November 8, 2024 - Venue TBD
$329.00/person
Understand the intricacies of treatment of infants and children with torticollis. At-home labs are offered and can be practiced with a baby-doll or partner.
Torticollis: Assessment and Treatment of Infants and Children Online Series
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Cindy Miles, PT, PhD, PCS, NDT, a leading expert on torticollis and plagiocephaly discusses the increased incidence, etiology, and pathophysiology of this disorder. This dynamic course is chock-full of case studies and interactive at-home lab practice opportunities to provide the knowledge of effective assessment and treatment of children with torticollis. Learn effective strategies including designing home exercise programs, infant positioning, manual techniques, and taping to support your clinical practice. You will explore how this diagnosis impacts the movement system and resulting impairments in gross, fine and speech motor skills. Evidence-based treatment strategies that can be integrated into routines and functional play will be provided as well as recommendations for follow-up.
Five Dynamic Online Sessions Recorded Live
Session A: Etiology and Implications for Development
The first of a five-part series details the background of torticollis including classifications, global effects of torticollis on the child, rising rates of the diagnosis, and indications for prevention.
Session B: Anatomy of Torticollis, its Effect on the Whole Child, and Differential Diagnosis
Find out how the anatomy of torticollis affects gross, fine and ocular motor development, as well as commonly related diagnoses.
Session C: Motor Development and Assessment Tools
This interactive online session provides at-home practice opportunities to improve your practice and clinical reasoning skills for assessment and treatment of the child with torticollis.
Session D: Treatment: Creative Stretching, Strengthening, and Functional Play
Learn creative stretching, strengthening and functional play activities as well as how to improve parent involvement and home program follow through.
Session E: Indications for Kinesiotaping, Mobilizations, and Surgery: Clinical Decision Making and Community Education
The last of five parts: you will learn prevention tools including helpful positioning devices for the NICU and home, indications for Botox and surgery, and kinesiotaping and mobilization principles that will help
Course Objectives:
- Identify the incidence, etiology, and pathophysiology of torticollis
- Discuss the relationship of the “change in sleep posture”, the effects of increased positional devices and how the environment influences postural development
- Discuss biomechanical effects of torticollis and its impact on midline perception, body awareness, and ocular issues
- List red flags that may require further workup
- Discuss treatment ideas, home exercise activities, and take-home messages from one of the case studies in the presentation
- Outline the most important components of assessment, home program implementation, parent education, and dosing
- Establish individualized goals and incorporate family-centered evidenced-based treatment regimes as part of their home education/therapy program
- Demonstrate three of your favorite stretches using a partner or doll
- Discuss three strengthening activities that would apply to your setting
- Discuss individualized goals and incorporate family-centered evidenced-based treatment regimens as part of the HEP
- Relate indications for joint mobilization and contraindications to joint mobilizations in the infant and young child
- Discuss 5 settings in which you can spread awareness about torticollis to help prevent rising rates
Schedules
Session A: Etiology and Implications for Development
1-15 minutes:
Torticollis background information, take home goals, clinical practice guidelines, levels of evidence, intervention evidence, rapidly changing statistics of torticollis,
15-30 minutes:
- SMT tumor, muscular torticollis, positional torticollis, looking at ultrasounds and eco-texture, literature on eco-texture, Etiology and pathophysiology of torticollis, predictive models, why it’s important to get babies early
30-45 minutes:
- Prone and why it’s important, interactive time of guessing problem with torticollis or pose, severity and which side is tight, how torticollis effects the entire child
45-60 minutes:
- Torticollis and development, partner exercise, interactive brainstorming session with different scenarios +10 minutes
60-75 minutes:
- Discussion of brainstorming session.
