In my practice as a rehabilitation physician, the number of adult patients is overwhelming. Because of this, I seem to be more impressed with the relatively small number of “little” patients. Lan Lan is nine months old and is full of “babbling” to people, and her chubby white face is very pleasing. However, a closer look revealed that her head and features were asymmetrical, and her head and neck were tilted to the right. Her mother brought her to me after being referred to me, and once she entered the consultation room, she blamed herself, saying that the baby had not been positioned properly when she was sleeping, resulting in her current appearance. She was overweight and her family did not want to deliver her by C-section, so it took a long time before she was delivered. I then made a careful physical examination and found that the right cervical sternocleidomastoid muscle was tense and there was a hard lump, and the upper thoracic spine was also bent and deformed. I told Lanlan’s mother that her fault was not that she did not position the child properly during sleep, but that she did not observe the abnormalities of the child’s head and neck and bring her to the doctor in time. What was wrong with Lanlan? It turned out that Lanlan was born with an injury to the right sternocleidomastoid muscle, which was damaged and bleeding, forming a hematoma, and because it was not treated in time, the hematoma was malabsorbed and became a hard mass, and the muscle contracted and shortened, so the head and neck tilted to the right. Due to the rapid development of the child, the tilt was long enough to cause the head and facial organs to develop asymmetrically, resulting in scoliosis. After nearly half a year of rehabilitation treatment in our department, Lan Lan’s neck was straightened, but the thoracic vertebrae were still a little scoliosis. After a few more months of corrective treatment, Lan Lan was finally “corrected”. On Jie’s second birthday, his parents invited friends and family to a hotel banquet to celebrate Jie finally being able to be a “proper” human being, and they made sure I attended. To make a long story short, Jie was born smart and attractive, but when he was almost a year old, Jie’s neck was always crooked to one side whenever he looked at objects, and slowly, his neck became crooked, not to mention how ugly it was! Mom and dad led Jie to see pediatrics, orthopedics, neurology, physiotherapy ….. He went to all the local hospitals and did physiotherapy for several months, but as time went on, the child’s crooked head became more and more obvious, which was a great worry for his parents. After careful examination, I found that the problem seemed to be in the eyes rather than in the neck, and recommended a consultation with an ophthalmologist. After examination by the ophthalmologist, it was confirmed that Jie was suffering from congenital superior oblique palsy and that the child’s tilted head was due to the eyes. He was later hospitalized in the ophthalmology department and underwent surgery. After the surgery, the child’s head tilt continued to improve and finally disappeared completely. After the cure, it was Jie’s second birthday, so his parents were happy on the one hand, and had a party to thank those who had helped him. Pediatric squint is actually very common, and there are many types according to the causes, such as muscular, ophthalmic, bony and neurological (spastic). Ophthalmic squint is mostly caused by congenital or traumatic eye injury and eye muscle paralysis. The most common form is superior oblique palsy in one or both eyes. Since superior oblique muscle paralysis can cause hyperfunction of its antagonistic muscle, the inferior oblique muscle. Ophthalmic strabismus is a compensatory response of the patient to avoid double vision due to impaired movement of the oculomotor muscles in certain directions, causing diplopia, i.e. looking at something with 2 non-overlapping shadows. When the patient’s head adopts a special position to make the eyes squint, the diplopia is reduced or disappears. Moreover, when the patient adopts this “crooked” head position, it can reduce the discomfort caused by strabismus, maintain binocular vision, and protect the visual function. However, a long-term tilted head and neck can bring about facial asymmetry, cervical scoliosis, and even scoliosis of the spine, as in the case of Jie. Bone tilt neck, also known as congenital short neck (webbed neck). The patient’s cervical vertebrae are mostly fused together, with a short, thick neck, low and wide hairline, webbed band, and severely restricted neck movement, which usually requires surgical correction. Spastic squint is a stubborn disease that is not easy to cure today. The patient’s head and neck are tilted and shaken constantly, and in severe cases, the patient cannot take care of himself. No matter what the cause is, if pediatric squint is not timely and effectively prevented, not only the head and neck will be skewed, but also the corresponding deformity of the face, the five senses will not be straight, the sides will not be symmetrical, the head will be deformed, and the spine will be bent. As long as parents are careful to detect early abnormalities and seek medical attention in time, most of the cases can be completely controlled without leading to serious consequences.