Identification and assessment of the slowly growing child.

Reliable measurements taken by trained personnel using appropriate equipment are essential in assessment of the slowly growing child. Linear growth plotted on appropriate statistical charts and expected growth based on parental heights are indicators of inappropriately reduced linear growth. Children older than three years of age who grow less than 1.75 in (4.5 cm) per year should be evaluated. Family and personal medical history (including prenatal and birth information) are important in the identification of familial short stature, constitutional delay and other causes of proportionate growth disorders. Other conditions, including chromosomal disorder, systemic disease and endocrine dysfunction, may be discovered during physical examination or appropriate laboratory investigation. Disproportionate growth of the limbs and trunk suggests the presence of a bone or collagen disorder. Bone age data based on radiographs of the left hand may assist in predicting the child's final height.