Little People Of America Research Articles

Natural history study of Pseudoachondroplasia: A focus on oral health.

Pseudoachondroplasia (PSACH) is a rare dwarfing condition characterized by short limbs and fingers, and multiple skeletal abnormalities/complications. There are few natural history studies delineating the medical problems in PSACH leaving a gap in many areas, especially oral health. Our study aimed to obtain information pertaining to oral health and other health-related problems (pregnancy and childbirth, skeletal health, joint pain) in patients with PSACH. To ascertain this information, an online Qualtrics survey was distributed to members of Little People of America, a support group, and through a PSACH online chatroom. Ninety-nine of 115 surveys were completed and included in the descriptive and multivariable analyses. PSACH individuals regularly sought dental care, but flossing was challenging because of short fingers. Untreated carries (5%), bleeding gums (16%) malocclusion (37%), obstructive sleep apnea (9%), and TMJ disorder (3%) occurred less frequently compared to the general population. Delivery was by Caesarean section in 100% of female respondents who delivered a baby. Bowlegs (74%), scoliosis (43%) and osteoarthritis (36%) were the most common skeletal complications. Joint pain was reported by 85% of respondents. This study provides novel insights into oral health, pregnancy and childbirth while confirming previously identified skeletal complications in PSACH. Our findings suggest that oral healthcare in PSACH presents unique challenges.

Preterm birth risk in women with skeletal dysplasias and short stature.

The primary objective was to estimate the risk of preterm delivery in a population of women with a skeletal dysplasia and short stature. The secondary outcome was to identify factors that increase the risk of preterm delivery. A cross sectional survey was performed asking detailed pregnancy and reproductive health questions, aimed at a convenience sample of women who were little people, administered through Little People of America, Little People UK, Little People Canada, and the World Dwarf Games. Comparisons were made on gestational age at delivery between pregnancies with and without the outcomes. The survey had a response rate of 74% (117/158). There was a total of 55 eligible subjects who had 72 live births. Delivery prior to 37 weeks occurred in 19/72 live births, which equates to a preterm birth rate of 26.4% . Besides short stature, no single factor was identified that could solely explain the elevated preterm birth risk in the study population. The risk of preterm delivery in women with skeletal dysplasias and short stature is elevated compared to the general population. This information will assist healthcare providers in pregnancy management and counseling.

Associated anomalies in cases with achondroplasia

Associated congenital anomalies may be observed in cases with achondroplasia. The prevalence reported in the literature and the types of co-occurring congenital anomalies are variable between the reported studies. The aim of this study was to establish the prevalence and to describe the associated anomalies in cases with achondroplasia. This study included 25 cases ascertained from our registry of congenital anomalies including all terminations of pregnancy, stillbirths and live births between 1979 and 2007 in 387,067 consecutive births (the prevalence of achondroplasia was 6.4 per 100,000 births), and 223 cases ascertained from the French Little People organization built on the model of LPA (Little People of America, Inc.). Out of these 248 cases of achondroplasia 37 (14.9%) had associated anomalies including 4 (1.6%) cases with chromosomal abnormalities (2 trisomies 21, one 22 q11.2 deletion, and one 47, XXX), 2 (0.8%) cases with recognizable non-chromosomal conditions (one Moebius syndrome and one Pierre Robin sequence) and 31(12.5%) cases with MCA (multiple congenital anomalies). The 31 cases with MCA had 45 anomalies. Anomalies in the urogenital system (24.4%), the cardiovascular system (20.0%), the musculoskeletal system (15.5%), the central nervous system (11.1%), the eye (11.1%), and the orofacial system (8.8%) were the most common MCA. The overall prevalence of associated anomalies shows that the individuals with achondroplasia need a careful screening for other congenital anomalies.

