Looking Beyond Linear Measurements
Why Clinical Assessment Matters
Beyond DSi® Scores
Measurements are an important tool — but they don't always tell the full story. Here's why our clinicians look further.
Why Measurements May Not Capture the Full Picture
Mild on the DSi®Scale — But Treatment Recommended?
Cranial asymmetry measurements are an important tool in evaluating infant head shape. However, anthropometric measurements are linear measurements — and while valuable for categorizing severity, they do not always fully capture the extent of cranial deformity or volume loss.
As a result, there are cases where an infant may fall within a "mild" range in measurements, yet treatment is still clinically recommended based on the overall head shape presentation.
Understanding the Limitation
Why This Happens
Linear Measurements Have Limitations
DSi® scores capture important data — but not the complete clinical picture
How DSi® Measurements Work
Measurements are captured using specific anatomical landmarks at a single level of the head. While these measurements provide important data, they may not fully reflect asymmetry occurring outside of that plane.
In some infants, the shape complexity exceeds what diagonal measurements can express.
What May Be Missed
- The most severe flattening may occur below the measured landmark level
- Volume loss may not be fully represented through diagonal measurements alone
- Indenting on the non-flat side can alter diagonal readings
- Posterior head height differences or cranial height asymmetry are not captured
What Clinicians Actually Evaluate
Clinical Assessment Goes Beyond the Number
Treatment recommendations are never based solely on one measurement.
Our Clinical Teams Also Evaluate:
Case Example
This Patient's Head Shape Is Severe
Case Study: Complex Plagiocephaly Presentation
Clinical ExampleThis patient presents with flattening on the left back side of her head, along with mild flattening on the right forehead. She also has increased height on the right side of the head and a forward shift of the right ear and facial features.
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Left posterior flattening — Primary flattening on the left back side of the head, extending beyond the measured landmark plane.
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Right forehead flattening — Mild compensatory flattening on the right forehead noted during visual assessment.
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Right cranial height increase — Increased height on the right side of the head — not captured by standard diagonal measurements.
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Ear & facial shift — A slight forward shift of the right ear and facial features, indicating true positional asymmetry.
The Number Is a Starting Point — Not the Final Word
DSi® measurements are a valuable, standardized tool — but cranial asymmetry is three-dimensional. Our clinical assessment process ensures that no infant is over- or undertreated based on a single metric. When a measurement appears mild but the overall presentation is complex, our team is trained to recognize it and recommend accordingly.