1. The influence of metabolism, hormones, the properties of bone, dietary life, nutrition, living and social environment make differences in growth and development of children. Source Figure; http://ghw.pfizer.co.jp/gh/in/comedical/seityou/seityou6_3.html ● Individual Differences in Growth and Development of Children

2. Standard Pattern of Height Growth Adolescent Growth Spurt Growth Spurt girl Source Figure; http://ghw.pfizer.co.jp/gh/in/comedical/seityou/seityou1_1.html

3. 1. Parents Height Height at 6 years of age, average of parents height, Bone Age, and entering the puberty period influence children ’ s height growth. 2. Late Adolescence Makes Height Increase See next figure. ● Factors influencing Height Growth

4. Height(cm ） boy Age(year ） Late Adolescence Growth Height Spurt average Early Adolescenc e Growt h Height Spurt Source Figure; http://ghw.pfizer.co.jp/gh/in/comedical/seityou/seityou1_3.html Late Adolescence Makes Height Increase

5. Standard Deviation （ SD ） shows how distribute the examples from the mean. Measured height data on many of the same age children have a normal distribution. See next figure. ● SD Score Method for the Evaluation of Height About 2.3 ％ of the total number of children with height data of under -2SD are considered to have growth disorders, such as growth hormone deficiency. ● SD Score

6. Averag e Height high low Height 68.3% of all the people whose height is between -1SD and +1SD 95.4% of all the people whose height is between -2SD and +2SD 2.3% of all the people whose height is less than -2SD Normal Distribution of Height Source Figure; http://ghw.pfizer.co.jp/gh/in/comedical/seityou/seityou2_1.html

7. height - average height SD Score = Standard Deviation （ SD ） Source Figure; http://ghw.pfizer.co.jp/gh/in/comedical/seityou/seityou6_2.html ● SD Score Equation

8. Evaluation of height growth on the same sex and age children. A child who has stopped growing or is growing more slowly than expected will often need an evaluation of height growth. ● Cross-Sectional Standard Growth Chart

9. Data in 2000 Height(cm ） boy Age(year ） Weight(Kg ） Heigh t Weigh t average Source Figure; http://ghw.pfizer.co.jp/gh/in/comedical/seityou/seityou2_3.html Cross-Sectional Standard Growth Chart

10. 1. Poor growth may be the first sign of a problem in some diseases. 2. Early diagnosis and treatment of some conditions may help children achieve a more typical adult height. 3. Child neglect or abuse may also be associated with failure to grow. ●Importance of Early Detection for Growth Disorders

11. Height(cm ） AGE(year ） Growth in Height shows down at point A average Source Figure; http://ghw.pfizer.co.jp/gh/in/comedical/seityou/seityou3_2.html Case of Growth Hormone Deficiency （ one girl ）

12. is a disorder that involves the pituitary gland (the small gland at the base of the brain that secretes several hormones, including growth hormone). A damaged or malfunctioning pituitary gland may not produce enough hormones for normal growth. ● Growth hormone deficiency

13. ＝ weight (kg)/ （ height (cm) 3 ）ｘ 10 7 ● Rohrer index ＝ weight (kg)/ （ height (m) 3 ）ｘ 10 Rohrer index Useful to calculate the obesity level of children ● Rohrer Index

14. Severely Underweightunder １ ００ Underweight １０１〜１１５ Normal Weight １１６〜１４４ Overweight １４５〜１５９ Obeseover １６０ ● Rohrer Index

15. ex. height : 135cm, weight : 30kg Rohrer index ＝ 30÷1.353×10 ＝ 30/2.46×10 ＝ 122 （ Normal Weight ） ● Rohrer Index