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Growth retardation

from Medical topics

Published online by Cambridge University Press:  18 December 2014

Michael Preece
Affiliation:
Institute of Child Health
Susan Ayers
Affiliation:
University of Sussex
Andrew Baum
Affiliation:
University of Pittsburgh
Chris McManus
Affiliation:
St Mary's Hospital Medical School
Stanton Newman
Affiliation:
University College and Middlesex School of Medicine
Kenneth Wallston
Affiliation:
Vanderbilt University School of Nursing
John Weinman
Affiliation:
United Medical and Dental Schools of Guy's and St Thomas's
Robert West
Affiliation:
St George's Hospital Medical School, University of London
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Summary

Definition

Variation in the growth of children occurs in two dimensions. The easiest to understand is the simple variation in height at any given age including full maturity. Less obvious is the variation that occurs in the timing of events during the growth process such as the age at which puberty commences or adult height is reached: this is usually referred to as tempo.

In the case of boys, the average age of attaining adult height is 18 years but this may vary by as much as three years in either direction. Thus a perfectly healthy boy may not stop growing until 21 years of age and this would be an example of growth retardation (Preece, 1998). In the case of girls, the same degree of variation is seen, but, on average, adult height is achieved some two years earlier than for boys.

Once the child reaches mature height, tempo has no more effect and the variation in height amongst adults is not dependent upon it. The major influence on adult height, assuming the individuals are all healthy, is heredity with a typical correlation coefficient between the mid-parental height and the height of the subject being 0.7 (Tanner, 1966). This is in keeping with a polygenic mode of inheritance for stature. During childhood the hereditary element still applies but variation in tempo will also contribute to the total variance in height.

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Publisher: Cambridge University Press
Print publication year: 2007

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References

Gordon, M., Crouthamel, C., Post, E. M. & Richman, R. A. (1982). Psychosocial aspects of constitutional short stature: social competence, behaviour problems, self-esteem and family functioning. Journal of Paediatrics, 101, 477–80.Google Scholar
Preece, A. M. (1998). Principles of normal growth: auxology and endocrinology. In Grossman, A. (Ed.). Clinical Endocrinology, (2nd edn.) (pp. 845–54). Oxford: Blackwell Scientific Publications.
Sandberg, D. E. & Voss, L. D. (2002). The psychosocial consequences of short stature: a review of the evidence. Best Practice and Research. Clinical and Endocrinology Metabolism, 16, 449–63.Google Scholar
Stanhope, R. & Preece, M. A. (1988). Management of constitutional delay of growth and puberty. Archives of Diseases of Childhood, 63, 1104–10.Google Scholar
Tanner, J. M. (1962). Growth at adolescence. Oxford: Blackwell.
Tanner, J. M. (1966). Galtonian eugenics and the study of growth. Eugenics Review, 58, 122–35.Google Scholar
Voss, L. D. & Mulligan, J. (1994). The short normal child in school: self-esteem, behaviour, and attainment before puberty (The Wessex Growth Study). In Stabler, B. & Underwood, L. E. (Eds.). Growth, stature and adaptation (pp. 47–64). Chapel Hill, NC: University of North Carolina.

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