II. Signs
- Delayed Growth and development in either parent (50%)
- Normal birth history
- Normal growth for the first several months
- Absence of organic or psychologic disease
- Discrete interval of severe growth deceleration (decreased Growth Velocity)
- Onset: under age 2 years (typically starting at 6 to 18 months of age)
- Duration: 1-3 years (Growth Velocity normalizes after period of decreased Growth Velocity)
- Onset Puberty delayed
- However, with onset of Puberty, catch-up growth occurs and normal adult height is achieved
- Final height appropriate for genetic height potential
III. Imaging: Bone Age Film
- Bone Age mildly lags Chronological Age
IV. Differential Diagnosis
- See Short Stature
V. Evaluation
- See Short Stature
VI. Management
- Expectant management and anticipatory guidance, as growth correction occurs with Puberty
- No referral needed to endocrinology unless other causes suspected for Short Stature
- However, GH Replacement may be considered if Delayed Puberty with secondary significant distress