ACADEMIC-ACHIEVEMENT AND PSYCHOLOGICAL ADJUSTMENT IN SHORT CHILDREN

Limited information is available on the educational and behavioral fun ctioning of short children. Through 27 participating medical centers, we administered a battery of psychologic tests to 166 children referre d for growth hormone (GH) treatment (5 to 16 years) who were below the third percentile for height (mean height = -2.7 SD). The sample consi sted of 86 children with isolated growth-hormone deficiency (GHD) and 80 children with idiopathic short stature (ISS). Despite average intel ligence, absence of significant family dysfunction, and advantaged soc ial background, a large number of children had academic under-achievem ent. Both groups showed significant discrepancy (p <.01) between IQ an d achievement scores in reading (6%), spelling (10%), and arithmetic ( 13%) and a higher-than-expected rate of behavior problems (GHD, 12%, p <.0001; ISS, 10%, p <.0001). Behavior problems included elevated rate s of internalizing behavior (e.g., anxiety, somatic complaints) and ex ternalizing behavior (e.g., impulsive, distractible, attention-seeking ). Social competence was reduced in school-related activities for GHD patients (6%, p <.03). The high frequency of underachievement, behavio r problems, and reduced social competency in these children suggests t hat short stature itself may predispose them to some of their difficul ties. Alternately, parents of short, underachieving children may be mo re likely to seek help. In addition, some problems may be caused by fa ctors related to specific diagnoses.