Model of normal prepubertal growth.

Growth over the short term is a highly complex non-linear process. Contrasting models of short term growth have been proposed which include periodic growth cycles versus abrupt growth spurts with intervening growth arrest ('saltation and stasis'). The variability of short term growth has been characterised from a study of 46 healthy prepubertal children measured three times a week over one academic year using a combination of descriptive statistical approaches and regression modelling. Growth in childhood over one year is represented by a biphasic process comprising three to six unpredictable growth spurts, each of mean length 56 days (range 13-155 days), separated by periods of stasis (less than or equal to 0.05 cm height increment over more than seven days), each lasting a mean of 18 days (range 8-52 days) and accounting for at least 20% of the period of observation. This is superimposed on strong seasonal trends in growth with a declining growth rate over the autumn months reaching a nadir in midwinter, followed by a growth spurt in the spring. Human growth over short periods is therefore a discontinuous, irregular, and unpredictable process.

[1]  K. Cumming,et al.  The reliability of height measurement (the Wessex Growth Study). , 1990, Archives of disease in childhood.

[2]  T J Cole,et al.  Cross sectional stature and weight reference curves for the UK, 1990. , 1995, Archives of disease in childhood.

[3]  D. Counts,et al.  Patterns of human growth. , 1995, Science.

[4]  W. Sippell,et al.  Periodical changes of short term growth velocity ('mini growth spurts') in human growth. , 1988, Annals of human biology.

[5]  R. Paludetto,et al.  Pulsatile weight increases in very low birthweight babies appropriate for gestational age. , 1990, Archives of disease in childhood.

[6]  J M Tanner,et al.  Standards from birth to maturity for height, weight, height velocity, and weight velocity: British children, 1965. I. , 1966, Archives of disease in childhood.

[7]  F. Cassorla,et al.  Short-Term Variation of Growth Rate and Somatomedin-C Levels in Normal Prepubertal Children , 1988 .

[8]  J. Tanner Auxology 88 : perspectives in the science of growth and development , 1989 .

[9]  L. Greco,et al.  Growth dynamics in cystic fibrosis , 1993, Acta paediatrica.

[10]  M. Lampl,et al.  A case study of daily growth during adolescence: a single spurt or changes in the dynamics of saltatory growth? , 1993, Annals of human biology.

[11]  Infradian rhythms in urinary growth hormone excretion. , 1996, The Journal of clinical endocrinology and metabolism.

[12]  B. Bogin Patterns of human growth , 1988 .

[13]  M. Wand,et al.  Multivariate Locally Weighted Least Squares Regression , 1994 .

[14]  G. A. Young,et al.  The bootstrap: To smooth or not to smooth? , 1987 .

[15]  Geoffrey J. McLachlan,et al.  Mixture models : inference and applications to clustering , 1989 .

[16]  M. Togo,et al.  Time-series analysis of stature and body weight in five siblings. , 1982, Annals of human biology.

[17]  M Lampl,et al.  Saltation and stasis: a model of human growth. , 1992, Science.

[18]  A. Gibson,et al.  Short-term growth: rhythms, chaos, or noise? , 1994, Archives of disease in childhood.

[19]  W. A. Marshall,et al.  Seasonal variation in growth rates of normal and blind children. , 1971, Human biology.

[20]  J M Tanner,et al.  Standards from birth to maturity for height, weight, height velocity, and weight velocity: British children, 1965. II. , 1966, Archives of disease in childhood.

[21]  W. Sippell,et al.  GH Deficient Children Receiving GH Replacement Do not Grow during Intermittent Infectious Illness , 1986, Acta paediatrica Scandinavica.

[22]  S. Ratcliffe,et al.  The cyclical nature of prepubertal growth. , 1990, Annals of human biology.

[23]  L. Greco,et al.  Pulsatile growth pattern during catch‐up growth in childhood coeliac disease , 1994, Acta paediatrica.