By N. Cameron
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Extra resources for Human Growth and Development
Karlberg2) claimed to have seen a small spurt in growth velocity at around 2 or 3 years of age and explained this spurt as an expression of the change in command of physiological growth. In puberty, the growth spurt, with its sigmoid-shaped distance curve, is superimposed onto the childhood component and controlled by both the growth hormone and sex steroids. The development of any given phase of growth is influenced by the physiological and pathological variations of the preceding phase. Growth in Infancy and Childhood: A Pediatric Approach 25 FIGURE 2-2 The three phases of postnatal growth, according to the ICP model.
For example, Figure 2-6 (point c) shows the attained height of a malnourished child 2 years old. We can say there is a marked height deficit. If the following measurement was point z, it would mean that the growth rate is abnormally slow and the child is progressively deteriorating and at high risk. On the contrary, if the following measurement was point v, then growth rate is higher than normal and we can assume the child is in the process of catching up and recovering from malnutrition. Some Considerations of Pediatric Value Both growth delay or small size are quite common causes for consultation in pediatric practice.
Predicted height is within the normal parental height, however, it is very common that, during puberty, the acceleration of bone age is below the predicted one. On average, children with delayed maturation attain a height some distance below their genetic target. Physical examination is normal, and growth velocity is also normal during childhood. This diagnosis is more frequently made in boys than in girls, which may be a reflection of problems in self-esteem and psychosocial integration, especially in puberty.