Height is a prominent physical attribute that distinguishes us from others.  Perception of what is considered a normal height is often distorted by a variety of factors such as family background, cultural background, media images, and peer groups.

 Extremes in height- short stature or tall stature- call attention to a person and may represent challenges for some in everyday life. Short stature remains a common concern in parents seeking medical evaluation for their child. There are conflicting reports both positive and negative on the impact of short stature, particularly in men, in adulthood.

 A child’s growth and height are strongly connected to genetics of his or her family. In other words, short children typically have short parents. A handy formula used help estimate a child’s genetic height target (the range of their adult height) is as follows:

Girls: [mother’s height in inches + (father's height in inches - 5)] divided by 2.
Boys: [(mother’s height in inches + 5) + father's height in inches] divided by 2.

The estimate is accurate for most children within a four inch range above or below the target. The height target also helps estimate the percentile range on the growth chart where most of a child’s growth points should be located.

Height is tracked using growth charts developed by the Center for Disease Control. A representative growth chart is shown below.


Sample boy's growth chartCredit: CDC Website



Percentiles are a statistical method of showing expected average height (or weight) for a child at a specific age. The 50th percentiles on the growth chart is exactly average. Percentiles above the 50th percentile indicate taller than average, and the percentile below the 50th percentile indicate shorter than average. The table below gives an idea of height outcome for a man or woman assuming that growth remained exactly on a specific percentile.


Adult Heights for Various Percentiles (rounded to nearest inch)



Man's Height

Woman's Height





Very Above Average




Above Average








Below Average




Very Below Average





A child who is growing below their genetic height target range is concerning. Of more concern, is a child who is growing at an abnormally slow speed as documented by dropping from higher to lower growth percentiles on the growth chart.


A common pitfall in seeking evaluation of short stature is loss of priority. Often, the primary priority is seeking a treatment of short stature with medication such as recombinant human growth hormone. However, short stature represents a symptom and a medical mystery. The first priority in approaching short stature is collecting medical clues to uncover the cause for short stature before addressing treatment plans. The specific causes of short stature in children are too numerous to easily list. Some of the more common causes include:


  • Normal growth variant of constitutional growth delay
  • Poor nutrition or malabsorption of food
  • Chronic illness such kidney disease of inflammatory bowel disease
  • Growth hormone deficiency
  • Hypothyroidism (underactive thyroid)


Parents who have concerns regarding their child’s growth should discuss their concerns further with their pediatrician or family practice doctor. Blood tests and x-ray tests are essential tools in growth evaluation. Lastly, referral to a pediatric endocrinologist, a specialist who deals with growth problems in children may be needed.

short stature evaluation in children