Long-term satisfaction and parental decision making about treatment of deformational plagiocephaly.

The incidence of deformational plagiocephaly (DP) has increased greatly during the last 2 decades since the recommendation of supine sleeping. Currently, there are 2 treatment options for DP, helmet therapy and repositioning therapy. This research investigated factors that influenced parental decision making about treatment choice and long-term satisfaction with head shape. A retrospective chart review identified 1660 children, now aged 2 to 10 years, seen in the DP clinic meeting inclusion criteria. Questionnaires were mailed to all eligible families. Four-hundred fifty-six completed questionnaires were returned. The questionnaires evaluated demographics of the family, factors that influenced treatment choice, and satisfaction with current head shape. Most of the respondents had white (93%) and male (70%) children. The mothers' mean age at the time of childbirth was 31 years; most of the mothers had a college degree or higher (77%) and household incomes of more than $76,000 (52.6%). Fifteen factors were used to evaluate which ones were significant in influencing parental treatment choice. Severity of the DP and time off work for follow-up appointments were the only 2 factors identified that significantly affected treatment choice. More parents who used helmet therapy reported that they were satisfied with their child's long-term head shape and would choose the same treatment again (P = 0.002) compared with those who used repositioning therapy.