Tall girls: a survey of 15 years of management and treatment

In the past 15 years 450 girls have been seen because of concern about tall stature: 168 of them have been treated with stilbestrol to control the growth rate. Of the latter group 87 have been followed after treatment for a sufficiently long time to be sure growth had ceased and to provide the data for this report. At the onset of treatment the following data (mean values) were recorded: chronologic age, 13.0 years; skeletal age, 13.2 years; height, 172.9 cm; estimated mature height 180.2 cm; and growth potential, 7.3 cm. At the end of treatment data of interest (mean values) were: reduction in final height, 3.5 cm; duration of therapy, 2.1 years; amount of stilbestrol given, 2.3 gm; age of last visit, 17.6 years. Side effects were minimal, though two girls developed parovarian cysts that required surgery during treatment. Not included in the series of 87, one additional girl was seen with a serous cystadenoma of the ovary, and one girl developed superficial venous thrombosis of the calf. Long-term follow-up has revealed no late complications. It is concluded that estrogen can reduce significantly the growth rate of almost all tall girls, but treatment must be carried out under very careful supervision, bearing in mind possible side effects.

Outline of a school psychiatric service in Montreal

For several years a psychiatric consultation service, now involving 1 1/2 days weekly, has been given to Area 5 schools of the Protestant School Board of Greater Montreal, Area 5 having 10,000 children. Treatment is not part of the service, but cases requiring it are generally referred to appropriate physicians or clinics. Prior to actual interviews with the children, data are collected from all suitable sources and intelligence testing is done. The majority of referrals for psychiatric assessment seem warranted. This is illustrated in a Table showing the findings in 18 children from one classroom. Reports from the principals indicate their approval of the service and their wish to see it expanded.