Activity Participation in the Pediatric Skeletal Dysplasia Population

<h3>Research Objectives</h3> To investigate activities children with skeletal dysplasia participate.To identify activities with the greatest and lowest participation rates among children with skeletal dysplasia .To investigate participation patterns among children with skeletal dysplasia. <h3>Design</h3> Children with skeletal dysplasia were asked to complete the Children's Assessment of Participation and Enjoyment (CAPE) survey during visits July 2014-June 2019. Demographic information and use of assistive devices was collected retrospectively. <h3>Setting</h3> City-based ambulatory orthopedic hospital. <h3>Participants</h3> Sixty-six children (38 females, 28 males) average age 11.5+/-4.21 years participated. Twenty-three (35%) were at least 13 years old, 43 (65%) were younger than 13. Thirty-two had average stature for age, 34 had short stature. There were 21 different skeletal dysplasia diagnoses among the participants. Fifteen children (23%) used assistive devices. Thirty-six children identified as white, 10 as black, 9 as Hispanic, 9 as Asian, 2 as other. <h3>Interventions</h3> CAPE was validated in Ontario, Canada for children (ages 6-21) with or without disabilities. <h3>Main Outcome Measures</h3> CAPE measures children participation of 55 informal and formal activities of five activity types: recreational, active-physical, social, skill-based, and self-improvement. <h3>Results</h3> Children participated in an average of 27.6+/-9.21 activities (overall diversity scores) out of 55 individual activities. CAPE diversity responses for each domain were used to compare the degree of activity involvement. Intensity and enjoyment were calculated. Chi-square analyses were conducted to analyze responses by each individual item. Paired t-tests were used to compare variation across population demographics. All statistical analysis was conducted using SPSS 22 for Windows. <h3>Conclusions</h3> Children with skeletal dysplasia participate in a wide variety of activities. Greatest participation was in social activities, lowest in physical activities. Use of assistive devices did not affect participation; there were no participation differences between genders. No study has previously evaluated the participation activities in this population. <h3>Author(s) Disclosures</h3> Dr. Cathleen Raggio received consulting fees from Alexion Pharmaceuticals, Ascendis and Biomarin. She was on speaker's bureau for Alexion Pharmaceuticals and Medical Advisory Board for Osteogenesis Imperfecta Foundation. Erin Carter on Medical Advisory Board for Little People of America, Inc.

Factors associated with health-related quality of life (HRQOL) in adults with short stature skeletal dysplasias.

Numerous factors associate with health disparities. The extent to which such factors influence health-related quality of life (HRQOL) among adults with short stature skeletal dysplasias (SD) is unknown. In an effort to update and clarify knowledge about the HRQOL of adults with SD, this study aimed to quantify HRQOL scores relative to the American average and assess whether specific indicators are associated with lower scores. Members (>18years) of Little People of America were invited to complete an online survey assessing HRQOL using the SF-12 supplemented with indicator-specific questions. SF-12 components (Physical Component Summary, PCS; Mental Component Summary, MCS) were compared to the standardized national American mean. Scores were divided at the median to identify factors associated with lower scores using multivariable logistic regression, adjusting for age, gender, race, education, and employment. A total of 189 surveys were completed. Mean and median PCS and MCS were below the national mean of 50 (p<0.001). Advancing decade of age corresponded to a significant decline in PCS (p<0.001) but not MCS (p=0.366). Pain prevalence was high (79.4%); however, only 5.9% visited a pain specialist. Significant factors for lower PCS included age >40years (p=0.020), having spondyloepiphyseal dysplasia congenita (SED) or diastrophic dysplasia relative to achondroplasia (p=0.023), pain (p<0.001), and "partial" versus "full" health insurance coverage (p=0.034). For MCS, significant factors included a lack of social support (p=0.002) and being treated differently/feeling stigmatized by health care providers (p=0.022). Individuals with SD face documented disparities and report lower HRQOL. Further research and interventions are needed to modify nuanced factors influencing these results and address the high prevalence of pain.

