Murfreesboro
1272 Garrison Drive, Suite 307
Murfreesboro, TN 37129
Phone: (615) 890-2160
Lebanon
365 S Hartmann Drive, Suite 112
Lebanon, TN 37087
Phone: (615) 443-7330
Nashville
397 Wallace Road, Suite 206
Nashville, TN 37211
Phone: (615) 327-1100
McMinnville
205 Oak Park
McMinnville, TN 37110
Phone: (931) 507-9900
Franklin
101 Forrest Crossing Circle, Suite 108A
Franklin, TN 37064
Phone: (615) 435-3031
Tullahoma
1816 N. Washington Street, Suite 104
Tullahoma, TN 37388
Phone: (931) 563-7660
Shelbyville
1114 North Main Street, Suite B
Shelbyville, TN 37160
Phone: (615) 890-2160
Call Toll Free: (866) 319-6762

 
 

Pediatric Helmets

Thank you for choosing Restorative Health Services for your child's helmet treatment The cost of each helmet is $2000.00. This includes the helmet and follow up/adjustment appointments after the delivery of the helmet.

Most insurance companies do not pay for remolding helmets for trial formed craniums because they consider this a cosmetic procedure. Due to this, Restorative Health Services requires a deposit of half the cost of the helmet ($1000.00) upon the casting appointment, and the other half ($1000.00) is due at the fitting. Payment arrangements on the second installment are possible. Please consult the staff about this. Restorative Health Services will not be filing your insurance, but we are happy to answer any questions you have about completing this process on your own.

