Short stature: increased in children with severe learning disability

Area of Science:

• Pediatrics
• Child Growth and Development
• Endocrinology

Background:

• The 'Health for All Children' initiative recommends screening for growth disorders at school entry using a 0.4th centile cutoff.
• Growth hormone deficiency was identified in four children attending special schools, prompting further investigation.
• A comparative study was designed to assess height distribution in children attending special schools versus mainstream schools.

Purpose of the Study:

• To compare the height distribution of children attending special schools with that of children in mainstream schools.
• To identify potential disparities in growth patterns among children with severe or profound learning disabilities.
• To evaluate the effectiveness of current screening recommendations in identifying growth disorders in special school populations.

Main Methods:

• Height measurements were taken from children at two special schools using a Leicester height measurer.
• Height data were converted to standard deviation scores (SDS) for standardized comparison.
• Data from special schools were compared with height data collected from local mainstream schools.

Main Results:

• The mean height SDS for children in mainstream schools (n=2301) was -0.09, aligning with national standards.
• Children in special schools (n=192) had a mean height SDS of -0.73 (95% CI -0.9 to -0.5).
• Even after excluding children with known causes for abnormal growth (n=120), the mean height SDS remained significantly lower (-0.613; 95% CI -0.8 to -0.4), with 6.7% falling below the 0.4th centile.

Conclusions:

• Children attending special schools, particularly those with severe or profound learning disabilities, are shorter than their peers in mainstream schools.
• This height difference persists even when accounting for known medical conditions affecting growth.
• The findings underscore the critical need for specialized professional assessment to accurately evaluate normal and abnormal growth in children, especially those in special educational settings.