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Parental Perceptions of Neurodevelopment in Toddlers Following Craniosynostosis Repair
Michael Alperovich1, Michael S Golinko, Z-Hye Lee
1*Department of Plastic Surgery, New York University Langone Medical Center, New York, NY †Division of Plastic Surgery, Arkansas Children's Hospital, Little Rock, AR.
Insights
Parental perceptions of neurodevelopment after nonsyndromic craniosynostosis surgery are generally positive. Most parents report age-appropriate development and would recommend the cranial vault remodeling procedure.
Area of Science:
- Pediatric Neurosurgery
- Developmental Pediatrics
- Craniofacial Surgery
Background:
- Nonsyndromic craniosynostosis (NSC) and its impact on neurodevelopment is debated.
- Limited data exists on parental views of child development post-surgery.
- Standardized testing shows variable results in NSC patients.
Purpose of the Study:
- To evaluate parental perceptions of neurodevelopment in children following cranial vault remodeling for NSC.
- To compare parental satisfaction with surgical outcomes and perceived developmental changes.
Main Methods:
- Anonymous survey distributed to parents of children who had NSC surgery (2011-2015).
- Survey assessed overall satisfaction, perceived developmental differences (motor, speech, behavior, attention), and likelihood to recommend surgery.
- Data analyzed with stratification by sex, age at surgery, and follow-up duration.
Main Results:
- 22 parents completed the survey; 52.4% male, 47.6% female.
- High satisfaction with head shape (mean 9.2/10).
- Majority reported no significant differences in motor (74%), speech (83%), or attention (67%) post-surgery. Parents of males reported greater perceived positive differences than parents of females (P=0.031).
Conclusions:
- Parental ratings suggest largely age-appropriate neurodevelopment post-cranial vault remodeling for NSC.
- Findings align with standardized neurodevelopmental assessments.
- Further assessment at school age may identify later developmental delays.
Introduction:
The relationship between nonsyndromic craniosynostosis and neurodevelopment remains controversial. Beyond standardized testing, little data exist about parental perceptions of their child's development.
Methods:
Parents of children who underwent cranial vault remodeling for nonsyndromic craniosynostosis from 2011 to 2015 were asked to complete an anonymous survey.
Results:
Twenty-two parents (31%) completed the survey. Patients included 52.4% males and 47.6% females with a mean age at surgery of 9.2 months and mean follow-up time of 19.8 months. Craniosynostosis types were primarily metopic (45%) and coronal (35%).The mean score for overall satisfaction with head shape with a maximum score of 10 was 9.2 (range 5-10). When answering whether their child is different for the better other than appearance with a 5 rating as "strongly agree," the mean score was 3.8 (range 1-5). When asked whether their child's motor, speech and behavior, or attention were different following surgery, the majority responded "No" (74%, 83%, and 67%, respectively).All parents would have their child undergo surgery again or recommend surgery to another family. There were no statistically significant differences when stratifying by age at surgery or length of follow-up. When stratifying by sex, parents of males gave higher ratings for whether their children were better other than appearance compared with females, 4.8 versus 3.1 (P = 0.031).
Discussion:
Parents rated their child's neurodevelopment as largely age-appropriate following cranial vault remodeling. These findings are concordant with the majority of formal, standardized testing for this age group. Assessing parental perceptions once children enter school age may reveal increased developmental delays.
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