Sometimes we just want the facts…
With the ever-growing information (and mis-information) available on the internet it can be difficult to distinguish between useful and trustworthy information and opinionated garbage (yes, my vocabulary is clearly influenced by my 5 and 6-year-old sons).
Research is an extremely important tool in clinical practice but it should never replace years of experience and anecdotal evidence that could never be replicated by a study. It is also something that we must ALWAYS look at with a critical eye. Studies can be flawed, weak, and biased in many ways.
Image a study that looks at functional concerns in relation to plagiocephaly and brachycephaly. Functional concerns are referenced in my practice as hats, helmets, glasses, headbands, etc not fitting properly due to a misshapen head. In seeking to find out if head shape affects the fit of these items I could ask a simple question in various ways…
Has your child ever worn a hat that doesn’t fit properly?
Does your child typically experience difficulty finding a hat that fits correctly?
You can imagine that the reply to those questions would vary depending on how it is asked, even though I am seeking the same information in both questions.
Included below are some articles that are worth noting. Keep in mind even this list is skewed to topics that I find helpful.
Articles Worth Reading
Examples of Weak Studies
PURLs: Helmets for positional skull deformities: A good idea, or not?
I have included this article as an example of an otherwise reputable study, that I personally have some serious issues with. First of all… it excludes any severe categories of deformity. Most of the helmets I fit in my clinic are for severe and very severe cases of cranial deformities. Second, the children in the study wear helmets for 6 months and the reports of the adverse effects included “skin irritation (96%), bad helmet odor (76%), pain associated with the helmet (33%), and feeling hindered from cuddling their child (77%)”. If your child is wearing a helmet for 6 months there is bound to be some sort of skin irritation (especially as the seasons change), an odor, and feeling hindered from cuddling. And pain associated with the helmet is subjective as we have no way of quantifying this in an infant. My goal is to have children in and out of their helmet in 8 weeks as this seems to be the amount of time that PARENTS tolerate a helmet on their child. This is only possible if treatment begins as early as possible - typically around 4 months.
Helmet study highlighted in The New York Times is flawed
This study examines a widely referenced article that was featured in the New York Times. The author does a great job examining this research study with a critical eye.