Archives of Disease in Childhood 

About: Archives of Disease in Childhood is an academic journal published by BMJ. The journal publishes majorly in the area(s): Population & Medicine. It has an ISSN identifier of 0003-9888. Over the lifetime, 23538 publications have been published receiving 645922 citations. The journal is also known as: ADC & eADC.

Variations in pattern of pubertal changes in girls.

Abstract: In Great Britain some girls begin to menstruate in their 10th or 11th years, while others who are equally healthy may not experience menarche until they 'are 14, 15, or even older. Menarche is, however, only a single event in the combination of physical changes which constitute puberty. The adolescent growth spurt, the development of the breasts, and the growth of the pubic hair occur more or less concurrently, and take, on the average, about 3 years from beginning to completion, with menarche occurring usually in the latter half of this period (Tanner, 1962). At present we lack detailed information about the rate at which girls progress through the stages of puberty and about the relation of one event to another. Only longitudinal studies (i.e. studies in which the same individuals are examined repeatedly over a period of time) can provide this information, which would be helpful both to the clinician in distinguishing the normal from the abnormal, and to the neuro-endocrinologist in constructing hypotheses about the mechanisms by which puberty is controlled. Present knowledge is based on studies carried out on small numbers of children in the United States a generation ago, together with some German studies of a similar period (for literature see Tanner, 1962). The only recent European study in which the events of puberty have been followed longitudinally is the Harpenden Growth Study, which began 19 years ago in England and is still in progress. Anthropometric measurements have been taken, and the development of the breasts and pubic hair have been recorded photographically at 3monthly intervals throughout puberty. Though these data may be subject to certain biases, discussed below, they provide information available from no other source. This paper describes the extent of normal individual variation observed in the events of puberty among the girls of the Harpenden Growth Study. We discuss: (a) variation in the chrono-

Variations in the Pattern of Pubertal Changes in Boys

Abstract: Mixed longitudinal data on the physical changes at puberty in 228 normal boys are presented together with normal standards for stages of genital and pubic hair development. The genitalia began to develop between the ages 9½ years and 13½ years in 95% of boys (mean = 11.6 ± 0.09) and reached maturity at ages varying between 13 and 17 (mean = 14.9 ± 1.10). The age at which pubic hair first appeared was not accurately determined, but its development through the later stages was studied. It reached the equivalent of an adult female distribution at a mean age of 15.2 ± 0.01 years. On average the genitalia reached the adult stage 3.0 years after they first began to develop; but some boys completed this development in as little as 1.8 years while others took as much as 4.7 years. Some boys complete the whole process in less time than others take to go from Stage G2 to Stage G3. The genitalia begin to develop before pubic hair is visible in photographs in practically all boys. The 41 boys in whom it could be studied reached their maximum rate of growth (peak height velocity) at a mean age of 14.1 ± 0.14 years. Very few boys (about 5%) reached peak height velocity before their genitalia were in Stage 4 and over 20% did not do so until their genitalia were adult. Peak height velocity is reached, on the average, nearly 2 years later in boys than in girls, but the boys9 genitalia begin to develop only about 6 months later than the girls9 breasts. Pubic hair appears about 1½ years later in boys than in girls.

Clinical longitudinal standards for height, weight, height velocity, weight velocity, and stages of puberty.

Abstract: New charts for height, weight, height velocity, and weight velocity are presented for clinical (as opposed to population survey) use. They are based on longitudinal-type growth curves, using the same data as in the British 1965 growth standards. In the velocity standards centiles are given for children who are early- and late-maturing as well as for those who mature at the average age (thus extending the use of the previous charts). Limits of normality for the age of occurrence of the adolescent growth spurt are given and also for the successive stages of penis, testes, and pubic hair development in boys, and for stages of breast and pubic hair development in girls.

Standards from birth to maturity for height, weight, height velocity, and weight velocity: British children, 1965. II

Abstract: (C) Whole-year Velocity Standards: Chronological Age-based and Individual Type We now consider how to construct velocity standards, to answer our second question 'Has this child's rate of growth been within normal limits ?' We are again confronted with the alternatives of plotting against chronological or developmental age at adolescence and we have adopted the same solution as before. First we give, in the conventional manner, centiles plotted against chronological age, over the whole age span. These are calculated simply from two measurements a year apart, without using further longitudinal data. They depend on a two-occasion longitudinal study, nothing further. At adolescence these standards are greatly scattered by the phase-difference effect. If we know nothing about a boy except that he is 12 years old and grew 3 cm. during the last year, we must plot 3 cm. at 11 * 5 years and interpret this according to the chronological age centiles. If, however, we know that he is midpubescent, or that his skeletal age is 14 * 0 years, then in theory we could make a more effective interpretation if we had the appropriate standards. We have to remember, however, that in one important respect velocity standards differ from distance ones. In velocity standards a child does not have the same strong tendency to stay in the same centile position from one age to another; there is always a contrary tendency to a move from the outer centile positions towards a more central position in the subsequent year. Though a child can follow the 60th or even 70th centile of velocity from the pre-school years till maturity and end up a large but normal adult, a child who follows the 97th centile

Body mass index reference curves for the UK, 1990.

Abstract: Reference curves for stature and weight in British children have been available for the past 30 years, and have recently been updated. However weight by itself is a poor indicator of fatness or obesity, and there has never been a corresponding set of reference curves to assess weight for height. Body mass index (BMI) or weight/height has been popular for assessing obesity in adults for many years, but its use in children has developed only recently. Here centile curves for BMI in British children are presented, from birth to 23 years, based on the same large representative sample as used to update the stature and weight references. The charts were derived using Cole's LMS method, which adjusts the BMI distribution for skewness and allows BMI in individual subjects to be expressed as an exact centile or SD score. Use of the charts in clinical practice is aided by the provision of nine centiles, where the two extremes identify the fattest and thinnest four per 1000 of the population.