MCHB Training Module -- Using the CDC Growth Charts : Use of the CDC Growth Charts for Children with Special Health Care Needs

7. Application of principles

7.1 Example 1: Child with trisomy 21

AB was followed in an early intervention program from 3 weeks until 41 months of age. Feeding was never a problem, but she was at risk for overweight. At 35 months of age, hypothyroidism was diagnosed, and medication was started.

Her growth was plotted on the CDC charts (head circumference-for-age, weight-for-age, length-for-age, weight-for-length, stature-for-age, and BMI-for-age).

Because she was followed past the age of 3 years, both the 0-36 month and the 2-20 years charts were used:

	(Roll your mouse over the links below to display visual aids on the chart to the right.)

	Year 1: Her length-for-age started at about the 25th percentile, and increased to about the 50th percentile at age 13 months.
	Year 1: Weight-for-age was about the 25th percentile.
	Year 2: Length-for-age decreased from about the 50th percentile at age 13 months to between the 5th and 10th percentiles at age 20 months.
	Year 2: Weight-for-age continued along the 25th percentile.
	Year 3: Although the recommendation is to use the 2-20 year old charts for children over the age of 2 years, the 0-36 month charts were used for AB. AB was not able to stand unassisted, so length was measured, and length-for-age and weight-for-age were plotted on the appropriate charts.
	Year 3: Length-for-age continued to decrease to slightly below the 5th percentile.
	Year 3: Weight-for-age increased to about the 50th percentile.


	Year 1: Weight-for-length increased from about the 25th percentile to about the 50th percentile.
	Year 2: Weight-for-length continued along the 50th percentile.
	Year 3: Weight-for-length increased to the 95th percentile.