: A literature review was performed by searching PubMed and Ovid Embase to identify studies pertaining to the “cost” of plagiocephaly diagnosis or treatment through direct financial factors, disturbance to daily routines (ie, through treatment prolongation), or related stress. Results: Twenty-nine peer-reviewed studies were included. Treatment options for plagiocephaly are stratified by severity and age of diagnosis, with different pathways available to treat different stages of asymmetry. The common factor across all treatment modalities is that earlier diagnosis unequivocally leads to better aesthetic outcomes and shorter treatment times. This leads to lower costs for treatment, a lower stress burden for parents, and lower costs for the healthcare system in the future through reduction of long-term effects. Our theoretical cost model suggests that early diagnosis at 4 months can lead to a treatment cost of $1495, when compared with $5195 for detection of deformity at or after 6 months. Conclusion: The dramatic cost disparity between early and late diagnosis highlights the need for reliable methods to accurately detect cranial deformity early in an infant’s life.

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“…The treatment team determines how severe a deformity is based on anthropometric criteria; however, the parents are the ones to choose the treatment approach (7). Parents' stress and worry can impact their decisions regarding the type of treatment (8). Parents' perception of the deformity and their level of satisfaction with the infant's appearance are the main factors in their choice of a treatment approach (9).…”

Section: Introductionmentioning

confidence: 99%

Parental Adherence to Cranial Remolding Orthotic Treatment of Infants with Positional Cranial Deformities: A Qualitative Content Analysis

Rouhani,

Kamali,

Babaee

2023

MJIRI

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Background: This qualitative study was designed to investigate parental adherence to cranial remolding orthotic (CRO) treatment of infants with positional cranial deformities.Methods: A qualitative content analysis was employed in this study. Researchers sought to find parental behavior while using a CRO for their infant with cranial deformity. Through in-depth and in-person interviews, researchers collected data from 22 participants using semi-structured questions regarding adherence to CRO treatment. Data were examined for patterns until saturation occurred, yielding categories that focused on the parents' main barriers and facilitators.Results: Two general themes of "potential barriers to CRO treatment adherence" and "potential facilitators to CRO treatment adherence" were extracted from 12 subthemes of parental burden, transportation, availability of CRO services in hometown, financial responsibility, maternal/paternal attachment attitudes, CRO-related problems, others feedback, adjustment to the treatment, motivation and self-confidence, aesthetic satisfaction, communication with orthotist, and wife's empathy/spousal support.Conclusion: Getting time off work, transportation to the orthotics' clinic, the lack of medical insurance coverage for CRO, reduced physical contact between parents and their child, and getting negative feedback from others were the most reported challenges. However, overcoming the initial difficulties and adjustment to the treatment with CRO, the high motivation of parents during therapy, an orthosis with good fitting and minor complications, a strong relationship between the parents and orthotist, and the father's companionship were revealed to facilitate the treatment process and increase adherence of treatment with CRO.

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Positional cranial deformity—the parents’ point of view

Cited by 15 publications

References 27 publications

Parental Education for the Prevention of Plagiocephaly

Parental Education for the Prevention of Plagiocephaly

Practical Review of the Cost of Diagnosis and Management of Positional Plagiocephaly

Parental Adherence to Cranial Remolding Orthotic Treatment of Infants with Positional Cranial Deformities: A Qualitative Content Analysis

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