Children who are receiving medication to treat attention deficit hyperactivity disorder (ADHD) and who are short for their age should be tested for a hormonal cause of their short stature, the authors of a new study recommend. The study will be presented Sunday, June 3, at The Endocrine Society’s 89th Annual Meeting in Toronto.

Slow growth in children taking stimulant medications for ADHD may not be a side effect of the medication, as is commonly thought, cautioned Dr. Samar Rahhal, a fellow in pediatric endocrinology at Indiana University School of Medicine and a study author. Previous studies have found that children taking stimulants experience slowing of their growth, but most children eventually catch up and reach normal adult heights.

Rahhal and her co-workers found that a significant number of children referred to their university’s pediatric endocrinology clinic for evaluation of short stature are receiving ADHD medications, and many of these children have a medical disorder responsible for poor growth.

The investigators randomly selected 120 medical records for review from the records of 309 new patients who were 5 years of age or older and were evaluated for poor growth. They found that 25 percent of the patients were receiving medication to treat ADHD. This is an unusually high percentage, Rahhal said. Only 5 percent of all children in Indiana are currently medicated for ADHD, according to the latest data from the U.S. Centers for Disease Control and Prevention. Furthermore, they discovered that the children who were medicated because of ADHD were just as likely as those who were not prescribed these medications to have growth hormone deficiency (10 versus 13 percent, respectively). Some of these children had other growth disorders that required growth hormone therapy.

“If short stature is the effect of only ADHD medicine, you would not expect to also see growth hormone deficiency in this many children,” Rahhal said. “This study highlights the importance of thoroughly screening short children with ADHD for endocrine diseases.”

Parents and pediatricians should not assume the child will have catch-up growth, she recommended, adding, “The child could have a growth disorder as well.”

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