Sometimes, special medical helmets can be used to help mold the baby’s skull into a more regular shape. Long-term studies demonstrate that in addition to correcting functional problems associated with craniosynostosis, reconstructive surgery has a positive effect on the child's self image and the ability to get along with … Craniosynostosis occurs in approximately one in 1700-250… Although average CBCL/CTRF broadband and total scores for all informants were consistently higher for children with SSC, these differences were small and unreliable. This can limit or slow the growth of the baby’s brain. Surgery can correct it. Kathleen A Kapp-Simon, PhD, Brent R Collett, PhD, [...], and Matthew L Speltz, PhD. This can lead to developmental problems, headaches, and brain damage. ehavioral problems related to this condition has been scarce. Methodologically, this study represents an advance over previous work in that it included a well-matched control group, longitudinal data points and multiple informants. Manual for the ASEBA Preschool Forms & Profiles. Means and standard deviations were calculated separately by group for all measures. Given the potential persistence of untreated behavior problems,28, 29 the effectiveness of behavioral interventions in early life,30 and the ease of developmental surveillance for children already followed closely by craniofacial teams, young children with SSC should be routinely screened with a measure like the CBCL, which is a low-cost method of identifying high risk children. Pike A, Iervolino AC, Eley TC, Prise TS, Plomin R. Environmental risk and young children's cognitive and behavioral development. attention problems (P , .05), and inattention problems (P , .01) than normative population and with other diagnostic subgroups. A pool of 581 control group participants were recruited through pediatric practices, birthing centers and announcements in newsletters and/or other publications of interest to parents of newborns. Psychological adjustment to pediatric physical disorders: a meta-analytic review. CONCLUSIONS: Although children who have syndromic craniosynostosis At T2, mothers of children with SSC again reported slightly more behavior problems than mothers of controls, though these differences were variable and small in magnitude (Table 3). Other reasons for non-participation included: time (4%), distance (3%), lack of interest (3%), and confidentiality concerns (2%). Correlations between parent and teacher reports were generally low at both assessments (r = 0.11 to 0.21 at T1; 0.14 to 0.38 at T2). Few studies of craniosynostosis have included measures of children’s behavior and social–emotional characteristics. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Exploratory analyses of diagnostic subgroups among children with SSC found no evidence of behavioral differences associated with location of the isolated cranial suture. Deborah’s daughters were born with craniosynostosis. Few children received out-of-home childcare at either age point, and CTRF data were only available for a subset of children in both groups (47 patients and 51 controls at T1; 48 patients and 72 controls at T2; 21 patients and 26 controls at both time points). Their head may look smaller, longer, wider, or more narrow than usual. 2008;146A:984–991. Craniosynostosis is a rare condition in which an infant has an abnormally shaped skull after the cranial sutures fusing too early. The most common complications of uncorrected craniosynostosis include increased intracranial pressure, asymmetry of the face, and malocclusion. This can lead to developmental problems, headaches, and brain damage. Finally, we examined the correlation between informants at both visits using Pearson’s r for the Externalizing, Internalizing, and Total Problems scores. Stata statistical software [computer program]. At T2 children with SSC had slightly more behavior problems on all scales, though these differences were small and variable (Table 4). The purpose of this study was to confirm initial reports of elevated behavior problems in children with single-suture craniosynostosis (SSC), using multiple informants, longitudinal analyses and a control group. Adjusted group differencesa in raw scores on the Child Behavior Checklist (CBCL) and Caregiver-Teacher Report Form (CTRF) scores for children with single suture craniosynostosis (SSC) versus controls at Time 1 and Time 2. 3 out of every 4 cases affect males. Campbell SB, Spieker S, Burchinal M, Poe MD. A total problem scale provides a summary score for all problems endorsed. Other possible problems (which can involve long term effects) include: Seizures; Developmental delays; Learning disabilities and vision problems, in later years Becker DB, Petersen JD, Kane AA, Cradock MM, Pilgram TK, Marsh JL. The study was approved by the institutional review boards (IRB) from each participating center: Seattle Children's Hospital; Children’s Memorial Hospital and Northwestern University in Chicago; Children’s Healthcare of Atlanta, St. Louis Children’s Hospital; University of Illinois in Chicago (UIC), the University of Chicago (UC) and Children’s Hospital of Philadelphia (CHOP). Craniosynostosis that's not corrected can cause pressure inside the skull (intracranial pressure). A population-based study of craniosynostosis in metropolitan Atlanta, 1989-2003. Heyting A, Tolboom JT, Essers JG. Bannink N(1), Maliepaard M, Raat H, Joosten KF, Mathijssen IM. These problems are not 100% unique to craniosynostosis but they are found in a very high incidence in the craniosynostosis kids compared