Long-Term Outcomes in Children with Positional Plagiocephaly/Brachycephaly

描述（由申请人提供）：在“重返睡眠”运动后，体位性斜头畸形/短头畸形（PPB）的患病率急剧增加，从5%增加到大约20%-30%。人们一直认为，PPB是仰卧睡姿的良性“副作用”，颅骨变形会随着儿童的成熟而消失。然而，现在有几项研究对这些假设提出了挑战。在最近完成的一项纵向研究中，我们发现从婴儿期到36个月，与未受影响的对照组相比，患有PPB的儿童发育迟缓的风险更高。虽然目前尚不清楚PPB是否会导致发育迟缓，但我们假设PPB是一个“标记”，可以用来识别需要发育评估和干预的婴儿。具体来说，我们预测早期和潜在微妙的神经运动缺陷使婴儿容易发展为PPB，并预测其他发展领域的缺陷。这项研究将是首次对患有和不患有PPB的儿童进行长期随访。我们将在8岁时重新评估参与我们早期PPB队列研究的儿童（n=215）和未受影响的对照组（n=163）。本研究将探讨两个主要假设：(1)患有PPB的儿童在神经心理和学业成绩方面的得分低于未受影响的对照组；(2)这些差异是由婴儿运动技能介导的。我们还将研究预测PPB儿童发展的人口学和临床变量。最后，我们将研究是否可以测量和观察到患有PPB的儿童与未受影响的对照组在头部形状上的差异。

DESCRIPTION (provided by applicant): 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.