#55: OT, Plagiocephaly, and Cognitive Outcomes with Amirra Condelee (CE Course)

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Full Course Details: Public course page
Learn more about our guest: Dr. Amirra Condelee, OTD, OTR/L:

Read the article and discussion upon which this podcast is based.

Released May 1, 2023.

Plagiocephaly has historically been thought of as a benign, cosmetic issue.

But, the seminal study we are looking at during this 1-hour course indicates that severe to moderate skull deformity may be best understood as a biomarker for developmental vulnerability. As we’ll see, moderate to severe skull deformity was linked with lower cognitive and academic outcomes, when the children reached school age.

It is critical to understand that this does not mean that plagiocephaly causes developmental delay. But, given the results of this study, developmental assessment, monitoring, and intervention is recommended for children moderate to severe plagiocephaly. After we break down this article for you, we’ll be joined by Amirra Condelee, OTD, OTR/L to discuss the implications for OTs who work with infants—and our role in our communities and families now that we understand the importance of this biomarker.

Primary Journal Article Explored

Cognitive Outcomes and Positional Plagiocephaly. Pediatrics, (2019).

Supporting Research and Journal Articles

Plagiocephaly perception and prevention: A need to intervene early to educate parents. The Open Journal of Occupational Therapy, (2021).

Safety and efficacy of independent Allied healthcare professionals in the assessment and management of Plagiocephaly Patients. Child’s Nervous System, (2019).

Barriers and facilitators influencing parental adherence to prevention strategies for deformational plagiocephaly: Results from a scoping review. Child: Care, Health and Development. (2023).

The effectiveness and safety of conservative interventions for positional plagiocephaly and congenital muscular torticollis: A synthesis of systematic reviews and guidance. Chiropractic &; Manual Therapies, (2020).

Using a 3D asymmetry index as a novel form for capturing complex three-dimensionality in positional plagiocephaly. Scientific Reports, (2022).

Plagiocephaly Resources Discussed

Learning Objectives

  • You will be able to recognize the type of developmental assessment that is indicated by plagiocephaly at different ages.
  • You will be able to identify the opportunities for speciality OT assessment and intervention related to plagiocephaly.

Agenda

Intro (5 minutes)

Breakdown and analysis of journal article (5 minutes)

  • Intro to positional plagiocephaly
  • Prevalence
  • Is it harmless? Flat head syndrome and development.
  • What were the methods?
  • What were the results?
  • Discussion
  • Conclusion
  • Takeaways for OT practitioners

Discussion on practical implications for OTs (with Amirra Condelee) (50 minutes)

  • Tell us how you first found OT.
  • How did you become interested in pediatrics?
  • What were your initial impressions of this article?
  • What can we do as OTs to prevent plagiocephaly in the first place?
  • Do you see a place for craniometry in EI OT?
  • What opportunities do you see for connecting with physicians for referrals based on this article?
  • Did the assessments utilized feel familiar to you? After reading the article, what assessments would you be likely to utilize with a child with positional plagiocephaly?
  • If you did have a child on your caseload with moderate/severe plagiocephaly, what resources do you know that EI therapists could access?
  • How has being a new mom changed your approach to working with families?

Contact Hours

1 hour (0.1 AOTA CEUs). Released online from Aurora, NE.

See public-facing course page for more details.

Speakers

Dr. Amirra Condelee, OTD, OTR/L:

Dr. Amirra Condelee, OTD, OTR/L

Sarah Lyon, OTR/L:

Sarah Lyon, OTR/L headshot

Ep55-AOTA-Badge

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Please share any other feedback below! Including, ideas for future programming, and most importantly, how you feel this podcast will impact your practice!

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I may have missed it but is there a way for us as practitioners to rate the plagiocephaly? As I listened again, It seems there was a training that was reasonable! Could we, as OTs, diagnosis plagiocephaly? Or measure from a possibly a screening and get a referral from the physician?
I am in private practice but really love working with the babies and would love to expand my practice in EI - as a private practice.

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Hey Ashley! I am learning right alongside you, but it seems like the low-tech way is to use a craniometer. (See below) @stacey3 is an OT and works for a cranial remolding company and they use 3D images…but I don’t think that would be necessary for OT work (unless @stacey3 thinks differently.)

Honestly, if I was really interested in getting into this area, I would check out the website below for more in-depth learning!

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Love hearing about how OT how can assist in helping with the mom-baby dyad. Also loved the point of prevention vs. treatment as most times (in my experience with my own children) has been a wait and see approach if they need services. Thank you for this great podcast!

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Great podcast~ Informative and engaging. Yes ~ I was wondering the same thing about if there is a scale to use as well as if OT’s are able to dx this and use insurance codes to tx. Thanks!

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Thank you!! I did look on Baby Begin as I heard about that training! Seems like a fabulous place to specialize! I will be looking into that for my practice!
Does the measurement tool give you “typical” ranges or I guess I could find that online? I bet that info is in their course!
Thanks for sharing this article and OT specialty!!

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I would imagine our OT codes would work for billing as it seems it would fit into our codes - ther ex (for exercises and ROM), or neuro re-education, or therap. procedure.

I was still wondering about if WE as OTs can diagnosis???

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Hey @aharrell! I thought this article was a really helpful read. It outlines the current barriers and potential roles for OT.

The article specifically says:

Because of physician time constraints during well-baby visits, the task of completing plagiocephaly screening and measurements could be delegated to an occupational therapist.

As with all things, OTs must leave it to a physician for a formal diagnosis. But, our role here could be to screen, assess and evaluate the severity (and also evaluate associated developmental delays). The article also points to the fact that the American Academy of Pediatrics has not made formal assessment recommendations for plagiocephaly. But, it does outline the available options for measurement.

So, alls that to say, I think this is an incredible area to specialize. But, would certainly try to connect with OTs who are already immersed in this work, like @stacey3 or Baby Begins before doing so!

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Also, @aharrell- I just saw you are hiring… how exciting!!!

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Thanks!!!
My business is growing! I’d love to do more education, CEUs, & actually use my capstone program education more! So
I’d love to hired an OT for direct client care! It’s exciting! Hoping to add this certification to my Infant Mental Health endorsement!

Keep doing what you’re doing SarahLyon!! Thanks!

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It seriously makes us so happy to see OT businesses growing! You are doing great work, @aharrell!!

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Yes ~ I think it would fit under the codes, but am unsure if we can really diagnose, too.

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I think that 's the question I got incorrect on the test - because we still need a script for insurance coverage where the md would assign that dx?

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As an Early Intervention in-home practitioner of 6+years. I just wanted to note for all clinicians who serve children under three I have never seen PPB in isolation, as I have always noted some degree of Torticollis in this population. In each case, PPB and torticollis have presented with reduced shoulder ROM to extend and adduct. In all case it impacts motor skills as Dr. Amirra Condelee noted. For example, infant is only able to roll in one direction, in tummy time is not reaching with the arm on the impacted side, etc. It also impacts hand use and dominance, as children show hand preference for the non-impacted side aeb only exhibiting unilateral reach and engagement. While PT often receive the referrals for this population, it is my humble opinion that OT are better positioned as it directly impact’s engagement, access, and function.

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I really enjoyed this podcast. It brought to light what we need to address as practitioners with newborns and early childhood patients.

1 Like