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Positional Skull Deformities and Neurodevelopmental Delay: Study on 449 Infants
Joan Pinyot1, David Lacambra1, Maria Garriga1
1Department of Pediatric Surgery, European Craniofacial Medical Center.
Insights
Positional skull deformities (PSD) are linked to significant neurodevelopmental delays (NDD) in young children, with boys experiencing greater delays than girls. Early monitoring and a multidisciplinary approach are crucial for affected infants.
Area of Science:
- Pediatric Neurodevelopment
- Craniofacial Abnormalities
- Developmental Pediatrics
Background:
- Positional skull deformities (PSD) are common in infants and can potentially impact neurodevelopment.
- Assessing neurodevelopmental delays (NDD) in children with PSD is essential for early intervention.
- Previous studies have explored links between PSD and developmental outcomes, but further data stratified by severity and gender is needed.
Purpose of the Study:
- To investigate neurodevelopmental delays (NDD) in early childhood among patients with positional skull deformities (PSD).
- To analyze the impact of PSD severity and gender on the extent of neurodevelopmental delays.
- To provide data for early identification and management strategies for NDD in infants with PSD.
Main Methods:
- A cross-sectional study involving 449 children (3-59 months) diagnosed with PSD.
- Neurodevelopmental assessment using Battelle Developmental Inventory (BDI) tests during and after cranial orthotic treatment.
- Comparison of BDI results with anthropometric measurements, stratified by PSD diagnosis, severity, age group, and gender.
Main Results:
- Ninety-five percent of assessed children exhibited significant NDD in at least one BDI domain.
- Male patients demonstrated more pronounced NDD compared to female patients.
- Specific deformities showed varying degrees of delay: brachycephaly and plagiocephaly combined (-7 mo), scaphocephaly (-3.5 mo), and plagiocephaly (-3.2 mo) at specific age ranges.
Conclusions:
- Neurodevelopmental assessment, including BDI testing and consideration of mixed PSD classifications, is recommended for patients with positional skull deformities.
- A coordinated team of medical specialists should monitor children diagnosed with PSD.
- Early identification and intervention for NDD in infants with PSD are critical.
Objective:
Provide data on a cross-sectional study of neurodevelopmental delays (NDD) in patients with positional skull deformities (PSD), based on severity and gender, in early childhood.
Methods:
Neurodevelopment of 449 patients with PSD, with an age range of 3 to 59 months, was assessed with Battelle Developmental Inventory (BDI) tests during and after their cranial orthotic treatment. Data obtained were compared with the anthropometric measurements taken the same day the test was made, and results were grouped by diagnosis and severity, segmented by age group, and split by gender.
Results:
From 3983 patients with PSD and simple craniosynostosis, 526 accepted to participate and took a total of 1261 BDI tests. Premature patients, patients with neurological diseases or congenital malformations, and tests taken when PSD had been corrected were excluded. The resulting study group was 449 children (123 girls and 326 boys) and 972 BDI tests. Ninety-five percent of tests presented significant NDD (median value, expressed in months) in one or more BDI domains; male patients present larger NDD than do female patients; largest delays were found in brachycephaly and plagiocephaly combined (-7 mo at age range 48-59 mo), scaphocephaly (-3.5 mo at age range 12-17 mo), plagiocephaly (-3.2 mo at age range 12-17 mo). No significant NDD were found in the receptive or cognitive domains.
Conclusion:
When evaluating PSD, BDI tests, or similar, as well as mixed PSD classification should be considered. Patients with PSD should be monitored by a coordinated set of medical specialists.
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