New ROKband research published in the Journal of Clinical Medicine.

If you’ve noticed a flat spot or asymmetry in your baby’s head shape, one of the first questions that may come to mind is:

“Should I wait and see, or should I have it checked now?”

It’s a question we hear from families every day.

And while every baby’s head shape and development are different, new research involving 1,054 infants treated at ROKband Pediatric Headshape Clinics across Canada is helping us better understand how the timing of cranial remodelling treatment may influence outcomes.

Published in the Journal of Clinical Medicine in September 2026, the study examined babies treated with 3D-printed cranial remodelling orthoses (CROs), like the ROKband, and found measurable head shape improvement across the infants studied. It also found that beginning treatment at a younger age was associated with higher rates of correction.

So, what does that actually mean for parents?

Let’s break down the research.

The study reviewed treatment outcomes for 1,054 infants who received treatment at six ROKband Pediatric Headshape Clinics in Canada during 2023.

Researchers looked at three types of deformational head shapes:

Deformational plagiocephaly (DP): flattening that creates an asymmetrical head shape

Deformational brachycephaly (DB): symmetric flattening toward the back of the head that results in a wider head shape

Deformational asymmetric brachycephaly (DAB): characteristics of both plagiocephaly and brachycephaly.

Babies were then grouped according to their corrected age when treatment began: under 6 months, 6–9 months, and 9–12 months. All infants included in the study began treatment between four and 12 months of corrected age. Families were instructed to follow a wear schedule of 20–23 hours per day, although individual wear times were not independently verified.

Researchers compared each baby’s head shape measurements before and after treatment and also looked at caregiver satisfaction.

When researchers study head shape improvement, they need a consistent way to measure progress.

For this study, they used two measurements:

Cranial Vault Asymmetry Index (CVAI): Measures how symmetrical a baby's head is.

Cephalic Ratio (CR): Looks at the relationship between the width and length of a baby's head.

Researchers defined “full correction” as reaching a CVAI below 3.5% and a CR of 90% or lower.

But here's something important to understand: not reaching these specific measurements doesn't mean a baby's head shape didn't improve.

Some babies experienced measurable improvement but didn't meet the study's strict definition of full correction. In some cases, families were already happy with their baby's progress and chose to finish treatment before reaching those measurements.

Keeping this distinction in mind helps us better understand the study's findings.

Some babies experienced measurable improvement but didn't meet the study's strict definition of full correction. In fact, among patients who did not achieve full correction, 68.75% chose to stop treatment because their families were happy with their baby's head shape.

This is an important distinction because a baby may not meet the study's specific measurement criteria, but their family may still be satisfied with the improvement achieved.

Keeping this in mind helps us better understand the study's findings.

Here’s the big takeaway:

Head shape measurements improved during treatment across all of the head shape groups studied.

The researchers used specific measurement criteria to define what they called “full correction.” Based on those criteria, 66.89% of the 1,054 infants reached full correction during treatment.

But when researchers separated the results by the age treatment began, an important pattern appeared.

Across all three head shape types, full correction was achieved by:

72.95% of babies who began treatment before 6 months

62.61% of babies who began treatment between 6–9 months

39.29% of babies who began treatment between 9–12 months.

In other words, earlier treatment initiation was associated with higher correction rates.

Another important finding was that outcomes varied depending on the type of head shape being treated.

Across all ages, the percentage of infants reaching the study's full-correction criteria was:

Deformational plagiocephaly: 76.85% Deformational asymmetric brachycephaly: 57.73% Deformational brachycephaly: 54.68%

Why is that worth mentioning?

Because babies don't begin treatment from the same starting point.

Their age, initial measurements, head shape, growth and other individual factors can all be part of the clinical picture. The study's statistical analysis found that both treatment initiation age and initial head shape measurements were significantly associated with the likelihood of reaching its correction criteria.

It's another reason an individualized assessment matters more than comparing one baby's progress to another's.

Your baby’s head is doing a lot of growing during their first year.

