Psychosocial Dwarfism : Detection , Evaluation and Managkment

Environmentally-induced growth retardation associated with psychosocial deprivation, emotional stress and/or neglect is probably the most common single cause of deviant growth in infants and children in the United States today. All too often, however, the child's small stature is ascribed to other etiologies because environmental factors are unappreciated. In 1967, Powell and associates described 13 young children with severe growth retardation, developmental delay, and bizarre behavior who had histories suggestive of emotional deprivation (1). These children were found to have hypopituitarism which resulved with change in their environment (2). Catch-up in physical and emotional growth was often dramatic. This syndrome of deprivation or psychosocial dwarfism has subsequently become more widely recognized by pediatric endocrinologists but it still remains often undiagnosed by many health professionals. It is important that there be awareness of this condition because earlier detection may help to prevent physical and developmental lags which often appear to be irreversible when intervention is delayed.