19parameters of healthy children of different age at a given point of time, while
the “longitudinal growth charts” are constructed by prospective follow-up of
anthropometric parameters of a cohort of healthy children. Cross-sectional
growth charts do not take into account height velocity or variations in height
during pubertal growth spurt of an individual. These limitations can be over-
come by the use of longitudinal growth charts. The cross-sectional growth
charts include Centre for Disease Control (CDC), Agarwal and Khadilkar
growth charts, whereas Tanner–Whitehouse chart is longitudinal. WHO growth
charts are mixed growth chart; it is longitudinal from 0 to 2 years of age and
cross-sectional thereafter. The characteristic features of different growth charts
are summarized in the table given below.ParametersNCHS/WHO,
1978 WHO, 2006 CDC, 2000 IAP, 2015
Type of growth
chartGrowth reference
chartGrowth standard
chartGrowth
reference chartGrowth
reference chart
Region specific USA Global (six
countries)USA IndiaAge 0–18 years 0–5 years 0–20 years 5–18 years
Growth
percentile5–95 5–95 3–97 3–97Method of
surveillanceLongitudinal Longitudinal Cross-
sectionalCross-sectional
0–2 years 0–2 years
Cross-sectional Cross-sectional
2–18 years 2–5 years- What is the utility of growth chart?
Growth chart is an important tool for monitoring anthropometric parameters of
a child and helps in the objective assessment of adequacy of growth. Accurate
plotting of height and weight of a child on a growth chart should be done prior
to evaluation of a child for growth abnormalities. Prospective follow-up of
height or weight of a child helps in early identification of growth faltering and,
thereby, timely evaluation. Growth chart also helps in the differential diagnosis
of short stature, prediction of final adult height of an individual, and monitoring
the response to therapy. It is imperative to use the same growth chart during
follow-up of a child.- What are the merits and demerits of WHO ( 2006 ) growth chart?
WHO (2006) growth chart is unique as it is a “growth standard chart” in com-
parison to other growth charts which are “growth reference charts.” These
growth standard charts were constructed by data obtained from healthy children
who were predominantly breastfed for at least initial 4 months of life, received
optimal nutrition thereafter, and were reared in a good psychosocial environ-
ment. WHO (2006) growth chart is also unique that it represents growth stan-
dard of children from six different countries. It also provides longitudinal data1 Disorders of Growth and Development: Clinical Perspectives