Leslie Cordero, DPT, a physical therapist at the Pineville office of Child and Family Development, gets a lot of satisfaction from evaluating and treating little ones with torticollis . Often, parents have questions about the recommendation for helmets. 

Recently, Leslie reviewed the latest literature on helmet treatment of deformational plagiocephaly.  Here is a summary:

• Torticollis is treated by stretching and strengthening neck musculature, typically under the supervision of a physical therapist. 
• Torticollis can be caused by limited space and positioning in the womb and therefore, is common when there are twins or multiple births.  It can also occur with a singleton due to their positioning in the womb.
• A helmet does not treat torticollis. The helmet strictly treats the head shape. 
• Plagiocephaly forms typically when a child has torticollis that causes the child to turn their head in one direction primarily and causes that side to become flat. 

Literature supports that repositioning, physical therapy and helmets can all play a role in the treatment of plagiocephaly.  Infants with moderate to severe plagiocephaly are best treated with a cranial helmet and the younger the infant begins helmet treatment, the better the outcome.  There was evidence that the helmet appears to provide a quicker and superior outcome than conservative intervention alone (i.e. only repositioning). 

A physical therapy evaluation can help to determine a torticollis diagnosis, as well as the most appropriate recommendations that may include ideas for home and/or a helmet.  The age of the child and severity of the plagiocephaly are always considered.  

Leslie’s first approach for mild flatness is repositioning and other conservative methods.  In her clinical experience, kids can make quick progress.