Growth-Attenuation Therapy: Principles for Practice

  title={Growth-Attenuation Therapy: Principles for Practice},
  author={David B. Allen and Michael S. Kappy and Douglas Diekema and Norman Fost},
  pages={1556 - 1561}
Publication of an account of growth attenuation with high-dose estrogen in a child with profound physical and cognitive disability brought widespread attention to a common and complex issue faced by families caring for similarly affected children, namely, the potentially negative effect of the increasing size of a child on the ability of his or her family to provide independent care, which in turn makes it more difficult for parents to keep the child in the home and involved in family… 
Growth Attenuation Therapy
  • N. Kerruish
  • Psychology
    Cambridge Quarterly of Healthcare Ethics
  • 2016
There is a need to redress this balance by analyzing published accounts both from parents of children who have received GAT and from parents who oppose treatment, and important points are illuminated regarding how parents characterize benefits and harms, and their responsibilities as surrogate decisionmakers.
Therapy of growth disorders
  • O. Ali, D. Wyatt
  • Medicine, Biology
    Current opinion in endocrinology, diabetes, and obesity
  • 2011
Growth hormone remains the mainstay of therapy for growth disorders, though other options, including recombinant insulin-like growth factor 1, are being investigated in various settings.
Growth attenuation therapy for children with severe physical and cognitive disability: Practice and perspectives of New Zealand paediatricians
This survey aimed to explore the attitudes of paediatricians towards GAT and the frequency of requests and initiation of GAT in NZ.
Forever Small: The Strange Case of Ashley X
I explore the ethics of altering the body of a child with severe cognitive disabilities in such a way that keeps the child “forever small.” The parents of Ashley, a girl of six with severe cognitive
Central Precocious Puberty and Response to GnRHa Therapy in Children with Cerebral Palsy and Moderate to Severe Motor Impairment: Data from a Longitudinal, Case-Control, Multicentre, Italian Study
D diagnosis of CPP could be partially mislead in CP due to growth failure that got worse during follow-up despite therapy, supporting the hypothesis of a more intense activation of hypothalamic-pituitary-gonadal-axis in these patients.
Rationale for routine and immediate administration of intravenous estrogen for all critically ill and injured patients.
An extensive body of extremely supportive experimental data has generated a very persuasive argument that intravenous estrogen should be routinely administered, as soon as possible, to all persons identified as having a critical illness or injury.
Retracted Article: Growth attenuation and young people with profound disabilities – why we need to talk about Charley
In 2004 an intervention known as the Ashley Treatment (AT) was sought on behalf of Ashley X, a girl with severe developmental disabilities. A discursive interpretive framework is used to investigate
  • Retracted
The Rights of Children in Biomedicine : Challenges posed by scientific advances and uncertainties
The report concludes that the biomedical controversies surveyed here signal a need for systemic, continuous and multidisciplinary oversight of these issues, as well as for many biomedical interventions that could not be covered here in depth.
Bone Age: A Handy Tool for Pediatric Providers
There is evidence that indicates the bone ages obtained from current methods are less generalizable to children of other ethnicities, particularly children with African and certain Asian backgrounds.
Evolution and Future of Growth Plate Therapeutics
During the past 4 decades, advances in understanding growth plate physiology have been accompanied by development and implementation of growth-promoting treatments that have progressed in both efficacy and specificity of action.


Attenuating growth in children with profound developmental disability: a new approach to an old dilemma.
It is suggested that after proper screening and informed consent, growth-attenuation therapy should be a therapeutic option available to children with severe, combined neurologic and cognitive impairment should their parents request it.
Growth attenuation: a diminutive solution to a daunting problem.
This work concludes that among the many extraordinary problems confronted by parents of children with profound cognitive and physical disabilities, figuring out how to provide care as the child grows into an adult is among the most difficult to solve and distressing to contemplate.
Growth Attenuation, Parental Choice, and the Rights of Disabled Children: Lessons from the Ashley X Case
The case of Ashley X, a profoundly disabled child from Washington whose growth and sexual development were purposely stunted through medical and surgical treatments elected by her parents, raises
Estrogen use in children and adolescents: a survey.
The purpose of this survey was to ascertain the prevalence of estrogen therapy in children and adolescents, as well as the estrogen preparation used, dose, benefits, and observed complications.
Tall girls: the social shaping of a medical therapy.
This case study illustrates how scientific knowledge is always created and applied within a particular social context and suggests that insight into the present-day treatment of short stature can be gained by comparing the use of estrogen therapy for tall girls with theUse of growth hormone therapy for short boys.
Estrogen treatment of girls with constitutional tall stature.
This report is based on the therapeutic results in 41 girls aged 10 to 15 years whose treatment now is finished, and the mean midparents' height was 177 cm, considerably higher than the average for the population, which in Great Britain is 168 cm, according to Tanner et al.
Long term sequelae of sex steroid treatment in the management of constitutionally tall stature.
There is no evidence that pharmacological doses of sex hormones have a long term effect on reproductive function, however, this period is still too short to draw definite conclusions.
Postmenopausal carcinoma as a result of estrogen treatment: survey of evidence.
Treatment of menopausal symptoms with estrogens should be brief as possible, should use the lowest dose possible, and should probably be given in cyclic fashion, particularly to women with intact uteruses.
Sex steroid treatment of constitutionally tall stature.
The treatment of Constitutionally Tall Boys and Estrogen Treatment in Tall Girls, and Alternative Treatment Modalities and Future Research, are recommended.