Expert: Catherine Ridenour - 7/18/2008

Question
Dear Catherine,

I am writing to you about my 21/2 month old grandson.  He tracks really well, makes great eye contact, and smiles in response to cues such as other people's smiles.  He also smiles and occasionally laughs when I make little "ooh..." "whoah..." sounds for him.  He tries to make the sounds too, although he can't yet.  He makes little "conversational sounds himself, and gets excited when I make the same sounds back to him.  My only concern is that when my daughter took him to the pediatrician yesterday the doctor noted that he had a very large head.  It's in the 95th percentile.  His height is at the 25th percentile, and his weight is at the 50th.  The doctor said that with head growth like this, the child bears watching.  His next appointment is four month from now.  The doctor mentioned some possible problems to my daughter, whio can't recall the terms.  I suggested hydracephalis (sp?), and my daughter said that that was one the doctor had mrntioned.  I googled this, along with "rapid head growth" and saw that this can also be a sign of autism.  Is this something to be worried/concerned about?  I can't really talk to my daughter about this: she is a very relaxed person, while I am a worrier, and I don't want to upset her.  I should note that my daughter's husband's family have large heads.  The baby's paternal grandmother said that one of her four sons had a head that was in the 100th percentil, and the other boys had very large heads too.  All of these relatives are fine.  Also, the doctor commented that the baby might well have "just a big Irish head." Thank you in advance for your response!

Answer
Hi Barbara,

If large heads run in his genes, that is probably the answer.

Hydrocephaly should definitey be watched for. If this child shows any signs of loss of alertness or he cries as if he is in pain and nothing will calm him (headache from intercranial pressure), he should have an MRI to rule out excess fluid in his brain.

So long as his behavior is normal, I would not worry.

Here is a link to a web site maintained by the U.S. Medical Library.

http://www.ncbi.nlm.nih.gov/pubmed/17641255?ordinalpos=1&itool=EntrezSystem2.PEn...

Note that not only head size, but overall length and weight were associated with autism.

(If this link won't work, go to the <http://www.ncbi.nlm.nih.gov> part and do a search for head circumference and autism.)

Keep making those fascinating noises and playing with your grandson. Attention and interaction are what teach language and social skills.

Best wishes,
Catherine