The prevalence of positional plagiocephaly/brachycephaly (PPB) increased dramatically following the Back to Sleep campaign, from 5% to approximately 20%-30%. It has been assumed that PPB is a benign "side effect" of supine sleep positioning and that skull deformation would resolve as children mature. However, several studies now challenge these assumptions. In a recently completed longitudinal study, we found that children with PPB were at elevated risk for developmental delays relative to unaffected controls from infancy through age 36 months. Although it is unclear whether PPB causes developmental delays, we hypothesize that PPB is a "marker" that could be used to identify infants in need of developmental assessment and intervention. Specifically, we anticipate that early and potentially subtle neuromotor deficits make infants vulnerable to developing PPB and predict deficits in other areas of development. This study will be the first long-term follow-up of children with and without PPB. We will re-assess children who participated in our earlier cohort study with PPB (n=215) and unaffected controls (n=163) at age 8 years. The study will explore two primary hypotheses: (1) Children with PPB will score lower than unaffected controls on neuropsychological and academic achievement measures, and (2) These differences are mediated by infant motor skills. We will also examine the demographic and clinical variables that predict development in children with PPB. Finally, we will examine whether differences in head shape remain measureable and observable for children with PPB versus unaffected controls.

Public Health Relevance

Positional plagiocephaly/brachycephaly (PPB) now affects approximately 20% to 30% of infants. Although assumed to be a harmless side effect of supine sleep positioning, recent studies suggest that the development of children with PPB lags behind that of children without PPB. This study will be the first to examine long-term outcomes in children with PPB relative to unaffected controls, testing the hypothesis that PPB is a marker of neuropsychological outcomes that could be used to identify infants who are in need of developmental monitoring and intervention.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
1R01HD080462-01A1
Application #
8695043
Study Section
Child Psychopathology and Developmental Disabilities Study Section (CPDD)
Program Officer
Freund, Lisa S
Project Start
2014-04-10
Project End
2019-03-31
Budget Start
2014-04-10
Budget End
2015-03-31
Support Year
1
Fiscal Year
2014
Total Cost
$491,937
Indirect Cost
$164,459
Name
Seattle Children's Hospital
Department
Type
DUNS #
048682157
City
Seattle
State
WA
Country
United States
Zip Code
98105