Torticollis and moderate pectus cavum

Rachel Posts:
DEAR ERI COMMUNITY: 10 month old with mild right torticollis and moderate pectus cavum
I am an EI occupational therapist working with this family for 2 months now.  I have only seen one other child with torticollis and that was in conjunction with a PT.  I am the only provider for this family.  He has full PROM and full AROM.  His head tilt to the right has gotten better already primarily through ball exercises.  His head tilt is at about 20 degrees still.  He is just learning to sit and is not yet crawling.  He is just starting to push thru straight arms.  He tends to scoot on his back arching up onto his head and pushing with his legs.  He rolls in both directions to get around too.  Either arm tends to get stuck under him when he tries to scoot forward on his belly which is rare. His trunk posture looks good during assisted tall kneeling, and he can maintain quadruped with rocking when given support at his hips.  In addition he has pectus cavum. 
1) What are your experiences with infants with pectus cavum and progression of motor skills?  Does pectus cavum affect upper body strength?  Could this be affecting his progress in addition to the torticollis?
2) Since he has full passive and active ROM, do I just measure his progress with being able to do functional activities to both sides equally?

3). Is there cause for concern with the back scooting?  About half the time he back scoots and half the time he rolls to get to a toy.

Thank you!
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2 Responses to Torticollis and moderate pectus cavum

  1. I would wonder if the pectus cavum is causing him breathing difficulties when on his stomach as he seems to avoid prone . I would definately not promote the pushing on his back and work more his arm strength as he is tolerating quad position so he does have some UE strength. He seems to have acquired some bad habits which need to be broken for being taught good functional habits. Try overhead reaching activities as well as quad play to strengthen arms. Avoid prone play if he does have difficulty breathing or any real physical stress. You can even use some weighted balls to place in an overhead basket. Good luck.

  2. Rachel says:

    Thank you! I will give your ideas a try!

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