Personalized medicine and the importance of measuring functioning and participation over time: lessons from achondroplasia

The tools of molecular biology have given clinical and translational researchers unprecedented understanding of the complexity of genotype on the spectrum of clinical phenotypes for children with skeletal dysplasia. Achondroplasia (OMIM 100800) is a non-lethal osteochondrodysplasia that affects more the 250 000 children and adults worldwide.1 This autosomal-dominant disorder is caused by a gain of function mutation in the gene encoding the type 3 receptor for the fibroblast growth factor (FGFR 3).2 More than 95% of children with achondroplasia have the same point mutation, and in 80% the mutation is spontaneous.3 The body structure consequences include macrocephaly, short limbs, ligamentous laxity, and hypotonia.4 The secondary consequences include bulbar and cervical spinal cord symptoms from narrowing of the foramen magnum, acquired spinal cord injury from narrowing of the spinal cord, and obesity because of disproportionate weight for stature. There are no obvious severe cognitive or sensory disabilities in functioning, though conductive hearing loss and cognitive consequences of obstructive sleep apnea occur frequently.5 To date, descriptions of challenges in activity and participation have not been described in a representative cohort. The study by Ireland et al.6 has begun the process of addressing these gaps in our knowledge. This team recruited a national representative sample of children aged 3 to 7 years with achondroplasia from centers of excellence in clinical genetics and orthopedics at major children’s hospitals as well as through the parent support group of the Short Statured People’s Association of Australia (http://www.sspa.org.au). (In the UK, Restricted Growth Associations,in the USA, Little People of America, Inc, http://www.lpaonline.org). Assessments included the criterion explicit tool, the Functional Independence Measure for Children (Wee FIMTM) and its domains of mobility, self-care and social cognitive functioning in daily activities. What were the findings? First, children with short limbs have challenges in transferring and climbing stairs that may not be directly discovered by clinicians who assess upright mobility on level surfaces. Second, though children master basic hand function skills at near distances with small objects and in using feeding utensils, they struggle and need assistance in grooming, dressing, and toileting. This is a direct consequence of the difficulty that short limbs have in reaching the top of the head for hair grooming, the toes for lower extremity dressing, and the sacrum for toileting hygiene. Third, although children are age appropriate in basic cognitive skills, they continue to need parental supervision for many tasks at kindergarten entry and at age 7. Some of this is a failure of thinking through accommodation strategies for task completion and some is the need for explicit parental instruction on promoting age-appropriate self-care and community mobility independence. Fourth, subtle delays in communicative challenges in children of short stature and parental fears may lead to less adept social skills between the ages of 5 and 7 years, a critical period for beginning the tasks of developing friendships and participating in community activities. Fifth, explicitly measuring criterion specific tasks in functioning and children’s participation in developmentally appropriate roles helps us to understand the impact of body structure on living with a difference and proactively monitoring for secondary complications that often require both medical and environmental interventions. What are the next steps? First, an explicit understanding of required modifications is needed to facilitate self-care and toileting skills. Second, the promotion of architectural modifications for negotiating the physical and recreational environment requires ongoing awareness and advocacy. Health professionals should not only encourage appropriate recreational experiences, but also emphasize the importance of physical activity in order to optimize fitness and lessen the risk for obesity. A useful resource is the Dwarf Athletic Association of America (http://www.daaa.org). Third, families require explicit ongoing counseling and support to promote age-appropriate learning and social experiences. Critical to this approach is to treat the individual child as a person with age- not stature-appropriate expectations who will become adults. Fourth, support groups cannot only help parental caregivers but can allow social networking so that children can become aware that they are not the only ones with a genetic difference. In addition, both children and parents can observe models of successful older peers attaining higher education, working, and raising children of their own. With the increased awareness of opportunities in the personalized medicine of the new genetics and the enablement perspective of the International Classification of Functioning (ICF) model, we can explicitly promote interventions and strategies so that genetic differences in body structure do not lead to missed opportunities to promote independent functioning and participation among children and adults.

