The disability of short stature.

Few paediatricians would deny that children with extreme short stature face a disability that may affect their physical, psychological, and social well being.Though considerable research has been performed on the nature of this disability, it has been focused on patients who are very short, secondary to conditions such as growth hormone deficiency or achondroplasia, and are attending specialised clinics.Increasingly, however, children are being referred who represent the extremes of normal variation in growth and physical develop- ment.They do not have a pathological condition and yet their parents are seeking medical advice, usually at their own instigation or at the suggestion of their family doctor, friends, or relatives.Though some individuals, such as Napoleon, are said to have been spurred on to greatness (or infamy!) by their small size, it is widely assumed that short stature, even within the normal range for the population, represents a disability and with the recent avail- ability of treatment with biosynthetic growth hormone this assumption requires further study.This review will examine the evidence available on the disability of short stature, which to date is based almost entirely on 'pathological' short stature.It will then summarise the relevance of these studies to 'short normal' children. Studies in children with extreme short statureA variety of diagnoses are represented, of which growth hormone deficiency is the commonest.In all the studies, however, short stature was the main medical problem.