Why an In-Person Evaluation Is Required
Many families first connect with us through a free telemedicine consultation — a valuable first step that helps parents understand the process and determine whether further evaluation is appropriate. However, the telemedicine call is not, and cannot be, a substitute for a comprehensive in-person evaluation.
The diagnostic procedures required to accurately assess a child's growth status must be performed in a clinical setting by qualified medical personnel. These include:
- Bone age X-rays: A radiograph of the left wrist and hand is used to determine skeletal maturity and compare it against chronological age. This cannot be performed remotely.
- Hormone panel blood work: Blood must be drawn and analyzed in a laboratory to measure levels of IGF-1, IGFBP-3, and other relevant biomarkers that may indicate growth hormone deficiency or other endocrine conditions.
- Growth hormone stimulation testing: In some cases, a physician may recommend provocative stimulation testing, which involves monitoring the body's hormone response over several hours in a clinical setting.
- Physical examination: A licensed physician must conduct a direct physical assessment — including precise height, weight, and body proportion measurements — to evaluate growth patterns and identify any relevant physical signs.
- Review of complete growth history: The physician will assess longitudinal growth records to evaluate growth velocity, percentile trends, and any deviations from expected developmental trajectories.
None of these procedures can be approximated through video or telephone. An in-person evaluation in Irvine, CA is therefore a prerequisite before any treatment consideration can be discussed with a licensed physician.
What the Evaluation Includes
The comprehensive pediatric growth evaluation conducted at our partner clinic in Irvine, California covers multiple diagnostic dimensions. Below is an overview of the core components that may be included based on your child's individual clinical picture.
Bone Age Assessment
A radiograph of the left wrist and hand is used to assess skeletal maturity. By comparing bone age against chronological age, physicians can gauge growth potential and identify skeletal development delays that may point toward a hormonal or endocrine condition.
Hormone Panel Testing
Blood work is drawn and analyzed to measure key growth-related biomarkers including IGF-1 (Insulin-like Growth Factor 1), IGFBP-3, thyroid function, and other endocrine markers. These results give physicians important data about how your child's endocrine system may be functioning.
Physical Examination
A licensed physician performs a complete growth assessment including precise height and weight measurement, body proportion analysis, pubertal staging, and examination for any physical features associated with growth-related conditions. This direct assessment is foundational to any clinical evaluation.
Additional Evaluation Components
Depending on your child's specific clinical presentation and initial test results, the evaluation may also include one or more of the following components, as determined by the examining physician:
📈 Growth Chart Analysis
The physician will carefully review your child's longitudinal growth data plotted against standardized national growth charts. Growth velocity — the rate at which a child is growing over time — can be as informative as a single height measurement and is often the first indicator that warrants closer attention. Patterns of crossing percentile lines downward may prompt further investigation.
📄 Medical History Review
A thorough review of your child's complete medical history is conducted, including birth history (gestational age, birth weight), developmental milestones, past illnesses, surgeries, medications, and any prior laboratory results. Family history — including parents' heights, growth patterns, and any known endocrine conditions — is also considered as part of the overall clinical picture.
⚗ Stimulation Testing (If Indicated)
When initial bloodwork suggests the possibility of growth hormone deficiency, the physician may recommend provocative growth hormone stimulation testing. This procedure involves administering a stimulus agent and measuring the body's hormone response over a period of time in a controlled clinical environment. Stimulation testing is the gold standard for confirming or ruling out GHD in many clinical scenarios and can only be performed in person.
📋 Individualized Results Review
Once all testing is complete, the examining physician meets with you and your child to review the findings in detail. You will have the opportunity to ask questions and discuss what the results may mean for your child. If results suggest a condition that may benefit from intervention, the physician will discuss available options — using careful, honest language that sets realistic expectations without making promises about outcomes.
How to Prepare for the In-Person Evaluation
Arriving prepared can help your appointment run more smoothly and ensure that the physician has all the information needed to conduct a thorough assessment. We recommend bringing the following to your evaluation:
- Growth records: Height and weight measurements from pediatric well-child visits going back as far as possible — ideally from birth onward
- Height measurements over time: Any home measurements with dates that document growth trends between checkups
- Insurance information: Your current insurance card and any prior authorization documentation you may have received
- List of current medications: All prescription and over-the-counter medications, vitamins, and supplements your child currently takes, including dosages
- Prior lab work: Any previous blood test results, hormone panels, or imaging studies related to growth or development
- Previous specialist notes: Letters or reports from pediatric endocrinologists, geneticists, or other specialists your child has seen
- Birth records: Gestational age at birth and birth weight, if available, as these are clinically relevant for some growth assessments
- Your written questions: A list of questions and concerns prepared in advance so you don't forget anything during the appointment
If you have questions about what to bring or how to request records from your current pediatrician, our care team can guide you through the process before your appointment. Please call us at (949) 468-3120 or email info@hghkids.com.
What Happens After the Evaluation?
Following the completion of all testing, you will meet with the examining physician to review results and discuss findings. The path forward depends entirely on what the evaluation reveals, and no two children's situations are identical.
Some of the possible outcomes following an evaluation include:
- Results that fall within normal ranges, providing reassurance that no intervention is currently indicated
- Findings that suggest a condition such as growth hormone deficiency or another endocrine disorder, prompting a more detailed discussion of potential treatment options
- Results that are borderline or inconclusive, leading the physician to recommend additional testing or a follow-up evaluation after a period of observation
- Identification of a different underlying condition requiring referral to another specialist
If the physician determines that a medical treatment may be appropriate for your child, a detailed discussion will follow — covering the potential benefits, risks, administration, and monitoring involved. All treatment decisions are made exclusively by the licensed physician based on clinical findings. HGHKids.com does not make medical determinations or recommendations and plays no role in prescribing.
It is important to understand that not every child who undergoes an evaluation will be a candidate for growth hormone therapy. The evaluation is designed to provide accurate clinical information — whatever that information may be. Families frequently find that even when no treatment is indicated, the peace of mind and clinical clarity gained from a thorough evaluation is itself extremely valuable.
Ready to Schedule Your Child's Evaluation?
Start with a free 20-minute telemedicine consultation to learn more about the evaluation process and determine whether scheduling an in-person visit may be the right step for your family. There is no obligation and no cost to speak with our care team.