Derived from the Latin torta for “twisted” and collum for “neck,” torticollis is a condition characterized by abnormal positioning of the head and neck, typically tilted or turned to one side. It results from damage to or tightening of the sternocleidomastoid muscle connecting the skull with the breastbone and collarbones. The most common form is congenital muscular torticollis (CMT), affecting approximately one in every 250 newborns and possibly caused by restricted movement in utero or trauma during the birthing process. Because torticollis limits an infant’s ability to interact with his surroundings, significant cognitive and motor developmental delays can ensue if left untreated—which is why early diagnosis and torticollis rehabilitation are vital to achieving optimal outcomes.
Diagnosing children with autism spectrum disorder (ASD), especially very young children who are first learning to communicate with the world around them, can often be challenging and complex. Parents may remark, “Something is wrong with my child,” but be unable to articulate in exactly what ways. So how do you recognize if your patient has ASD in order to facilitate early diagnosis, which is critical to implementing early intervention?
You’re in the midst of an examination and the parents tell you their child is quite active, that he tends to be overexuberant and boisterous. Maybe he has been disruptive at daycare or school and is having difficulty with structure and restrictions. These may be the earliest signs of ADHD, a complex condition that is becoming more prevalent in pediatric practice. It often is diagnosed between four and six years of age and typically manifests as distractedness, increased activity, or a combination of the two as they relate to oppositional or hard-to-manage behavior.
Several years ago, a study published in Pain discussed the prevalence of chronic pain syndromes among children and urged clinicians to become more aware and knowledgeable about this growing medical problem and its long-term consequences. In a past blog, I discussed Complex Regional Pain Syndrome (CRPS), formally known as Reflex Neurovascular Dystrophy (RND) or Regional Sympathetic Dystrophy (RSD), which typically strikes the limbs, often after a child suffers a fractured bone or even a bad sprain. A more common chronic pain syndrome is Amplified Musculoskeletal Pain Syndrome (AMPS), which causes intense systemic pain that can affect any part of the body, much like fibromyalgia and mysofascial pain, and waver between being constant and intermittent.
For children with autism, or who are suspected of having autism, early intervention is especially important. The prevalence of autism seems to be increasing with the latest information from the CDC stating that “about 1 in 68 children has been identified with autism spectrum disorder (ASD).” The Federal Government has mandated every state provide early intervention services for children from birth to three years of age who exhibit need. Services vary by state, with some states offering only evaluation and the development of an Individualized Family Service Plan (IFSP), while others also offer services outlined in the IFSP. New Jersey’s program is among the latter and can be accessed toll-free by both physicians and parents at 888-653-4463.