Association of Positional Plagiocephaly and Developmental Delay Within a Primary Care Network.
Jessica F Rohde, Neera K Goyal, Sara R Slovin and 3 others
PMID 33538454WHAT IT FOUND
Infants diagnosed with positional plagiocephaly in primary care were more likely to later receive a developmental delay diagnosis, particularly for motor and language delays.
The skull shape diagnosis typically appeared months before the delay, suggesting it may serve as an early marker for children who need closer developmental monitoring.
Key findings
01Infants with plagiocephaly had higher odds of any developmental delay diagnosis after adjusting for factors like prematurity and torticollis.
02The association was significant for motor, language, and general delays, but not for social or cognitive delays.
03In children with both diagnoses, plagiocephaly was identified before the developmental delay in the vast majority of cases.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study relied on billing codes from electronic records, which may have missed or misclassified diagnoses of plagiocephaly or developmental delay. It could not determine the severity of plagiocephaly or whether treatments like helmet therapy or physical therapy influenced the outcomes. The design is observational and retrospective, so it shows an association but cannot prove that plagiocephaly causes developmental delay. Data on developmental screening tools and their results were not available, so the study depends on provider judgment for the delay diagnosis. Some potential risk factors, such as maternal age, birth order, or amount of time spent supine, could not be controlled for.
Declared interests
The authors declared no conflicts of interest relevant to the article.
The easy way to misread this
Do not assume plagiocephaly causes developmental delay. This study shows an association, but other factors like abnormal tone or unmeasured perinatal risks may contribute to both the skull shape and the delay. Also, do not expect this association to hold for social or cognitive delays, which were not significantly linked to plagiocephaly in this analysis.