3. Measurement considerations for children with special needs

3.1 Measures of Stature and Length

Segmental lengths: Upper arm length and lower leg length
For some children for whom stature measurements are impossible, segmental lengths (for example, upper arm length and lower leg length) can be used to monitor growth.

Upper arm length is not as affected by a high spinal lesion as stature. It is recommended for children with spina bifida who are bedridden or wheelchair bound (or for other children unable to stand or stretch out on the length board) (Cloud, 1997; Scott, 1997).

For children with cerebral palsy or other conditions that cause or result in contractures, lower leg length can be measured using either a steel or plastic tape measure or an anthropometer. This is a difficult measurement to take and, when taken, should be used with children ages 6-18 years (Cloud, 1997; Scott, 1997; Chumlea, Guo, Steimbaugh, 1994).

These measurements may be plotted on the CDC charts for stature-for-age or length-for-age. Even if measurements fall below the 5th percentile, they establish a growth pattern over time. Reference data exist for some segmental lengths (e.g., knee height), however they are old and do not include children with special health care needs or children who are non-ambulatory (and therefore may have different growth patterns) (Chumlea, et al, 1994).