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Identifying developmental vulnerability through linear growth screening: a UK cross-sectional study

Michael Papasavva1, Joanna Orr1, Isabella Cordani1

  • 1Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK.

BMJ Public Health
|June 29, 2026
PubMed

Insights

Being short for genetic potential, not just stunting, identifies children at higher risk for developmental vulnerability. This finding suggests incorporating parental heights into growth monitoring can help flag neurodevelopmental concerns earlier.

Area of Science:

  • Pediatrics
  • Child Development
  • Public Health

Background:

  • Linear growth is routinely monitored in UK children.
  • Early identification of neurodevelopmental vulnerability is crucial, especially in diverse urban settings.
  • The link between linear growth faltering and neurodevelopmental risk is not well understood.

Purpose of the Study:

  • To investigate whether short stature (stunting) or being short for genetic potential flags children at risk of developmental vulnerability.
  • To assess children aged 2-2.5 years using routine developmental screening.
  • To inform early neurodevelopmental review strategies.

Main Methods:

  • Cross-sectional analysis of 555 children (24-30 months) in East London.
  • Developmental vulnerability defined by Ages and Stages Questionnaire (ASQ-3) cut-offs.
  • Exposures: stunting (height-for-age z-score <-2 SD) and short for genetic potential (deviation from mid-parental height [DMPH] <-2 SD).
  • Logistic regression adjusted for covariates; Griffiths III Mental Development Scales (GMDS-III) used for validation.

Main Results:

  • 25.4% of children screened positive for developmental vulnerability.
  • No association found between stunting and developmental vulnerability (aOR 1.35).
  • Children short for genetic potential showed significantly higher odds of developmental vulnerability (aOR 4.18).

Conclusions:

  • Deviation from genetic height potential, not stunting, is a key indicator of increased neurodevelopmental vulnerability risk in urban UK children.
  • Integrating parental height measurements into routine growth surveillance may provide an early trigger for neurodevelopmental assessment.
  • This approach could enhance early identification and intervention for at-risk children.
Abstract

Keywords:
HumansPublic HealthSociodemographic Factors

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