Common Types of Pediatric Services:

- Fracture stabilizers
- Clavicle stabilizer
- Wee walker
- Cranial Reshaping Helmet
- Dafo System / AFO SMO UCB Foot orthotics
- Hip dysplasia - Pavlic Harness
- Scoliosis Bracing
- Shoes - Corrective / Dennis Brown Bar

Considerations when fitting pediatric devices:

The purposes for fitting a child with an orthotic, prosthetic or pedorthic device are the same as for an adult, to offer prevention and/or correction of a deformity and to provide functional improvement.

Relatively few orthotic or prosthetic devices are designed specifically for pediatric application. The same biomechanical principals and design perspectives apply for both adults and children. However, children are not small adults; therefore management of pediatric services present unique opportunities and challenges.

Custom vs. off the shelf:

The majority of pediatric orthoses are custom made due to the reduced tolerance for error corresponding to the child's stature and smaller surfaces on which forces can be focused. The design of a custom device also takes into account a child's bones and muscles do not necessarily grow synchronously. Providing a functional device, which will keep pace with the patient's growth, is a part of the design and fitting process.

‘Pavlik harnesses' and ‘night splints' are two commonly fit ‘prefabricated' devices.

Developmental age:

Each child presents his/her unique combination of motor development, cognitive and adaptive function and learning abilities—including disease processes. These variables challenge the orthotist/prosthetist to provide componentry suited to the patient's capacity to benefit from the service.

Communication:

Very young and some older developmentally impaired children are often unable to verbalize pain or describe problems relating to the way an orthosis/prosthesis fits or feels. Young patients cannot understand or remember details of application, wearing schedule, skin care, device care, etc. To realize the intended benefits from orthotic/prosthetic intervention, the orthotist/prosthetist must rely on training, observation, various communication approaches with the child as well as the involvement of the parents, physician and therapists.

Device Weight And Fabrication Materials:

One goal in fitting either an orthotic or prosthetic device to a child is to minimize the weight of the device while incorporating sufficient durability to withstand the stress imposed by an active child. Typically, plastics or other synthetic materials are chosen over metal.    

Finishing Enhancements:

Colorful, creative furnishings such as cartoon/action figures or materials of “fun” colors can make wearing an orthosis/prosthesis significantly more acceptable to a younger child.

In efforts to increase wearing compliance, considerations such as designing brace to be worn under clothing or to fit inside shoes of a popular style, can reduce self-consciousness appearance concerns for pre-teens and adolescents.

Family Support:

Though a child's abilities, viewpoints and responses will vary significantly from infancy to adolescence, few pediatric patients can be expected to independently carry out the “at-home” portion of the orthotic/prosthetic plan. Active parental and family participation during the orthotic/prosthetic intervention process is critical.

Our staff has training, experience, and understanding to help families address the unique orthotic, prosthetic, pedorthic concerns children present.

We welcome the opportunity to be a part of your child's medical team.

The use of a ‘cranial remolding' orthosis has become a preferred treatment for infants with cranial asymmetry commonly resulting from prolonged supine positioning, commonly called plagiocephaly.

The orthotic treatment focuses on redirecting cranial growth by maintaining contact over the areas of fullness and allowing growth in areas of depression or flatness.

The helmets are made from lightweight, plastic and foam created from a cast impression of the infant's head. The design, fabrication process, and materials used are FDA approved.

When Should A Helmet Be Obtained?

The best treatment results are obtained during the earlier stages of cranial development (3-18 months of age). Once the child reaches approximately 18 months of age, the skull reduces its ability to be reshaped.

Depending upon severity of asymmetry, some children may outgrow the concern without the use of a helmet. The team of the infant's parents, pediatrician and an orthotist, can best decide if using a cranial helmet is the appropriate approach.


How Soon Will Improvements Be Seen?

The rate of change varies, but some parents have seen improvement after only 2 weeks of use. Correction continues over time and requires complete compliance to achieve the greatest degree of symmetry.



Will My Infant Experience Any Discomfort Wearing The Helmet?

In most cases, children adapt quite easily to the helmet.

Is Progress Routinely Evaluated? YES! Although routine evaluations and frequent helmet adjustments are scheduled with the orthotist, additional concerns regarding the fit of the helmet may arise and scheduling an earlier appointment is encouraged. The referring physician may wish to see the child after 6-8 weeks to evaluate progress.

How Do You Know When To Stop Wearing The Helmet?

The decision to discontinue wearing the helmet should be made by the physician in conjunction with the parents and orthotist. The helmet has done its job when the head rounds into the desired symmetrical shape.

Will More Than One Helmet Be Needed During The Treatment Process?

Although one helmet is usually all that is needed, in cases of moderate to severe positional plagiocephaly, it may be possible to outgrow the helmet before maximum correction may be achieved.