Short stature: increased in children with severe learning disability

Abstract

'Health for all children' recommends that children should be screened for growth disorders at school entry with a 0.4th centile 'cut-off'. Following the diagnosis of growth hormone deficiency in four children attending local special schools, our aim was to compare the height distribution of children attending special schools with mainstream schools. Children at two local special schools were measured using a Leicester height measurer and values converted to standard deviation scores (SDS). Children were categorized according to whether there were known factors that could affect height. The data were compared with those collected from local mainstream schools. In total, 242 children were registered at the two special schools and 192 children were measured. The mean height SDS of children in mainstream school (n = 2301) was similar to national standards at -0.09 (SD 1.02). The mean height SDS distribution of the 192 children in special schools (age range 3.2-18.4 years; median age 11.3 years) was -0.73; 95%CI -0.9 to -0.5. In those with no established diagnosis to explain altered growth (n = 120) this was -0.613; 95%CI -0.8 to -0.4. Both pre-pubertal (n = 37) and pubertal (n = 83) children were short and eight (6.7%) had a height less than the 0.4th centile. Children attending special school with severe or profound learning disability were shorter than those attending mainstream school. This is still the case following the exclusion of children with a known cause for abnormal growth. This underlines the importance of each child being assessed by professionals with a refined knowledge of normal and abnormal growth.