Back Is Best

Cranial remolding helmets for plagiocephaly have become more and more in demand since it has been known that it is safer for an infant to sleep on his/her back. During the early stages of development, the skull is vulnerable to any outside pressure, causing it to change shape. Below will outline what to expect if your pediatrician/specialist has recommended or prescribed a Cranial Remolding Helmet for your child.

REASONS A CRANIAL REMOLDING HELMET IS PRESCRIBED:

A physician or specialist typically prescribes a helmet because the child has been diagnosed with the following*:

• PLAGIOCEPHALY: Typically the result of torticollis of the neck and the infant usually laying with their head always to the same side.
• BRACHYCEPHALY: Caused by infant laying on his/her back and the back of the head is becoming flat.
• SCAPHOCEPHALY:  Infant’s head is constantly rolling side to side causing the head to be elongated.

*If your child is diagnosed with plagiocephaly, brachycephaly, or scaphocephaly, therapy may be presribed for your child, as well as changing the sleeping arrangements. Both of which should be discussed with the pediatrician/specialist.*

AT WHAT AGE IS IT BEST FOR A CHILD TO WEAR A HELMET?  

Most of the infants we see range in age from three months to nine months. The younger the patient the more potential there is for head growth during the therapy; thus we see a better change and success with the helmets. Since there is more growth at a younger age, the child may not have to wear the helmet quite as long as they may have if they were older. Another factor to consider is that older children have a greater ability to grab and possibly remove the Velcro® strap holding the helmet together (Note: helmet will not fall off if the strap is removed but will not be closed completely).

INSURANCE COVERAGE*

It is very common that insurances do require conservative treatment before they will provide coverage for the Cranial Remolding Helmet. They typically require at least six weeks of conservative treatment which can include re-positioning in the crib and therapy. Therapy can include a physical therapist and/or occupational therapist stretching the neck muscles so the infant does not tend to turn to one side or the other.

Insurance also bases coverage on whether or not the measurements of the infant’s head fall into the moderate to severe range on the Cranial Vault Asymmetry Index (CVAI). If your child’s measurements are in that range then there is a good chance the helmet will be covered. These measurements would be taken at your first evaluation (which is free!).

WHAT TO EXPECT AT YOUR INITIAL APPOINTMENT 

During your first appointment, we go through the history of the pregnancy; we also ask about any complications during delivery. After the history is taken, then measurements of the head are recorded.  Next, a stockinette is placed on the child’s head and the orthotist uses a laser scanner around the head to obtain a 3-D picture.

Based on the measurements, we then decide if a helmet is necessary; if not, we can set up another appointment to re-evaluate and see if the condition has worsened. The scans are only viable for 2 weeks; after that time, if a helmet is to be ordered, new measurements and scan must be obtained. Once the measurements and scan are collected and the child’s measurements fall in the moderate-to-severe range. then we order the helmet.

WHAT TO EXPECT AT THE HELMET AND FOLLOW-UP 

Once the helmet has been received from Boston Brace, we set up the fitting as quickly as possible. After the first fitting, we setup up bi-weekly appointments for either new measurements and/or scans to check progress. Adjustments of the helmet are then made at that time. Typically the helmet is not needed once the patient has measurements in the mild-to-moderate range and/or the parents are satisfied with the results.

HOW THE BOSTON BAND CRANIAL REMOLDING HELMET WORKS

The Boston Band is a full coverage cranial remolding helmet that encompasses the whole head and sits on the base of the skull. This helps ensures that the helmet does not shift while your child is wearing the helmet. The inside of the helmet is layered with soft foam that one help make the helmet more comfortable and two make it easy for our orthotist to adjust as the child grows. You will also notice on the inside of the helmet there is a open cut-out; this is used on the flatter portion of your child’s head to allow the skull to grow in that area and provide a more round shape.

*All helmets require a signed prescription from a physician or specialist. Coverage is based on individual plans and may be subject to a deductible.*