Abdullah N, Drummond P, Gray N, Al-Khalidi O, Barry R, Cheetham T
Department of Paediatrics, Newcastle upon Tyne Hospitals NHS Trust, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
Child Care Health Dev. 2009 Mar;35(2):266-70. doi: 10.1111/j.1365-2214.2008.00910.x. Epub 2008 Nov 19.
'Health for all children' recommends that children should be screened for growth disorders at school entry with a 0.4th centile 'cut-off'. Following the diagnosis of growth hormone deficiency in four children attending local special schools, our aim was to compare the height distribution of children attending special schools with mainstream schools.
Children at two local special schools were measured using a Leicester height measurer and values converted to standard deviation scores (SDS). Children were categorized according to whether there were known factors that could affect height. The data were compared with those collected from local mainstream schools.
In total, 242 children were registered at the two special schools and 192 children were measured. The mean height SDS of children in mainstream school (n = 2301) was similar to national standards at -0.09 (SD 1.02). The mean height SDS distribution of the 192 children in special schools (age range 3.2-18.4 years; median age 11.3 years) was -0.73; 95%CI -0.9 to -0.5. In those with no established diagnosis to explain altered growth (n = 120) this was -0.613; 95%CI -0.8 to -0.4. Both pre-pubertal (n = 37) and pubertal (n = 83) children were short and eight (6.7%) had a height less than the 0.4th centile.
Children attending special school with severe or profound learning disability were shorter than those attending mainstream school. This is still the case following the exclusion of children with a known cause for abnormal growth. This underlines the importance of each child being assessed by professionals with a refined knowledge of normal and abnormal growth.
“所有儿童的健康”建议在儿童入学时使用第0.4百分位数的“临界值”对生长障碍进行筛查。在当地特殊学校就读的4名儿童被诊断出生长激素缺乏后，我们的目的是比较特殊学校儿童与主流学校儿童的身高分布情况。
使用莱斯特身高测量仪对当地两所特殊学校的儿童进行测量，并将测量值转换为标准差评分（SDS）。根据是否存在可能影响身高的已知因素对儿童进行分类。将这些数据与从当地主流学校收集的数据进行比较。
两所特殊学校共有242名儿童注册，其中192名儿童接受了测量。主流学校2301名儿童的平均身高SDS为-0.09（标准差1.02），与国家标准相似。192名特殊学校儿童（年龄范围3.2 - 18.4岁；中位年龄11.3岁）的平均身高SDS分布为-0.73；95%置信区间为-0.9至-0.5。在那些没有既定诊断来解释生长改变的儿童中（n = 120），这一数值为-0.613；95%置信区间为-0.8至-0.4。青春期前儿童（n = 37）和青春期儿童（n = 83）均身材矮小，8名（6.7%）儿童的身高低于第0.4百分位数。
就读于有严重或极重度学习障碍的特殊学校的儿童比就读于主流学校的儿童身材矮小。在排除有已知生长异常原因的儿童后，情况依然如此。这凸显了由对正常和异常生长有精深了解的专业人员对每个儿童进行评估的重要性。
