When a pediatrician makes a diagnosis of plagiocephaly or flat head syndrome, they will sometimes include technical terms and measurements. As someone new to the diagnosis how are you to make sense of all of this technical information? This guide will walk you through the levels of the Plagiocephaly Severity Scale in simple terms that any parent can understand.
What is the Plagiocephaly Severity Scale?
In 1999 Dr. J. Mulliken set out to create a scale that could be used by physicians worldwide to properly classify the levels of plagiocephaly. He made the distinction of mild, moderate, or severe cases of flat head syndrome and included a detailed five-point scale to measure each child properly. This measure allows pediatricians to take more accurate measurements and track progress. Most pediatricians will note a CVAI score when making a formal diagnosis, which can range from 3.5 percent to upwards of 11 percent. This measurement is a universal equation that uses two cranial measurements, one of either side of the skull to classify the severity. The scale also evaluates things like ear shifting, anterior skull involvement and how many quadrants are involved.
Level 1 Plagiocephaly Severity Scale
Although level one is included on this scale, children with a CVAI score of less than 3.5 percent are considered within normal limits. There would be no treatment need, but careful repositioning is always recommended to avoid any problems.
Level 2 Plagiocephaly Severity Scale
At this level the malformation is considered very mild. Children in this level will have minimal irregularity in only one area of the skull. The CVAI score associated with this level is between 3.5 and 6.25 percent. The treatment would likely begin by starting a repositioning program; if after two months of repositioning there is no change, cranial remolding become an option but is generally considered cosmetic.
Level 3 Plagiocephaly Severity Scale
Level three of flat head syndrome is labeled as a moderate malformation. A CVAI score between 6.25 and 8.75 percent would classify as level three. Doctors would also make the diagnosis if one or more of the following are present:
- Two quadrants involved
- Moderate to severe flattening
- Minimal ear shift or anterior involvement
The treatment options at this level vary based on a case-by-case basis. Some pediatricians take a more laid-back approach and create a repositioning program for home use, while other docs will move more aggressively and use cranial remolding as the first course of action. The decision on what plan to use depends upon a number of factors, but most importantly age and family history.
Level 4 Plagiocephaly Severity Scale
The fourth level of plagiocephaly is considered severe with a CVAI score of 8.75 to 11 percent. Doctors would also observe one or more of the following in order to make a diagnosis:
- Two or three quadrant involvement
- Severe flattening
- Moderate ear shift
- Anterior involvement including noticeable orbit asymmetry
Once a diagnosis of level four is made the standard treatment is to begin cranial remolding immediately.
Level 5 Plagiocephaly Severity Scale
Children with a CVAI score of great than 11 percent are considered to be at level five, which is the very severe category. At this level it would be typical to see some or all of the following:
- Three or four quadrant involvement
- Severe flattening
- Severe ear shift
- Anterior involvement including orbit and cheek asymmetry
Like level four, at this level cranial remolding is the choice of pediatricians.
Advances in plagiocephaly devices have made treatment options available at all levels of the malformation. Receiving a level five diagnosis doesn’t mean that you don’t have options. There are excellent treatments available at every level of the diagnosis.
One of the first questions that most plagiocephaly parents ask when the pediatrician prescribes cranial remolding is how long will my baby need to wear the helmet. Most doctors will hesitate to give a specific time frame, because there is a range. While there is no one answer to this question, there is certainly a typical range for most infants and a number of factors that can help reduce the length of time to treat flat head syndrome.
Those first few precious months of life can be hectic. In a blur of sleeplessness and adjustment to a new baby, simply making it through the day can take all of our energy. Who has time to think of ways to make sure you are helping baby in her development? These are five simple activities that you can do with your baby to promote excellent growth and development.
In recent times, pediatricians have been stressing the importance of tummy time for a baby. New parents are being made aware of the importance of tummy time and why it is beneficial for their babies.
Flipping your baby on his belly will do him loads of good. To sit, crawl and walk a baby needs strong trunk, back and neck muscles. By putting him on his tummy you can help him to develop these muscles properly and gain control over his body. The American Association of Pediatrics has conducted several studies on the benefits of tummy time. From these reports it is evident that a baby should spend most of the waking hours on his tummy. Here are some of the benefits discovered by those studies:
Wearing a helmet to correct a cranial deformity can be an emotional struggle for younger children. If your toddler is undergoing helmet therapy, you can ease the process by helping them decorate their helmet in a way that shows their personality. Although they are still very small, by the time your little one starts helmet therapy, they are already showing hints of who they will be when they grow up. In this article, we’ll go over how you can help your child to pick a helmet design or color that they love.