Related Experiment Video
Updated: Jun 17, 2026
Midface Hypoplasia and Cranial Base Morphology in Syndromic Craniosynostosis: A Comparative Analysis Study Using a Predictive Regression Model
Published on: November 4, 2025
Surgical Timing as a Marker for Developmental Diagnoses and Behavioral Therapy Utilization in Nonsyndromic
Victoria Kong1, Andrew Salib, Omar Allam
1Department of Surgery, Division of Plastic and Reconstructive Surgery, Yale New Haven Hospital, Yale School of Medicine; New Haven, CT.
Purpose:
To evaluate the association between surgical timing and psychiatric and developmental diagnoses, behavioral therapy utilization, and associated financial burden in children with nonsyndromic craniosynostosis (NSC).
Methods:
A retrospective cohort study was performed using the Merative MarketScan Commercial Database (2016-2022). Children with NSC were identified and stratified by surgical timing (≤12 versus >12 mo). Outcomes included disorder prevalence and behavioral therapy intensity/costs, adjusted for sociodemographics using multilevel logistic regression.
Results:
Of the 1523 patients, 1301 (85.4%) underwent early intervention and 222 (14.6%) underwent late intervention. Late intervention (>12 mo) was a significant independent predictor of behavioral therapy utilization (OR: 2.63, 95% CI: 1.60-4.31; P<0.001). Compared with the early group, late-intervention patients utilized therapy at nearly double the rate (48.2% versus 26.1%), with significantly higher session intensity (median 25 versus 17) and costs ($2048 versus $1424, all P<0.001). Late intervention was also associated with a significantly higher prevalence of developmental (19.8% versus 11.4%, P<0.001) and psychiatric disorders (8.6% versus 4.5%, P<0.001). Multilevel regression confirmed late intervention was an independent predictor of developmental disorder diagnosis (OR: 1.88, 95% CI: 1.00-3.53, P=0.048).
Conclusions:
Delayed NSC repair beyond 12 months is associated with a higher prevalence of developmental diagnoses and behavioral therapy utilization. While the retrospective nature of this study precludes causal inference, these findings identify a high-risk cohort that may benefit from proactive neurodevelopmental surveillance.