to the regular population. Craniosynostosis that's not corrected can cause pressure inside the skull (intracranial pressure). They found that 20% of the school age children in their sample required assistance from a classroom aid to manage their behavior. Around two years of age, a child’s skull bones begin to join together because the sutures become bone. Attention problems on both instruments are indexed by a syndrome scale of the same name and the DSM-IV attention deficit hyperactivity (ADHD) scale; both scales describe behaviors commonly associated with ADHD (e.g., can’t concentrate, restless or hyperactive). When these joints come together too early, a baby’s skull cannot grow properly. Craniosynostosis is a condition in which the sutures close too early, either in the womb or shortly after birth, that may cause problems with skull growth, and in some cases with brain growth. We also used logistic regression to calculate odds ratios (OR) to determine whether patients were more likely than controls to score above established clinical cut-offs on the CBCL and CTRF broadband and total scores (defined as T-scores ≥60) based on the reports of any single informant (mother, father or teacher), either parent, or the combination of all three informants. The participants were 232 patients with SSC and 235 matched controls for whom questionnaire data were available from one or both assessment visits. Speltz, Morton, Goodell, and Clarren (1993) found that children with various craniofacial anomalies—including those with craniosynostosis—were more than twice as likely as children in a matched control group to have teacher- and parent-reported behavior problems at school … Differences on the 18 month Externalizing and Total Problems scales were minimal, with wide confidence intervals. Among patients, 102 had sagittal synostosis, 53 had metopic synostosis, 56 had right or left unilateral coronal synostosis, and 12 had lambdoid synostosis. Relatively few children in either group scored above the established clinical cut-off based on scores from any of the three reporters (Table 5). Recent studies have suggested that children with SSC have elevated risk for emotional and behavioral problems, based on comparisons of these children with behavior checklist norms.5, 6 However, the present study, which is the first to include a demographically-matched control group, found little support for this hypothesis, at least among very young children. Items from the CBCL and CTRF are nearly identical, with some rewording of CBCL items on the CTRF to accommodate childcare or preschool situations. On all scales, a higher score indicates more problems. The doctor also will look for any problems with the shape of the baby’s face. Craniosynostosis Complications. A CBCL was completed at Time 1 (T1) when children were ~19 months by 436 mothers (219 patients and 217 controls) and 371 fathers (177 patients and 194 controls); and at Time 2 (T2) when children were ~37 months by 361 mothers (175 patients and 186 controls) and 303 fathers (142 patients and 161 controls). At T2, all differences were small and statistically non-significant (p-values = 0.286 to 0.938). Predictive value of minor anomalies: I. Differences were negligible based on gender (64% non-participants were male, versus 65% participants). We used descriptive statistics to summarize demographic characteristics separately for children with and without SSC. The ePub format uses eBook readers, which have several "ease of reading" features Treatment for craniosynostosis. The spaces between a typical baby’s skull bones are filled with flexible material and called sutures. As a service to our customers we are providing this early version of the manuscript. We hypothesized higher levels of maladjustment for children with SSC than comparison children, particularly at the older age and in selected areas of previously observed vulnerability: attention and social adjustment. For example, by age 3 nearly 18% of our children with SSC exceeded the clinical cutoff on the internalizing or externalizing problem scale. Parent-to-parent support groups also can be useful for new families of babies with birth defects of the head and face, including craniosynostosis. Results from a large-scale population study. The development and maintenance of anxiety symptoms from infancy through adolescence in a longitudinal sample. Physical exam. To examine for attrition bias, we compared the demographic characteristics of participants and non-participants at T1 (i.e., those who were enrolled in the study, but lost to follow-up before completing T1 questionnaires). Infants with SSC were referred to the project at the time of diagnosis by the treating surgeon or pediatrician. The predictive significance of small group differences in attention and social adjustment will be assessed in a follow-up of this cohort at age 7. The authors hypothesized that children with single-suture craniosynostosis would have higher levels of maladjustment than comparison children, particularly … 2011;26:451–457. Compared to participants, non-participants (i.e., children who were enrolled in the study but lost to follow-up prior to T1) were less likely to be white (61% non-participants, versus 74% participants) and less likely to be from a middle to upper SES family (46% non-participants, versus 71% participants). Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. As the baby’s brain grows, the skull can become more misshapen. The images are in the public domain and thus free of any copyright restrictions. Premature fusion of both coronal sutures (bicoronal) leads to craniosynostosis in a majority of people with this condition. