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

[Guest guest]

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It turns out it wasn't just one study Tim was referring to (in his post and in

previous clinical research papers) but entire textbooks on the subject of

anthropometry. Two titles that he gave me:

1. Anthropometry of the Head and Face, Second Edition by Lesli G. Farkas.

2. Craniofacial Anthropometry – Practical Measurement of the Head and Face

for Clinical, Surgical and Research Use – Kolar, Salter

Happy reading! ;-)

> > > >

> > > > ,

> > > > 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!

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> > > >

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> > > > >

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 As you indicated, sometimes these numbers seem `outdated' because we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