Children with growth hormone deficiency have a slow rate of growth, usually less than 2 inches per year. The slow growth may not appear until a child is 2 or 3 years old.

The child will be much shorter than most or all children of the same age and gender.

Children with growth hormone deficiency still have normal body proportions, as well as normal intelligence. However, their face often appears younger than children of the same age. They may also have a chubby body build.

In older children, puberty may come late or may not come at all.

A physical examination including weight, height, and body proportions will show signs of slowed growth rate. The child will not follow the normal growth curves.

Tests may include the following:

• Dual energy x-ray absorptiometry (DEXA) scans can also determine bone age.
• Hand x-ray (usually the left hand) can determine bone age. Normally, the size and shape of bones change as a person grows. These changes can be seen on an x-ray and usually follow a pattern as a child grows older.
• Measuring growth hormone and binding protein levels (IGF-I and IGFBP-3) will show whether the growth problem is caused by a problem with the pituitary gland.
• MRI of the head can show the hypothalamus and pituitary glands.
• Tests to measure other hormone levels (lack of growth hormone may not be the only problem) may be done.
• X-ray of the head may show problems with the skull.