Congenital Torticollis

Summary

Congenital torticollis, also known as congenital muscular torticollis (CMT), is a condition where the neck muscles (specifically the sternocleidomastoid muscle) become shortened, limiting the movement of the neck. As a result, the infant may tilt their head towards the side of the shortened muscle and rotate it to the opposite side. This condition may be associated with other problems such as head shape deformities (plagiocephaly) or developmental hip dysplasia, and these conditions can sometimes affect each other. It’s important for healthcare providers to rule out other causes such as eye problems, spinal issues, or neurological conditions.

Diagnosis and When to Seek Help

If you notice that your infant has difficulty turning their head or appears to tilt it in one direction consistently, it may be a sign of congenital torticollis. It’s essential to consult a healthcare provider to confirm the diagnosis and rule out any other potential causes. A thorough physical exam, along with a review of the child’s medical history, will help in determining the best course of action.

Management

Treatment for congenital torticollis typically involves:

Carer education on positioning: Parents and caregivers are taught how to gently position the infant in ways that encourage normal neck movement.
Physiotherapy: Physical therapy exercises can help improve the flexibility and strength of the neck muscles.
Botulinum toxin injections or surgery: These are reserved for severe cases that do not respond to conservative treatments.

Follow-Up and Monitoring

Ongoing follow-up with a healthcare provider is important to monitor the progress of the condition. Regular assessments help ensure that the neck muscles are improving and that no additional complications, like cranial deformities, are developing. If the condition doesn’t improve with conservative treatments, additional interventions may be needed.

History and Exam

Key diagnostic factor

Presence of risk factors

Other diagnostic factors

Twin birth
Unvaried supine sleep and resting position
Decreased prone awake time
Head tilt

Risk factors

Plagiocephaly
Breech delivery
Caesarean section delivery
Twin A (lower in utero)

Diagnostic Investigations

1st investigations to order

Cervical spine X-ray
Pelvic X-ray
Hip ultrasound

Investigations to consider

Neck ultrasound
Skull X-ray
Cervical/cranial MRI

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phimosis / circumcision

malformation of the kidney

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disorders of sexual development

scrotal issues (undescended testis, hernias)

Hydrocele in Children

hydronephrosis

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stones (kidney, ureter, bladder)

tumors (kidney, testis)

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Social and emotional functioning refers to a child’s ability to understand, express, and manage their emotions, as well as to interact effectively with others. These skills are fundamental for building positive relationships, developing empathy, and coping with the everyday challenges of growing up.

Children who experience difficulties in social and emotional functioning may struggle with recognizing their own feelings or those of others, regulating emotional responses, or responding appropriately in social situations. This can lead to challenges such as anxiety, low self-esteem, difficulty making friends, or misunderstandings with peers and adults.

In the school environment, social and emotional difficulties can impact a child’s engagement, cooperation, and overall learning experience. Emotional distress may manifest as withdrawal, irritability, or disruptive behaviour, which can further affect academic progress and peer relationships.

Assessment of social and emotional functioning as part of a neuropsychological evaluation typically includes behavioural observations, standardized rating scales, and information gathered from parents, teachers, and sometimes the child. This comprehensive approach helps identify strengths and areas for support in emotional regulation, social skills, and adaptive behaviours.

Understanding a child’s social-emotional profile allows for the development of tailored strategies to enhance emotional wellbeing, build resilience, and improve social communication. Early intervention and supportive environments can empower children to navigate their emotions more effectively, fostering confidence and meaningful connections.

At Offspring Health, we aim to provide transparent information about the costs involved in neurodevelopmental and educational assessments.

Neuropsychological assessments typically involve multiple sessions that usually take between 8 and 16 hours in total, depending on the complexity and individual needs. Our hourly rate is $260, so the total cost typically ranges between $2,300 and $4,230.

Fees generally cover:

Initial consultation and history gathering
Testing sessions where your child will complete various fun and interactive tasks
Liaison with schools or health professionals as needed
Comprehensive case analysis and report preparation
Feedback sessions with families and, where applicable, educators or other professionals

Please note that standard neuropsychological assessments are generally not covered by Medicare. However, some assessments and therapy services may be funded through the National Disability Insurance Scheme (NDIS) for eligible participants. We recommend discussing funding options with your NDIS planner or support coordinator prior to booking. Private health insurance may offer partial rebates depending on your level of coverage.

What’s the next step?

Please phone reception for a discussion about your needs or email psychology@offspringhealth.com