Just because a child isn’t growing or developing exactly like his or her peers doesn’t mean a host of medical tests are in order.
In fact, five medical tests commonly ordered for children who are short, overweight or showing signs of early puberty aren’t always necessary. And, that’s particularly true if youngsters are otherwise healthy, according to the American Academy of Pediatrics (AAP).
The five tests include hormone tests, endocrine tests, vitamin D screening, thyroid or insulin tests for overweight children and thyroid ultrasounds for kids with an enlarged thyroid gland or autoimmune thyroid disease, the group noted.
Doctors and their patients should carefully weigh the risks and benefits of these procedures, advised Dr. Paul Kaplowitz in an AAP news release. He’s past chairperson of the AAP Section on Endocrinology.
“As a pediatric endocrinologist, I’ve counseled many parents who are worried about their children’s growth,” Kaplowitz said.
“There is a wide range of what is ‘normal’ for child growth and development. If a child is otherwise healthy and is following their own curve, what the parents often need is reassurance that their child is fine, and not a lot of testing,” he said.
The AAP compiled a list of the five commonly used procedures, urging doctors to use evidence-based strategies when ordering these tests.
Hormone tests, for example, may be unnecessary for children with pubic hair or body odor but no other physical signs of puberty, such as a growth spurt or breast development.
Screening tests for endocrine disorders are unlikely to benefit children with a normal growth rate, according to the AAP.
Even when these tests are performed on children who are shorter than average, they only reveal an underlying health issue in 1 percent of cases. Screening tests may be indicated, however, for children who are significantly shorter than they should be based on their parents’ height, the group added.
Meanwhile, testing for vitamin D deficiency is only appropriate for patients with disorders associated with low bone mass, such as rickets.
For obese children, thyroid testing should only be considered if their growth rate is abnormally low or there is another sign of a thyroid issue.
Thyroid ultrasounds may cause unnecessary worry and expenses among children and their parents. This test should be limited to children with swelling on only one side of their neck, nodules that can be felt through the skin and those with very enlarged thyroid glands.
“This new Choosing Wisely list will enhance discussions physicians and families have about issues in growth and development that often come up, and help craft the best treatment plans,” Kaplowitz said.
The U.S. National Library of Medicine provides more information on disorders that affect children’s glands and growth.