Encyclopedia of American disability history

Like race and gender, disability history has recently become a critical field of study in examining our nation's heritage. Sparked by the disability rights movement of the late 20th century, disability history both expands and challenges the traditional American narrative of self-reliance, individualism, and opportunity and yields new understandings of such bedrock American values as community, family, and citizenship. From the asylum movement of the 19th century and the cover-up of Franklin Roosevelt's paralysis during his presidency to the landmark Americans with Disabilities Act and the impact of every war on veterans' physical and mental health, the experience of disability - and society's reaction to it - has changed markedly from one era to the next. The definitions of disability have also changed since the colonial era, revealing competing views, approaches, and attitudes. Encyclopedia of American Disability History is the first encyclopedia to focus on this important topic in American history. By examining the issues, events, people, activism, laws, and personal experiences and social ramifications of disability throughout U.S. history, this comprehensive three-volume reference provides a new and broader, more inclusive approach to our nation's past. More than 300 historians, scholars, and experts contributed to the more than 750 articles in this impressive work. Arranged alphabetically, each signed article includes cross-references to related entries and suggestions for further reading. Ideal for the high school and college curriculum, this accessible new encyclopedia also includes a comprehensive chronology and dozens of original documents. Entries include: Alexander Graham Bell Association for the Deaf; Amputees and amputation; Asperger's Syndrome; Blind Boys of Alabama; Buck v. Bell; Disability art and artistic expression; Down Syndrome; Eugenics; Thomas Gallaudet; The Glass Menagerie; Guide dogs; Impairment/impaired; Little People of America; Long-term care; Million Dollar Baby; Miss Deaf America; Reproductive rights; South Park; Special Olympics; Ugly Laws; Workers' compensation; and The Yellow Wallpaper.

Intrauterine E.coli inoculation alters PURKINJE cell morphology, tumor necrosis factor- and calbindin expression in the developing brain

tion about pregnancy and delivery in dwarf women would be useful to LPs and their healthcare providers. STUDY DESIGN: A retrospective cohort study of LPs with R one prior conception (regardless of outcome), pertaining to her pregnancy and delivery experience, maternal physical status preand post-delivery, and general opinions about pregnancy in LPs. LP women were recruited via a genderand age-specific mailing to members of the Little People of America, Inc. following Medical Advisory Board and IRB approval. RESULTS: To date, 45 women representing 94 total pregnancies with 12 different skeletal dysplasia diagnoses are enrolled, including achondroplasia (26), pseudoachondroplasia (4), hypochondroplasia (3), diastrophic dysplasia (2), other dysplasias (10). 72 liveborn infants were delivered via cesarean section (39 general anesthesia-GA, 33 spinal and/or epidural), 16 miscarriages, and 1 termination. 4 liveborn infants were delivered vaginally; 2 without anesthesia to a mother with hypochondroplasia, 2 with epidural to a mother with femoral focal hypoplasia. One pregnancy is ongoing. CONCLUSION: Thus far, there is no apparent increased rate of pregnancy loss or fetal complications related to maternal dwarf condition. Most LP women require cesarean section due to cephaloplevic disproportion, yet vaginal delivery is noted in skeletal dysplasias with minimal truncal or pelvic disproportion. Many LPs have carried successful pregnancies and delivered with adequate pain control, under both regional and GA. We neither promote nor discourage childbearing in LP women, yet there is little medical literature regarding pregnancy and delivery in dwarfs. We present practical experiences with obstetrics and obstetrical anesthesia from the dwarf and healthcare provider perspective for others who choose to have children and those who provide their medical care.

