The Value of Head Circumference Measuements
March 6, 2018
The Question: Are routine head circumference measurements a good screening tool for neurodevelopmental problems?
The Study: Head circumference measurements are a routine part of well-child exams. The rationale is that children who don’t follow a growth pattern (percentile shifts) may be at an increased risk of neurodevelopmental problems and warrant additional studies.
The 10,851 children in this study had two or more head circumference measurements in their medical records. The measurements were routinely performed by the child’s healthcare provider at two, nine, eighteen, and twenty-four months of age and by researchers at four, eight, twelve, and eighteen months. All the children had an IQ test (Wechsler Intelligence Scale for Children) at eight years old.
The Results: More than 15% of the children demonstrated a shift of one standard deviation with one-third having a sustained shift. Over 2% had a shift of two standard deviations. In most cases, the shift occurred only at one measurement with a return to their previous growth curve at the next measurement.
The data analysis revealed that children with small heads were seven times more likely to have neurodevelopmental problems. However, 85% of the children with small heads had no problems and 93% of the children with neurodevelopmental problems had normal head circumferences.
Comment: The authors conclude that head circumference or head circumference measurements as part of routine well-child visits are not good ways to determine risk of neurodevelopmental problems. Such measurements may raise unnecessary parental concerns.
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