Re: Question regarding developmental delays and plagiocephaly

[Guest guest]

I just wanted to jump in and say that lack of early babbling is not

necessarily a sign of anyhting serious. My daughter, now 21 months

old, didn't babble until fairly late. She is now starting to talk

and she is perfectly fine. She did not have plagio, tort or any

other medical condititon. Some kids just talk late. Of course, it

is very important to rule out serious problems early.

Edina

Mom to Ethan - 6.5 mo, plagio, tort resolved, DOCband 9/16-present

> This post seems very timely to me. Georgia (9.5 months old)

is going for a formal hearing evaluation next week. I know she can

hear (or at least hear some things) but she is showing language

delays already. For example, she does not babble with vowel-

consonant combinations--she is very heavy on the vowel sounds--and

she does not say either " mama " or " dada " . Formal hearing evaluation

is the first step in evaluating her current delay. (She passed the

newborn hearing test at birth.) She also has some gross motor

delays. She is only now starting to show signs of crawling and she

is not yet able to pull herself to a standing position. However, she

was in a Pavlik harnass (for a dislocated hip) until she was 6 months

old, so of course she had very low truncal muscle tone. Her motor

skill delays may or may not be caused by her orthopedic problems.

Needless to say, I am very anxious. I am very afraid that her

hearing is absolutely perfect and we will have to find some other

> cause for her language delays. I will most certainly be on the

lookout for other relevant articles pertaining to the long term

developmental outcomes of plagio babies.

>

> (mom to Georgia, Starband 8/20)

>

> Re: Question regarding developmental delays and

plagiocephaly

>

>

> Hi Bobbye,

> I'm very sorry for the difficulties your daughter is

experiencing! I hope they are able to give some insight and

suggestions at the special ed meeting that can better help her reach

her goals educationally.

> Only in the last few years have studies begun to look at any

association between plagio and health risks, etc. Except for two

studies done showing problems with proper visual field development,

I'm not aware of any of the studies being repeated to see if results

still confirm an associated risk. There is one study that will be of

interest to you that the scientific community has deemed of high

merit that does show plagio babies go on to show subtle grade school

problems. This study was conducted in 2000. A follow-up study was

concluded recently, but I have been informed that those results are

not available for public knowledge - I don't remember if the hold-up

is peer review or publishing, etc.)

> Long-Term Developmental Outcomes in Patients With Deformational

Plagiocephaly (Feb. 2000)

> 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.

> http://pediatrics.aappublications.org/cgi/content/full/105/2/e26

> Other studies show issues with visual field development, auditory

processing, astigmatism, etc. Here are the rest of the studies that

I know of:

> Auditory ERPs Reveal Brain Dysfunction in Infants with

Plagiocephaly (pub. Jul. 2002)

> In the current study we demonstrated, for the first time, that the

central sound processing, as reflected by ERPs, is affected in

children with plagiocephaly.

> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve & db=PubMed & list_uids=12140415 & dopt=Abstract

> Neurodevelopment in Children with Single-Suture Craniosynostosis

and Plagiocephaly without Synostosis (pub. Nov. 2001)

> The objective of this study was to determine whether children with

nonsyndromic craniosynostosis and plagiocephaly without synostosis

demonstrated cognitive and psychomotor delays when compared with a

standardized population sample. 0 percent of the subjects in the

group with plagiocephaly without synostosis were accelerated, 67

percent were normal, 20 percent had mild delay, and 13 percent had

significant delay.

> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve & db=PubMed & list_uids=11711916 & dopt=Abstract

> Ophthalmologic Findings in Patients with Nonsyndromic

Plagiocephaly (pub. July 2003)

> The purpose of this article was to study the prevalence of

strabismus and astigmatism in children with nonsyndromic

plagiocephaly. Children with deformational plagiocephaly do have an

increased prevalence of astigmatism.

> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve & db=PubMed & list_uids=12867869 & dopt=Abstract

> The relationship between craniofacial morphology and obstructive

sleep apnea in whites and in African-Americans. (pub. Mar 2001

> We assessed the association of head and facial form with the apnea

hypopnea index (AHI) in 364 white individuals and 165 African-

Americans. We conclude that brachycephaly is associated with an

increased AHI in whites but not in African-Americans.

> http://ajrccm.atsjournals.org/cgi/content/full/163/4/947

> Visual Field Testing in Deformational Plagiocephaly (pub. Dec

2003)

> Our study demonstrates a notable incidence of visual field

constriction in patients with Positional Plagiocephaly (PP.) In

addition, patients with PP may have delayed progression of visual

field development. Our data sheds doubt on the concept that PP is a

benign entity with no neurologic sequelae and requires treatment for

cosmetic purposes only.

> http://www.aans.org/Library/Article.aspx?ArticleId=10865

> Visual field defects in deformational posterior plagiocephaly.

(June 2005)

> Thirty-five percent of infants with deformational posterior

plagiocephaly had constriction of one or both hemifields by at least

20 degrees from established normal patients. Hemifield asymmetry of

20 degrees or more was found in 17.5% of infants tested.

Deformational posterior plagiocephaly may affect visual field

development but neither the laterality nor the severity of skull

deformity is predictive of the severity of visual field defects.

(Note: The significance of this study is that severity of this health

concern didn't correlate to severity of plagio, so that even

mild/moderate plagio might result in more marked visual field

constriction.)

> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve & db=pubmed & dopt=Abstract & list_uids=15956949 & query_hl=1

> Anthropometric Analysis of Mandibular Asymmetry in Infants with

Deformational Posterior Plagiocephaly (pub. Aug. 2002)

> This study supports the clinical observation that the mandibular

asymmetry in deformational posterior plagiocephaly is secondary to

rotation of the cranial base and anterior displacement of the

temporomandibular joint (quantified by anterior auricular position)

and not the result of primary mandibular deformity. Also this study

showed that improvement in cranial asymmetry occurred with helmet

therapy, but there was no correction of auricular and

temporomandibular joint position.

> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve & db=PubMed & list_uids=12149730 & dopt=Abstract

> About 75-80% of plagio babies also have/had tort, and, of course,

tort can be associated with physical delays.

> There is also a Poll question in the Polls section of this group

that address Delays, if you'd like to take a look at it. Hopefully

you will get some replies to your post here with some personal

examples.

> Take care,

> Christie (Mom to Repo'd Remy)

>

> --- In Plagiocephaly , " gordowg2005 " <Mombobwg@a...>

wrote:

> >

> > Hi

> >

> > My daughter, now 9, wore a helmet from 8 mos to her first

birthday.

> > She had the parallelagram shaped head and received good care at

the

> > local children's hospital.

> >

> > But, at two years of age she was not talking. Our pediatrician

> > recommended intervention and she started speech therapy at a

college

> > clinic followed by an IEP in preschool.

> >

> > Everything seemed fine...until now. We noticed in first grade

that

> > she just didn't " get " the simple numbers they did. The teachers

> > response to my questions was: " Oh, Mom, don't worry about it. "

She

> > did OK in 2nd but never achieved the amount of success that you

would

> > expect based on the time and effort she expended. She did her

> > homework and studied for the tests, but always with poor results.

> >

> > Now Third grade and no different. I requested and they have begun

> > testing through special school district. When she was two I

looked

> > for information linking plagiocephaly with delays and found

nothing.

> > Recently, however, I did find several references on the web

> > and one discusson board reply led me to this group.

> >

> > I am wondering if anyone else has had experiences similar to ours

or

> > if there are articles or references you might recommend. Because

the

> > school specialtists are not familar with plagiocephaly, I am

> > compiling a folder of information to take with me to the next

special

> > ed meeting.

> >

> > I apologize for the lengthy post.

