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Reliability of anthropometric measurements in children with special needs
  1. Jane Hardy1,
  2. Hayley Kuter2,
  3. Malcolm Campbell3,
  4. Dexter Canoy4
    1. 1 Department of Community Paediatrics, Manchester University NHS Foundation Trust, Manchester, UK
    2. 2 Department of Community Paediatric Dietetics, Manchester University NHS Foundation Trust, Manchester, UK
    3. 3 Division of Nursing, Midwifery & Social Work, School of Health Sciences, The University of Manchester, Manchester, UK
    4. 4 The George Institute for Global Health, University of Oxford, Oxford, UK
    1. Correspondence to Dr Jane Hardy, Department of Community Paediatrics, Manchester University NHS Foundation Trust, Manchester M40 2JP, UK; jane.hardy{at}


    Objective To determine the reliability of anthropometric and body composition measurements in children with special needs.

    Design Observational study.

    Setting Specialist support schools (primary and secondary) in Manchester, UK.

    Participants 53 children with moderate-to-severe learning disability; 30 non-standers (14 boys) and 23 standers (15 boys). Mean ages were 11 years (range 3–20) for non-standers and 12.4 years (range 8–19) for standers.

    Measures Anthropometric measures included: height/length, segmental measures, weight, skinfolds, body circumferences and body composition estimated from bioelectrical impedance analysis (BIA). These were measured twice, 2–4 weeks apart.

    Main outcome measures Reliability was assessed using the technical error of measurement (TEM).

    Results The TEM for height and supine length was 0.55 cm for standers and 2.47 cm for non-standers, respectively. For non-standers, the TEMs for knee height and tibial length were 0.81 and 1.57 cm, respectively. The TEM for weight was 0.55 kg for standers and 0.75 kg for non-standers. For skinfold thickness, the TEM was smaller for non-standers than standers. The TEM for mid-upper arm circumference for standers and non-standers was 0.91 and 0.82 cm, respectively. The TEM for BIA in standers and non-standers was 34.7 and 54.1 Ω, respectively. Some measurements, including waist circumferences, were difficult to obtain reliably.

    Conclusions Anthropometric and body composition measurements were feasible to obtain in children with special needs. However, the reliability of these measures differs between non-standers and standers and should be considered when choosing appropriate measures.

    • anthropometric measurements
    • special needs
    • reliability
    • general paediatrics
    • bioelectrical impedance
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    • Contributors JH: lead investigator, developed study design, research protocol, ethics application, data collection, analysis and manuscript. SC: involved in data collection in secondary schools. DB: involved in data collection in the primary specialist support schools. MC: provided statistical review and intellectual input. HK: provided important intellectual input and contributed in the revision of subsequent versions of the manuscript. DC: provided intellectual input and contributed in the revision of the manuscript.

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Parental/guardian consent obtained.

    • Ethics approval Ethical approval was obtained from the National Research Ethics Service Committee North West—Greater Manchester South (07/Q1403/68).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Collaborators Boyd, Diane. Campbell, Stephanie

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