No abstract

. (1970), Archives of Disease in Childhood, 45, 13. Variations in the pattern of pubertal changes in boys. Mixed longitudinal data on the physical changes at puberty in 228 normal boys are presented together with normal standards for stages of genital and pubic hair development.The genitalia began to develop between the ages 91 years and 131 years in 95% of boys (mean = 11 -6 ± 0 09) and reached maturity at ages varying between 13 and 17 (mean = 14-9 ± 1 10). The age at which pubic hair first appeared was not accurately determined, but its development through the later stages was studied. It reached the equivalent of an adult female distribution at a mean age of 15'2 ± 0-01 years.On average the genitalia reached the adult stage 3 * 0 years after they first began to develop; but some boys completed this development in as little as 1 * 8 years while others took as much as 4 * 7 years. Some boys complete the whole process in less time than others take to go from Stage G2 to Stage G3. The genitalia begin to develop before pubic hair is visible in photographs in practically all boys.The 41 boys in whom it could be studied reached their maximum rate of growth (peak height velocity) at a mean age of 14i 1 ± 0 14 years.Very few boys (about 5 %) reached peak height velocity before their genitalia were in Stage 4 and over 20% did not do so until their genitalia were adult. Peak height velocity is reached, on the average, nearly 2 years later in boys than in girls, but the boys' genitalia begin to develop only about 6 months later than the girls' breasts. Pubic hair appears about 14 years later in boys than in girls.In a recent paper we described variations in the ages at which girls reached different stages of puberty and in the rates at which they passed from one stage of development to the next (Marshall and Tanner, 1969). We discussed also the degree to which progress in one event of puberty, for example breast development, could normally be out of step with another, such as growth of pubic hair. We now report a similar study of the maturation of boys.The ages at which Dutch boys reached various stages of genital and pubic hair development in 1965 were estimated in a large cross-sectional study by Van Wieringen et al. (1968), but there are no comparable recent data from other parts of Europe. In any case, cross-sectional data cannot tell us how much individuals vary in the rate at which they pass through puberty nor how the

No abstract

The health of a population is most accurately reflected in the rate of growth of its children. It is this theme which underlies the analysis and presentation of what is by far the largest compilation of growth data ever assembled. The first edition, published in 1976, included all known reliable recent results on height, weight, skinfolds and other body measurements from all parts of the globe. In this edition, the very numerous measurements taken between 1976 and 1988 have been included as well as the results of the large number of new studies made on rate of maturation as evinced by bone age and pubertal development stages. Many sections of the book dwell on disentangling the effects of the environment and heredity on growth, and thus answer the question of whether one universal standard suffices for all peoples of the world, or whether different populations (such as races or nations) should each have their own optimal growth standards. Written by practical people with experience of the problems in developing countries, this book explains in simple terms the different sorts of growth surveys, how to set about making them, and which sort to choose. All who are professionally concerned with child health should read it.

No abstract

No abstract

. (1970). Archives of Disease in Childhood, 45, 755. Standards for children's height at ages 2-9 years allowing for height of parents. Charts* are presented which give centile standards for boys' and girls' heights at ages 2 to 9 when parents' height is allowed for. Mid-parent height is used (i.e. the average of father's and mother's height).A comparison is made with results from the existing 'parent-unknown' British standard charts. A child at the 3rd centile on the parent-unknown charts is (i) at the 20th centile on the new charts if his parents are small enough to average 3rd centile for adults, (ii) at about the 1st centile if his parents average the 97th centile. Conversely a child with 97th centile parents has only to be at the 25th centile for the population in the parent-unknown charts to be at the conventional 3rd centile limit of normal when parental height is allowed for. Thus the new standards result in considerably increased precision.Examples are given of normal boys with small parents who piotted outside the 3rd centile on the conventional charts but inside on the present charts. The differential diagnosis of genetic small stature is made considerably more straightforward by the use of these charts.The correlation coefficients are given at successive ages, from 1 month to 9 years, for child's supine length or height with mid-parent height and for mother-daughter, mother-son, father-daughter, and father-son relationships.Current standards for the height attained by a child at a given age (e.g. Tanner, Whitehouse, and Takaishi, 1966) make no alowance for the height of his parents. We know, however, that tall parents in general produce tall children and short parents short children. If a child is at the 5th centile for height, therefore, it makes a considerable difference whether his parents are themselves 5th centile persons (in which case he is probably normal) or whether they are 95th centile persons (in which case he is almost certainly pathologicaUy small). This paper gives standards which allow for parental height. They apply at present only to children aged 2-0 to 9 0 years, since earlier and later ages require separate treatment. These standards are more powerful than the 'parentunknown' standards in the sense of being able to

No abstract