Long-Term Outcomes in Children with Positional Plagiocephaly/Brachycephaly

描述(申请人提供)：体位性斜头/短头畸形(PPB)的患病率在恢复睡眠运动后急剧增加，从5%上升到大约20%-30%。人们一直认为，PPB是仰卧睡眠姿势的良性“副作用”，随着儿童的成熟，头骨变形会得到缓解。然而，现在有几项研究挑战了这些假设。在最近完成的一项纵向研究中，我们发现，与未受影响的对照组相比，患有PPB的儿童从婴儿期到36个月的发育延迟风险更高。虽然尚不清楚PPB是否会导致发育迟缓，但我们假设PPB是一个可以用来识别需要进行发育评估和干预的婴儿的“标记物”。具体地说，我们预计早期和潜在的轻微神经运动缺陷会使婴儿容易发生PPB，并预测其他发育领域的缺陷。这项研究将是对患有PPB和不患有PPB的儿童的第一次长期随访。我们将在8岁时重新评估参与我们早期队列研究的儿童，PPB组(n=215)和未受影响的对照组(n=163)。这项研究将探索两个基本假设：(1)PPB儿童在神经心理和学习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调节的。我们还将研究预测PPB儿童发展的人口统计学和临床变量。最后，我们将检验患有PPB的儿童与未受影响的对照组相比，头部形状的差异是否仍然可以测量和观察到。

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.