A cranial remodelling orthosis is designed to work with that natural growth, providing space in areas where growth is desired while maintaining contact in other areas to help guide the developing head shape. Each ROKband used in the study was custom-designed using a 3D scan of the baby’s head shape, allowing the orthosis to be tailored to their individual measurements.

The study found that younger babies generally experienced greater measurement changes during treatment.

For babies with deformational plagiocephaly, for example, the average improvement in CVAI — a measurement used to assess head shape asymmetry — was greater among babies who started before six months than among those who started later. Similar patterns were observed for the other head shapes studied.

This doesn't mean that there is a deadline after which treatment cannot help.

Babies in the older groups also experienced measurable head shape improvement.

Instead, the findings help explain why early awareness and assessment can be valuable.

No.

And this is an important distinction when we talk about early assessment.

Having your baby's head shape checked earlier does not mean beginning treatment earlier if treatment isn't clinically indicated.

Depending on your baby's age, head shape and assessment, the next step may be repositioning strategies, monitoring their growth, returning for a free rescan, exploring other pediatric support, or no treatment at all.

If cranial remodelling treatment is recommended, having that information earlier gives families more time to understand their options and make the decision that feels right for them.

An early assessment allows families to explore the options available while their baby's head is still growing. Families can also return for a second free assessment when monitoring is recommended.

Clinical measurements were only part of the research.

The study also looked at how caregivers felt about their baby's post-treatment head shape.

Overall, 94.4% of caregivers were recorded as satisfied with their child's post-treatment head shape.

Caregiver satisfaction was highest among the youngest treatment group, with 96.26% satisfaction among families whose babies began treatment before six months. Satisfaction was 93.58% in the 6–9 month group and 82.14% in the 9–12 month group.

For us, this is an important part of the conversation.

Head shape measurements allow clinicians to objectively monitor change, but behind every scan is a baby and a family going through the treatment experience.

Cranial remodelling orthoses have been studied for many years, but much of the existing research has focused on traditionally fabricated devices. Research specifically examining 3D-printed CROs is still comparatively limited.

This study adds to the growing body of research on 3D-printed cranial remodelling orthoses, providing valuable data from more than 1,000 infants treated across Canada.

The findings help us better understand how treatment outcomes can vary depending on a baby's age and head shape, while reinforcing the importance of individualized clinical recommendations.

Most importantly, this research gives clinicians and families more evidence to support informed conversations about cranial remodelling treatment.

One of the most important findings from this research is that the age at which treatment begins can make a difference in head shape outcomes.

The study found that babies who began cranial remodelling treatment at a younger age were more likely to achieve the researchers' definition of full correction. However, this doesn't mean every baby with a flat spot needs treatment.

So, when should you have your baby's head shape assessed?

At ROKband, we recommend an initial head shape assessment around 4–6 months of age. This is an ideal time to evaluate your baby's head shape, understand the severity of any flattening or asymmetry, and determine whether further monitoring or treatment may be appropriate.

Depending on the findings, your clinician may recommend repositioning strategies, monitoring your baby's growth, a follow-up scan, or cranial remodelling treatment if clinically indicated.

The important distinction is that early assessment doesn't necessarily mean early treatment. It simply allows families to understand their options while their baby's head is still growing and developing.

ROKband offers free head shape assessments for babies between 4 and 18 months, with no referral required.

About the study

Impact of Age on Success of 3D-Printed Cranial Remolding Orthoses for Deformational Head Shapes was published in the Journal of Clinical Medicine on September 10, 2026. The retrospective cohort study included 1,054 infants treated at six Canadian ROKband Pediatric Headshape Clinics during 2023.

As with all research, the findings should be considered alongside the study's limitations. The study did not include an untreated control group or a comparison group using traditionally fabricated CROs, and the authors note limitations related to its retrospective design, caregiver-reported wear time and the smaller number of infants in the oldest treatment group.

The study was funded by HeadStart Medical, the manufacturer of the ROKband CRO. ROKband-affiliated authors participated in the research, while researchers from the University of Texas Southwestern Medical Center contributed to statistical analysis and interpretation of the results.

Read the published study here.