Pediatrics Medical News about deformational plagiocephaly

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Use physical therapy to head off this deformity in infants
The Journal of Family Practice, 08/03/09

Vargish L et al. – Identify infants with positional preference early and consider referral to pediatric physical therapy at 7 or 8 weeks to prevent severe deformational plagiocephaly (DP). Strength of recommendation:B: Based on a single well–done randomized controlled trial (RCT). The incidence of positional preference has been reported to be as high as 22% at 7 weeks, making it a relatively common problem encountered by family physicians. Beyond cosmetic concerns, DP is associated with problems such as auditory processing disorders, mandibular asymmetry, and visual field defects. Most children with positional preference do not develop DP and when they do, it is typically a cosmetic problem. Ruling out torticollis, craniosynostosis, and other congenital causes is critical. Ascertaining parental preference is a major consideration in the decision to refer for PT. All of this takes time. However, parents are often concerned about their baby’s misshapen skull. The authors think that addressing positional preference is time well spent, especially since we now have evidence that a noninvasive approach — PT — can effectively prevent DP.

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