ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Pediatric Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1630919
Association Between Short Stature and Behavioral and Emotional Difficulties Among Children in Jordan: A Cross-Sectional Study
Provisionally accepted
Tamara Kufoof1*
Randa K Saad2Redab Al-Ghawanmeh1Seri Sawaqed3
Zaid Hamdan1
Zaid Qolaghasi1
Adnan Alswiti1Layan Sharkas1
Osama Sharkas1- 1Department of Pediatrics, Faculty of Medicine, The Hashemite University, Zarqa 13133, Jordan
- 2Research and Policy, Eastern Mediterranean Public Health Network (EMPHNET), Amman, Jordan
- 3Department of Internal Medicine, Faculty of Medicine, The Hashemite University, Zarqa 13133, Jordan
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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.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.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.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.
Keywords: short stature, Jordan, behavioral difficulties, emotional difficulties, Strengths and Difficulties Questionnaire (SDQ)
Received: 18 May 2025; Accepted: 05 Aug 2025.
Copyright: © 2025 Kufoof, Saad, Al-Ghawanmeh, Sawaqed, Hamdan, Qolaghasi, Alswiti, Sharkas and Sharkas. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Tamara Kufoof, Department of Pediatrics, Faculty of Medicine, The Hashemite University, Zarqa 13133, Jordan
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