75-90 minutes:
- Case Study, SIDS risk factors, supine vs. prone sleep, benefits for prone, changing environment and impact on development
90-105 minutes:
- Back to sleep campaign, parent education, prevention for SIDS, Tummy time recommendations
105-120 minutes:
- Prone outcomes, protecting baby’s heads from hard surfaces, tummy time tools/ideas
120-150 minutes:
- Post-test (30 minutes)
Session B: Anatomy of Torticollis, its Effect on the Whole Child, and Differential Diagnosis
1-15 minutes:
- Anatomy that affects the cranio-cervical region including relationship to the scapula
15-30 minutes:
- Differential diagnosis, and how to look at an ultrasound/sonoelastography) of the neck muscles, benign proximal torticollis of infancy,
30-45 minutes:
- Red flags, when to refer out, vertebral artery precautions and differential diagnosis
45-60 minutes:
- Differential diagnosis, and how to look at an ultrasound/sonoelastography) of the neck muscles, Case study with viewer participation (+10 minutes), ocular torticollis
60-75 minutes:
- GERD and treatment ideas, the meaning and impact of hypotonia
75-90 minutes:
- Toe walking, indication, treatment, suggestions, precautions
90-97 minutes:
- Toe walking treatment and orthotics, case study
97-127 minutes:
- Post-test (30 minutes)
Session C: Motor Development and Assessment Tools
1-15 minutes:
- Demonstration and lab of biomechanical effects of torticollis on movement patterns, Hip dysplasia assessment demonstration, +10 minute lab
15-30 minutes:
- Importance of variability, complexity of movement, active problem solving, and repetition in children learning new motor patterns, handling ideas to promote improved movement patterns
30-45 minutes:
- When to make a referral, compare/contrast of typical baby vs. baby with torticollis, case study, examples of variability and complexity in intervention
45-60 minutes:
- Importance of symmetry, sensory systems interaction with motor patterns, typical vs. atypical vision development
60-75 minutes:
- How to improve vision development, vision development related to speech, autism warning signs and vision development, vision development interventions, Guidelines for assessment and treatment. How to take a good history and listen to/discuss with parents,
75-90 minutes:
- Evaluation components, observation postures, balance and postural control. How to use the muscle function scale to assess babies with torticollis, examples of muscle function scale and norms to be referenced. How to assess active neck range of motion, devices for measurement
90-105 minutes:
- More devices for measurement, measuring active range of motion, which side is tight? Game, Feeding and torticollis,
105-120 minutes:
- Evaluation case study, how to educate parents on positioning and facilitation of movement,
120-135 minutes:
- Measuring active range of motion, which side is tight? Games, Feeding and torticollis. Documentation examples – How to write: history, motor abilities, characteristics of movement patterns, recommendations, parent education, plan of care, home program, letter to physician
135-150 minutes:
- How to make HEP handouts for families, when to follow up, comparing atypical and typical movement patterns, respecting families
150-175 minutes:
- Most important treatment techniques, how to figure out dosing and factors that are related to episodes of care. Postural alignment to avoid secondary impairments, make it fun
175-190 minutes:
- Goals: (symmetry, age appropriate movement patterns), case study problem solving
190-220 minutes:
- Post-test (30 minutes)
Session D: Treatment: Creative Stretching, Strengthening, and Functional Play
1-15 minutes:
- Stretching principles and suggestions, treatment frequency, clinical practice guidelines,
15-30 minutes:
- Stretching demonstration, more stretching positions, help with parent instruction, lateral flexion and rotation stretches, other muscles to stretch, stretching through functional movements, (+10 minutes to practice stretching and functional movement with doll to improve recall)
30-45 minutes:
- Case study, stretching, parent instruction and empowerment, why it’s important to follow up with families, movement analysis,
45-60 minutes:
- Complications with predicting outcomes, symmetry and head shape, skin integrity, practice time (+10 minutes to practice stretches with partner)
60-75 minutes:
- Evidence on stretching, Intervention/treatment ideas: midline, symmetry, strengthening, ball strengthening ideas, abdominal strengthening, quadriceps strengthening, balance improvement, eye activities, importance of hard work.
