Siberry's song, "This Old Earth", was nominated for Best Original Song at the 1990 Genie Awards.[1] Siberry rerecorded the song as "Something About Trains", and it appeared on her 1989 album Bound by the Beauty.
In a review at AllMusic, Ted Mills described The Top of His Head soundtrack as "[a] less aggressive work compared to [Frith's] other releases, though not exactly gentle by any means."[2] Mills said the atmosphere of the album is "moody", and many of the tracks include "synthesizer and guitar drones", and "industrial environmental collages". The exception is Siberry's "This Old Earth", which Mills felt comes across as "an almost normal song".[2]
Nicole V. Gagné wrote in her 1990 book, Sonic Transports: New Frontiers in Our Music that The Top of His Head has "some of the strongest pieces Frith has ever made".[3] She called "Driving to the Train" "astounding",[3] and described the two guitars on "Gus Escapes" as "one of the most memorable duets of any Frith recording".[4] Gagné was pleased to see the return of humour on the album after its absence on The Technology of Tears, but added that "you can feel a dark undercurrent, the frustrated inarticulacy of Speechless".[4]
