Cranial Remolding orthosis

throughout Charlotte, Rock Hill & Lancaster

What We Treat

Infants sometimes have flattened areas on one side or back of their heads, called deformational plagiocephaly or brachycephaly. These conditions are typically caused by: 

– Position of the baby while in the womb
– Amount of time a baby spends on his back–in crib, baby swing or carrier
– Torticollis, a condition in which a neck muscle is tight and limits the baby’s head motion

The Cranial Remodeling Program is for children who are 4-6 months old. This is the ideal time for optimal head correction because the skull has not yet fused and there is still rapid brain growth. The conditions that we treat are:

Plagiocephaly: A flattening of an infant’s head on one side
Brachycephaly: A flattening that is mostly straight across the back of the head
Asymmetrical brachycephaly: An excessively wide head with asymmetry
Scaphocephaly: A long, narrow head
Post-Surgical Craniosynostosis: A birth defect in which the bones in the baby’s skull fuse together too early

Services We Offer

Prosthetic & Orthotic Institute offers specialized care from an experienced pediatric team. We provide comprehensive assessment and education by a board-certified orthotist and education on developmentally appropriate ways to encourage self-correction. Plagiocephaly treatment may include:

  • Repositioning and increased tummy time
  • Watchful observation by your orthotist and the baby’s caregivers
  • Physical therapy
  • Cranial remolding orthosis (helmet)

When referred to us early enough, more than half of our patients who are evaluated do not require a helmet due to our focus on care giver education, monitoring and team approach to treatment. If a cranial remolding helmet is needed, it is our goal to complete treatment with one helmet. We answer your questions and provide you with everything you need to know so that you can properly apply and care for your child’s helmet. We will closely monitor changes in your baby’s head shape to track progress.

Additionally, our staff includes experienced insurance specialists who will make every effort to get your cranial helmet covered by your baby’s insurance plan. In the instance that your baby’s cranial helmet is not covered by his or her insurance our staff will guide you through our easy payment process. We will even assist you in filing an appeal to your insurance company if the opportunity allows.

The cost of our cranial helmets is highly competitive and affordable when compared to our competitors in the area.

POI’s Unique Approach

Many babies do not require treatment with a cranial remolding helmet because they respond well to repositioning techniques caregivers can practice at home, especially when we first meet them at an early age. The earlier repositioning starts, the more likely it is to be successful. With a prescription from your doctor, we offer an initial assessment at no cost to you. Ideally, we can do our first evaluation and obtain baseline measurements at 2-3 months of age. Although we would never utilize a cranial helmet at this early age it is an ideal time to begin education on repositioning and tummy time for the most desirable outcomes and the greatest chance of not needing to use a cranial helmet.

Prosthetic & Orthotic Institute is a leader in cranial remolding. Our board-certified orthotist has over 20 years of pediatric experience, 12 of those years were devoted solely to cranial remolding.


Technology We Use

  • The SmartSoc™: Records three-dimensional (3-D) information about your baby’s head shape. It’s safe, non-invasive and takes less than two minutes to complete. The scan provides data that our orthotists and doctors use to monitor changes in head shape. The SmartSoc eliminates the need for making plaster casts of the infant’s head.
  • The STARband™ cranial remolding orthosis: A thermoplastic shell with a soft foam liner, custom-molded to your baby’s head shape. The SmartSoc scan provides the information needed to create a custom-made shell for your child. As the child grows, the orthosis acts as a guide to gradually allow the head to reshape. Most babies adjust easily to wearing a helmet.:

Get Started Today. You Can Reach Us through Our Contact Form.

Deformational Plagiocephaly FAQ


What is deformational plagiocephaly? 

Deformational plagiocephaly, also referred to as positional plagiocephaly or flat head syndrome, is a positional head deformity that affects the skull, making an area of a baby’s head appear flattened or misshapen.
The skull is made up of several “plates” of bone which, when we are born, are not tightly joined together. As we grow older, they gradually fuse, or close. Once this happens a baby’s “soft spot” is no longer palpable. The absence of the “soft spot” often indicates that a child is fully fused.

What causes deformational plagiocephaly?

Deformational or positional plagiocephaly is produced by pressure from the outside on part of the skull. It can occur while the baby is still developing in the womb or it can occur after the baby is born. There are a number of risk factors associated with deformational plagiocephaly.

  • The most commonly known risk factor of deformational plagiocephaly is back sleeping. In 1994, the American Academy of Pediatrics (AAP) recommended that infants be slept on their backs to reduce the risk of SIDS, this initiative is known as the “Back-to-Sleep” Campaign. Consequently, many lives have been saved! However, as a result, a number of craniofacial surgeons and neurosurgeons around the country began to document a dramatic increase in the number of infants presenting with deformational plagiocephaly. Many studies were published that documented the link between sleeping infants on their backs and the development of deformational plagiocephaly. Back sleeping remains the recommendation to this day.

In an effort to prevent deformational plagiocephaly, we would never recommend sleeping your baby on their stomach. Specialists involved in treating deformational plagiocephaly support the AAP recommendation which now goes a step further and recommends frequent rotation or repositioning of your child’s head. So, when your baby is awake and supervised, make sure he or she spends plenty of time on his or her tummy. Please refer to information on tummy time – Tummy Time Info.

  • A restrictive intrauterine environment causes the fetus to not have enough room to move, thus they stay in one position. This may occur because the baby is in a breech position, they are a very large baby, or one of twins or multiples (triplets etc.), the mother has a small pelvis or malformed uterus, or an abnormal amount of amniotic fluid.
  • Congenital Muscular Torticollis (CMT) is a condition where a neck muscle called the sternocleidomastoid (ster-no-cly-do-mas-toyd) is very tight or restricted on one side. This causes the head to always tilt to that side and often turn toward the opposite direction. It is a culprit in the development of deformational plagiocephaly because it causes the infant to constantly turn their head in one direction. Thus, the back of the head on that side gets very flat and the face progressively becomes asymmetrical.
  • If an infant is born premature, they are not moving very much on their own and are often in a dependent position (typically side to side) for extended lengths of time. Their head is also very soft and susceptible to deformational forces. Therefore, these infants are at risk for developing an abnormal head shape that is often long and narrow. It is difficult to prevent this at times, because the health and potential survival of the premature infant may depend on this type of positioning. Many NICUs (neonatal intensive care units) use special mattresses to avoid this. However, they can benefit from becoming aware of the potential deformation of the head and utilize positioning techniques throughout the NICU stay.








Share This