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Children's Health

Head Circumference- Adoption



My husband and I are adopting a little girl (19 months) from Korea. She was born at 36 weeks weighing 1490g and was diagnosed as an IUGR baby. She is still under the 3% for height weight and head circumfrance with the later being the smallest. Her HC is just 41.8cm at 19 months. Although her measurements are not on the chart they do create a perfect, steady curve and meet growth guidlines for her age. I am curious about what this means cognitively. Some doctors give us a very grim outlook while others are not at all concerned because "she follows her own curve" Which is true? She is meeting developmental milestones and has had every imaginable test and nothing has come up. I would appreciate your advice!


It is difficult to impossible to determine cognitive skills based on external variables such as head circumference as there are many other variables that may impact cognition more so than a specific physical feature. Other factors such as prematurity and IUGR, while cause for concern, have different effects on different individuals. 

To fully assess cognitive functioning, an evaluation with a psychologist familiar with early childhood (providers at Children's Hospitals may be the most helpful and/or the adoption service may already be linked with a psychologist who can evaluate), is recommended. 

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Response by:

Michelle Spader, PsyD
Clinical Assistant Professor of Pediatrics
College of Medicine
The Ohio State University