Physical Characteristics of Children

As Related to Death and Injury for Consumer Product Design and Use

UM-HSRI-BI-75-5 Final Report Contract FDA-72-70 May 1975



                                
              PHYSICAL CHARACTERISTICS OF CHILDREN
                  AS RELATED TO DEATH & INJURY
               FOR CONSUMER PRODUCT SAFETY DESIGN




               Richard G. Snyder, Ph.D.
               Biomedical Department
               Highway Safety Research Institute
          and  Department of Anthropology
               College of Literature, Science and the Arts

               Martha L. Spencer, M.D.
               Department of Pediatrics and Communicable Diseases
               School of Medicine

               Clyde L. Owings, M.D., Ph.D.
               Department of Pediatrics and Communicable Diseases
               School of Medicine
          and  Department of Electrical and Computer Engineering
               College of Engineering

               Lawrence W. Schneider, Ph.D.
               Biomedical Department
               Highway Safety Research Institute

SUMMARY

This report presents the results of a three-year study designed to collect analyze, and reduce selected anthropometric data on 4027 infants and children representative of the current U.S. population ranging in age from newborn to 12 years of age. Since the major purpose was to provide basic measurement data most useful and critical to consumer product design, regulatory con- sideration, or other direct applications, 12 of the 41 measurements taken were applied measurements which have not been previously available. As an example of the direct application to product design, measurement of buttock depth on 3-to 6-month-old infants provided an objective basis for establish- ment of crib interslat distances.

A substantial portion of the study involved the design, fabrication, development, and testing of a new generation of anthropometric measuring de- vices which transmit measurement signals to a portable mini-computer data acquisition system or to a set of readout meters. These include highly modified anthropometers and calipers for lineal measurements and a hand-held girth measuring device for circumference measurements. A pressure transducer has been incorporated in the moving paddle blade of the calipers and anthropo- meters in order to achieve greater reproducibility in making soft tissue mea- surements on infants and small children where immature skeletal development often precludes use of standard adult landmarks. Numerous specialized devices to measure inside and outside grip dimensions, finger diameters, and minimum hand-through-hole diameters have also been developed. In addition, two sizes of portable center-of-gravity (C.G.) devices designed during the study are capable of instantaneously measuring seated or standing centers of gravity. These instruments have been incorporated for use with a Nova 1220 mini computer to provide a completely automated anthropometric measurement system for the majo- rity of measurements taken.

The results presented in this report summarize the complete data which have been provided on magnetic tape for automated data analysis and retrieval. Each of the 41 measurements is defined and illustrated, and tabular charts are provided listing the mean, standard deviation, 5th, 50th, and 95th per- centiles by age and sex, and for combined sexes. In addition, the mean, 5th and 95th percentiles are shown graphically.


TABLE OF CONTENTS


LIST OF FIGURES

FIGURES                                                    TITLE                                                     PAGE

Fig.  1.   An initial questionnaire form . . . . . . . . . . . . . .20

Fig.  2.   Final questionnaire form. . . . . . . . . . . . . . . . .21

Fig.  3.   Questionnaire used for Spanish speaking people. . . . . .22
 
Fig.  4.   Sample parental informed consent - English (a)
              Spanish (b). . . . . . . . . . . . . . . . . . . . 23,24

Fig.  5.   Sample letter explaining project - English (a)
              Spanish (b). . . . . . . . . . . . . . . . . . . . 25,26

Fig.  6.   Modified Dodge Maxi-Van  used  to  carry  equipment  to
              the measurement sites. . . . . . . . . . . . . . . . .28

Fig.  7.   Drawings of modified  anthropometer  in  (a)  and  mod-
              ified sliding caliper in (b) . . . . . . . . . . . . .33

Fig.  8.   Photographs of modified anthropometer in (a) and
              modified sliding caliper in (b). . . . . . . . . . . .34

Fig.  9.   Modified girth device . . . . . . . . . . . . . . . . . .34

Fig. 10.   Nova 1220 portable mini-computer system . . . . . . . . .35

Fig. 11.   Keyboard and T.V. monitor showing initial display
               of MAP program. . . . . . . . . . . . . . . . . . . .36

Fig. 12.   Member of measuring team carrying suitcase with
               measuring instruments and digital readout unit. . . . . . 37

Fig. 13.   Drawing of infant c.g. device indicating position
               of load cells and principal of operation. . . . . . .38

Fig. 14.   Infant c.g. device in (a)  and  child  c.g.  device  in
               (b) showing subject in supine (standing) position . . . . . . .39

Fig. 15.   Infant c.g. device in (a)  and  child  c.g.  device  in
               (b) showing subject in the seated position with
               knee angle at 90. . . . . . . . . . . . . . . . . . .40

Fig. 16.   Measuring team unloading computer from van at
               measuring site. . . . . . . . . . . . . . . . . . . .41

Fig. 17.   Calcomp plot of waist measurement curves and data
               points. . . . . . . . . . . . . . . . . . . . . . . .45

ACKNOWLEDGEMENTS

This study has represented a major multi-disciplinary effort requiring the support and assistance of a large number of individuals over the three- year period of this work. The authors wish to gratefully acknowledge the valuable assistance provided by Gayle Kirma, Barbara Surovel, Emily Maiten, Barbara Johnson, Martha Kransdorf, Terri Gendel, Margaret Morris, and Susan Anderson in the tedious but critical task of taking measurements, coordinat- ing schedules, and assisting in reducing the data; Barbara Nash, Peter Ford, and John Ferguson in writing the computer programs; Leigh Peck, and Paul Katz in technical assistance; and by Carol Ann Compton, secretary, who typed the manuscript and maintained the paperwork. Drs. John Gesink and Don Ellis gave freely of their expertise in the initial instrumentation design phase.

