Head Circumference Observation

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Head circumference monitoring of children is very crucial and is basic tool for early detection of neuro-developmental disorders in children (1,2,3). An abnormal rate of head growth could suggest a pathological disorder and would require further evaluation(4). So there is need of a valid, precise, accurate and reliable tool for head circumference measurement.
Currently used measuring tapes for taking anthropometric measurements do not give accurate readings after being used for few months because of its stretchability (1) and currently there are no guidelines on when to replace the tape. Further, Inter-observer variations are very common because of different forces (stretch) used by the different observers while taking head circumference. It is also common to see variations in readings taken by the same observer (1, 5-6). Observer variations in anthropometric measurements of > 0.5cm are common. This might result in missing an at risk child or it may be a false alarm
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At the start of the study both the observers (post graduate students) were trained for taking head circumference measurement accurately by the guide (faculty). They were taught about the important landmarks for taking head circumference. Both the observers used the same stretchable and non-stretchable exclusive OFC tapes for measurements.
The stretchable tapes were discarded after their use for a period of 1 month and thereafter a new stretchable tape was used. Non-stretchable exclusive OFC tape was assessed every monthly for its reliability and accuracy against standard steel rule for head circumference measurement. It was decided if repeated use a non-stretchable exclusive OFC tape was not able to provide accurate reading then it would be discarded and a new tape would be used.
Necessary measures and precautions were taken to avoid possible bias which could have arose while taking head circumference