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Updated: Aug 18, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Recognition of children with psychosocial short stature: a spectrum of presentation
B C Gohlke1, V V Khadilkar, D Skuse
1Great Ormond Street Hospital for Children, Institute of Child Health, London, UK.
Insights
Psychosocial short stature in children is linked to adverse family environments and abuse. Early identification of growth failure and associated symptoms is crucial for intervention.
Area of Science:
- Pediatrics
- Endocrinology
- Child Psychology
Background:
- Psychosocial short stature (PSS) is a diagnosis of exclusion characterized by growth failure.
- It is associated with emotional and social deprivation, impacting a child's physical development.
- Understanding the complex interplay of environmental factors is key to diagnosing and managing PSS.
Observation:
- This study analyzed 65 children with PSS, noting a high prevalence of adverse family conditions such as parental divorce and unemployment.
- Many patients presented with low birth weight, prematurity, or low birth-weight syndrome.
- Associated symptoms included abnormal eating patterns, behavioral issues, encopresis, and enuresis.
Findings:
- A significant proportion of children (41%) experienced sexual or physical abuse during the observation period.
- Abused children exhibited a higher incidence of hyperphagia, peculiar eating habits, behavioral problems, soiling, and nocturnal enuresis.
- Growth failure was the primary referral reason, with environmental or psychosocial factors often suspected but not initially linked to the growth deficit.
Implications:
- The findings highlight the critical need for comprehensive psychosocial and abuse evaluations in children presenting with growth failure.
- Early recognition and intervention for PSS and associated trauma can improve long-term health outcomes.
- This research underscores the importance of a multidisciplinary approach involving pediatricians, endocrinologists, and mental health professionals.
Abstract:
We describe 65 children (32F, 33M) with psychosocial short stature from 51 families. Average age was 6.6 years (range 0.9-16.5) and all but five were prepubertal. 67% of the patients lived in families with three or more children, but in 73% of cases the patient was the first or the second born child. 45% of the parents were divorced and in 31% of the families the father was unemployed. In 56 children, the birth weight was known and in only 29% was it above 3000 g; 21% were premature, 29% had features of low birth-weight syndrome (including four with Russell-Silver syndrome). Average birth weight was 2786 g (range 1650-4676). In all patients, the predominant reason for referral was growth failure. In 28% an environmental aetiology was suspected and in a further 29%, social or emotional problems were known to the referring physician but not suspected as the aetiology of the growth failure, despite social services involvement in 60% at the referral to our unit. At initial presentation in our clinic, we found additional features leading to the suspicion of psychosocial short stature; 54% abnormal eating pattern, 42% behaviour problems, 26% encopresis, 18% nocturnal enuresis and 12% inappropriate urination. During the observation period of a mean of 3.7 years, 27 (41%) of our patients were found to have been sexually or physically abused. In these 27 children hyperphagia, bizarre eating habits, behaviour problems, soiling and nocturnal enuresis were more common.
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