PEDIATRICS Vol. 105 No. 2 February 2000, p. e26
ELECTRONIC ARTICLE:
Long-Term Developmental Outcomes in Patients
With Deformational Plagiocephaly
Received Apr 30, 1999; accepted Aug 30, 1999.
and
From the * Center for Human Development and Disability,
University of Washington School of Medicine, Seattle, Washington;
Madigan Army Medical Center, Tacoma, Washington; § Craniofacial
Center, Children's Hospital and Regional Medical Center, Seattle,
Washington; and the Department of Pediatrics, University of
Washington School of Medicine, Seattle, Washington.
Objectives. To determine whether there was an increased rate of later developmental delay in school-aged children who presented as infants with deformational plagiocephaly without obvious signs of delay at the time of initial evaluation.
Methods. A retrospective medical record review of 254 patients evaluated at the Craniofacial Center of the Children's Hospital and Regional Medical Center in Seattle, Washington, from 1980 through 1991 was completed. Consenting patient families were interviewed via telelphone to determine what, if any, special medical or educational problems had occurred for the children who had had plagiocephaly in infancy or their siblings with normal head shapes.
Results. A total of 181 families from the medical record
review could be notified about the study and 63 families agreed to
participate in a telephone interview. The sample of participants for
the telephone interview was random to and representative of the group
as a whole. The families reported that 25 of the 63 children (39.7%)
with persistent deformational plagiocephaly had received special help in primary school including: special education assistance, physical therapy, occupational therapy, speech therapy generally through an
Individual Education Plan. Only 7 of 91 siblings (7.7%), serving as
controls, required similar services (
2 = 21.24). Delays could not be specifically anticipated at the time
of the diagnosis of deformational plagiocephaly from any simple set of
factors including treatment with helmet therapy, although effected
males with reported uterine constraint were at the highest risk for
subsequent school problems.
Conclusions. Infants with deformational plagiocephaly comprise a high-risk group for developmental difficulties presenting as subtle problems of cerebral dysfunction during the school-age years. There is a need for additional research on the long-term developmental problems in infants with deformational plagiocephaly. plagiocephaly, facial asymmetry, torticollis, developmental delay. .
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