> > Thanks,

> > Bobbye

> >

>

>

>

> For more plagio info

[Guest guest]

I just wanted to jump in and say that lack of early babbling is not

necessarily a sign of anyhting serious. My daughter, now 21 months

old, didn't babble until fairly late. She is now starting to talk

and she is perfectly fine. She did not have plagio, tort or any

other medical condititon. Some kids just talk late. Of course, it

is very important to rule out serious problems early.

Edina

Mom to Ethan - 6.5 mo, plagio, tort resolved, DOCband 9/16-present

> This post seems very timely to me. Georgia (9.5 months old)

is going for a formal hearing evaluation next week. I know she can

hear (or at least hear some things) but she is showing language

delays already. For example, she does not babble with vowel-

consonant combinations--she is very heavy on the vowel sounds--and

she does not say either " mama " or " dada " . Formal hearing evaluation

is the first step in evaluating her current delay. (She passed the

newborn hearing test at birth.) She also has some gross motor

delays. She is only now starting to show signs of crawling and she

is not yet able to pull herself to a standing position. However, she

was in a Pavlik harnass (for a dislocated hip) until she was 6 months

old, so of course she had very low truncal muscle tone. Her motor

skill delays may or may not be caused by her orthopedic problems.

Needless to say, I am very anxious. I am very afraid that her

hearing is absolutely perfect and we will have to find some other

> cause for her language delays. I will most certainly be on the

lookout for other relevant articles pertaining to the long term

developmental outcomes of plagio babies.

>

> (mom to Georgia, Starband 8/20)

>

> Re: Question regarding developmental delays and

plagiocephaly

>

>

> Hi Bobbye,

> I'm very sorry for the difficulties your daughter is

experiencing! I hope they are able to give some insight and

suggestions at the special ed meeting that can better help her reach

her goals educationally.

> Only in the last few years have studies begun to look at any

association between plagio and health risks, etc. Except for two

studies done showing problems with proper visual field development,

I'm not aware of any of the studies being repeated to see if results

still confirm an associated risk. There is one study that will be of

interest to you that the scientific community has deemed of high

merit that does show plagio babies go on to show subtle grade school

problems. This study was conducted in 2000. A follow-up study was

concluded recently, but I have been informed that those results are

not available for public knowledge - I don't remember if the hold-up

is peer review or publishing, etc.)

> Long-Term Developmental Outcomes in Patients With Deformational

Plagiocephaly (Feb. 2000)

> 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.

> http://pediatrics.aappublications.org/cgi/content/full/105/2/e26

> Other studies show issues with visual field development, auditory

processing, astigmatism, etc. Here are the rest of the studies that

I know of:

> Auditory ERPs Reveal Brain Dysfunction in Infants with

Plagiocephaly (pub. Jul. 2002)

> In the current study we demonstrated, for the first time, that the

central sound processing, as reflected by ERPs, is affected in

children with plagiocephaly.

> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve & db=PubMed & list_uids=12140415 & dopt=Abstract

> Neurodevelopment in Children with Single-Suture Craniosynostosis

and Plagiocephaly without Synostosis (pub. Nov. 2001)

> The objective of this study was to determine whether children with

nonsyndromic craniosynostosis and plagiocephaly without synostosis

demonstrated cognitive and psychomotor delays when compared with a

standardized population sample. 0 percent of the subjects in the

group with plagiocephaly without synostosis were accelerated, 67

percent were normal, 20 percent had mild delay, and 13 percent had

significant delay.

> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve & db=PubMed & list_uids=11711916 & dopt=Abstract

> Ophthalmologic Findings in Patients with Nonsyndromic

Plagiocephaly (pub. July 2003)

> The purpose of this article was to study the prevalence of

strabismus and astigmatism in children with nonsyndromic

plagiocephaly. Children with deformational plagiocephaly do have an

increased prevalence of astigmatism.

> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve & db=PubMed & list_uids=12867869 & dopt=Abstract

> The relationship between craniofacial morphology and obstructive

sleep apnea in whites and in African-Americans. (pub. Mar 2001

> We assessed the association of head and facial form with the apnea

hypopnea index (AHI) in 364 white individuals and 165 African-

Americans. We conclude that brachycephaly is associated with an

increased AHI in whites but not in African-Americans.

> http://ajrccm.atsjournals.org/cgi/content/full/163/4/947

> Visual Field Testing in Deformational Plagiocephaly (pub. Dec

2003)

> Our study demonstrates a notable incidence of visual field

constriction in patients with Positional Plagiocephaly (PP.) In

addition, patients with PP may have delayed progression of visual

field development. Our data sheds doubt on the concept that PP is a

benign entity with no neurologic sequelae and requires treatment for

cosmetic purposes only.

> http://www.aans.org/Library/Article.aspx?ArticleId=10865

> Visual field defects in deformational posterior plagiocephaly.

(June 2005)

> Thirty-five percent of infants with deformational posterior

plagiocephaly had constriction of one or both hemifields by at least

20 degrees from established normal patients. Hemifield asymmetry of

20 degrees or more was found in 17.5% of infants tested.

Deformational posterior plagiocephaly may affect visual field

development but neither the laterality nor the severity of skull

deformity is predictive of the severity of visual field defects.

(Note: The significance of this study is that severity of this health

concern didn't correlate to severity of plagio, so that even

mild/moderate plagio might result in more marked visual field

constriction.)

> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve & db=pubmed & dopt=Abstract & list_uids=15956949 & query_hl=1

> Anthropometric Analysis of Mandibular Asymmetry in Infants with

Deformational Posterior Plagiocephaly (pub. Aug. 2002)

> This study supports the clinical observation that the mandibular

asymmetry in deformational posterior plagiocephaly is secondary to

rotation of the cranial base and anterior displacement of the

temporomandibular joint (quantified by anterior auricular position)

and not the result of primary mandibular deformity. Also this study

showed that improvement in cranial asymmetry occurred with helmet

therapy, but there was no correction of auricular and

temporomandibular joint position.

> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve & db=PubMed & list_uids=12149730 & dopt=Abstract

> About 75-80% of plagio babies also have/had tort, and, of course,

tort can be associated with physical delays.

> There is also a Poll question in the Polls section of this group

that address Delays, if you'd like to take a look at it. Hopefully

you will get some replies to your post here with some personal

examples.

> Take care,

> Christie (Mom to Repo'd Remy)

>

> --- In Plagiocephaly , " gordowg2005 " <Mombobwg@a...>

wrote:

> >

> > Hi

> >

> > My daughter, now 9, wore a helmet from 8 mos to her first

birthday.

> > She had the parallelagram shaped head and received good care at

the

> > local children's hospital.

> >

> > But, at two years of age she was not talking. Our pediatrician

> > recommended intervention and she started speech therapy at a

college

> > clinic followed by an IEP in preschool.

> >

> > Everything seemed fine...until now. We noticed in first grade

that

> > she just didn't " get " the simple numbers they did. The teachers

> > response to my questions was: " Oh, Mom, don't worry about it. "

She

> > did OK in 2nd but never achieved the amount of success that you

would

> > expect based on the time and effort she expended. She did her

> > homework and studied for the tests, but always with poor results.

> >

> > Now Third grade and no different. I requested and they have begun

> > testing through special school district. When she was two I

looked

> > for information linking plagiocephaly with delays and found

nothing.

> > Recently, however, I did find several references on the web

> > and one discusson board reply led me to this group.

> >

> > I am wondering if anyone else has had experiences similar to ours

or

> > if there are articles or references you might recommend. Because

the

> > school specialtists are not familar with plagiocephaly, I am

> > compiling a folder of information to take with me to the next

special

> > ed meeting.

> >

> > I apologize for the lengthy post.

> > Thanks,

> > Bobbye

> >

>

>

>

> For more plagio info