Income is a Better Predictor of Knowledge and Positive Perceptions of Positional Plagiocephaly than Education Level

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Authors

• Brittney Collins, Michigan State University College of Human Medicine Medical Student
• Hanna Pfershy, Michigan State University College of Human Medicine Medical Student
• Caroline Baker, Pediatric Research Operations - Corewell Health West
• Kyle Knapp, Bioinformatics - Corewell Health West
• John Girotto, Plastic Surgery - Corewell Health West
• Anna Carlson, Pediatrics - Craniofacial Surgery - Corewell Health West
• Aditi Kanth

Description

Positional Plagiocephaly (PP) is the acquired deformation of an infant's skull due to consistent external pressures, such as frequently lying in the same position. Literature continues to debate the best management for PP, however some methods such as helmet molding are currently widely used. Due to the use of protective helmets in children at risk of accidental head injuries, such as those with Autism Spectrum Disorder (ASD), children with PP seen wearing molding helmets may be assumed to have cognitive or developmental delays. Demographic factors may play a role in a person's perception of molding helmets. This study aims to understand the relationship between income and education level on a person's understanding of positional plagiocephaly and their perceptions of children in molding helmets.

A compensated online survey was distributed through Amazon Mechanical Turk (MTurk) to individuals in the United States who were over age 18. Income and highest education level were gathered, among other demographic data. Participants were asked about their knowledge of positional plagiocephaly, perceptions of infants in molding helmets, personal history with the condition, and any decisions made in their own children's PP management. Descriptive and Chi-Square analysis were performed with Bonferroni multiplicity adjustments applied to p-values.

Compared to all other income levels, participants making over $200k knew that babies in helmets did not have a "brain problem" (100%, p< 0.0001) but instead a "skull problem" (87.5%, p< 0.0001). They did not think children in helmets were clumsy (0%, p=0.0019) or autistic (0%, p< 0.0001). They knew that babies get PP between 0-6 months (93.8%, p=0.0005), the flat spot can go away on its own (100%, p< 0.0001), and that it does not affect brain growth (93.8%, p< 0.0001). Those with a Bachelor's degree were the most likely education level to think that babies in helmets had a skull problem, however this was only 31%(p=0.0004). About 10% of overall participants thought babies in helmets were autistic, and 20% thought babies in helmets were clumsy. Education level was not a statistically significant predictor. Both those with doctorate and high school level degrees incorrectly thought that children get positional plagiocephaly after age 6 months (73%, 71%, p=0.0008).

The results of this survey show that there are varying perceptions of babies in helmets and oftentimes incorrect beliefs regarding positional plagiocephaly across all demographics. However, this study also supports that income level is a better predictor of correctness compared to the highest level of education pursued.

Publication Date

5-8-2026

Disciplines

Plastic Surgery

Recommended Citation

Collins B, Pfershy H, Baker C, Knapp K, Girotto J, Carlson A, Kanth A. Income is a better predictor of knowledge and positive perceptions of positional plagiocephaly than education level. Presented at: Research Day Corewell Health West; 2026 May 8; Grand Rapids, MI.

Comments

2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 1940