ASSESSMENT OF ABNORMAL GROWTH-CURVES

An important part of well-child care is the assessment of a child's gr owth. While growth in the vast majority of children falls within norma l percentile ranges on standard growth curves, an occasional child dem onstrates worrisome deviations in weight, height or head size. A singl e growth percentile value at any particular point in a child's life is only of limited usefulness to the physician. More important is the ch ild's rate of growth. Children whose growth parameters are at the extr emes of the growth curve but whose growth rates are normal are likely to be healthy. Conversely, accelerated or slowed growth rates are rare ly normal and warrant further evaluation. This article addresses the i nitial steps to be taken when evaluating children with suspected growt h abnormalities, the guiding principles that apply to all growth probl ems, and the most common growth curve deviations and approaches to the ir management.