CONTEXT: Accurate determination of the length of very young children is important because weight-for-length standards are used to assess both under- and overweight. Clinical measurements of length, which usually involve a paper-and-pencil method, may often be inaccurate in children younger than 2 years. OBJECTIVE: To compare length measured by the conventional clinical paper-and-pencil method with length measured by the research standard recumbent length-board method in a sample of children under 2 years of age. METHODS: Research assistants measured 160 children 0 through 23 months of age using the recumbent length-board method, and clinical staff measured the same children using the paper-and-pencil method. To assess the relationship between the research and clinical length measurements, we used ordinary least squares regression. RESULTS: We found a strong linear relationship between the 2 measures of length (R2 = 0.98). The paper-and-pencil method systematically overestimated length in children under 2 years of age. A fitted regression equation estimated that the research standard length was 95.3% of the clinical measurement plus 1.88 cm. Over the entire age span, the mean (SD) difference between clinical and research measurements was 1.3 (1.5) cm. CONCLUSIONS: Using the paper-and-pencil method can lead to underestimates of overweight and exaggerated estimates of thinness. To improve the accuracy of length measurement, medical providers should use standardized procedures with a recumbent length board to measure children under 2 years of age, at least for children whose initial paper-and-pencil measurement of length puts them at one extreme or the other.
CONTEXT: Accurate determination of the length of very young children is important because weight-for-length standards are used to assess both under- and overweight. Clinical measurements of length, which usually involve a paper-and-pencil method, may often be inaccurate in children younger than 2 years. OBJECTIVE: To compare length measured by the conventional clinical paper-and-pencil method with length measured by the research standard recumbent length-board method in a sample of children under 2 years of age. METHODS: Research assistants measured 160 children 0 through 23 months of age using the recumbent length-board method, and clinical staff measured the same children using the paper-and-pencil method. To assess the relationship between the research and clinical length measurements, we used ordinary least squares regression. RESULTS: We found a strong linear relationship between the 2 measures of length (R2 = 0.98). The paper-and-pencil method systematically overestimated length in children under 2 years of age. A fitted regression equation estimated that the research standard length was 95.3% of the clinical measurement plus 1.88 cm. Over the entire age span, the mean (SD) difference between clinical and research measurements was 1.3 (1.5) cm. CONCLUSIONS: Using the paper-and-pencil method can lead to underestimates of overweight and exaggerated estimates of thinness. To improve the accuracy of length measurement, medical providers should use standardized procedures with a recumbent length board to measure children under 2 years of age, at least for children whose initial paper-and-pencil measurement of length puts them at one extreme or the other.
Authors: Juhee Kim; Karen E Peterson; Kelley S Scanlon; Garrett M Fitzmaurice; Aviva Must; Emily Oken; Sheryl L Rifas-Shiman; Janet W Rich-Edwards; Matthew W Gillman Journal: Obesity (Silver Spring) Date: 2006-07 Impact factor: 5.002
Authors: R J Kuczmarski; C L Ogden; L M Grummer-Strawn; K M Flegal; S S Guo; R Wei; Z Mei; L R Curtin; A F Roche; C L Johnson Journal: Adv Data Date: 2000-06-08
Authors: T H Lipman; K D Hench; T Benyi; J Delaune; K A Gilluly; L Johnson; M G Johnson; H McKnight-Menci; D Shorkey; J Shults; F L Waite; C Weber Journal: Arch Dis Child Date: 2004-04 Impact factor: 3.791
Authors: Izzuddin M Aris; Sheryl L Rifas-Shiman; Ling-Jun Li; Ken P Kleinman; Brent A Coull; Diane R Gold; Marie-France Hivert; Michael S Kramer; Emily Oken Journal: Int J Epidemiol Date: 2019-02-01 Impact factor: 7.196
Authors: Amy L Louer; Denise N Simon; Karen M Switkowski; Sheryl L Rifas-Shiman; Matthew W Gillman; Emily Oken Journal: J Vis Exp Date: 2017-02-02 Impact factor: 1.355
Authors: Karen M Switkowski; Paul F Jacques; Aviva Must; Ken P Kleinman; Matthew W Gillman; Emily Oken Journal: Am J Clin Nutr Date: 2016-08-31 Impact factor: 7.045
Authors: Erin S Ross; Nancy F Krebs; A Laurie W Shroyer; L Miriam Dickinson; Paul H Barrett; Susan L Johnson Journal: Early Hum Dev Date: 2009-07-15 Impact factor: 2.079