Fundamentals in Human

Growth UNIT 3 METHODS OF STUDYING GROWTH

Contents
3.0 Introduction:
3.1 Methods of Studying Growth
3.2 Cross-sectional Method
3.2.1 Merits and Demerits of Cross-sectional Method
3.3 Longitudinal Method
3.3.1 Merits and Demerits of Longitudinal Method
3.4 Mixed Longitudinal Method
3.4.1 Merits and Demerits of Mixed Longitudinal Method
3.5 Summary
3.6 References
3.7 Answers to Check Your Progress
Learning Objectives
After going through this unit you will be able to:
 understand the concepts of different methods of studying human growth;
 differentiate various methods of studying human growth along with their
merits and demerits; and
 select the most appropriate method of studying growth in various population
groups.

3.0 INTRODUCTION
We can easily observe differences in body’s physical growth every day. Individuals
do differ in weight, height, the relative length of the body proportions. The way
we move and perform physical activities differs from individual to individuals.
All these differences provide us the vision into our growing stage and maturation
phase to the overall developmental stage. Physical growth and development are
considered as the basic yet the most important characteristics taking place during
the lifespan of every living organism. Though the terms “Growth” and
“Development” are often used in a replaceable manner but in reality, they are not
at all same in the biological sense. Basically, the general shape and design of a
growing body is similar for all people. However, there can be some significant
variations in the growth rate and the timings or the phases of growth and in the
attainment of body size.
Growth refers to the increase in size and weight of the body while on the otherhand
development refers to the structural changes taking place within the body during
growth. Therefore, growth brings changes in the size of an organism whereas the
development brings changes in the form and structure of the body. Growth is
defined as the development of a living thing progressively, specifically the process
by which the several organs and body parts reach their point where complete
physical maturity takes place, starting from the fertilization by cell multiplication
Contributor: Dr Monika Bhuker, PhD, Department of Anthropology, University of Delhi, Delhi
and Ms. Kaneeka Joshi, Ph.D. Scholar, Faculty of Anthropology, School of Social, IGNOU,
40 New Delhi
and intercellular components. It is considered as an essential and vital Methods of Studying Growth
characteristic of all living beings.
Changes in size are the important factor which are the outcomes of three
fundamental cellular processes:
a rise in the cell number hypertrophy;
an increase in the cell size i., e, termed as hyperplasia; and
growth in the intercellular materials or also called as accretion.
Growth occupies a significant and important place while studying individual
diversity in form and function in man. For many of these, this also rises through
the differential growth rates of specific body parts in relation to others. Watson
and Lower (1967) refers to growth as an increase or upsurge in the physical size
of the entire or any of the body part/organ. The measurements are taken in
centimetres, kilograms, or by using the metabolic balance (retention of calcium
and hydrogen in the body). According to Juan Comas, growth is defined as an
objective manifestation of hypertrophy and hyperplasia of the organism, and its
constituent tissues; which is mainly determined by the post-natal body’s size. It
is majorly depending on certain factors such as ethnicity, environment, nutrition,
etc. Growth has been defined in various forms, like Bogin in 1991 refers to
growth as a quantitative increase in body size or mass body; whereby height
being measured in centimetres and weight in kilograms; both indicative of the
amount of growth that takes place in a child. Measuring the number, weight, or
cell size describes the growth of a body or organ at a point in time. The
development of the human body begins as soon as a fertilized egg gets embedded
within the mother’s womb at the time of conception. Development occurs by the
production of specialized tissues from unspecialized ones and growth takes place
by repeated cell division. At birth, differentiation of cells and tissues gets almost
completed, while further development being mainly a matter of growth.

In this unit, we will introduce you to various approaches to studying growth in

humans along with their advantages and disadvantages. Growing from a small
infant to a fully grown adult is the most fascinating thing one can see in human
growth. The process of growth and development in humans is the most incredible
and complex phenomenon. The clinical assessment of the individual’s growth
involves answering numerous questions regarding the amount of growth and the
consistent velocity of growth. Is the growth or increase in body size/ mass normal
according to age or is it proportionate? Thus, the study of human growth is a
very fascinating area of biological anthropology that gives us a clear understanding
of all these concepts.