A Guide for Parents on the Cranial Helmet Treatment Process

Frequently Asked Questions

  • What is a cranial helmet? A cranial helmet is an orthotic devise, or orthosis aimed to prevent the continued development of an abnormally-shaped head.
  • What is the proper age for the helmet therapy? Usually between 4 to 6 months. Positive results have been achieved for children up to 18 months, but the treatment lasts longer and may require additional helmet(s) to be fabricated. Only your child's doctor can decide if the child is still in the APPROPRIATE age range.
  • How is a helmet made? A plaster of paris impression of the child's head is taken. In our practice we use a two stage casting technique. This means that two impressions are taken in a manner that can be separated for ease of removal. The casting procedure takes approximately thirty minutes. For the casting appointment, we suggest that you do not dress the child in new clothes . Prepare the child by nurturing it before the procedure, bring a favorite toy, and be prepared to actively assist the staff member in casting. Casting is absolutely harmless but usually quite emotional. After the impression is taken, a positive model of the child's head is made, modified, and appropriate soft padding (liners) and a plastic shell are fabricated.
  • Do parents have an option in the choice of the cosmetics of the helmet? RHS provides a custom-made helmet designed to provide the best treatment outcome for each child. At the same time, we offer a good variety of choices in helmet colors. The choice of color does not influence helmet shape, treatment process, or price. The helmet will be split down the center in the front to assist caregivers with ease of donning and doffing the helmet.
  • How much pressure will the helmet apply to the child's head? Minimal! In our practice we do not modify the positive mold so that the helmet will “squeeze” the high points of the head. Instead we create “relief” in the desired areas (usually flattened areas) and allow the natural growth of the cranial (head) bones into the relief. The general shape of the modified positive mold is symmetrical and complies with anatomical and cosmetic standards.
  • How long does it take until the helmet is delivered? We realize that a child's head grows in spurts, and we will fabricate a helmet as soon as possible. Generally a helmet is completed within 10 business days. We strive for the fastest time possible delivery time to allow patients to begin treatment as soon as possible. Make a scheduled appointment for fitting when you make the appointment for casting. Delays in fitting can compromise the fit of the helmet due to cranial growth.
  • How long will it take to fit a helmet? The initial fitting will take about two hours. All necessary trimmings will be done with the child present in the office to ensure a proper fit. As we pursue the highest standards in the initial fitting, follow-ups should be shorter in time, approximately 15 to 20 minutes. We will not be able to fit a child's helmet if the child's head has thick hair. Hair must be trimmed short and not braided or it will jeopardize proper modification positioning on the child's head.
  • How long is the child supposed to wear the helmet? Generally, the treatment time is 3-4 months. Your prescribing physician can answer this question more definitively than your orthotist. The helmet should be on the child's head approximately 23 hours a day. Only your prescribing physician should make the decision to stop helmet treatment. Even with the greatest results achieved, a child's head can regress in shape without the helmet.
  • Is one helmet enough? Usually, yes. The helmets are fabricated with several layers of padding that allow for additional adjustments in the fit if necessary. In some cases, additional modifications and/or an increase in the frequency of follow-ups are needed. During the initial evaluation your orthotist will inform you if there is a chance your child may need these considerations. Additional fee(s) may be charged for time and labor if these special considerations are required. Carefully monitor the helmets proper positioning on the head. In some cases, an additional helmet may be necessary. The life expectancy of a helmet is four months. This does depend on the severity of the malformation and the age of the patient. One helmet may not be adequate to treat severely malformed children, as they may grow out of the helmet before the desired shape is achieved.
  • Will the helmet fit 2-3 months down the road? Every helmet is fabricated with removable inner liners. The first layer may be removed in partial or whole in about 3-4 weeks to accommodate for the head growth. The referring physician or the treating clinic determines this. As the head continues to grow, an additional liner may be removed. Only your prescribing physician or orthotist will make this determination and complete the removal.
  • What should I, as a parent, do to avoid any complications during the helmet treatment? RHS Helmets should cause no pain or discomfort. They are made from hypoallergenic plastic. However, to ensure that the helmet fits comfortably, and that no irritation develops, the infant's skin should be evaluated regularly for signs of irritation, e.g., every three to four hours for the first two or three days of use, and then daily after that. [see: Helpful Hints]
  • Can any company fabricate helmets? No! Only companies with FDA 510K certification can fabricate cranial helmets. This assures some level of competency in your child's care. Please review the FDA site.
  • Is Restorative Health Services FDA certified? Yes. We were one of the first in the country to receive this level of certification.
  • What is the cost of the helmet treatment and is it covered by my insurance? It depends. There is a base price for helmet treatment. In some cases, we will need to make additional modifications to the helmet, or even a second helmet may be necessary. Our practitioner will explain the specifics of each helmet to you. Additional liner modifications may be necessary to provide correction with a single treatment. All helmets include a 90-day period of follow-up care that includes expected head growth, accommodative modifications, consultations, and free educational materials. After ninety days our office will start charging for any modifications requiring more than fifteen minutes of labor. The current rate is $20.00 per 15 minutes. Insurance differs in coverage; we will do our best to provide you with all necessary information. You may be required to pay copay or deductibles, depending on your insurance policy. A second helmet is not common and most likely will not be covered by insurance.
  • Why does the treatment cost so much? Helmet treatment is a procedure requiring significant amounts of time and labor to correctly treat patients. Most of all, it involves professional staff expertise, which will provide the best treatment results. Remember though, it is a package that includes initial evaluation, casting and measuring, fitting and follow-up visits.

Special Concerns

Red skin marks are an inseparable part of the helmet treatment. Do not be concerned with the marks that go away within 15-20 minutes. If you see red spots, try to locate a spot in the liner that is against the red spot, apply a small amount of baby powder on the liner, and reapply the helmet. Do not apply baby powder to the entire liner! Wipe any excess away from the liners prior to donning the helmet. The helmet should be worn approximately one hour and rechecked. If the problem persists after the addition of the powder, contact the office immediately.

In addition, you should be concerned if you see any of the following*:

  • Red marks that are persistent
  • Signs of blistering
  • Bruising
  • Skin breaks

*Notify your practitioner if you notice any of these conditions.

Hygiene

Troublemaker number one in helmet therapy is a dirty liner. Irritation from wearing the helmet alone is rare. However, regular bathing of the infant and cleaning of the helmet can reduce the likelihood of irritation. Liners MUST be perfectly clean, as they touch the skin of the child's head. Basic care is keep the child's head CLEAN inside a CLEAN helmet.

We recommend daily washing of the infant's head and of the helmet. You can observe the following steps to ensure maximum hygiene for you child during the course of therapy.

Patient

The child may perspire heavily during the first several days of treatment, until the body adjusts to the helmet. You may wipe the child's forehead and face with a towel, but please do not remove the helmet frequently during the day other than for bathing.

