Screening for torticollis and plagiocephaly: The role of the pediatrician

The purpose of this study was to observe the effects of providing a standardized screening examination method to a group of attending and resident physicians on the rate of torticollis and plagiocephaly diagnoses, the age at time of diagnosis, and the attitudes and practice patterns of the physicians. All subjects were given a standardized screening procedure by verbal instruction and handout, and also completed a pre- and post-intervention questionnaire, which assessed the subjects' practice regarding the diagnosis and management of torticollis and plagiocephaly. A retrospective chart review was conducted to observe the changes in frequency and mean age of patients diagnosed by subjects over the 6-month intervention period compared to the previous 3 years. Pediatric residents reported a statistically significant increase in the frequency of diagnosing plagiocephaly (P = .001), their comfort level in screening for torticollis (P < .001) and plagiocephaly (P = .001), and their frequency of referral to physical therapy for torticollis (P = .005). There was a significant increase in the percent of patients diagnosed with plagiocephaly at 1 of the 6 clinics during the intervention year (P = .001). There was a significant decrease in the age at the time of diagnosis of torticollis patients at 1 of the 6 clinics during the intervention year (P = .03 and P = .02). This study showed that providing a standardized examination technique for torticollis and plagiocephaly can be useful in educating resident pediatricians on how to diagnose torticollis and plagiocephaly in a more accurate and timely manner.