Re: Cephalic Index Question Answered by CT's Tim Littlefield

[Guest guest]

I'm sorry, but I think my eyes are starting to cross...I'm not very

scientifically minded, so I get confused easily!

I honestly don't even know if CT uses those same classification of numbers.

Molly has been posting them for years, and her son wore a STARBand. Plus my son

had plagio, so I'm not an expert on brachy but I do know that his CI was in the

high 70s, so completely " normal " by those standards. Tim is not in charge of

these scientific studies, so I'm not sure there is much that can be done to

force another one to be done. Anthropologists aren't very concerned with flat

heads, I would guess, and that's why it's gone without a new study for so long.

I've said before that CT does NOT rely on numbers, they focus more on the

overall picture, that's why they don't measure at every visit and really ONLY

measure at all because a lot of insurance companies require it. Their severity

assessment chart on their website lists no numbers at all, only pictures of

different levels of flatness. So for parents who are focused solely on numbers,

I'm afraid that their concerns about the " norm " will never be fully satisfied,

even with another study. I think that you have to go with what LOOKS normal. No

one is going to be going around measuring other people's heads when they get

older to see how much plagio or brachy they have. As long as the head looks

normal to you and everyone else, the other stuff doesn't really matter. So you

might have to get a special fitting bike helmet some day. So what?

I was a tummy sleeper, never had tort, etc. But my ears are off, both up and

down and front and back (2mm tops). The only reason I know this is because I

wear glasses. So I have to get them adjusted more often to fit tight and

straight. When they're sitting on a table, they look funny cause one stem is

shorter and tilted more than the other. But they're fine when I wear them, so

it's no big deal to me. I got through life okay (I've been wearing glasses since

I was 7), so that's all I think anyone can ask for. As long as the child's head

looks like MOST other kids their age, I believe everything will be just fine.

Helmets and glasses and braces, or whatever comes out of plagio/brachy down the

line, is really secondary, in my opinion.

> >

> > ,

> > I really appreciate you posting this interesting response from Mr.

Littlefield. My first reaction was that he is saying some of what I did in a

post last week: namely, that what is common or even average is not necessarily

healthy. (I gave obesity as an example.)

> >

> > On the other hand, let us keep in mind that Mr. Littlefield can hardly be

considered objective since he works for a company that profits from orthotic

molding devices.

> >

> > One more comment: 1 in 30 or 1 in 60 is a plenty high fraction of the

population, in my opinion!

> >

> >

> >

> >

> > >

> > > Hi ,

> > >

> > > Carol forwarded your email to my attention to see if I could answer your

question about cephalic index. It is an excellent question and one that I know a

lot of people struggle with.

> > >

> > > The values we use for cephalic index come from some very well controlled

anthropometric studies that were performed a few decades ago. They are the most

accurate we have ever found. They were performed by expert anthropologists who

had been formally trained in the measurement of human form, and they are still

the gold standard used in most clinical research studies worldwide.

> > >

> > > As you indicated, sometimes these numbers seem `outdated' because we see

so many children with cephalic indices that are so much greater than the mean of

79%. However, there are a couple of things to consider. First, is that many of

the children you deal with on the boards, as well as what we see here, do in

fact have deformational brachycephaly and their heads are in fact many standard

deviations above the norm (often having CI's in the 90's or higher). This does

not mean the norms should be adjusted so these don't appear so bad. From a

purely functional and anatomical perspective, any infant who has a cranial width

that is approaching their cranial length will likely have many other issues as

well (increased posterior head height, shortened skull base distance behind the

foramen magnum, possible malocclusion etc) not to mention will have difficulty

wearing protective head gear which is designed around the normal values.

> > >

> > > The second point is really the same as the first †" we have to remember

that the infants we see on a daily basis do not represent the normal population

(we see what 1 in 60, 1 in 30 infants?). To really understand whether the normal

values need to be adjusted because of back sleeping, a new anthropometric study

looking only at infants without any kind of deformational plagiocephaly or

brachycephaly would need to be completed. Unfortunately, I do not see that

happening any time in the near future, although I do think it would be very

interesting to see what impact supine sleeping has had on our heads.

> > >

> > > If you would like to share this information, or if you would rather have

me answer questions directly on the board, it is fine with me.

> > >

> > > Thanks

> > >

> > > Tim

> > >

> > > P.S. To answer your other question †" the numbers we use are probably

what Molly has, and this is also what the insurance companies use as well.

> > >

> > > Tim Littlefield, MS

> > > Vice President

> > > Cranial Technologies, Inc.

> > > 480-403-6332

> > > www.CranialTech.com

> > >

> >

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