In about 20% of children, a deformation of the skull develops during the first few months of life. Deformation of the skull in otherwise healthy children is considered a purely cosmetic consequence of the supine lying position that is advised to prevent cot death. To some extent, the skull deformation will diminish as a result of natural recovery when more active behavior of the growing child will result in reduced pressure on the malleable skull. Another option is to fit the child with an orthopedic helmet, to reduce pressure on the skull in some places and add pressure in others. The effect of the helmet compared to natural recovery is currently unknown.

Despite this lack of evidence, the rise in children which are prescribed helmet treatment has risen dramatically over the last years. This rise is attributed to a combination of parental demand and (health) professional pressure on the parents to use this (only) treatment option. The choice for helmet treatment is a preference sensitive treatment decision in which the perceived effect of the helmet on head symmetry is weighted against the perceived treatment discomfort.

It is unclear which factors contribute most to the decision made by parents and their physicians. The objective of this study is to determine parental and health professional preferences for treatment, and to study to which extent they are based on (perceived) health benefits of the helmet and how much of their decision is based on other motives (social environment, parental fears). A second objective of this study is to determine the relationship between the extent of treatment preferences and satisfaction with care and the effect of treatment.

The funding organization of this project is ZonMW (website).