The child's head might develop an odor similar to the smell acquired by sweaty feet. The smell is due to the poor circulation of air on the skin. Washing the child's head with soap and water daily will help control the odor. Unfortunately, the odor cannot be completely prevented.

If you use lotions or creams on your child's head, remove them thoroughly before applying the helmet.

Cleaning the Helmet

A. Dampen a cloth with water and wipe out the inside of the helmet. Dry completely DO NOT COVER THE HELMET WITH WATER! Moisture may become trapped inside the helmet and may cause bacteria to grow. This will cause a strong odor. It is also very important that you dry the inside of the helmet completely before placing it back on your child. THE HELMET SHOULD NOT BE WORN WHILE WET. B. Dampen a different cloth with rubbing alcohol and wipe out the inside of the Helmet again. Wash and rinse, pat dry with a cloth. You may clean the plastic shell with rubbing alcohol in addition to washing.

Helpful Hints

  1. Generally, children acclimate to the helmet well and in a short period of time.
  2. The wearing schedule starts with the child wearing the helmet 2-4 hours at a time, with a 15-30 minute break. During this break, check the child's head for red marks and time the duration for natural skin tone to return. Replace the helmet and continue this schedule day 1 and 2 until bedtime. The child will not wear the helmet to sleep the first night. If there are no apparent complications within the first two days, the child will wear it to sleep the second night. This is the time to start the 23 hours a day therapy. If a child is prone to skin problems or has a difficult time adjusting to the helmet, we suggest the following schedule. Day 1 -- 1 hour on/ 1 hour off until bedtime – no sleeping in the helmet Day 2 -- 2 hour on/ 1 hour off until bedtime – no sleeping in the helmet Day 3 -- 3 hour on/ 1 hour off until bedtime – 1 hour sleeping in the helmet Day 4 -- 4 hour on/ 1 hour off until bedtime – 2 hours sleeping in the helmet Day 5 -- Start regular schedule of 23 hours in helmet except bathing Once the 23 hours a day schedule is started, the helmet should be removed three times a day. This includes before and after bedtime and early afternoon. Clean the helmet during these times and check the child's head for pressure areas.
  3. It is the parents' discretion on use of the helmet if the child is ill. Remember that head growth is unpredictable. A few days without the helmet can jeopardize the fit. This may lead to the helmet not fitting correctly upon the next attempt and a new helmet will be required.
  4. Sweating problems often go away after a few days. Please do not forget that children run on a higher metabolism rate, thus their body temperature and heat exchange is higher. Every helmet is fabricated with a sufficient amount of ventilation holes. Thus far, we have not encountered significant problems with hygiene. Purchase a small battery operated fan and run an occasional stream of cool air through the holes. Do not do this for more than a few seconds!
  5. You are welcome to customize the helmet's appearance with stickers. Do not put paint on the helmet or cover a ventilation hole with a sticker.
  6. Proper positioning of the helmet on the child's head is important in order to prevent discomfort and ensure the maximum benefit. Your orthotist will show you how to put the helmet on and secure the strap when you receive the helmet. Practice with the orthotist until you are comfortable. You will find your own technique to donn the helmet. The safest way with our helmet is to follow the instructions below.
    • Try not to separate the helmet too far as this narrows it back to front and locks it on the child's head.
    • Roll helmet on/off the head. Direction of the roll is specific to the shape of the head and may require some sideways movements. Never force the helmet straight down or up! Your practitioner will show you the right way to apply the helmet. In most cases, the helmet is slit to provide comfortable donning. This will not influence the therapy outcome.
    • The most common mistake while applying the helmet is to have one's own fingers inside the helmet. The helmet is made with the most intimate fit and does not have extra space. The second most common mistake is spreading the helmet too much, which locks it on the child's head.
    • Trust your child while applying the helmet. You will notice that the child is actually helping you to put the helmet on or take it off. If the helmet does not go on/off snugly, either you are doing something wrong or it is time to open the helmet.
    • Do not squeeze the helmet, or your child's head when applying the helmet. The helmet should fit snugly without causing discomfort. The slit in the helmet should fold back together once it is on. If it does not, contact your physician, as an evaluation and new fitting may be necessary. Once the helmet is on and the sides of the slit fold back together, you should secure them with the velcro control strap. This is done by simply pulling the strap over the slit, and placing it down securely on the piece of velcro secured on the other side.
    • We have an important reason for keeping the ear opening as close to the back of the ear lobe as possible. The ear has no bones in it, is flexible, and if slightly bent by the helmet, will not “stay like this for the rest of the patient's life.” Do not force the practitioner to open the helmet in that area unless there is a skin problem involved.
    • Helmets are made with a significant amount of pocket relief built into them. The helmet will look loose on the head for a couple of weeks. As long as the helmet is not falling off the head, cannot be removed by the child, and is not causing significant rotational problems, do not worry about the helmet being loose. This will go away as the cranium grows.
    • The helmet must sit low on the forehead, almost next to the eyebrows. As soon as you notice that it is sitting too high – inform the practitioner.
    • Do not use collared shirts or any type of cloth that will get in between the helmet and the child's neck.
  7. Over a long period of use, some odor may develop from the helmet. This is not usually noticeable. DO NOT use any deodorants on the inside of the helmet or in between the helmet-liner space. No chemicals should stay in proximity to the child's skin.
  8. Treating children with helmets is very sensitive therapy and proper follow-ups are necessary. Your referring physician will schedule routine follow-ups, generally every four weeks until therapy is dismissed. Your treating clinician will follow up with you two weeks after the initial fitting, four weeks after the initial fitting, and every four weeks from that point forward until dismissed. For very young infants, and some older infants whose heads grow at a faster rate, more frequent follow-up visits may be necessary

