Atlantic Prosthetics & Orthotics- Cranial Molding Helmets
Cranial Molding Helmets
The cranial remolding orthosis treatment program focuses on redirecting cranial growth toward
greater symmetry. This is accomplished by maintaining contact over the prominent areas of the
head, and allowing room for growth in the areas of flattening. This treatment has been used by
medical professionals since 1979 when Sterling Clarren, MD wrote the first article about the use of
cranial remolding orthoses for infants with deformational plagiocephaly and torticollis.
There are certain signs that may indicate that your infant
needs a cranial remolding orthosis. However, please
keep in mind that some degree of asymmetry in the skull
is normal for everyone, so it is actually the magnitude of
the asymmetry that indicates whether treatment with a
cranial remolding orthosis is warranted. If you recognize
that your infant's face is not symmetrical, their head is
higher or wider than normal, or that there is flatness on
the back side of their head, you may want to visit your
physician for further assessment.
Front of Helmet
Side of Helmet
The best age for treatment is between 4 and 7 months when the skull is growing at the fastest rate.
However, cranial remolding orthoses can be used successfully between 3 and 18 months of age.
Caregivers should try to reposition for at least two months prior to initiating treatment with a cranial
remolding orthosis unless the infant is older than 7 months. At this point, infants are able to reposition
themselves, and caregiver efforts to reposition are often futile.

Even though the head grows fastest during the first 3 months of life, this time period is best spent
actively repositioning your infant to encourage more symmetry. Between 4 and 7 months of age, the
head grows about 1 cm per month*, and this rapid growth can be harnessed within the orthosis to
produce rapid change in the desired direction of growth. At this point, the infant is starting to develop
more head control and can tolerate the additional 6-8 ounces of weight from the helmet. It is actually
the infant's own growth that is the most active part of any orthotic treatment program. The orthosis is
specially designed to make total contact in the areas of the skull where growth needs to be curbed, and
allow space in the areas where growth is desirable. Between 8-12 months, the skull still grows quickly,
but the rate is reduced to 0.5 cm per month*. Between 13-18 months, the rate drops below 0.5 cm per
month*, and the skull begins to get thicker. Change is still possible in these older babies, but change is
slower and generally requires longer treatment programs.

* Infant head growth charts are available at
Atlantic Prosthetics & Orhotics uses the
STARband Cranial Molding Helmet.  This
design is appropriate for all head shapes
except scaphocephaly, which is a long, narrow
head shape. The STARband is made of a
plastic shell with 1/2" foam liner. A mold of
the infant's head is modified at Orthomerica to
produce a more symmetrical head shape. The
practitioner sees the infant every two weeks
and may shave additional material out of the
STARband to allow space in the areas of
flatness. The side and top openings make this
a lightweight and easy to apply orthosis for
caretakers, and is the most popular cranial
design at Orthomerica because it is
appropriate for so many different head
shapes.  The casting process involves laying a
series of plaster splints over the infant's head
and molding them as they dry. The cast is
removed, producing a negative impression of
the infant's head. The entire process takes
between 15 and 30 minutes. The negative
impression is then filled with liquid plaster to
produce a positive, 3-D model of the infant's
Your pediatrician or craniofacial specialist will prescribe a cranial remolding orthosis for your infant. You
will then be referred to a credentialed orthotist who will provide the cranial orthosis and the ongoing
treatment program. These allied health care professionals are specifically trained and educated to provide
and manage the provision of custom orthoses (braces) and prostheses (artificial limbs).

These health care practitioners maintain high standards of continuing education through national
certifying bodies and many have specialized pediatric orthotic practices. As key medical team members,
these practitioners bring value to the orthotic treatment program with a strong background in anatomy,
biomechanics, material science and patient care. These practitioners also work closely with other
members of the health care team to provide quality orthotic management to ensure that your infant has
optimal results.

Once you have received a prescription from your physician please contact Atlantic Prosthetics &
Orthotics and we can schedule a free consultation for your child so that we may provide you with more
information about the process.  

For more information about the STARband helmet please visit their website at

Please also visit Orthomerica for more information on Cranial Molding Helmets

*All information above was provided by STARband and Orthomerica