Growth is an assessable and measurable method, and anthropometry plays an

important and crucial part while assessing growth. The growth values at
consecutive ages are plotted in a graph. The graph is used to attain growth
curves. There are usually two types of growth curves that are drawn namely
distance curve and
velocity curve.
Here, growth is considered as a function of motion where the object moves from
one place to another, covering a distance that can be measurable. At different
ages, body parts grow, whereby the increase in the body shape/weight/size can
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Fundamentals in Human be measured and depicted on a curve. Such a curve is called a distance curve.
Growth
Again, all through movement, an object might not be in motion with the same
speed. It is then that during the different growth stages, the velocity of growth
rate may not be the same; that can be determined from a velocity curve. It may,
therefore, kept in mind that different body parts do not grow with the same speed
and rate during different stages/ phases of growth.

To have a better and deep comprehension of the changing aspects of human

growth, development, and the patterns of average growth, it is important
to have a piece of complete knowledge about the several methods that
focus on growth. Data can be collected using different approaches or
methods of evaluating growth that is then used to establish the growth
standards, charts, or norms for a population. Growth standards and
charts are used as a dynamic tool for the purpose to teach and encourage
health workers and parents to take action for maintaining and improving
the growth of a child and screening the growth faltering and directing of
proper involvements. Therefore, it becomes important to make you
understand the ideas and facts of various methods such as longitudinal,
cross-sectional, and mixed longitudinal. All these methods are used for
data collection and analysing the growth from the available data along
with their advantages and disadvantages. Knowledge produced has its
consequences in the scheming of a well-planned growth study.

This information will also help you in choosing an appropriate method to employ
while undertaking specific growth studies. In this Unit, an attempt has been made
to explain various methods of studying growth in a very simple way and with the
help of suitable examples wherever required, to make you understand the
importance of each method in studying human growth.
Check Your Progress 1
1) Name the two types of growth curves.
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3.1 METHODS OF STUDYING GROWTH

A well-planned growth study is a pre-requisite to obtain information about status
of health of a particular population. So, to study the health and nutrition status of
a given population it is very much required to use the standardized and well-
designed method of growth study. Before starting with the detailed discussion
about this topic, a rigorous thought is required to start with collecting data. While
collecting data, this should be considered for what purpose you are gathering
data. There are some other characteristics as well that should be considered such
as regarding method of study, cost, time, efforts involved along with the detailed
planning and scheduling of sample procedures or measures, performing training
in a careful manner by measuring anthropometric parameters and for the purpose
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of analysing data, use of statistical analysis. It is important to select the appropriate Methods of Studying Growth
and the suitable method that helps in increasing the understanding about the
changing aspect of human growth and average patterns of growth. Various
approaches are used while conducting the surveys regarding growth of children
in different populations. The precise methods for these surveys are used by
anthropologists, auxologists, health professionals and nutritionists. At the initial
stage of the study, this should be considered that the chosen type of method
should depend on the aims and objectives of the study. Let’s say if the objective
of your study is to determine the growth patterns of a particular community, so at
that time, a cross-sectional would suit. So, there are two methods from which
growth can be ascertained – (a) cross-sectional study and (b) longitudinal study.
During the adolescent growth spurt, variations are examined and investigated
using the longitudinal design for several years so that the time the growth spurt
was initiated and peak of the growth spurt should be identified. This approach
also talks about the magnitude of the squirt quantified. During a cross-sectional
study, measurements of participants are taken only one time. It includes the
involvements from different ages that helps in providing the general explanation
of growth changes which are related to age. Whereas in case of longitudinal
method, every single participant is measured for several years. In simple words,
same individual or group of subjects/ participants is/ are measured again and
again for year to years.

