Uk Boys 2-20 Yr Childhood And Puberty Close Monitoring (Cpcm) Growth Chart printable pdf download

BOYS UK

Clinical assessment of

Body mass index

pubertal progress

2-20yr

Please place sticker (if available) otherwise write in space provided.

(BMI) chart

Tanner stage assessment requires

Age in years

considerable expertise; so unless

Childhood and puberty

Name:

________________________________________

BOYS

you have been adequately trained

you should use the “puberty phases”

close monitoring CPCM)

NHS / CHI No:

approach (see chart instructions

2-20 years

over). For a detailed description of

growth chart

each stage consult a standard

Hospital No:

paediatric reference book (see

for

Date of Birth:

further information).

Assessment by clinical examination

Adult height predictor

should be undertaken only with

This allows prediction of the child’s adult height based on

parental and child consent and

with adequate privacy.

their current height, including a regression adjustment to

This chart is mainly intended for use in children and young

allow for the tendency of very tall and short children to be

The charts below show the age

people whose growth requires close monitoring, or whose

less extreme in height as adults. Four boys out of five will

ranges for each of the five Tanner

measurements are outside the usual centile range. It is based

have an adult height within ±6 cm of this predicted height.

stages of genital and pubic hair

on the UK 1990 growth reference from 4-20 years and at

development, and mean testicular

birth, and the WHO growth standard from 2-4 years (as per

Body mass index BMI) centile chart

volumes

using

the

Prader

the UK-WHO 0-4 years charts). For children aged under 2

orchidometer.

Where over- or underweight is a concern BMI can be

years whose growth needs detailed assessment, the neonatal

calculated and plotted on the BMI chart. BMI is calculated by

Once the Tanner stage has been

and infant close monitoring chart (NICM) is available. This 2-

dividing weight (in kg) by the square of height (in metres e.g.

determined, make a small dot on

20 chart has a number of novel features including some

1.32 m, not centimetres e.g. 132 cm). A simple way to do this

the relevant stage line at the child's

puberty phase specific centile lines. For further information

on a calculator or mobile phone is:

age. The horizontal dotted lines

1. Enter the weight; 2. Divide by height;

show the stage centiles for age. If

about the development of this chart and supporting

3. Divide the result by height.

the point is between the 2nd and

references see .

98th centiles then development is

within normal limits. If the point is

Birth centile plotting scale

The result should be plotted on the BMI chart provided. To

above the 98th centile development

allow the monitoring of severely obese children, the BMI

The chart starts at age 2 years, but there is a scale to the left

is precocious, and if below the 2nd

chart displays high lines at +3, +3.33, +3.66 and +4 SD, and

of the chart where birth weight, length and head

centile it is delayed. In these cases

-4 and -5 SD for those severely underweight.

circumference for term infants can be plotted.

further

investigation

may

required. Please note that unlike

Pubertal assessment

Children with extremes of height or weight

height and weight centiles, the

For most purposes the puberty phase approach will be

stage centile position may change

In addition to the usual nine centile lines, the height charts

sufficient, based on the history and clinical examination as

substantially from one age to the

also show lines -4 and -5 SD below and +4 SD above the

below. Where more detailed assessment of the progress of

next.

mean. The additional weight lines are -4, -5, and +3 SD

puberty is required see the chart flap for Tanner staging.

Genital stage

respectively. Children whose growth lies on these outer lines

The three vertical black lines (puberty lines) on the right hand

are likely to have additional clinical problems, and if not

99.6th

side of the chart (9-20 years) indicate the normal age limits

Precocious

already receiving medical attention should be referred. For

98th

for the phases of puberty described below:

exceptionally heavy or light children BMI should be calculated

91st

Pre-puberty

In Puberty

Completing Puberty

and plotted.

75th

(Tanner stage 1)

(Tanner stages 2-3)

(Tanner stages 4-5)

Parent height comparator mid-parental centile)

If both of the

If any of the following:

The mid-parental centile is the average adult height centile to

following:

Slight deepening of the

Voice full broken

25th

be expected for all children born of this child’s parents. It

voice

Transit point

9th

incorporates a regression adjustment to allow for the

from UK-WHO

No signs of pubertal Early pubic or armpit

Moustache and early

2nd

tendency of very tall and short parents to have children with

Delayed

to UK90 data.

development

hair growth

facial hair growth

less extreme heights. Comparing the mid-parental centile

0.4th

8 9 10 11 12 13 14 15 16 17 18 19 20

with the child’s current height centile can help assess whether

Enlargement of testes

Adult size of penis

Pubic hair stage

the child’s growth is proceeding as expected. The larger the

or penis

with pubic and

discrepancy between the two, the more likely it is that the

axillary hair

99.6th

Precocious

child has some sort of disordered growth. Most children’s

98th

What does a measurement in a shaded area mean?

height centiles (nine out of ten) are within ± 2 centile spaces

91st

The chart provides extra guidance about the lower limit

of the mid-parental centile, and only 1 percent will be

75th

(0.4th centile) for late-maturing boys in pre-puberty and the

discrepant by more than 3 centile spaces.

upper limit (99.6th centile) for early-maturing boys

completing puberty. If height and weight falls within a

Mid-parental target height

shaded area on the chart, pubertal assessment will be

25th

The mid-parental target height is obtained by plotting the

required. For boys in pre-puberty, height or weight within the

9th

mid-parental centile on the height chart at age 20 and

lower shaded areas are likely to be normal, particularly if

2nd

reading off the corresponding height. Four boys out of five

Delayed

height is not markedly discrepant from the mid-parental

0.4th

will have an adult height within ±7 cm of this target height.

8 9 10 11 12 13 14 15 16 17 18 19 20

centile and BMI is within normal limits. Similarly, boys

However predicted adult height (above) is usually closer to

completing puberty who have measurements in the upper

Mean testicular volume ml)

the child’s final height.

shaded area are usually normal.

Precocious

Measurement 1

Measurement 2

Measurement 3

Measurement 4

98th

Recording Date

91st

Weight

75th

Length/Height

BMI

Location

Health worker name

25th

Measurement 5

Measurement 6

Measurement 7

Measurement 8

Recording Date

9th

Weight

2nd

Length/Height

Delayed

Age in years

0.4th

BMI

8 9 10 11 12 13 14 15 16 17 18 19 20

Location

Van Buuren S. Growth charts of human development;

Statistical Methods in Medical Research.

Health worker name

DOI: 10.1177/0962280212473300

Uk Boys 2-20 Yr Childhood And Puberty Close Monitoring (Cpcm) Growth Chart

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