{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T14:10:01Z","timestamp":1770819001908,"version":"3.50.1"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T00:00:00Z","timestamp":1746835200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T00:00:00Z","timestamp":1746835200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Childs Nerv Syst"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Positional plagiocephaly (PP) and brachycephaly are conditions characterized by head flattening. There has been a sharp rise in the number of patients diagnosed since the American Academy of Pediatrics initiated the \u201cBack to Sleep\u201d policy to combat sudden infant death syndrome. This study compares providers\u2019 and guardians\u2019 perceived head shape differences, highlighting how these scores can alleviate parental anxiety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective chart review was performed for all pediatric patients seen for a PP consult from January 2018 to November 2023. Fifty-nine patients (43 with plagiocephaly and 16 with brachycephaly) met the inclusion criteria, in which documentation recorded two severity scores, one rating each by the provider and parental guardian. Patient demographics, severity scores, and comorbidities were recorded. The institution utilized validated, qualitative assessment forms that evaluated plagiocephaly on a 15-point scale and brachycephaly on a 9-point scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      For plagiocephaly, the providers and guardians rated severity with a median of 4 (IQR 3\u20134.5) and 4 (IQR 3\u20137), respectively (Wilcoxon signed rank test,\n                      <jats:italic>p<\/jats:italic>\n                      -value\u2009&lt;\u20090.05). For brachycephaly, the providers and guardians rated severity with a mean of 3.59 (SD 1.28) and 4.69 (SD 1.66), respectively (paired\n                      <jats:italic>T<\/jats:italic>\n                      -test,\n                      <jats:italic>p<\/jats:italic>\n                      -value\u2009&lt;\u20090.005).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study highlights the similarities in scores assessing clinical severity between providers and parents evaluated in a standardized, qualitative assessment for PP. On average, plagiocephaly reflected a \u201cmild\u201d severity, while brachycephaly reflected a \u201cmild\u201d to \u201cmoderate\u201d severity on a graded scale. Future studies are needed to determine how patient-provider interactions may influence parents\u2019 scores through shared decision-making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00381-025-06833-1","type":"journal-article","created":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T00:08:15Z","timestamp":1746835695000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Are we all seeing the same thing? Discrepancies between parent-reported and physician-reported positional plagiocephaly severity scores"],"prefix":"10.1007","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4912-1519","authenticated-orcid":false,"given":"Grace Soojin","family":"Ryu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Newland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Hiller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elias","family":"Rizk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Samson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,5,10]]},"reference":[{"issue":"1","key":"6833_CR1","doi-asserted-by":"publisher","first-page":"e10","DOI":"10.3928\/19382359-20221114-03","volume":"52","author":"GS Santiago","year":"2023","unstructured":"Santiago GS, Santiago CN, Chwa ES, Purnell CA (2023) Positional plagiocephaly and craniosynostosis. Pediatr Ann 52(1):e10\u2013e17. https:\/\/doi.org\/10.3928\/19382359-20221114-03","journal-title":"Pediatr Ann"},{"issue":"1","key":"6833_CR2","doi-asserted-by":"publisher","first-page":"86e","DOI":"10.1097\/PRS.0b013e318272c12b","volume":"131","author":"CR Forrest","year":"2013","unstructured":"Forrest CR, Hopper RA (2013) Craniofacial syndromes and surgery: Plast Reconstr Surg 131(1):86e\u2013109e. https:\/\/doi.org\/10.1097\/PRS.0b013e318272c12b","journal-title":"Craniofacial syndromes and surgery: Plast Reconstr Surg"},{"key":"6833_CR3","unstructured":"NHS. Plagiocephaly and brachycephaly (flat head syndrome). Published online August 3, 2022. Accessed January 10, 2025. https:\/\/www.nhs.uk\/conditions\/plagiocephaly-brachycephaly\/"},{"issue":"2","key":"6833_CR4","doi-asserted-by":"publisher","first-page":"80","DOI":"10.7181\/acfs.2020.00059","volume":"21","author":"BK Jung","year":"2020","unstructured":"Jung BK, Yun IS (2020) Diagnosis and treatment of positional plagiocephaly. Arch Craniofacial Surg 21(2):80\u201386. https:\/\/doi.org\/10.7181\/acfs.2020.00059","journal-title":"Arch Craniofacial Surg"},{"issue":"1","key":"6833_CR5","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1136\/adc.2010.190934","volume":"96","author":"BL Hutchison","year":"2011","unstructured":"Hutchison BL, Stewart AW, Mitchell EA (2011) Deformational plagiocephaly: a follow-up of head shape, parental concern and neurodevelopment at ages 3 and 4 years. Arch Dis Child 96(1):85\u201390. https:\/\/doi.org\/10.1136\/adc.2010.190934","journal-title":"Arch Dis Child"},{"issue":"7","key":"6833_CR6","doi-asserted-by":"publisher","first-page":"1184","DOI":"10.3390\/children10071184","volume":"10","author":"M