Both of the studies used for assessing the growth have limitations, so to overcome
all those drawbacks, there is another approach that is used to study growth is
linked longitudinal and mixed-longitudinal methods. This is the third type of
study that includes a group of participants followed longitudinally. If during the
entire study, any of the subjects leave the study, then other participant of the
same age joins the study at some point in time. This is called as mixed longitudinal
study. All these studies are described separately in detail.

3.2 CROSS-SECTIONAL METHOD

Cross- sectional method is one of the most common approach used for studying
human growth. This approach involves the measurements of participants having
different ages or age groups once during the entire duration of the study. For
instance, if during a study, investigator measures all children participated in the
study at an age of 9 years are totally different from those at 8 years of age, which
in turn are entirely different from the children being measured at 7 years of age
and so on. Let’s explain this in other words, Cross sectional study is the method
that uses different participants at each age. It is a cross-section of a given age
group, sex group, or of a given population. Such kind of method does not follow
any element of periodic evaluation. Cross-sectional surveys and assessments are
ideal for developing distance-curves of growth for any region and type of
body. This study is used to determine and analyze the growth and development
that provides baseline knowledge at one point in time.

3.2.1 Merits and Demerits of Cross-sectional Method

Merits: Cross-sectional methods are considered suitable for studying
 the distributions of several anthropometric measurements among various
individuals at different ages;
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Fundamentals in Human  also data gathered using this technique which is regarded as ideal for
Growth
constructing standards of attained growth, (e.g., height and weight standards);
 results obtained from the cross-sectional studies performed on growth,
maturity, physical activity status or performance of a sample of children and
the presence of variability within the sample.
Thus, such studies provide detailed information on the size of the body, maturity
stage or performance level, and particularly activity while attaining the
survey. Centile distribution of growth patterns could be calculated from cross-
sectional study data; which are then often used as the basis for population
standards. This method is very useful for creating growth standards for
communities, ethnic groups, and populations.

Cross-sectional studies and surveys are significant at identifying and measuring

the status of nutrition and health-associated problems dominant in
different nutritional status and health-related problems prevailing in different
groups at a certain point of time (Malina et al., 2004).

However, after having said this, cross-sectional approaches are also requisite in
conditions where continuity of subjects is not possible, such as studying internal
organs and other through autopsy.

Demerits: Cross-sectional studies

 do not reveal anything about individual rates of growth (individual increments
from one year to the next) adding limitations to the usefulness of even large-
scale cross-sectional studies.
 though estimate the mean rate of growth of a population; however, nothing
about the variability around that means is known using this method of study.
 do not provide detailed and accurate information about timings of specific
stages of growth like the inception of “Juvenile Growth Spurt”, the
achievement of “Peak Height Velocity” and “Peak Weight Velocity” etc.
This is precisely the most needed to know in a clinical context to compare an
individual’s pace of growth with the available standards for the rate of growth in
their age. For these longitudinal studies are needed to refer to the relating growth
standards. They do not provide any other information about variability around
the value of the mean. Thus, be careful as, do not compare the “growth velocity”
of any parameter which are based on the cross-sectional study.
Check Your Progress 2
2) What are the merits of cross-sectional studies?
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 Methods of Studying Growth
3.3 LONGITUDINAL METHOD
In a longitudinal study, at every age, the same participant is used for evaluating
the growth patterns. This method deals with the study of human growth over the
enrolled participant sometimes, who is measured for body measurements (one
or more) at fixed time intervals throughout the study.  

In simple words, a longitudinal method includes the recurrent observations on

the same individuals at particular intervals over a specific period. This method/
approach of studying human growth includes the measurement of each child
occasionally involved in the study for 1 or more parameters at set time intervals
throughout the study. Let’s understand this with an example, if say, children who
are measured at 5 years of age will remain the same as those children who were
analyzed and examined at 4 years of age. There are two fundamentals of this
particular study that are to be studied and considered i.e., the constant sample
size and strict observations to a definite periodicity at which participants are
required to follow up. This particular study can be performed and carried out for
several years. In terms of obtaining the basic type of velocity standards,
participants are required to be measured two times i.e., once a year.

