Supplementary Material for: When Do Short Children Realize They Are Short? Prepubertal Short Children’s Perception of Height during 24 Months of Catch-Up Growth Hormone Treatment

Aim: To examine perceived height during the first 24 months of growth hormone (GH) treatment in short prepubertal children. Methods: Ninety-nine 3- to 11-year-old short prepubertal children with either isolated GH deficiency (n = 32) or idiopathic short stature (n = 67) participated in a 24-month randomized trial of individualized or fixed-dose GH treatment. Children’s and parents’ responses to three perceived height measures: relative height (Silhouette Apperception Test), sense of height (VAS short/tall), and judgment of appropriate height (yes/no) were compared to measured height. Results: Children and parents overestimated height at start (72%, 54%) and at 24 months (52%, 30%). Short children described themselves as tall until 8.2 years (girls) and 9 years (boys). Prior to treatment, 38% of children described their height as appropriate and at 3 months, 63%. Mother’s height, parental sense of the child’s tallness and age explained more variance in children’s sense of tallness (34%) than measured height (0%). Conclusion: Short children and parents overestimate height; a pivotal age exists for comparative height judgments. Even a small gain in height may be enough for the child to feel an appropriate age-related height has been reached and to no longer feel short.研究目的：探讨身材矮小的青春期前儿童接受生长激素（growth hormone，GH）治疗的前24个月内的感知身高变化情况。 研究方法：本研究纳入99名3~11岁的青春期前身材矮小儿童，其中孤立性生长激素缺乏症（isolated GH deficiency）患者32例，特发性矮小症（idiopathic short stature）患者67例；所有受试者参与一项为期24个月的随机对照试验，比较个体化剂量与固定剂量生长激素治疗的疗效。研究采集儿童及其家长对三项感知身高评估工具的应答结果，包括相对身高评估（轮廓知觉测验（Silhouette Apperception Test））、身高感知度（视觉模拟量表（Visual Analogue Scale，VAS）矮/高维度）以及适宜身高判断（是/否作答），并将上述结果与实际测量身高进行对比分析。 研究结果：治疗初始时，儿童与家长分别有72%、54%的比例高估孩子的身高；治疗24个月后，该比例分别为52%、30%。身材矮小儿童会将自身描述为偏高，这一现象在女童8.2岁、男童9岁前持续存在。治疗前，38%的儿童认为自身身高适宜；而在治疗3个月后，该比例升至63%。母亲身高、家长对孩子身高偏高的感知以及儿童年龄，对儿童自身身高感知的变异度解释度达34%，显著高于实际测量身高的解释度（0%）。 研究结论：身材矮小儿童及其家长均存在身高高估现象；儿童的身高比较判断存在关键年龄节点。即使身高仅获得小幅增长，也足以让儿童认为自身已达到与年龄相匹配的适宜身高，不再感觉身材矮小。