New Study Identifies Key Predictors of Developmental Delays in Children with Craniosynostosis

A newly published study from Weill Cornell Medicine provides new clarity on the factors associated with developmental delays and therapy resource utilization in children undergoing surgical treatment for craniosynostosis. The research, published in the Journal of Craniofacial Surgery, highlights how coexisting neurodevelopmental conditions such as autism, hydrocephalus, hearing loss or epilepsy and the need for revision surgery play a more significant role in developmental outcomes than surgical technique alone. 

The study, “Predictors of Developmental Delays and Therapy Resource Utilization in Craniosynostosis Patients,” was conducted by a multidisciplinary team within Weill Cornell Medicine’s Department of Neurological Surgery in collaboration with colleagues in Plastic and Reconstructive Surgery, reflecting a coordinated approach to pediatric craniofacial care. 

Understanding Developmental Outcomes in Craniosynostosis 

Craniosynostosis occurs when one or more cranial sutures fuse prematurely in infancy, potentially affecting skull growth and brain development. While the condition has historically been linked to an increased risk of developmental delay, distinguishing the effects of craniosynostosis itself from other contributing factors is challenging. 

To better understand these relationships, the research team performed a retrospective analysis of 259 nonsyndromic craniosynostosis patients who underwent either endoscopic or open surgical correction between 2016 and 2023. Investigators evaluated a range of clinical and demographic variables to identify independent predictors of developmental delay, speech delay and long‑term utilization of rehabilitative therapies. 

Key Findings From the Study 

The study found that developmental and speech delay rates among surgically treated craniosynostosis patients were comparable to those observed in the general pediatric population. Developmental delay was identified in 10 percent of patients, while 14.7 percent had speech or language delays. 

Surgical approach, sutural involvement and timing of surgery beyond six months of age were not independent predictors of either developmental or speech delays. 

Instead, two factors consistently emerged as meaningful predictors: 

“These findings help refine how we counsel families,” said Caitlin Hoffman, MD, pediatric neurosurgeon at Weill Cornell Medicine and senior author of the study. “Rather than attributing developmental risk solely to craniosynostosis or surgical timing, this analysis underscores the importance of recognizing additional neurodevelopmental factors that may independently influence outcomes.” 

Dr. Caitlin Hoffman, Pediatric Neurosurgeon

Therapy Utilization and Multidisciplinary Follow‑Up 

Beyond developmental diagnoses, the study also examined which patients were more likely to require speech, physical or occupational therapy over time. Increased use of rehabilitative services was associated with coexisting developmental conditions, surgery performed after six months of age, male sex and participation in early intervention or school‑based programs. 

“For many families, surgery is just one step in a much longer care pathway,” said Michelle Buontempo, MSN, CPNP, pediatric nurse practitioner and co‑author of the study. “Understanding which children may benefit from early therapy services allows us to coordinate support sooner and help families navigate the resources their child may need as development unfolds.” 

Thomas Imahiyerobo, MD, pediatric plastic surgeon and co‑author, emphasized the importance of a comprehensive approach to care. “This work reinforces that optimizing outcomes in craniosynostosis requires more than technical success in the operating room,” he said. “Close developmental monitoring and collaboration across specialties are essential to identifying children who may benefit from targeted supports and long‑term follow‑up.” 

While surgical correction remains critical to addressing skull growth and intracranial pressure concerns, long‑term outcomes depend on coordinated care that extends beyond surgery. By identifying factors most strongly associated with developmental delays and therapy needs, this study helps guide more individualized counseling, follow‑up, and support for children with craniosynostosis and their families