Measurements and Milestones   A great deal of emphasis is put on measurements of the fetus during pregnancy and on the achievement of milestones after the child is born. I'm not certain I always agree with all of that, but I can understand how it is sometimes helpful. I also know that parents who are still pregnant or very early in their journey would like a little glimpse into what might lie ahead. So, with the requisite admonition that every child develops in his or her own way and that hydrocephalus manifests itself in a myriad of different ways, I thought I would share Owen's measurements and milestones. Prenatal Measurements I have hesitated to post these measurements because no one has ever been able to really predict the long term outcome of a child with hydrocephalus by looking at these numbers. However I know that I would have given anything to have had something to compare Owen's measurements to while I was pregnant, so I feel obligated to share these measurements here. Owen has a severe case of hydrocephalus, and a head circumference that is one of the largest I have seen amongst all of the babies that I have met through this site, so keep that in mind when looking at the numbers. You may also wish to know that the reference for the largest "normal" ventricle size is 10 mm (millimeters) or 1 cm (centimeter). Week of Pregnancy Head Circumference Head Circumference Left Ventricle Right Ventricle 18 weeks 17.07 cm 19 weeks 5 days 20 mm (2.0 cm) 15 mm (1.5 cm) 21 weeks 3 days 22.69 cm 24 weeks 5 days 29.8 mm (29.8 cm) 1.56 mm (1.56 cm) 25 weeks 3 days 30.15 cm 33 weeks 3 days 52.8 mm (5.28 cm) 26.4 mm (2.64 cm) 28 weeks 1 day 35.78 cm 42 weeks 0 days N/A N/A We stopped letting them do the measurements after this because the doctors made it clear that they weren't going to do anything any different no matter what the measurements were, and it was depressing us. We did have one more detailed ultrasound after these measurements when we moved our care to Duke, but I don't have those. Measurements at Birth Head Circumference: 52.6 cm Length: 57 cm (22.4 inches) Weight: 4260 g (9 pounds 6 ounces) For reference, normal head circumference for a boy at birth at the 50th percentile is 34.8 cm. The 95th percentile at birth for a boy is 38.6 cm. 52.6 would be about the 97th percentile for a 36 month (3 year) old. After Shunting Head Circumference decreased to 49.5 cm, but went back up to 51+ after the shunt failure at 4 months. Milestones OK, I will do my best here. I didn't write down when a lot of these were achieved, but if I know I'll put it in there, or at least my best guess. Note: After CI means after cochlear implant. Owen is deaf and did not meet some of the reaction to sound milestones until after the implant was turned on. This milestone list was taken from the American Academy of Pediatrics website. Milestone Normally Acheived By Owen Can Do It? When Achieved Notes Raises head and chest when lying on stomach 3 months Yes Around 1 year   Supports upper body with arms when lying on stomach 3 months Yes 18 months-ish He could do this in therapy much sooner, but it wasn't until around 2 years that he would do this on his own Stretches legs out and kicks when lying on stomach 3 months Yes A long time ago   Opens and shuts hands 3 months Yes By 3 months   Pushes down on legs when feet are placed on a firm surface 3 months Sort of   Will push down to stand up in walker, but not if you just hold him under the arms. Brings hand to mouth 3 months Yes By 3 months   Takes swipes at dangling objects with hands 3 months Yes By 3 months   Takes swipes at dangling objects with hands Grasps and shakes hand toys Yes 1/2 By 3 months Owen has always grasped toys, but does not shake them, probably because he is deaf and can't hear the rattle sound. Watches faces intently 3 months Yes By 3 months   Follows moving objects 3 months Yes By 3 months   Recognizes familiar objects and people at a distance 3 months Yes By 3 months   Starts using hands and eyes in coordination 3 months Yes By 3 months   Smiles at the sound of your voice 3 months Yes After CI   Starts using hands and eyes in coordination 3 months Yes By 3 months Deaf children babble. Owen actually even said mamamama and dadadada, but didn't progress to just Mama and Dada. But he has always babbled and still does. Begins to imitate some sounds 3 months Yes After CI Getting him to deliberately imitate you is very hit and miss. If he's in the right mood he'll try sometimes. Turns head toward direction of sound 3 months Yes After CI Owen only has hearing now on one side, so he'll look around to see where the sound is