When can an orthotic program begin?

• A. Within the first days of life.
• B. At 6 months of age.
• C. Only after motor milestones are achieved.
• D. After the child starts walking.

Answer: (A)

Starting an orthotic program in the newborn period is appropriate and often beneficial. For babies with spinal dysraphism like myelomeningocele, joints and muscles are developing quickly, and early orthotic support helps keep hips, knees, and feet in good alignment, reduces the risk of contractures, and provides a stable base for early care and therapy. Fitting and adapting an orthotic device soon after birth allows families to become comfortable with its use and gives clinicians time to tailor it as the child grows, rather than waiting for milestones to be reached or for the child to start walking. Delaying initiation to six months, after motor milestones, or only after walking can permit deformities to progress and limit the effectiveness of later orthotic intervention. So, beginning the orthotic program within the first days of life aligns with promoting proper alignment and early development.