Association between short stature and behavioral and emotional difficulties among children in Jordan: a cross-sectional study

Abstract

Background: Short stature is associated with psychological and emotional challenges, yet its impact on children’s behavioral well-being in Jordan remains underexplored. This study examines the association between short stature and behavioral and emotional difficulties in Jordanian children. Methods: A cross-sectional study was conducted at Prince Hamza Hospital, Amman (2023–2024). We recruited eighty-three children aged 4–14 years with a height percentile ≤3%. The Strengths and Difficulties Questionnaire (SDQ) assessed behavioral and emotional difficulties. Differences in SDQ scores by gender, age group, and growth hormone (GH) therapy status were analyzed. Results: The mean total difficulties score was 13.7 ± 6.1, with 30.1% of participants classified in the “high” or “very high” category. Emotional difficulties (31.3%), peer problems (31.3%), and conduct issues (34.9%) were notably prevalent. Boys exhibited significantly higher conduct problems (p < 0.001), hyperactivity (p = 0.002), and total difficulties scores (p = 0.010), while girls showed stronger prosocial behaviors (p = 0.004). No significant differences were observed between younger (3–10 years) and older (11–14 years) children. Children receiving GH therapy reported significantly higher emotional problems (p = 0.029), though other SDQ scores did not differ significantly between treated and untreated groups. Conclusion: Short stature in Jordanian children is associated with significant behavioral and emotional challenges, particularly among boys. GH therapy was not associated with improved scores in this sample. A multidisciplinary approach integrating psychological support and public health initiatives is needed to address stigma and improve well-being.