Social spaces of little people: The experiences of the Jamisons

Dwarfs, midgets, even freaks, are the terms that have been used to label little people. Little people are individuals who for genetic or hormonal reasons grow to a height of less than 4 feet 8 inches (1.42 m). While little people face similar issues of access to those of other physically disabled groups, they live in spaces that are designed, both physically and socially, for people of 'average height'. In addition, little people face unique stigmas that are historically rooted in mythology, idealized body types, and the commodification of body difference for profit. This paper draws upon the spatial conception of Henri Lefebvre and the premise that social spaces are produced. Specifically, this paper offers the term, staturized space, to describe how the material environment produces relative stature in common representations of space. Furthermore, it identifies the ways in which dwarfism affects social relations as they are played out in spaces intended for average-height people. Finally, this study describes the ways little people's homes and meetings of the organization Little People of America are re-staturized spaces both physically and socially. The production of such alternative social spaces produces enabling and normative environments for little people. These issues are explored through in-depth interviews and participant observations with a married couple in which both individuals are little people. The case study of the Jamisons is part of a larger project which seeks to reveal aspects of the social spaces of a population that is difficult to access and frequently misunderstood. Geographers can benefit from the perspectives of little people by becoming increasingly sensitized to discourses of height and their material implications in the production of public and private spaces.

Latest developments in skeletal dysplasias#

American Journal of Medical GeneticsVolume 106, Issue 4 p. 241-243 Introduction Latest developments in skeletal dysplasias# Nicola C. Ho, Nicola C. Ho Guest Editor Nicola C. Ho is a pediatrician and medical geneticist. She is Assistant Professor of Pediatrics at Johns Hopkins University School of Medicine, and a research scientist with the National Institutes of Health. Dr. Ho's interests include dysmorphology, skeletal dysplasias, connective tissue disorders, molecular genetics, and study of genetic disorders in inbred populations.Search for more papers by this authorClair A. Francomano, Corresponding Author Clair A. Francomano Guest Editor francomanocl@grc.nia.nih.gov Section of Human Genetics and Integrative Medicine, Laboratory of Genetics, NIA/NIH-IRP, Room 4A, 5600 Nathan Shock Drive, Baltimore, MD 21224-6825. Clair Francomano is an internist and medical geneticist whose work has centered on the hereditary connective tissue disorders and skeletal dysplasias. She has published widely on the molecular genetics underlying human connective tissue disorders and skeletal dysplasias. She serves on the Advisory Boards for the National Marfan Foundation and the Little People of America. Her current position is Senior Investigator, Laboratory of Genetics, National Institute on Aging.Section of Human Genetics and Integrative Medicine, Laboratory of Genetics, NIA/NIH-IRP, Room 4A, 5600 Nathan Shock Drive, Baltimore, MD 21224-6825.Search for more papers by this author Nicola C. Ho, Nicola C. Ho Guest Editor Nicola C. Ho is a pediatrician and medical geneticist. She is Assistant Professor of Pediatrics at Johns Hopkins University School of Medicine, and a research scientist with the National Institutes of Health. Dr. Ho's interests include dysmorphology, skeletal dysplasias, connective tissue disorders, molecular genetics, and study of genetic disorders in inbred populations.Search for more papers by this authorClair A. Francomano, Corresponding Author Clair A. Francomano Guest Editor francomanocl@grc.nia.nih.gov Section of Human Genetics and Integrative Medicine, Laboratory of Genetics, NIA/NIH-IRP, Room 4A, 5600 Nathan Shock Drive, Baltimore, MD 21224-6825. Clair Francomano is an internist and medical geneticist whose work has centered on the hereditary connective tissue disorders and skeletal dysplasias. She has published widely on the molecular genetics underlying human connective tissue disorders and skeletal dysplasias. She serves on the Advisory Boards for the National Marfan Foundation and the Little People of America. Her current position is Senior Investigator, Laboratory of Genetics, National Institute on Aging.Section of Human Genetics and Integrative Medicine, Laboratory of Genetics, NIA/NIH-IRP, Room 4A, 5600 Nathan Shock Drive, Baltimore, MD 21224-6825.Search for more papers by this author First published: 23 October 2002 https://doi.org/10.1002/ajmg.10232 # This article is a US Government work and, as such, is in the public domain in the United States of America. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume106, Issue4Special Issue: Latest Developments in Skeletal DysplasiasWinter 2001Pages 241-243 RelatedInformation

Functional health status of adults with achondroplasia.

