Most short children are healthy and simply following a familial or constitutional pattern. A minority have a treatable cause, and distinguishing between the two is the purpose of assessment.
What assessment involves
Accurate serial height measurement plotted on growth charts, mid-parental height calculation, bone age X-ray, thyroid function, coeliac screening, and — where indicated — growth hormone testing. Growth velocity over time is more informative than any single measurement.
Treatable causes
These include growth hormone deficiency, hypothyroidism, coeliac disease, chronic illness, Turner syndrome in girls, and nutritional deficiency. Where growth hormone therapy is appropriate it is most effective when started before the growth plates begin to close, which is why early referral matters.
Puberty
Delayed puberty and precocious (unusually early) puberty are both assessed and managed, with attention to the emotional impact on the child as well as the hormonal picture.