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Head growth and neurocognitive outcomes
Charlotte M Wright1, Alan Emond2
1Peadiatric Epidemiology and Community Health Unit, School of Medicine, MVLS College, University of Glasgow, Glasgow, United Kingdom; and charlotte.wright@glasgow.ac.uk.
Pediatrics
|May 20, 2015
Summary
Head circumference (HC) centile shifts are common and often due to measurement error, not developmental issues. Extreme head sizes are not reliable indicators for neurodevelopmental disorders (NCDs).
Area of Science:
- Pediatric Neurodevelopment
- Growth Monitoring
- Public Health Screening
Background:
- Limited evidence exists on the utility of head circumference (HC) as a screening tool.
- Understanding head size trajectories and their link to neurodevelopmental outcomes is crucial.
Purpose of the Study:
- To investigate the incidence of head centile shifting in children.
- To determine the association between extreme head sizes and later neurodevelopmental problems.
Main Methods:
- Utilized data from the Avon Longitudinal Study of Parents and Children.
- Collected head circumference measurements at multiple time points from infancy to adolescence.
- Assessed neurocognitive disorders (NCDs) and measured IQ at age 8.
Main Results:
- Over 15% of children experienced head centile shifts, but most were not sustained.
- Only 0.5% showed sustained shifts outside the typical range.
- While consistently small heads increased NCD likelihood (up to 7x), most children with small heads had no NCDs, and most with NCDs had normal head sizes.
Conclusions:
- Common centile shifts likely stem from measurement variability, complicating trajectory assessment.
- Routine HC measurement appears unhelpful for screening NCDs due to low specificity and sensitivity.
- Extreme head size is not a reliable predictor of neurodevelopmental issues.
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