Intended for healthcare professionals


Are short normal children at a disadvantage? The Wessex growth study

BMJ 1997; 314 doi: (Published 11 January 1997) Cite this as: BMJ 1997;314:97
  1. A Bruce Downie, research assistant (psychology)a,
  2. Jean Mulligan, data managera,
  3. Robert J Stratford, senior lecturer in psychologyb,
  4. Peter R Betts, consultant paediatricianC,
  5. Linda D Voss, senior research fellowa
  1. a Department of Child Health, Southampton University Hospitals Trust, Southampton General Hospital, SO16 6YD
  2. b Department of Psychology, University of Southampton, Southampton, SO17 1BJ
  3. c Department of Paediatrics, Southampton University Hospitals Trust, SO16 6YD
  1. Correspondence to: Dr Voss
  • Accepted 28 October 1996


Objective: To examine whether short stature through childhood represents a disadvantage at around 12 years.

Design: Longitudinal non-intervention study of the physical and psychological development of children recruited from the community in 1986-7 after entry into primary school at age 5-6 years; this is the second psychometric assessment made in 1994-5 after entry into secondary school at age 11-13 years.

Setting: Southampton and Winchester health districts.

Subjects: 106 short normal children (<3rd centile for height when recruited) and 119 controls of average stature (10th-90th centile).

Main outcome measures: Psychometric measures of cognitive development, self concept development, behaviour, and locus of control.

Results: The short children did not differ significantly from the control children on measures of self esteem (19.4v 20.2), self perception (104.2 v 102.4), parents' perception (46.9 v 47.0), or behaviour (6.8 v 5.3). The short children achieved significantly lower scores on measures of intelligence quotient (IQ) (102.6 v 108.6; P<0.005), reading attainment (44.3 v 47.9; P<0.002), and basic number skills (40.2 v 43.5; P<0.003) and displayed less internalisation of control (16.6 v 14.3; P<0.001) and less satisfaction with their height (P<0.0001). More short than control children, however, came from working class homes (P<0.05). Social class was a better predictor than height of all measures except that of body satisfaction. Attainment scores were predicted by class and IQ together rather than by height. Height accounted for some of the variance in IQ and locus of control scores.

Conclusions: These results provide only limited support for the hypothesis that short children are disadvantaged, at least up until 11-13 years old. Social class seems to have more influence than height on children's psychological development.

Key messages

Key messages Most studies into the psychology of short stature in childhood have been of children referred to clinics, who do not necessarily come from a range of social classes

In this study, in which referral bias was avoided, short children displayed normal psychosocial adjustment up to age 11-13 years

Social class was shown to be a better predictor than stature of psychometric performance.


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