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Growth Disorders

Summary

Growth Hormone Deficiency (GHD) is a rare but treatable condition that affects a child’s growth. Growth hormone (GH) plays an important role not just in height but also in bone strength, body composition, metabolism, and overall well-being.

Children with GHD may have a slow growth rate and be shorter than their peers. The condition can occur on its own (isolated GHD) or along with other hormone deficiencies (combined pituitary hormone deficiency, CPHD). It can be present from birth (congenital) or develop later (acquired).

With early diagnosis and treatment, most children can reach a normal adult height and enjoy a healthy life.

Diagnosis and When to Seek Help

You should talk to a doctor if your child:

  • Grows much slower than other children of the same age
  • Is significantly shorter than their peers
  • Has low energy levels or low blood sugar
  • Shows delayed puberty

A diagnosis is made based on a child’s growth pattern, medical tests, and brain scans. Doctors look at hormone levels, medical history, and imaging of the pituitary gland (which produces GH) to confirm GHD.

Management

The main treatment for GHD is daily injections of recombinant human growth hormone (rhGH). This therapy is safe and highly effective in helping children grow to their expected height.

If other hormone deficiencies are present, additional hormone treatments may be needed. Managing GHD often requires a team of specialists, including endocrinologists, to monitor growth and overall health.

Follow-Up and Monitoring

Children receiving GH treatment need regular check-ups to track their growth and adjust the dosage if needed. Once growth and puberty are complete, doctors will reassess whether GH therapy should continue into adulthood. Some individuals may need ongoing treatment due to GH’s other benefits on bone strength, metabolism, and overall health.

Early diagnosis and treatment can make a big difference, helping children with GHD grow and thrive. If you have concerns about your child’s growth, consult a pediatric endocrinologist.

History and Exam

Key diagnostic factor

  • presence of risk factors
  • short stature
  • poor growth velocity
  • short for target height

Other diagnostic factors

  • assisted birth
  • visual impairment
  • associated dysmorphic features
  • focal neurological deficits

Risk factors

  • family history of GHD
  • other pituitary hormone deficiencies
  • central nervous system (CNS) tumours/cysts
  • radiotherapy

Diagnostic Investigations

1st investigations to order

  • x-ray wrist
  • thyroid function tests
  • IGF1 and IGFBP3
  • baseline pituitary function tests

Investigations to consider

  • GH provocation test
  • MRI brain
  • CT brain/x-ray skull
  • full pituitary hormone evaluation

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      Social and emotional functioning refers to a child’s ability to understand, express, and manage their emotions, as well as to interact effectively with others. These skills are fundamental for building positive relationships, developing empathy, and coping with the everyday challenges of growing up.

      Children who experience difficulties in social and emotional functioning may struggle with recognizing their own feelings or those of others, regulating emotional responses, or responding appropriately in social situations. This can lead to challenges such as anxiety, low self-esteem, difficulty making friends, or misunderstandings with peers and adults.

      In the school environment, social and emotional difficulties can impact a child’s engagement, cooperation, and overall learning experience. Emotional distress may manifest as withdrawal, irritability, or disruptive behaviour, which can further affect academic progress and peer relationships.

      Assessment of social and emotional functioning as part of a neuropsychological evaluation typically includes behavioural observations, standardized rating scales, and information gathered from parents, teachers, and sometimes the child. This comprehensive approach helps identify strengths and areas for support in emotional regulation, social skills, and adaptive behaviours.

      Understanding a child’s social-emotional profile allows for the development of tailored strategies to enhance emotional wellbeing, build resilience, and improve social communication. Early intervention and supportive environments can empower children to navigate their emotions more effectively, fostering confidence and meaningful connections. 

      At Offspring Health, we aim to provide transparent information about the costs involved in neurodevelopmental and educational assessments.

      Neuropsychological assessments typically involve multiple sessions that usually take between 8 and 16 hours in total, depending on the complexity and individual needs. Our hourly rate is $260, so the total cost typically ranges between $2,300 and $4,230.

      Fees generally cover:

      • Initial consultation and history gathering
      • Testing sessions where your child will complete various fun and interactive tasks
      • Liaison with schools or health professionals as needed
      • Comprehensive case analysis and report preparation
      • Feedback sessions with families and, where applicable, educators or other professionals

      Please note that standard neuropsychological assessments are generally not covered by Medicare. However, some assessments and therapy services may be funded through the National Disability Insurance Scheme (NDIS) for eligible participants. We recommend discussing funding options with your NDIS planner or support coordinator prior to booking. Private health insurance may offer partial rebates depending on your level of coverage.

      What’s the next step?

      Please phone reception for a discussion about your needs or email psychology@offspringhealth.com