Head circumference in young children with autism: the impact of different head circumference charts

Area of Science:

• Neurodevelopmental Disorders
• Pediatric Neurology
• Growth Monitoring

Background:

• Accurate head circumference measurement is crucial for identifying neurodevelopmental disorders.
• Different growth charts exist, potentially leading to variations in diagnoses like macrocephaly.
• Autism spectrum disorder (ASD) is a common neurodevelopmental disorder where head size may be altered.

Purpose of the Study:

• To investigate if the prevalence of macrocephaly differs based on the head circumference growth chart used.
• To compare the diagnostic performance of Nellhaus, CDC, and Rollins et al. growth charts in children with neurodevelopmental disorders, including those with ASD.

Main Methods:

• Head circumferences of 253 children (12-36 months) with neurodevelopmental disorders were plotted.
• Three growth charts were used: Nellhaus, CDC, and Rollins et al. revision.
• A subgroup of 59 children had a diagnosis of autism spectrum disorder.

Main Results:

• The CDC and Rollins et al. charts identified significantly more cases of macrocephaly compared to the Nellhaus chart.
• These newer charts also identified fewer cases of microcephaly.
• No significant difference was observed in macrocephaly identification between the CDC and Rollins et al. charts for children with autism.

Conclusions:

• The choice of growth chart can influence the detection of macrocephaly in children with neurodevelopmental disorders.
• Current CDC and Rollins et al. charts are more sensitive in identifying macrocephaly than the older Nellhaus chart.
• Further research may be needed to standardize growth chart usage in pediatric neurodevelopmental assessments, particularly for autism spectrum disorder.