Child Too Short? Too Tall? What to Do
Short or tall stature is considered to be height below or above the 3rd or 97th percentile respectively.
Abnormal growth velocity, showing on serial height measurements, is also an important finding.
Growth charts based on the US NHANES study are available from www.cdc.gov/growthcharts/charts.htm. Copies of growth charts, together with height velocity and puberty charts are available at the Australasian Paediatric Endocrine Group (APEG) website, https://apeg.org.au/clinical-resources-links/growth-growth-charts/. Local Australian growth charts are currently not available.
The height of the parents should be considered in evaluating the child. Expected final height can be calculated from the parents’ heights as follows:
For boys: Expected final height = mean parental height + 6.5cm
For girls: Expected final height = mean parental height – 6.5cm
Assessment of bone age (hand/wrist) is also useful. With familial short or tall stature, bone age matches chronological age. Conversely, in a child with pathological short stature, bone age is often well behind chronological age, and may continue to fall if the disease is untreated.
The stage of puberty is relevant, as it will affect the likely final height.