title: Motor and cognitive development at one-year follow-up in infants with torticollis.
abstract: BACKGROUND
  Clinical experience suggests infants with torticollis are at risk for developmental delay.
  
  
  OBJECTIVE
  To examine gross motor (GM) skills at presentation in infants with torticollis; report first-year GM and cognitive outcomes; examine relationship between types of torticollis and above outcomes.
  
  
  METHODS
  Prospective follow-up study.
  
  
  METHODS
  Infants referred to 2 regional child development centers from April 2001-December 2002 with torticollis/head tilt and no perinatal complications syndromes were studied.
  
  
  METHODS
  GM function was measured using the Alberta Infant Motor Scale and classified as normal (>10%), suspect (5-10% inclusive), or abnormal (<5%). Cognitive function was measured at follow-up using CAT-CLAMS-r Developmental Assessment. Follow-up data obtained between 8 and 15 months of age.
  
  
  RESULTS
  One hundred and one infants with torticollis were seen for initial assessment at mean age 2.9 (SD 1.5) months. Eighteen had sternomastoid tumor, 47 muscular torticollis and 36 postural torticollis. At presentation, 35 (35%) of the 101 infants had suspect or abnormal GM function. 19/66 children with normal GM and 17/35 with suspect or abnormal GM function had postural torticollis (p=0.054). All children received physical therapy. Follow-up assessment of 83 participants, mean age 12.8 (SD 3.6) months, showed 75 had normal GM function and 8 had suspect or abnormal GM function; 11/83 still had torticollis. Cognitive assessment on 66 infants, mean age 14.4 (SD 4.8) months, revealed 57 (87%) had normal cognitive function and 9 (13%) were either delayed or significantly delayed.
  
  
  CONCLUSIONS
  Infants with torticollis are at increased risk for early GM delay but most normalize by one year. Torticollis is not associated with delays in early cognitive function.
authors.affiliation: Institute for Child Development, Kupat Holim Meuhedet, Central Region, Herzeliya, Israel. mitch_s@meuhedet.co.il
authors.forename: Mitchell
authors.initials: M
authors.lastname: Schertz
authors.forename: Luba
authors.initials: L
authors.lastname: Zuk
authors.forename: Sandra
authors.initials: S
authors.lastname: Zin
authors.forename: Lilach
authors.initials: L
authors.lastname: Nadam
authors.forename: Dorit
authors.initials: D
authors.lastname: Schwartz
authors.forename: Robert S
authors.initials: RS
authors.lastname: Bienkowski
mesh_terms: D002657:Child Development / Q000502:physiology*; D003071:Cognition / Q000502:physiology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D011446:Prospective Studies; D014103:Torticollis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014463:Ultrasonography