There are other forms of Longitudinal study i.e., the short-term longitudinal study
also exists extending from 3-6 years of age, for illustration; others from full birth
to maturity – longitudinal methods where children might be examined once,
twice, quarterly, or sometimes more than that of every year from birth until the
age of 20 years and more based on the aims and objective of the ongoing study.
Generally, during infancy band early childhood, and adolescence, longitudinal
studies are considered to be more useful. So, these two periods of life are
characterized by fast change and growth. But the main demerits of a complete
longitudinal method are long time consumption to complete the span with a
relatively small number of subjects who are followed for the study.

To overcome problems like these ‘Linked Longitudinal Studies’ are commenced

where studies performed covering the ages from 0 to 6, 5 to 11, 10 to 15, 14 and
till 20 years. Using this design, the complete age range of the growing phase of
human life within a period of six years is spanned and covered. Though, efficient
sampling of the population is crucial and important for the smooth collection of
data during short time intervals.

Longitudinal studies which are of a long term are important even from birth to
maturity for a thorough investigation going on continuously between unfolding
events in individuals and sometimes when performing clinical investigations of
disorders related to growth. It is important to use appropriate statistical methods
while working out the results of different types of studies.

3.3.1 Merits and Demerits of Longitudinal Method

Merits: Longitudinal studies
 provide information about the gross size i.e., attainment of the distance growth
along with the individual growth rate that is measured by a increase between
two consecutive time intervals for e.g., Kg/year or cm/year.

45
Fundamentals in Human  provide us an idea regarding the effectiveness of specific stages such as
Growth
initiation of juvenile spurt of growth or the spurt of adolescent growth of
individuals.
 help us to learn the genetic and environmental influential parameters on the
changing aspects of growth of children; like observing the short-termed illness
during childhood; with an understanding that velocity of growth is defined
as the innate capacity of a child from their growing age to developmental
phase.
 allow knowing about the span of any disease or stress due to nutrition with
which the participant is being distressed for a longer period.
 intervention plans are noted where participants are included in surveys such
as monitoring these studies periodically.
Demerits: Longitudinal studies
 regarded very expensive, requiring great skills to organize as a true
longitudinal study from birth to young adulthood would take approximately
18 to 20 years. Such studies are expensive that require a well-organized
logistical team making them very laborious and time-consuming.
 tends to have the number of subjects who complete a longitudinal study
small. And that is why it sometimes becomes impossible to maintain
reliability and consistency of sample size throughout the complete span of
the study, as many participants leave the study because they are migrating
to different places due to occupational, social, or financial reasons.
To overcome these situations, these studies require perseverance, patience, and
motivation for both subjects and researchers undertaking the study. This is the
reason, researchers adhere to the pre-fixed schedule occasionally during the entire
term of the study, which then often becomes a little difficult for the participants
to adhere to because of certain compelling circumstances.

Hawthorne Effect
This effect is a unique concept but not a common phenomenon in relation to
human growth. The primary disadvantage of a longitudinal study is mainly the
time taken to complete the study, along with the small number of participants
that could generally be followed up. In such studies, one of the proper ways to
maintain a sample size satisfactorily is by producing a large number of
participations among children and their parents involved in the study.
Unfortunately, as the involvements increase, it becomes more probable to affect
the growth of children who are involved/participated in the study. The process of
large involvement of parents in case of longitudinal method generates Hawthorne
effect (Blalock, 1970), which achieves that subject should know that they are
included or are a part of their study. According to Johnston in 1980, constant and
persistent advice should be provided regarding health care, so the parents whose
children are involved in the longitudinal study may become aware regarding the
relationship that exists between growth and necessity for a proper environment.
As a result, they may change the diet of their children, etc. which might lead to
an improved and enhanced status of the general growth of the children who are
included in the longitudinal study.