Blanco-Diaz","year":"2023","unstructured":"Blanco-Diaz M, Marcos-Alvarez M, Escobio-Prieto I et al (2023) Effectiveness of conservative treatments in positional plagiocephaly in infants: a systematic review. Children 10(7):1184. https:\/\/doi.org\/10.3390\/children10071184","journal-title":"Children"},{"issue":"1","key":"6833_CR7","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1186\/s13052-021-01079-4","volume":"47","author":"I Pastor-Pons","year":"2021","unstructured":"Pastor-Pons I, Lucha-L\u00f3pez MO, Barrau-Lalmolda M et al (2021) Efficacy of pediatric integrative manual therapy in positional plagiocephaly: a randomized controlled trial. Ital J Pediatr 47(1):132. https:\/\/doi.org\/10.1186\/s13052-021-01079-4","journal-title":"Ital J Pediatr"},{"issue":"5","key":"6833_CR8","doi-asserted-by":"publisher","first-page":"e4328","DOI":"10.1097\/GOX.0000000000004328","volume":"10","author":"A Watt","year":"2022","unstructured":"Watt A, Alabdulkarim A, Lee J, Gilardino M (2022) Practical review of the cost of diagnosis and management of positional plagiocephaly. Plast Reconstr Surg - Glob Open 10(5):e4328. https:\/\/doi.org\/10.1097\/GOX.0000000000004328","journal-title":"Plast Reconstr Surg - Glob Open"},{"issue":"3","key":"6833_CR9","doi-asserted-by":"publisher","first-page":"282","DOI":"10.3171\/2016.9.PEDS16278","volume":"19","author":"S Lam","year":"2017","unstructured":"Lam S, Luerssen TG, Hadley C et al (2017) The health belief model and factors associated with adherence to treatment recommendations for positional plagiocephaly. J Neurosurg Pediatr 19(3):282\u2013288. https:\/\/doi.org\/10.3171\/2016.9.PEDS16278","journal-title":"J Neurosurg Pediatr"},{"issue":"4","key":"6833_CR10","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1177\/10556656211069816","volume":"60","author":"A Junn","year":"2023","unstructured":"Junn A, Dinis J, Long A et al (2023) Disparities in access to cranial remodeling orthosis for deformational plagiocephaly. Cleft Palate Craniofacial J 60(4):454\u2013460. https:\/\/doi.org\/10.1177\/10556656211069816","journal-title":"Cleft Palate Craniofacial J"},{"issue":"11","key":"6833_CR11","doi-asserted-by":"publisher","first-page":"1275","DOI":"10.1007\/s00381-007-0373-y","volume":"23","author":"P Steinbok","year":"2007","unstructured":"Steinbok P, Lam D, Singh S, Mortenson PA, Singhal A (2007) Long-term outcome of infants with positional occipital plagiocephaly. Childs Nerv Syst ChNS Off J Int Soc Pediatr Neurosurg 23(11):1275\u20131283. https:\/\/doi.org\/10.1007\/s00381-007-0373-y","journal-title":"Childs Nerv Syst ChNS Off J Int Soc Pediatr Neurosurg"},{"issue":"4","key":"6833_CR12","doi-asserted-by":"publisher","first-page":"E2","DOI":"10.3171\/2013.7.FOCUS13260","volume":"35","author":"JL Goh","year":"2013","unstructured":"Goh JL, Bauer DF, Durham SR, Stotland MA (2013) Orthotic (helmet) therapy in the treatment of plagiocephaly. Neurosurg Focus 35(4):E2. https:\/\/doi.org\/10.3171\/2013.7.FOCUS13260","journal-title":"Neurosurg Focus"},{"key":"6833_CR13","doi-asserted-by":"publisher","first-page":"g2741","DOI":"10.1136\/bmj.g2741","volume":"348","author":"RM van Wijk","year":"2014","unstructured":"van Wijk RM, van Vlimmeren LA, Groothuis-Oudshoorn CGM, Van der Ploeg CPB, Ijzerman MJ, Boere-Boonekamp MM (2014) Helmet therapy in infants with positional skull deformation: randomised controlled trial. BMJ 348:g2741. https:\/\/doi.org\/10.1136\/bmj.g2741","journal-title":"BMJ"},{"issue":"1","key":"6833_CR14","doi-asserted-by":"publisher","first-page":"33","DOI":"10.2174\/1874434601509010033","volume":"9","author":"F Lennartsson","year":"2015","unstructured":"Lennartsson F, Wennergren G, Nordin P (2015) Reliable assessors of infant cranial asymmetry in child health care. 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Published online September 30, 2020. https:\/\/doi.org\/10.1542\/aap.ppcqr.396215","DOI":"10.1542\/aap.ppcqr.396215"}],"container-title":["Child's Nervous System"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00381-025-06833-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00381-025-06833-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00381-025-06833-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T13:17:44Z","timestamp":1770815864000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00381-025-06833-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,10]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["6833"],"URL":"https:\/\/doi.org\/10.1007\/s00381-025-06833-1","relation":{},"ISSN":["0256-7040","1433-0350"],"issn-type":[{"value":"0256-7040","type":"print"},{"value":"1433-0350","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,10]]},"assertion":[{"value":"22 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Human Research Protection Program of Penn State College of Medicine reviewed and approved this retrospective study protocol, approval number [STUDY00022298]. Ethics approval has been granted an exemption from requiring ethics approval by the Pennsylvania State University\u2019s Office for Research Protections.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Written informed consent for this study has been granted an exemption by the Pennsylvania State University\u2019s Office for Research Protections.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"176"}}