Warranty Information

YOUR NEW HELMET IS COVERED FOR 90 DAYS FROM THE TIME OF DELIVERY. THIS INCLUDES FREE FOLLOW-UPS, ADJUSTMENTS, CONSULTATIONS AND MODIFICATIONS.

RESTORATIVE HEALTH SERVICES, INC. DOES NOT ASSUME RESPONSIBILITY FOR DAMAGE DONE TO THE HELMET BY HIGH FORCE APPLICATIONS, HIGH TEMPERATURES, OR UNAUTHORIZED MODIFICATIONS DONE BY SOMEONE OTHER THAN A RESTORATIVE HEALTH SERVICES, INC., STAFF MEMBER.

RESTORATIVE HEALTH SERVICES, INC. WILL NOT ASSUME RESPONSIBILITY FOR HELMET FABRICATIONS CAUSED BY A SUDDEN PHYSIOLOGICAL CHANGE IN THE CHILD THAT CANNOT BE ACCOMODATED BY STANDARD PROCEDURES.

RESTORATIVE HEALTH SERVICES, INC. DOES NOT ASSUME RESPONSIBILITY FOR A HELMET REFABRICATION IF THE FIT WAS LOST DUE TO AN IMPROPER WEARING SCHEDULE OR MISUSE OF THE HELMET.

RESTORATIVE HEALTH SERVICES, INC. DOES NOT ASSUME RESPONSIBILITY FOR ANY SKIN PROBLEMS CAUSED BY POOR CHILD/HELMET HYGIENE, IMPROPER CLEANING TECHNIQUES, USE OF UNAUTHORIZED CLEANING/COSMETIC MATERIALS, OR ANY OTHER ALTERATIONS DONE TO THE HELMET THAT COULD CAUSE DAMAGE TO THE CHILD'S SKIN.

RESTORATIVE HEALTH SERVICES, INC. DOES NOT ASSUME RESPONSIBILITY FOR HELMET REFABRICATION IF THE FIT WAS LOST DUE TO MISSED FOLLOW-UP APPOINTMENTS. IT IS THE RESPONSIBILITY OF THE PARENT(S) TO ARRANGE AN APPOINTMENT WITH A PRACTITIONER AS SOON AS THEY NOTICE ANY SIGNS OF CONCERN.

THE STAFF OF RESTORATIVE HEALTH SERVICES, INC. THANKS YOU FOR PATRONAGE AND LOOKS FORWARD TO PROVIDING ALL YOUR FAMILY'S PROSTHETIC AND ORTHOTIC NEEDS.