Monday, April 30, 2012

Stephanie Pruitt---Guest Post!!

This is Donna---Stephanie Pruitt is the author of the book The Truth About Tummy Time.  Her book has been reviewed on this blog, and I highly recommend it.  I'm honored to have her blog here!
It is always a pleasure to work with other professionals on a shared interest.  Thank you, Donna, for the opportunity to post this guest blog on your site. 
In working with parents for the last several years, I am always shocked to hear one say “The doctor told me this would just go away.”  In terms of torticollis (shortened neck muscles) and plagiocephaly (flattening of the skull), this cannot be further from the truth.  Both conditions can and will get worse if nothing is done to correct the situation. 
Although torticollis and plagiocephaly have a number of things that cause them, the most common cause we see today is positional related.  What this means is the baby spends a disproportionate amount of time in one position throughout the day.  This can be long hours spent in car seats, swings or bouncers or always being placed in the same position when laid down to sleep.  These conditions have become much more common since the advent of the Back to Sleep campaign as most parents always place babies on their backs and rarely place babies on their stomachs even to play. 
If left untreated, torticollis can lead to a number of difficulties for the baby as he or she grows Some of these include scoliosis, shoulder alignment problems, muscle imbalance of the neck and back resulting in developmental delay or compensatory movements to accomplish movement goals- developmental milestones.  The eyes can also be affected if the baby is unable to turn his or her head to one direction or if the head is tilted to one side.  The brain will reset the horizontal for this tilted view of the world which can then lead to balance challenges.  Lastly, a baby can experience facial and ear deformity as a result of the abnormal muscle pull on the face and side of the head. 
Studies have shown that untreated plagiocephaly can lead to long-term problems such as subtle brain dysfunction which present as language disorders, learning disabilities, and attention deficits when a child reaches school age.  This may be due to “compression in certain areas of the brain” during growth in the first year.* It is estimated that 40% of children with untreated, persistent plagiocephaly require additional services such as special education, physical therapy, occupational therapy and speech language pathology.  Plagiocephaly can also cause facial deformity due to the disproportionate forces on the head. 
While torticollis and plagiocephaly are treatable, the best treatment is prevention.  Placing your baby in a variety of positions- tummy, on each side as well as on the back- will ensure balanced muscle development and head rounding.  If you are concerned about a head tilt or the shape of your baby’s head, ask for a referral to a pediatric physical therapist to assist you in treatment.  
For further information about Torticollis and Plagiocephaly or to read more about The Truth About Tummy Time A Parent’s Guide to SIDS, the Back to Sleep program, Car Seats and More visit or follow the blog at  

Stephanie J. Pruitt, PT
Director of Pediatric Physical Therapy at Eagle Rehab, Madison, AL
Author of The Truth About Tummy Time

*Miller, R., S. K. Clarren. Long-Term Developmental Outcomes in Patients with Deformational Plagiocephaly