coming from since he can't tell the direction from the sound itself. Begins to develop a social smile 3 months Yes By 3 months   Becomesmore communicative and expressive with face and body 3 months Yes By 3 months He has always been expressive with his face. Imitates some movements and facial expressions 3 months Yes 18 months Really started after 2nd cord blood infusion when he began to sign Rolls both ways (front to back, back to front) 7 months Yes Don't remember I have this written down, I'll look it up later but it's Owen's room and he's asleep. Sits with, and then without, support of their hands 7 months Yes-ish 2 yrs & 3 months Can do this for short periods of time. His record is 5 minutes, but it is usually less than that. He is ramping this up quickly though and can sit in a bumbo seat indefinitely. Supports whole weight on legs 7 months Yes-ish 2 yrs & 1 month He can do this for a few seconds in his walker Reaches with one hand 7 months Yes A long time ago   Transfers object from hand to hand 7 months Yes A long time ago   Uses raking grasp 7 months Yes A long time ago   Responds to own name 7 months Yes After CI   Begins to respond to "no" 7 months Yes A long time ago Responded to sign for "no" early on. Now responds to word after CI. Distinguishes emotions by tone of voice 7 months Yes After CI   Responds to sound by making sounds 7 months Yes After CI   Uses voice to express joy and displeasure 7 months Yes By 7 months Could do this even when he couldn't hear. Babbles chains of consonants 7 months Yes After CI He could do this somewhat even before the CI, but much more now. Finds partially hidden object 7 months Yes Eventually This took a while, but I can't remember when exactly. Explores with hands and mouth 7 months Yes By 7 months   Struggles to get objects that are out of reach 7 months Yes By 7 months   Enjoys social play 7 months Yes By 7 months Again, this markedly increased after 2nd cord blood infusion at 18 months. Interested in mirror images 7 months Yes By 7 months   Responds to other people’s expressions of emotion and appears joyful often 7 months Yes By 7 months You've seen the pictures, he's a happy baby! Gets to sitting position without assistance 12 months Nope     Crawls forward on belly by pulling with arms and pushing with legs 12 months Yes 18 months - 2 yrs Somewhere in that range he started doing the "army crawl". Assumes hands and knees position 12 months Nope     Creeps on hands and knees supporting trunk on hands and knees 12 months Nope     Gets from sitting to crawling or prone (lying on stomach) position 12 months Yes   Owen is very good at getting himself back to the laying down position from just about any position you put him in. Pulls self up to stand 12 months Nope     Walks holding onto furniture 12 months Nope   He gets around quite well in a baby walker though Stands momentarily without support 12 months Nope     May walk two or three steps without support 12 months Nope     Uses pincer grasp 12 months Yes 18 months-ish   Bangs two cubes together 12 months Yes 2 yrs   Puts objects into container 12 months Yes-ish 2 yrs He won't do this on his own, but will during therapy. Keep in mind that he doesn't have a lot of freedom of movement yet though to go explore this possibility. Takes objects out of container 12 months Yes 18 months - 2 yrs-ish   Lets objects go voluntarily 12 months Yes By 12 months   Pokes with index finger 12 months Nope   Interestingly enough, he only sucks his index finger, not his thumb. However he doesn't tend to just use the index finger to poke things with. Tries to imitate scribbling 12 months Nope   No matter how much we try, he just wants to eat the crayon. Pay increasing attention to speech 12 months Yes By 18 months I'm including signs in this as well since that was his primary communication for a long time. Responds to simple verbal requests 12 months Yes By 18 months I'm including signs in this as well since that was his primary communication for a long time. He knew "give" and "no" by this time. Responds to no 12 months Yes By 18 months I'm including signs in this as well since that was his primary communication for a long time. Uses simple gestures, such as shaking head for no 12 months Not really   He just gets angry when he means no. Babbles with inflection 12 months Yes By 12 months Even without the CI he did this. Says Dada and Mama 12 months No   We've heard distinct Mommy and Daddy's a few times, but still not reproducible. Made the sign for Mommy and Daddy a few times, but not often. Uses exclamations, such as "oh-oh" 12 months Yes By 18 months Makes the sign for clapping (open hand waving) for an exclamation of excitement. That is now joined by a shriek of happiness since the CI. Tries to imitate words 12 months Yes By 18 months He would try to imitate signs before the CI. Now if you get him in the right mood he will try for the sounds in words during speech therapy. Explores objects in many different ways (shaking, banging, throwing, dropping 12 months Yes By 12 months   Finds hidden objects easily 12 months Nope   Hasn't a clue that he should look under something. Looks at correct picture when image is named 12 months Nope     Imitates gestures 12 months Yes By 18 months Signs are gestures and he can do those Begins to use objects correctly (drinking from a cup, brushing hair, etc) 12 months Nope   Just examines them or chews on them Shy or anxious with strangers 12 months Ish Ish Owen has been handled by so many people since he was born that he doesn't really mind much. Sometimes though he will be upset if I hand him off to someone else. Cries when mother or father leaves 12 months Yes By 12 months See previous one Shows specific preferences for certain people and toys 12 months Yes By 12 months   Test parental responses to behavious 12 months Yes By 12 months   May be fearful in some situations 12 months Yes By 12 months Are you kidding? Just try to bring a needle near him... he remembers the hospital and what happens there. Prefers mother and/or father over all others 12 months Yes By 12 months He doesn't like babysitters when he's used to a lot of Mommy and Daddy time. Repeats sounds or gestures for attention 12 months Yes By 12 months   Finger feeds himself 12 months Yes By 18 months He is totally independent when it's just finger foods Extends arm or leg to help when being dressed 12 months Yes By 12 months   Walks alone 24 months Nope   Independent in his walker Pulls toys behind them while walking 24 months Nope     Carries large toy or several toys while walking 24 months Nope     Begins to run 24 months Nope   He can get his walker up to ramming speed! Stands on tiptoe 24 months Nope     Kicks a ball 24 months Nope     Climbs onto and down from furniture unassisted 24 months Nope     Walks up and down stairs holding onto support 24 months Nope     Scribbles spontaneously 24 months Nope     Turns over container to pour out contents 24 months Yes By 18 months   Builds tower of four blocks or more 24 months Nope   Doesn't have any interest in stacking Points to object or picture when it's named for him 24 months Nope     Recognizes names of familiar people, objects and body parts 24 months Ish   He knows what a cookie is, his own name and such Says several single words 15- 18 months Yes 18-24 months I'm talking about signs here, no verbal words yet Uses simple phrases 18-24 months Yes-ish   He will sometimes string together two signs such as "more eat" Uses two to four word sentences 24 months Nope     Follows simple instructions 24 months Yes 18-24 months Knows words/signs for give to me or take this or no Repeats words overheard in conversation 24 months Nope     Finds objects even when hidden under two or three covers 24 months Nope     Begins to sort by shapes and colors 24 months Nope     Begins make-believe play 24 months Nope     Imitate behaviour of others, especially adults and older children 24 months Nope     Increasingly aware of themself as separate from others 24 months Yes 24 months   Increasingly enthusiastic about company of other children 24 months Yes 24 months   Demonstrates increasing independence 24 months Yes By 24 months   Begins to show defiant behavior 24 months Yes By 24 months Oh yes, we have this one! And I'll stop there because Owen is just two years and three months old right now. I'll add more when he gets older. We don't know where he will end up of course, but I don't really sweat the milestones just yet. He has so many delays that are due to head size and deafness that it's impossible to know which ones are due to those and which ones are true cognitive delays. So much is measured by gross motor skills, but it's hard to sit up and build a tower when your head is bigger than your six year old sister's! So we just wait and see. He has made so much progress in the last few months since his head control has improved that at the moment it seems the sky is the limit!     Legal Disclaimer: While every effort has been made to make certain that the information contained in this website is accurate, it must be remembered that the content is managed by a parent, not by a doctor. Information contained here is for general support purposes only and is no substitute for the care of a doctor.