Little is known regarding the functional health status of individuals with achondroplasia. This cross-sectional survey of adults with achondroplasia was undertaken to assess the functional health status of this population and its determinants. The study sample consisted of members of the Little People of America (LPA) who completed a mailed questionnaire consisting of a demographics component, a general and disease-specific comorbidities component, and the Short Form 36 (SF-36) health status questionnaire. Univariate analyses and multivariate linear regression models were used for data analysis. Four hundred thirty-seven individuals with a mean age of 38 years completed the survey. The age- and gender-adjusted Mental Component Summary (MCS) scores did not significantly differ from those of the general population. In contrast, the age- and gender-adjusted Physical Component Summary (PCS) scores were significantly lower than the general population starting in the fourth decade of life. Musculoskeletal diseases were most prevalent and had the greatest impact on the PCS scores. Two-thirds of this cohort had undergone at least one operation. Only musculoskeletal procedures were significantly associated with PCS and MCS scores. The functional health status of adults with achondroplasia, as measured by the SF-36, is not drastically reduced in comparison with that of the general U.S. population.

Natural history study of pseudoachondroplasia

Pseudoachondroplasia (PSACH) is a well-characterized autosomal dominant dwarfing condition. A great deal of information is available about orthopedic complications, but little is known about extraskeletal complications in adulthood. This study was undertaken to delineate the natural history of PSACH at all ages. Seventy-nine individuals responded to an extensive questionnaire that included information about deformities, operations, general health, chronic diseases, and reproduction. PSACH individuals were ascertained through the University of Texas Medical Genetics patient population, a genetic linkage study, and the social organization, Little People of America. The results show that PSACH individuals with a family history do not have a distinct or more severe phenotype than new mutation cases. There were no differences in the number of orthopedic complications, operations, or number of offspring between these two groups. Less than half of affected adults reported having total hip replacement surgery, which was less common than previously reported. Extraskeletal complications were generally uncommon. There were four cases of cancers in 41 individuals queried. Premature osteoarthritis was the major health problem for PSACH individuals. PSACH individuals are generally healthy but have problems associated with debilitating osteoarthritis. © 1996 Wiley-Liss, Inc.

Natural history study of pseudoachondroplasia

Pseudoachondroplasia (PSACH) is a well-characterized autosomal dominant dwarfing condition. A great deal of information is available about orthopedic complications, but little is known about extraskeletal complications in adulthood. This study was undertaken to delineate the natural history of PSACH at all ages. Seventy-nine individuals responded to an extensive questionnaire that included information about deformities, operations, general health, chronic diseases, and reproduction. PSACH individuals were ascertained through the University of Texas Medical Genetics patient population, a genetic linkage study, and the social organization, Little People of America. The results show that PSACH individuals with a family history do not have a distinct or more severe phenotype than new mutation cases. There were not differences in the number of orthopedic complications, operations, or number of offspring between these two groups. Less than half of affected adults reported having total hip replacement surgery, which was less common than previously reported. Extraskeletal complications were generally uncommon. There were four cases of cancers in 41 individuals queried. Premature osteoarthritis was the major health problem for PSACH individuals. PSACH individuals are generally healthy but have problems associated with debilitating osteoarthritis.