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Let’s see from a methodological perspective, Hawthorne effect is considered to Methods of Studying Growth
be an innate, estimated, and predictable aspect of the longitudinal approach that
helps in understanding human growth. On the bright side, it results in improving
the general growth phase and status of children who have participated in this
unique longitudinal approach due to its simple nature of the design. While, on
the other hand, it seems like a harsh prosecution of the longitudinal method, as
infants having the improved status of growth stop by representing the population
from which they were drawn initially as a sample. The above concept has not
been discussed because it provides information that longitudinal design is not
basic to the learning of growth, rather, it majorly focuses that a longitudinal
study should only be started after cautious consideration of all parameters of
design, of which Hawthorne effect could be a critical one (Bhalla and Kumar,
1986).
Check Your Progress 3
3) Why has Hawthorne not included as method of studying growth?
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3.4 MIXED LONGITUDIAL METHOD

The maximum form of information could be extracted from an amalgamation of
techniques of longitudinal and cross-sectional data collection (Tanner, 1951). It
is called a mixed-longitudinal study where participants enter and may leave at
different ages, giving various degrees of longitudinalty to the study. Under some
circumstances, the manipulation of increments derived from each participant
who is measured twice or more gets reasonably efficient and simple. The mean
values of such increments could then be used to calculate more efficient
measurement at a given age or ‘distance’ means at successive ages. For this, the
mean value of the measurement at that age at which the greater number of subjects
is available (say t) and working forwards and backward from it. Thus, the next
mean upwards (t+1) is obtained by adding the mean increment from t to t+1 of
children present on both occasions. The same is repeated from occasion t+1 to
t+2 and so on (Tanner, 1965). Many factors affect the constancy of a sample in
longitudinal studies. The most important factor relates to population mobility
i.e. a participant’s family might need to move out of the area so he/she has to
leave the study. Similarly, sometimes subjects may simply get tired of participating
(normal attrition). Some children may not report on certain occasions because of
ill health, family circumstances, or mortality. Whatever may be the reason for
leaving the study it affects the sample size at different age groups. Thus, on one
end such a study results in the accumulation of data with missing values, on the
other hand, this type of design provides an opportunity to compensate the sample
loss by registering new participants at any requisite points of age. 47
Fundamentals in Human Check Your Progress 4
Growth
4) What is mixed longitudinal study?
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3.4.1 Merits and Demerits of Mixed Longitudinal Method

Merits: Mixed Longitudinal Study
 is relatively inexpensive to perform in lesser time, hard work, and exertions
compared to pure and basic longitudinal studies.
 also provide information about both parameters: distance and velocity arches,
(i.e., involves both status and rate of growth).
Demerits: Demerit of Mixed Longitudinal Study are:
 for different parameters of the body, estimating the rate of growth velocity
from mixed longitudinal method that involves the missing value is a
monotonous task, for which different statistical procedures are needed to
get the pertinent information in detail out of such data.
 in some situations, the handling of augmentations derived from each
participant is measure two times or more is practically simple and effective.
The types of such augmentations might often be used to calculate efficiently
measurements at a given age or distance means at successive ages.

3.5 SUMMARY
While analysing the state of a child’s health and nutrition, assessing the growth
and development is considered to be very helpful. And it is the best general
index of the nutritional and health status of a specific child, and a population.
Normal growth and development in the continuation are signs of indication of
good health and nutrition of a child. Failure in growth or abnormal or irregular
growth is observed as a basic symptom of the appearance of the disease. And it
is almost impossible to assume any study regarding growth without having
information about its methodology.