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. These issues will be addressed in a follow-up assessment of this cohort at age 7, which is currently underway. Craniosynostosis can also cause increased pressure in the brain, which can lead to vision loss and learning problems. n.bannink@erasmusmc.nl In these cases, premature closure of the sutures may prevent the skull from expanding sufficiently to allow normal brain growth, and cause the pressure inside of the head to increase. Your child may just have regular check-ups to monitor it. Compared to controls, children with SSC received higher CBCL Internalizing scores reported by mothers at T1 (ES = 0.19, p = .046) (Table 3). Craniosynostosis is a condition where one or more of the sutures of the skull close too early. Most babies with craniosynostosis are otherwise healthy. Longitudinal analysis of emotional problems in children with congenital heart defects: a follow-up from age 6 to 36 months. A computerized tomography (CT) scan of your baby's skull can show whether any sutures have fused. Long-term neuropsychological development in single-suture craniosynostosis treated early. What Are the Signs & Symptoms of Craniosynostosis? Other signs may include: Doctors can identify craniosynostosis during a physical exam. NICHD Early Child Care Research Network. Some children, however, have developmental delays or intellectual disabilities, because either the craniosynostosis has kept the baby’s brain from growing and working normally, or because the baby has a genetic syndrome that caused both craniosynostosis and problems with how the brain works. Trajectories of aggression from toddlerhood to age 9 predict academic and social functioning through age 12. Among these participants, 98 children (47 patients and 51 controls) had a CTRF completed by a teacher or daycare provider at T1 and 120 children (48 cases and 72 controls) had a CTRF completed by a teacher or daycare provider at T2. CDC twenty four seven. Average CBCL/CTRF externalizing, internalizing and total scores for all informants were consistently higher (worse) for children with SSC than control group children, but most differences were small and statistically non-significant. Babies with craniosynostosis can often benefit from early interventionexternal icon services to help with any developmental delays or intellectual problems. In the other parts of the skull where the sutures have not joined together, the baby’s head will continue to grow. Rasmussen SA, Yazdy MM, Carmichael SL, Jamieson DJ, Canfield MA, Honein MA. The causes of craniosynostosis in most infants are unknown. A doctor will feel the baby’s head for hard edges along the sutures and unusual soft spots. Boys with single-suture craniosynostosis score lower on academic and IQ tests than girls; and males are more likely than females to have learning problems (50 vs 30%); males with unicoronal synostosis have a 86% risk of learning disorder . Group differences based on fathers’ report at T1 were negligible on all global scales. One parent (generally the mother) was interviewed to update the child’s medical and early intervention history and to determine if the child was currently in preschool or cared for by an adult other than parents for any part of the week (or had been since the previous evaluation). Differences in CBCL scores between T2 participants and non-participants were small (differences in T-scores = 0.0 to 0.8 on broad band scales). The problem occurs in 1 in every 2,000 live births. Infants in the control group had no known craniofacial condition and did not meet any of the exclusionary criteria for patients described above. This work was supported by a grant from the National Institute of Dental and Craniofacial Research (NIDCR grant # R01 DE 13813 awarded to Dr. Speltz). These findings were virtually unchanged with the application of IPW (Internalizing: ES = 0.19, p = 0.048; Externalizing: ES = 0.02, p = 0.841; Total: ES = 0.08, p = 0.450). We recruited control infants who were generally similar to patients, taking into consideration: 1) age, 2) sex, 3) family socioeconomic status within the same Hollingshead 4-factor classification category19 and 4) ethnicity. METHODS: We administered standardized tests of intelligence, reading, … Briggs-Gowan MJ, Carter AS. The types of craniosynostosis depend on what sutures join together early. Unadjusted T-score means and standard deviations (SD) from Child Behavior Checklista and Caregiver/Teacher Report Forma for children with single suture craniosynostosis (SSC) and controls at Time 1 and Time 2. At age 3 we noticed Calvin using one eye to look at the TV or if he dropped a toy he would turn his head and use one eye to try and find it on the ground. This can lead to developmental problems, headaches, and brain damage. Centers for Disease Control and Prevention. However, in most cases, craniosynostosis is thought to be caused by a combination of genes and other factors, such as things the mother comes in contact with in her environment, or what the mother eats or drinks, or certain medications she uses during pregnancy. Usually, the first sign of craniosynostosis is an abnormally shaped skull. Sample demographic characteristics are summarized in Table 1. However, several methodological limitations reduce the certainty of this impression. We are experimenting with display styles that make it easier to read articles in PMC. 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