Pediatrics > Cranial Remolding Orthosis

Cranial Remolding Orthosis

What is a Cranial Remolding Orthosis? 

A cranial remolding orthosis or helmet, is a device used to treat head shape deformities such as plagiocephaly, brachycephaly and scaphocephaly.  The helmet treatment is effective in infants from 3-18 months of age.  The earlier treatment is initiated, the better the outcome due to the decrease in growth rate as the child ages.  The first cranial remolding orthosis was developed by Dr. Clarren in 1979.  At Union Orthotics and Prosthetics, we provide the STAR family of cranial remolding helmets.  Thousands of infants have been treated with the STARband, which is the first cranial remolding device with FDA clearance and availability to pracitioners across the world.  The STARfamily of cranial remolding orthoses are manufactured by Orthomerica.


The improvements in head shape are achieved by providing contact in the bossed areas and reliefs in the flattened areas.  As the skull continue to grow, the reliefs are filled out and the skull rounds out.  The amount of improvement is directly related to the amount of growth during their time in the helmet.  The younger the infant, the faster the rate of skull growth.  The ideal age for initiation of helmet treatment is 4-7 months. 

What causes head shape deformities?

The most common cause of head shape deformation is supine sleep positioning.  An infant's head triples in size in the first 12 months of life.  During this time, their head is susceptible to external pressure that may influence it's shape such as supine sleep position, inutero constraint, car seats, baby carriers etc.  Increased risk factors include, multiple births, premturity and torticollis.  Torticollis is a condition in which a tight neck muscle on one side causes the head to tilt and turn.  Physical therapy is recommended to stretch, strengthen and improve range of motion at the neck. 


Repostitioning should be attempted in all cases as early as possible.  If two months of repositioning does not improve head shape, a helmet may be necessary.  Repositioning and tummy time is important for ALL infants.  Since infants spend the majority of time on their backs, spending waking hours on their tummy is critical in strengthening for normal physical development.  Click here for a handout on repositioning.  Tummy Time Tools

When is a cranial remolding orthosis needed?

Once any skull flatness or asymmetries are noticed, it is advised to ask your pediatrician to refer you to a craniofacial specialist.  The specialist will evaluate the infant to rule out potentially more serious causes such as craniosynostosis(premature fusing of a cranial suture), assess head shape and determine if a helmet and/or any other treatment are needed.  Pediatricians can prescribe a cranial remolding orthosis, but it is advised to see a specialist in order to rule out other potential, more serious issues.  The earlier the infant is evaluated the better the overall outcome.  Repositioning efforts must be attempted for at least two months.  If these efforts fail to improve the head shape, a helmet may be required. 

Will insurance cover a cranial remolding orthosis?

We see coverage from 0% to 100%.  It is best to call your insurance and see if there are any exclusions in your specific plan.  Cranial remolding orthoses fall under a sub category of orthotics and prosthetics which are under the category durable medical equipment.  The device code is S1040.  Contact our main office and ask for a cranial remolding billing specialist for further questions. 

To read more about the STARscanner data acquisition system information click here.

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