These children, although short, have a normal growth velocity or rate of growth and will usually have a delay in starting puberty, and possibly a prolonged slowdown in growth that is usually present in children just before they begin puberty. They will usually also have a bone age that is much less than their chronological age, showing that there is room to grow and that they will continue growing even after other children of the same age have stopped growing. Because of the extra room and time to grow, children with constitutional delay usually have a normal adult height. Similarly, other family members usually also report a delay in starting puberty and a late adolescent growth spurt and have a normal final adult height. While children with a constitutional delay in growth will eventually begin puberty, go through the pubertal growth spurt and reach a normal final adult height, it can be distressing for many teens to be so much shorter and less developed than their peers.
Many parents are worried about growth hormone deficiency in their short children.
Growth hormone is required for normal growth, and children with growth hormone deficiency are short, often look younger than their chronological age, and they can be chubby with their weight higher than their height. A growth hormone stimulation test may also be done by an endocrinologist. Treatments for growth hormone deficiency include growth hormone replacement. Other conditions for which growth hormone is currently being successfully used include Turner syndrome, chronic renal failure and Prader-Willi syndrome. For example, if his height had been following along at the 75th percentile and has now moved down to the 10th or 25th percentile.