For a successful planning of a growth study, we should be very clear about the
data collection methods, size of the sample, tools, and techniques for sampling,
also includes relevant anthropometric measurements, training of the research
staff, methods for funding, and statistical approach to be employed for analyzing
the data. In this unit, an effort has been made to explain different methods of
studying human growth along with their merits and demerits. After going through
this unit, you can understand various methods of studying human growth, the
simple variances between the between cross-sectional, longitudinal, and mixed
longitudinal methods and this type of detailed information helps in choosing the
most suitable method to be employed for a particular study. The cross-sectional
method is the most common method of determining growth. For example, this
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collects data on children over a range of ages, each child contributing a Methods of Studying Growth
measurement at a single moment in time. The distance curve of growth of body
dimensions is based on the surveys of a cross-sectional study. These types of
studies are used for analyzing growth and development to give information over
a period of time. These cross-sectional studies estimate the trends in mean annual
growth through differences in the size of consecutively year groups, but they
provide no information about the variability of growth. Although cross-
sectional studies are seemingly simpler to undertake than longitudinal studies,
they require considerable care while sampling so that subjects who got selected
for the study features a right cross-section for the population that is being studied.

The longitudinal approach (that is a repeated-measure design) provides the serial

data in the form of information that is dependant and then corrected. This type of
study includes observations in a repeated manner on the same participant at a
particular time interval. As a result, they are laborious, costlier, and time-
consuming. Both the subjects and staff must be encouraged and inspired to
continue the study for which patience and persistence are must have a parameter
for those who participated or are involved in the study.

In mixed longitudinal study, special statistical techniques are needed to get the
maximum information out of this data. The period over which assessment of
growth takes place is the main existing difference between a longitudinal and a
mixed longitudinal study. Longitudinal methods are time taking. If annual
velocities are the only concern then two successive surveys one year apart, with
say 50% of subjects measured on both occasions, constitutes a mixed longitudinal
study that provides all the required growth velocity information, data collection
using several research methods which are used to construct the standard or norms
of a population for measuring growth.

3.6 REFERENCES
Bhalla, A. K., & KUMAR, V. (1986). Hawthorne effect: A methodological
problem in growth studies during infancy. Journal of the Anthropological Society
of Nippon, 94(1), 33-38.
Blalock, H. M. (1970). An introduction to social research (No. HN29 B5).
Englewood Cliffs, NJ.; Prentice-Hall.
Bogin, B. (2020). Patterns of human growth (Vol. 88). Cambridge University
Press.
Comas, J, 1960 In Kaushik Bose, Concept of Human Physical Growth and
Development, Vidyasagar University, India
Johnston, F.E. (1980). Research design and sample selection in studies of growth
and development. In Human Physical Growth and Maturation (Eds.): F.E.
Johnston; A.B. Roche and Ch. Sussannc, New York; Plenum Press.
Malina, R. M., Bouchard, C., & Bar-Or, O. (2004). Growth, maturation, and
physical activity. . second edition,Champaign; Human kinetics.
Tanner, J. M. (1951). Some notes on the reporting of growth data. Human
Biology, 23(2), 93.

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Fundamentals in Human Tanner, J. M., & Taylor, G. R. (1965). Growth. New York: Time, Inc.
Growth
Watson EH, Lowrey GH. Growth and Development of Children. (1967). 5th
Edition. Year Book Publishers; Chicago, IL:

3.7 ANSWERS TO CHECK YOUR PROGRESS

1) There are usually two types of growth curves drawn namely distance curve
and velocity curve.
2) Cross-sectional methods bear merit for studying:
a) the distributions of several anthropometric measurements among various
individuals at
b) different ages;
c) also, data gathered using this technique is regarded as ideal for
constructing standards of attained growth, (e.g., height and weight
standards);
d) results obtained from the cross-sectional studies performed on growth,
maturity, physical activity status or performance of a sample of children
and the presence of variability within the sample.
3) It provides information that longitudinal design is not basic to the learning
of growth, rather, it majorly focuses that a longitudinal study should only be
started after cautious consideration of all parameters of design, of which
Hawthorne effect could be a critical one
4) It is called a mixed-longitudinal study when participants enter and may leave
at different ages, giving various degrees of longitudinally to the study.

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