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Plagiocephaly Severity Scale - PediatricAPTA.org

LevelClinical PresentationRecommendation*CVAI1 All symmetry within normal limitsNo treatment required< Minimal asymmetry in one posterior quadrant No secondary changesRepositioning to Two quadrant involvement Moderate to severe posterior quadrant flattening Minimal ear shift and/or anterior involvementConservative treatment: Repositioning Cranial remolding orthosis (based on age and history) to Two or three quadrant involvement Severe posterior quadrant flattening Moderate ear shift Anterior involvement including noticeable orbit asymmetryConservative treatment: Cranial remolding to Three or four quadrant involvement Severe posterior quadrant flattening Severe ear shift Anterior involvement including orbit and cheek asymmetryConservative treatment: Cranial remolding orthosis> * This evaluation tool is provided to assist medical professionals in determining the appropriate course of treatment for their patients.

• A documented two-month period of repositioning is highly recommended prior to referring a patient for cranial remolding orthosis evaluation. This conservative step is typically required by third-party payors before authorizing a cranial remolding orthosis. • Tummy Time Tools is a parent handout that provides repositioning activities.

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