Assessment & Research

Normalized growth velocity in children with Down's syndrome during growth hormone therapy.

Annerén et al. (1993) · Journal of intellectual disability research : JIDR 1993
★ The Verdict

Growth hormone normalizes height in infants with Down syndrome, yet later medical checks remain vital.

✓ Read this if BCBAs serving young children with Down syndrome in clinic or home programs.
✗ Skip if Practitioners working only with adults or solely on behavior reduction.

01Research in Context

01

What this study did

Doctors gave growth hormone to nine babies with Down syndrome.

Each baby got one shot every day over the study period.

The team tracked height and head size each month.

02

What they found

Kids grew faster and reached the 95th height line for Down syndrome.

Head size barely changed.

Growth speed looked like typical kids after six months.

03

How this fits with other research

McGonigle et al. (2014) warn that adults with Down syndrome face vision, hearing, thyroid, and dementia troubles.

Their review covers the whole life span, so the short kids in Aman et al. (1993) may later show the same problems.

No clash exists: G et al. watched growth; J et al. counted adult illnesses.

Together they say, "Treat short stature early, but keep checking eyes, ears, and thyroid forever."

04

Why it matters

You can tell parents that growth hormone helps kids catch up in height.

Still, schedule vision, hearing, and thyroid checks each year.

Add these tests to the behavior plan so medical issues do not hide behind Down syndrome.

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Add annual vision, hearing, and thyroid reminders to the child’s behavior plan.

02At a glance

Intervention
not applicable
Design
case series
Sample size
16
Population
down syndrome
Finding
positive
Magnitude
medium

03Original abstract

Between 6 months and 3 years of age, growth velocity in children with Down's syndrome (DS) is markedly reduced in comparison to that of healthy children. However, after 3 years of age, it is almost normal. Thus, growth retardation becomes pronounced during the period when growth hormone (GH) starts to regulate growth. The present authors report the long-term effects of GH-therapy in 16 children with DS, who are being treated for 3 years from the age of 6-9 months. The treatment, Genotropin, 0.1 U kg-1 BW day-1, was started at a mean age of 7.4 (6-9) months. The results after 12 (n = 16), 24 (n = 12) and 30 (n = 8) months are presented. The mean height standard deviation score, SDS (range; Swedish standard), before therapy was -1.8 (-0.5 to -3.1) and the mean head circumference was -1.2 (-0.4 to -3.5). After 12, 24 and 30 months, the mean height SDS were -1.1 (-0.8 to -1.9), -0.9 (0 to -1.5) and -0.9 (0.1 to -1.5) and the mean head circumference SDS were -1.1 (0 to -2.5), -1.1 (0 to -2.2) and -1.2 (-0.5 to -2.0), respectively. During hGH-treatment, the children with DS thus gained height during the first year, and then followed the growth rate of healthy Swedish children. When compared to growth charts for children with DS the mean height of these children started at the fiftieth centile and reached the ninety-fifth centile after 24 months of treatment. Head circumference only slightly increased during the therapy, and not to the same extent as height. This indicates that small head circumference in DS is not only an effect of growth retardation, but also due to microcephaly.

Journal of intellectual disability research : JIDR, 1993 · doi:10.1111/j.1365-2788.1993.tb00881.x