I am currently seeing a 5 year old boy with a diagnosis of developmental delay. He has had consistent P.T., O.T., etc.for his entire life. He is active and walks unassisted except that he has worn various DAFO designs since the age of 18 months and is now in SMO’s. His currant issue is head tilt. He has a history of muscular torticollis. He was treated successfully with P.T., in that he has normal ROM of his neck and near normal muscle strength in all planes of motion. However his head tilt persisted so he was seen by a pediatric neuro-opthamalogist and received vision therapy. This therapy corrected his vision and improved his visual motor skills but the tilt remains. He was fitted with a TOT Collar 6 months ago but compliance was a problem and he has shown no improvement. The P.T. requested suggestions for the most definitive device available so a pinless halo was offered which created considerable consternation for the family.
There are many orthotic designs described in the literature but no “gold standard”. I would appreciate hearing your suggestions for correcting his head tilt, along with the specific protocols which have proven successful in your clinical setting. I will post results.
Jim Dryden, CPO
10711 Riverside Drive
North Hollywood, CA 91602