3. Measurement considerations for children with special needs

3.1 Measures of Stature and Length

Children unable to stand should be measured on a recumbent board. Scoliosis and leg contractures decrease the accuracy of the length measurement. Alternative measurements can be used to assess linear growth, including:

crown-rump length and sitting height

arm span

upper arm length

lower leg length

Crown-rump length and sitting height
Sitting height and crown-rump length are sometimes used in place of stature and length when a child is unable to stand, but can sit erect.

Crown-rump length
Crown-rump length is measured using a recumbent length board.

		Equipment: recumbent length board
		Technique: The head is positioned as with a length measurement. The legs are raised so that the thighs are at a 90-degree angle to the board and held in that position during the measurement. The sliding footboard is brought up against the buttocks with firm pressure and the reading is taken.
		Plotting and Interpretation: The measurement can 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 (Lohman, 1988; McCammon, 1970). Reference data exist, however the data set is small and does not include children with special health care needs (McCammon, 1970).

Sitting height
(Lohman, 1988; Hamill, et al, 1973)

		Equipment: sitting base of a known height (e.g., 50 cm x 40 cm x 30 cm) and a wall-mounted stadiometer
		Technique: The child is placed as erect as possible with buttocks, shoulders, and head in contact with backboard of the stadiometer. Total height is measured. The height of the sitting surface is then subtracted from the total height.
		Plotting and Interpretation: The measurement can be plotted on the CDC charts for stature-for-age. Even if measurements fall below the 5th percentile, they establish a growth pattern over time. There are reference data for sitting height, however the data are old and do not include children with special health care needs (Hamill, et al, 1973).