Related Experiment Video
Updated: Aug 11, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Referral criteria for growth screening
1Department of Pediatrics, Maidstone Hospital, Kent, United Kingdom.
Insights
Population height screening identifies organic diseases in children below the third centile. Early detection of growth disturbances, including Turner
Area of Science:
- Pediatrics
- Endocrinology
- Public Health
Background:
- Population height screening over 20 years reveals 17-21% of children below the third centile have organic disease.
- Disease likelihood increases to 50% for children below -3 Standard Deviations (SDs).
- Screening age impacts detection of acquired diseases and progressive growth disorders like Turner's syndrome.
Purpose of the Study:
- To evaluate the effectiveness of population height screening in identifying organic diseases in children.
- To assess the utility of height velocity and height/weight relations in improving screening sensitivity.
- To determine optimal screening protocols, including measurement frequency and referral systems.
Main Methods:
- Analysis of population height screening data spanning two decades.
- Evaluation of height velocity as a screening tool for growth disturbances.
- Assessment of height/weight relations for early detection of conditions like coeliac disease and eating disorders.
- Consideration of measurement frequency (minimum three, preferably five-six) for growth pattern definition.
- Proposal of a two-level referral system for efficient resource allocation.
Main Results:
- Significant proportion of children with short stature have underlying organic disease.
- Height velocity and height/weight relations show potential for enhanced screening sensitivity.
- Early detection of coeliac disease and eating disorders is possible with integrated screening.
- A minimum of three to six measurements are recommended for accurate growth pattern assessment.
- Referral for discrepancies greater than three centile bands between height and weight is advised.
Conclusions:
- Population height screening is crucial for detecting organic diseases and growth disturbances in children.
- Incorporating height velocity and height/weight assessments can improve early diagnosis.
- A structured, multi-level referral system optimizes resource use for managing growth issues.
Abstract:
Population height screening studies performed over the past 20 years have shown that between 17 and 21% of children with heights below the third centile have organic disease, of whom about 20% will be new diagnoses. The likelihood of organic disease increases to 50% for children with heights below -3 SDs. The age of screening will also influence the outcome as both acquired disease and disorders with progressive growth slowing, such as Turner's syndrome, are more likely to be detected by screening at an older age. Height velocity as a screening tool has evoked interest for many years as, despite technical problems, slowly growing children are thought more likely to have disease. Inclusion of height or height/weight relations may further improve screening sensitivity. It may assist in the early detection of coeliac disease or eating disorders in older children. A minimum of three measurements is required to define an individual's growth pattern and, preferably, five or six measurements spread over the preschool and primary school years. The value of extension of growth screening to the secondary school age group remains uncertain. Children should be screened for both height and weight and referred when there are major discrepancies between these two measurements (more than three centile bands). A two level system of referral with a community assessment for some children and a direct referral to a growth clinic for children with more severe growth disturbance may be the best use of resources.
