Comparison of school nurse and auxologist height velocity measurements in school children with short stature. (The Hackney Growth Initiative).

To examine the possible use of height velocity (HV) as a growth screening tool, annual HV data calculated from height measurements made by school nurses were compared with those based on an auxologist's measurements in 20 short school children. The subjects were 12 primary school children (seven girls, five boys) with a mean (+/- SD) age of 5.9(0.6) years and eight secondary school children (six girls, two boys) with a mean (+/- SD) age of 11.8 (0.4) years. Heights were measured by the school nurses, separated by an interval of 1 year. Mean HV of the primary school children when assessed by school nurses was 5.92 cm/year compared with 5.97 cm/year when assessed by the auxologist. Mean (+/- SD) HV standard deviation score (HVSDS) was 0.03 (0.97) and 0.10 (1.15) respectively. Mean HV of the secondary school children when assessed by school nurses was 6.04 cm/year compared with 5.63 cm/year when assessed by the auxologist. Mean (+/- SD) HVSDS was -0.8 (2.1) and -1.21 (1.54) respectively. Of eight children (three primary, five secondary) identified by the auxologist as having HV < 25th centile of Tanner and Whitehouse standards only four were identified by school nurses (one primary, three secondary). One child identified by school nurses to have HV < 25th centile was found by the auxologist to be above the 25th centile. We conclude that HV assessment may fail to identify significant pathology in the community and that accurate height measurement rather than HV should be the principal referral criterion.