75-90 minutes:
- Activities for active extension for trunk stabilization and torticollis treatment, importance of parent involvement, predictors of parental adherence,
90-120 minutes:
- Post test (30 minutes)
Session E: Indications for Kinesiotaping, Mobilizations, and Surgery: Clinical Decision Making and Community Education
1-15 minutes:
- Mobilizations (contraindications, precautions, and methods), history of therapists in NICU
15-30 minutes:
- Goals of therapists in the NICU, positioning in the NICU, motor and autonomic signs (stable vs. stress) in early intervention and NICU, positioning: Tortle, midliner, Z-flo, cranial cups, moldable positioning,
30-45 minutes:
- How and when to use a Tortle for repositioning, case study on NICU baby to 70 months, positioning during play (devices and activities)
45-60 minutes:
- Smart phone compatible baby boot for ambulation with data, taking caution with common positional devices, DME & orthoses,
60-75 minutes:
- Kinesio-taping practice lab (indications, precautions, methods), + 10 minutes for practice time
75-90 minutes:
- Prevention, discharge planning, important questions to ask during the evaluation about sleep and tummy time,
90-105 minutes:
- Surgical treatment, indications, scar management, removal of SCM case study,
105-120 minutes:
- Case study of child with SCM surgery, expecting more from clients, why physical activity is important
120-135 minutes:
- Therapist’s role in: Community exercise, education programs, tots for trikes, obesity epidemic
135-150 minutes:
- Why exercise is for everyone and can be adapted for the populations that we work for. Changing presentation of torticollis
150 – 180 minutes:
- Post-test (30 minutes)
Cindy Miles
Cindy Miles, PT, PhD. PCS, CNDT - In Memoriam. The late Cindy Miles was a beloved and valued member of our faculty. For nearly 20 years, Cindy was an engaging instructor at ERI, energetically presenting the latest research to improve evaluation and treatment skills for Torticollis and Plagiocephaly among her course participants. Cindy was a distinguished pediatric clinician, serving as President of APTA for 6 years, as well as a successful private practice owner in Pennsylvania for 25 years.
Dr. Miles was a graduate of the University of Pittsburgh, School of Health Related Professionals and East Stroudsburg University with a Master of Education in exercise physiology. She held a PhD in Pediatric Science from the Rocky Mountain University of Health Professions. Her doctoral research was on potential risk factors related to the diagnosis of Torticollis. She was Board Certified by the American Board of Physical Therapy Specialties as a Pediatric Clinical Specialist, specializing in treating children from birth through to young adults. Cindy completed the eight week Pediatric NeuroDevelopmental training course and the Advanced Infant course.
ERI President, Carol Loria, shares this sentiment:
“I first met Cindy nearly 20 years ago when the diagnosis of torticollis was largely unknown to the therapy community. In addition to her clinical expertise and her commitment to excellence in teaching, research and public health, I could not help but be struck by her kindness, warmth and passion for improving the lives of children and their families. She has been a beloved and valued member of our faculty ever since. Our hearts go out to her family, friends and to the many children, parents, and therapists whose lives she enriched. Our ERI family mourns with you.”
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Once you purchase an online course, you will have the opportunity to take an exam to test your retention of the material. If you have purchased this course, please ensure you have logged in to your account in order to take the exam. The exam must be completed with a pass rate of 80% or more in order to receive your certificate of attendance.
This series is offered for 13.5 Contact Hours, 1.35 CEUs (Intermediate Level).
License # _________. Education Resources Inc. is an AOTA Approved Provider of professional development. Provider #3043. This Distance Learning-Independent course is offered at 13.5 contact hours 1.35 CEUs. Intermediate level, OT Service Delivery. AOTA does not endorse specific course content, products or clinical procedures. This course can be used toward your NBCOT renewal requirements for 13.5 units. Approved Provider for the Florida Occupational Therapy Association CE Broker for 16 CE Hours - CE Broker # 20-695253.
Approved by the KY Physical Therapy Association for 13.50 Category 1 contact hours, expiration Date: 3/6/25, approval # CS61-2023-APTAKY. Course meets the basic criteria of the MD Board of Physical Therapy Examiners for 1.3 CEU's, 1.3 contact hours. Approval #2206-59 by the NJ State Board of Physical Therapy Examiners for 13.5 CEC's. Approved sponsor by the State of IL Department of Financial and Professional Regulation for Physical Therapy for 16 contact hours. The Illinois Early Intervention Training Program has approved this event for 13.5 hours of EI credential credit in the area of Intervention . Approved provider by the NY State Board of Physical Therapy for 16.2 contact hours (1.62 CEUs). Approved Provider for OK State Board of Medical Licensure & Supervision #BAP202310003.
Education Resources is an approved agency by the PT Board of CA for 13.5 contact hours. This activity is provided by the TX Board of PT Examiners accredited provider #1910017TX for 13.5 CCUs and meets continuing competence requirements for PTs and PTAs licensure renewal in TX.
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