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Understanding Growth : Normal vs. Abnormal Patterns ...

Supported by a grant from The Genentech Foundation for Growth and Development. Thesematerials may be freely reproduced, but may not be modified without written consent of Growth : Normal vs. Abnormal PatternsFacilitator s GuideCase Author:Laurie E. Cohen, MDHarvard Medical SchoolChildren s Hospital, BostonCase Advisors:S. Jean Emans, MDJohn R. Knight, MDHarvard Medical SchoolChildren s Hospital, BostonTopic: Understanding GrowthAbstract: Growth problems are common in children and adolescents. Every child should have his/herheight and weight plotted on an appropriate Growth chart as part of routine medical abnormalities will often present first to the primary care clinician.

bone age lags behind chronologic age (e.g., constitutional delay, malnutrition, hypothyroidism, growth hormone deficiency). (d) Flip now to longitudinal growth chart. Replot on a syndrome-specialized growth chart (i.e., Bayer-Bayley or Tanner and Davies). • The NCHS growth charts are derived from cross-sectional data and tend to flatten out

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