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Training Module: Adolescent Physical Development

Case #1: Assessing Pre-pubertal Growth
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4. Case #1: Use of Growth Charts for Assessing Pre-pubertal Growth During Adolescence

Mandy is a 12 year old female who has been a ballet dancer since age 6. At her health supervision visit, she weighs 66 lbs (3rd percentile) and is 58 inches tall (25th percentile). Her BMI is 13.8 (< 3rd percentile for age). She has no evidence of breast or pubic hair development, and expresses no interest in "growing up" because she does not want to "get fat." She has heard her dance teachers make comments about other students in her dance class gaining weight too quickly. She eats a low-fat diet because her mother was found to have a high cholesterol and Type II diabetes associated with moderate obesity, weighing 175 pounds at 64 inches tall. Father is a 70 inch tall competitive runner, who is a self-described "fitness fanatic."

  Chart showing Mandy's stature-for-age constant at the 50th percentile until age 10, then dropping down to 25th percentile by age 12; Mandy's weight-for-age constant at the 25th percentile until age 10, then falling off to 3rd percentile by age 12.    Chart showing Mandy's BMI at 13.8 at age 12.


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