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Cranial Remodeling Orthosis

The third type of helmet we will discuss in our helmet series is cranial remodeling orthoses (CROs) or “plagiocephaly helmets”. Last month focused on protecting our noggins post-craniectomy, if you have a seizure disorder or are self-injurious, while the month before focused on protecting our noggins from brain injuries that may occur during sports and various activities.

CROs treat cranial asymmetries through passive correction and guided growth. In the 90s, Health Canada issued the “Back to Sleep” campaign to decrease Sudden Infant Death Syndrome, occurring when parents put their children to sleep on their backs. The incidence of SIDS has decreased, however infants are now on their backs for the majority of their first months of life increasing their risk for developing cranial asymmetries. Cranial growth is rapid in the first few months of life, when the skull grows circumferentially in the path of least resistance. However if the child repeatedly lies on one part of their head (due to prolonged sleeping, neck tightness or side-preferencing) then the skull cannot grow in that region. Parents are encouraged to practice repositioning and tummy time techniques at a young age to prevent the progression of cranial asymmetry.

Once the cranial sutures begin to fuse, correction and reshaping becomes less effective. Cranial growth slows considerably after one year of age and is mostly formed by 18 months of age. Therefore if the child is not self-correcting, helmet treatment should be initiated before six months of age. Some mild asymmetries will self-correct with repositioning techniques, however more severe asymmetries will not correct on their own and therefore cranial remodeling therapy should be prescribed. Treatment is a passive process and dependent on guiding growth toward the flattened regions. A CRO contains growth over the bossed regions, providing space over the flattened areas for growth. There is no squishing, forcing or manual manipulation done to your child’s head.

If you have any questions about cranial asymmetry, CROs or the treatment process, please contact our clinic and we would be happy to help. Custom Orthotics of London provides complimentary consultations and would love to help you and your loved ones through this process.


The Custom Orthotics Team (519) 850-4721 | office@customorthoticsoflondon.com | @cool_bracing


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