A Promising App-Based Torticollis Awareness & Prevention Intervention

The aim of this study was to test the feasibility of an app-based intervention for 1) increasing parents’ awareness of torticollis and 2) facilitating changes in parents’ behavior related to torticollis prevention

Sarah Berger, Maristella Lucchini, Shambhavi Thakur, Natalie Barnett

Presented at 13th Biennial Conference of the Society for the Study of Human Development



  • 4-16% of infants have torticollis – a musculature disorder where muscles attaching the skull to the collarbone are tight and shortened causing the head to tilt or rotate. [1]
  • ‘Back to Sleep’ campaign to decrease the risk of SIDS led to to rise in torticollis rates due to increased time infants spent on their back while awake.[2]
  • if intervention is started before 1 month of age, 98% of infants achieve range of motion within 6 weeks
  • waiting until after 1 month to intervene may prolong physical therapy up to 6 months. [3]


Test the feasibility of an app-based intervention for

  1. increasing parents’ awareness of torticollis and
  2. facilitating changes in parents’ behavior related to torticollis prevention


241 families with infants < 1 month old, without a prior torticollis diagnosis participated
All families used Nanit, a commercial home video baby monitoring system



No difference between control & test groups at start of intervention

  • in torticollis awareness
  • in alternating placement in the crib
  • in alternating sides during feeding

Significant difference between control & test groups by 12th week of intervention

  • in alternating placement in the crib
  • in alternating sides during feeding


  • Meeting parents where they were – in an app they already used – successfully delivered information designed to increase awareness
  • Relevant messaging “nudged” parents into making behavioral changes
  • Torticollis prevention strategies typically rely on healthcare providers to educate parents, but short appointments leave little time to cover torticollis prevention
  • This intervention is a cost-efficient & practical opportunity to put “an ounce of prevention, worth a pound of cure” into practice
  • Next steps include tracking families to document whether the intervention successfully reduces the rates of torticollis


[1] Stellwagen, L. M., Hubbard, E., & Vaux, K. (2004). Look for the" stuck baby" to identify congenital torticollis. Contemporary Pediatrics, 21(5), 55-64.

[2] Öhman, A., Nilsson, S., Lagerkvist, A. L., & Beckung, E. V. A. (2009). Are infants with torticollis at risk of a delay in early motor milestones compared with a control group of healthy infants?. Developmental Medicine & Child Neurology, 51(7), 545-550.

[3] Sargent, B., Kaplan, S. L., Coulter, C., & Baker, C. (2019). Congenital muscular torticollis: bridging the gap between research and clinical practice. Pediatrics, 144(2).

About the researchers

The authors included Sarah Berger, Maristella Lucchini, Shambhavi Thakur, and Natalie Barnett.

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  • Dr. Sarah Berger is a Professor of Psychology at the College of Staten Island and the Graduate Center of the City University of New York. She received her PhD from New York University. Dr. Berger was an American Association of University Women Postdoctoral Research Fellow and a Fulbright Research Scholar. Dr. Berger studies the interaction between cognitive and motor development in infancy, particularly response inhibition and its implications for the allocation of attention in very young children. A line of National Science Foundation (NSF)-funded work, in collaboration with Dr. Anat Scher, has been the first to study the impact of sleep on motor problem solving in infancy.
  • Dr. Maristella Lucchini serves as Senior Clinical Researcher at Nanit. In her role, Maristella works to secure grant funding in collaboration with Nanit’s university research partners and supports the development of the company’s research collaborations around the world. Previously, Maristella served as an Assistant Research Scientist in the Division of Developmental Neuroscience, Department of Psychiatry at Columbia University Irving Medical Center where she led projects across several cohorts focusing on sleep health for pregnant and postpartum women and their children. Maristella’s research focused on underserved communities and sleep health disparities in the perinatal period. During her years as a postdoctoral researcher at Columbia University Irving Medical Center in the Department of Psychiatry, Maristella was selected to participate in the American Academy of Sleep Medicine Young Investigator Research Forum. She holds a Ph.D. in Biomedical Engineering from Politecnico di Milano.
  • Shambhavi Thakur serves as Clinical Research Data Analyst at Nanit. She holds a Masters degree in Health Informatics and Life Sciences. She oversees the research collaborations with various universities and analyzes sleep data for internal as well as external studies.
  • Dr. Natalie Barnett serves as VP of Clinical Research at Nanit. Natalie initiated sleep research collaborations at Nanit and in her current role, Natalie oversees collaborations with researchers at hospitals and universities around the world who use the Nanit camera to better understand pediatric sleep and leads the internal sleep and development research programs at Nanit. Natalie holds a Ph.D. in Genetics from the University of New England in Australia and a Postgraduate Certificate in Pediatric Sleep Science from the University of Western Australia. Natalie was an Assistant Professor in the Neurogenetics Unit at NYU School of Medicine prior to joining Nanit. Natalie is also the voice of Nanit's science-backed, personalized sleep tips delivered to users throughout their baby's first few years.

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