Evidence-Based Care of the Child With Deformational Plagiocephaly, Part I: Assessment and Diagnosis

• Published in: Journal of pediatric health care 2012-07, Vol.26 (4), p.242-250
• Main Authors: Looman, Wendy S., PhD, RN, CNP, Kack Flannery, Amanda B., MS, RN, CNP
• Format: Article
• Language: English
• Subjects: Advanced Practice Nursing; assessment; cranial asymmetry; Deformational plagiocephaly; Diagnosis, Differential; Evidence-Based Medicine; evidence-based practice; Facial Asymmetry - diagnosis; Facial Asymmetry - etiology; Facial Asymmetry - therapy; Female; Head Protective Devices; Humans; Infant; infant care; Infant, Newborn; Male; Maxillofacial Development; Nursing; Pediatrics; Plagiocephaly, Nonsynostotic - diagnosis; Plagiocephaly, Nonsynostotic - etiology; Plagiocephaly, Nonsynostotic - therapy; Risk Factors; Severity of Illness Index; Sleep; Supine Position; Torticollis - complications; Torticollis - diagnosis; Torticollis - therapy
• ISSN: 0891-5245; 1532-656X
• DOI: 10.1016/j.pedhc.2011.10.003

Abstract Non-synostotic deformational plagiocephaly (DP) is head asymmetry that results from external forces that mold the skull in the first year of life. Primary care providers are most likely to encounter DP when infants present for well-child care, and for this reason it is important that providers be competent in assessing, diagnosing, and participating in the prevention and management of DP. The purpose of this two-part series on DP is to present an overview of assessment, diagnosis, and evidence-based management of DP for health care providers. In Part I we provide a brief background of DP and associated problems with torticollis and infant development, and we present strategies for visual and anthropometric assessment of the infant with suspected DP. We also provide tools for differentiating DP from craniosynostosis and for classifying the type and severity of lateral and posterior DP. Part II (to be published in a future issue of the Journal of Pediatric Health Care ) provides a synthesis of current evidence and a clinical decision tool for evidence-based management of DP.