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Agency for Healthcare Research Quality

Children's Health

Children with short stature function within the normal range on most standardized tests

On average, children with short stature (2 to 3 deviations below the mean for height) score lower than their peers on tests of mental and physical functioning (perhaps due to the underlying condition that caused both the short stature and cognitive impairment). However, few short children score outside the normal range. In addition, most children with primary short stature score within the normal range on functional tests, and there is no evidence that treatment of short stature improves function. Nevertheless, in the opinion of the authors, growth hormone treatment may be warranted in children with severe short stature (4 to 5 standard deviations below the mean for height) to relieve practical restrictions such as being unable to use school bathrooms or reach elevator buttons.

These conclusions are based on a systematic review of the evidence conducted by the Tufts-New England Medical Center Evidence-based Practice Center, which is supported by the Agency for Healthcare Research and Quality (contract 290-97-0019). EPC researchers reviewed studies of children (aged 17 years and younger) with short stature and functional limitations conducted through October 2001. The studies included children with isolated short stature (ISS), constitutional growth delay (CGD), growth hormone deficiency (GHD), or multiple hormone deficiency (MHD).

Short children showed no substantial deviation from normal, but many studies found that children with short stature had slightly lower intelligence and academic achievement scores than children of average height.

The three studies that evaluated visual motor perception found significant visual-motor skill reduction among short children; however, the studies had numerous limitations. Teacher-based evaluation of behavior in children with short stature was, in general, similar to that for normal-height children. No study found a direct causal link between short stature and functional impairment.

See "Short stature and functional impairment: A systematic review," by Patricia G. Wheeler, M.D., Karen Bresnahan, M.D., Barbara A. Shephard, M.D., and others, in the March 2004 Archives of Pediatric and Adolescent Medicine 158, pp. 236-243.

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