Ambiguity and difference: Families with dwarf children

The social complexities of dwarfism differ from those of other conditions included under the rubric of physical disability because of the historical mystique of dwarfism and the fact that most dwarfs do not have severe physical restrictions on their activities. The ambiguities around being a dwarf in American society foster ambivalence and multiple perceptions and understandings of daily life experiences for parents and their dwarf children. This paper will examine areas in the child's career in which these ambiguities are played out. The data were gathered through interviews with 25 families, and through attendance at meetings of Parents' Groups of Little People of America from 1976 to 1987.

Points: Little people of America

Points: Little people of America

Little people of America.

It had taken over a year of letter writing, grant applications, and visa petitioning, but as the lift doors opened I knew I had finally arrived. . . . Family groups were sitting in the waiting area and among them were several people clearly affected by dwarfism?the little people of America as I came to know them. This was the Department of Medical Genetics at the Johns Hopkins Hospital, Baltimore, USA, and I was beginning my student elective as a clinical clerk, seeing patients with genetically determined disorders. Hupkins, as it is affection? ately known, is a 1000-bed hospital, serving both a large residential section of east Baltimore and acting as a referral centre for rare and complex conditions. In its century of existence it has earned world renown as a teaching and research hospital. The original nineteenth-century red-brick hospital with its marble floors and cupola-roofed entrance has been skilfully incorporated into the modern glass, steel, and concrete clinical buildings. The influence of William Osier, the first professor of medicine, is still strongly in evidence, and during my visit I was to encounter just one of the syndromes originally described by him. Subsequent physicians there have lent their names to numerous clinical signs, while surgeons have pioneered piocedures from the introduction of surgical gloves to the correction of congenital heart malformations. Even the patients at Hopkins have achieved world fame?for example, the cervical tumour of Henrietta Lacks has become the source of the ubiquitous HeLa cell.

The Parents' Auxiliary of Little People of America: a self-help model of social support for families of short-statured children.

Average-sized parents of newborn and young dwarf children characteristically experience emotional distress growing out of a lack of knowledge about the practical and social problems their child will experience. The Parents' Auxiliary of Little People of America provides information and advise which enables parents to deal successfully with the medical and logistical problems of child rearing and their short-statured child's development. It further offers social and psychological support that legitimizes self-image for dwarfs and their families, and provides role models of happy, effectively functioning adult dwarfs and children who have made successful adaptations to the average-sized world around them.

Dwarfism and social identity: Self-help group participation

This paper describes a specific process relating to destigmatization and social identity which is a chief dynamic operative in a self-help group for dwarfs, Little People of America. In our society persons of abnormal short stature typically experience varied forms of stigmatized and stigmatizing social interactions within the average sized world. Data are presented here from a recent study of dwarfs and their families which examined a variety of dimensions of the dwarfism experience and the impact of self-help group membership on social identity and life style. It is suggested that a cognitive restructuring of self-image occurs through the process of forced objective perception of others who share a similar physical condition. This acceptance of self-identity and the physical identification of dwarfism then allows the person to lead his/her life more happily and effectively.

Achondroplasia

"I have been associated with the Little People of America, a national organization of dwarfs, for five years, and have been running a registry for bone dysplasias at the University of Minnesota for two years. On the basis of this experience, I know that many individuals with other conditions are given the diagnosis of achondroplasia and that the implications of this diagnosis are often not recognized, or at least not trans mitted to the patient. 1 believe it is safe to say that a number of teachers of pediatrics consider achondroplasia as a broad category rather than a specific condition. I think this is wrong for the reasons stated in the pa per. Also, it seems to me, if this idea is abandoned more of an effort may be made to find out about conditions which are now considered 'atypical achondroplasia.'" —From the submission letter by the author.

The Problems of Midgets and Dwarfs and Organizational Remedies: A Study of the Little People of America

Research of the Little People of America reveals the problems faced by stigmatized persons and how social organization can help to alleviate these problems. Important efjects of membership in the L.P.A. include opportunities for social participation and mate selection, and the facilitation of psychological and role adjustments. A finding of the study relates degree of satisfaction with membership in the L.P.A. to incentive for joining.