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| Problem Suspected |
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| “We haven’t been to see a doctor, but I think my child might have a growth disorder.” |
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| What is short stature? |
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| What is short stature—or how short is too short? Children who are short fall into three categories: those who are small and growing normally, those who are short as a result of a congenital or birth-related condition, and those who develop growth failure during childhood. In order to assess if a child is exceptionally short, the height is measured and then compared to a graph that shows the range of heights for the population at a certain age. This graph is known as a growth chart. The lines or channels on the chart are known as percentiles or centiles. There are a number of growth charts available depending on the age and sex of the child. |
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| Worksheet A: Boy’s Growth Chart (PDF) or Worksheet B: Girl’s Growth Chart (PDF) allow you to see where your child falls in terms of his/her height in comparison to other children in the United States of his/her age and sex. For an interactive, online growth chart (courtesy of the MAGIC Foundation), click here. |
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| A child’s height is considered within the normal range if it falls between the 3rd and the 97th percentile on standardized growth charts such as those provided above. If your child’s height is below the 3rd percentile (e.g., he/she is shorter than 97% of his/her peers), he/she is considered to be of short stature, and may have a growth disorder. |
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However, the rate of growth of a child is probably more important than the actual
height. The medical term for rate of growth is
growth velocity. Growth velocity is a road map to see where the child
will end up if he/she continues on his/her current track. A change in growth pattern
(either slowing or quickening of the growth rate) indicates the presence of a growth
disorder.
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| What might cause short stature?
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| Short stature can be classified into a number of disorders, including: |
- Familial short stature, where the growth rate is normal, but the child may be shorter than most of his/her peers because his/her parents are of short stature. A diagnosis of familial short stature should be made only if other underlying causes of the short stature have been ruled out. When a doctor makes this diagnosis, it is important to remember that a diagnosis of familial short stature should only be made if both short parents had no medical cause for their short stature.
- Constitutional delay of growth, where the child is growing at a normal rate, but one that is delayed when compared to the majority of his/her peers. Children with this condition may reach a normal height, they will just get there later. Children with constitutional delay of growth have a bone age that is below their chronological age. This is the most commonly diagnosed growth disorder in the US; however, it is generally not treated, as these children have time and room to grow, and may attain a normal adult height
- Note: many experts believe familial short stature and constitutional delay of growth may coexist in the same person
- Medical conditions/growth disorders
- Malnutrition
- Pituitary tumors and tumor treatment surgery or radiation
- Short bowel syndrome
- Congenital abnormalities such as Russell Silver Syndrome and babies born small for gestational age (SGA)
- Chromosomal disorders/variations
- Turner syndrome, Noonan syndrome, and Prader-Willi syndrome are chromosomal disorders that are associated with short stature
- Chronic medical conditions, including gastrointestinal, heart, kidney, or lung diseases
- Note that if such medical conditions are the cause of a growth disorder, other signs and symptoms are usually, but not always, present
- With respect to GH, our understanding is changing. For many years, it was thought that GH was directly responsible for growth. However, it is now understood that GH causes the production of another hormone—IGF-1—a separate, growth-promoting hormone directly responsible for bone and tissue growth. With this new knowledge also comes the understanding that in short stature, even if GH levels are normal, there may be low levels of IGF-1, a key contributor to growth
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| How do I determine whether or not my child has a growth disorder?
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| Worksheet C: Does My Child Have a Growth Disorder? (PDF) has been designed to help you determine whether or not your child is growing normally. |
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Note these worksheets may be helpful as you complete Worksheet C:
Worksheet A: Boy’s Growth Chart (PDF)
Worksheet B: Girl’s Growth Chart (PDF)
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| You will need Adobe® Reader® to download PDFs from this site. To download a free copy, click here. |
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