We are indebted to Dr. Anthony Schork, Pei Ruey, and Robert Anderson, Department of Biostatistics, School of Public Health, for biostatistical de- sign assistance; to Dr. Stanley Garn, Center for Human Growth and Development; to Dr. Alphonse Burdi, Department of Anatomy, School of Medicine, the University of Michigan; and to anthropologists Dr. Herbert M. Reynolds, HSRI, Dr. John McConville, Webb Associates, Yellow Springs, Ohio, and Joseph W. Young, Chief Human Biology, Civil Aeromedical Institute, FAA, U.S. Department of Transportation, for their expert counsel in the design and technical oper- ation of this study. Credit also should be given to Bert Lavastida, Douglas Rideout, and their staff at the Audio-Visual Education Center for their Pro- fessional assistance in producing a documentary movie of this work.

We also wish to respectfully acknowledge the technical monitors who have managed this program during its development and whose foresight and experience has made a major contribution to the overall conduct of the work:

Carl W. Blechschmidt (April 1972 - Nov. 1973), John K. O'Connor (Nov. 1973 - April 1974) and Terry Van Houten (May 1974 - 1975), and more recently under the guidance of Dr. Albert Esch. Dr. Sam Southard, formerly of the National Commission on Product Safety, and Elaine Besson, were early support- ers of this program.

The authors are grateful to the many school, day care center, nursery, and child care center administrators, teachers, physicians, and nurses who -willingly gave their time and for their sincere interest and generous cooperation; and finally we wish to acknowledge the 4,027 infants and children (and their parents) throughout the country without whose willing participation this study could not have been conducted. It has been an experience -which has been shared among many dedicated individuals.

I INTRODUCTION

1. Background

The available estimates of infant and child fatality and injury data relative to consumer products have indicated the urgent need for improved design guidelines concerning body measurement data.

The total number of infants and children in the United States who died during 1974 consists of 74,667 infants under one year of age and 28,395 children from age one to fourteen years [1]. The majority of infant fatalities has been attributed primarily to endogenous factors for the first four post- natal weeks, and from four weeks increasingly to exogenous environmental influences. [2] By age one year accidents have been identified as the leading cause of childhood deaths [3-6]. During 1974, accidents accounted for 4,300 of the 11,548 reported deaths in the one- to four-year age group [1].

In testimony by the U.S. Department of Health, Education and Welfare at the National Commission on Product Safety Hearings of 21 October 1968, it was estimated that toys were responsible for injuries to 700,000 children each year [7]. Many of these injuries were concluded to be due to hazards imposed by non-existent or improper physical design standards. At present (1975) data from the Consumer Product Safety Commission indicate that upwards of 2 million children are injured each year in accidents attributed to toys, playground equipment, bicycles, and other children's products [8]. These figures are in agreement with those reported by the National Commission on Product Safety in 1970 [9, p.9]. Bicycle accidents alone in the U.S. have been estimated to be as high as 9,460,000 annually for children 5-18 years of age. It is estimated that from 403,000 [10] to 76o,ooo [11] of the children involved require medical attention. The problem of bicycle related injuries has been reported on in a number of recent studies [12-19]. The Federal Hazardous Substances Act (as amended, January, 1971, Sec. 2 Par. (5), added by sec. 2 (d) of P.L. 91-113) specifies that "an article may be determined to represent a mechanical hazard if, in normal use or when subjected to reasonably forseeable damage or abuse, its design or manufacture presents an unreasonable risk of personal injury or illness (1) from fracture, fragmentation, or disassembly of the article, (2) from propulsion of the article (or any part or accessory thereof), (3) from points or other protrusions, surfaces, edges, springs, or closures, (4) from moving parts, (5) from lack or insufficiency of controls to reduce or stop motion, (6) as a result of self-adhering character- istics of the article, (7) because the article (or any part or accessory thereof) may be aspirated or ingested, (8) because of instability, or (9) because of any other aspect of the article's design or manufacture" [20, p.6].

Only in recent years have pathological and clinical attempts been made to more closely define the exact cause of death in infants. These efforts have produced more objective statistics than have previously been available. As Neale has pointed out, in England in 1904 over 3,000 death certificates recorded "related to teething" as cause of death [4]. The need to improve such vague medical terminology has led to more careful assessments and testing techniques and more specific knowledge concerning cause of infant deaths and injuries may be reasonably made.

Although most tabulations use large generalized categories to tabulate cause of death, evidence is mounting that a large number of fatal and injurious it accidents" to infants and younger children involve the commercial products of their environment at this age. In 1970 the National Safety Council recorded 1,520 deaths due to mechanical suffocation or 'ingestion of food or object" in children under one year of age [21]; by 1974 this number was reported as 1,272 [1]. The death rate from accidental mechanical suffocation for children under one year of age involving beds and cradles was 18.6 (per 100,000 live births) in 1965, and was as high as 27 in 1959. Keddy, in a study of injuries in 17,141 Canadian children, found 589 cases of falls from furniture, 271 injuries due to screws, nails, or tacks, 97 due to slivers, 261 falls on or against furniture, 250 injuries in contact with furniture, and 130 from falls from beds [22]. Although these generalized data are not conclusive, they do suggest that a strong relationship exists between improperly designed furniture and accidental death and injury.

Few studies of this specific relationship have appeared in the clinical literature. However, communications with individual pediatricians and coroners support the fact that many cases of death or injury have been attributed to improper or dangerous design of infant or juvenile furniture. In Florida, Blackbourne noted 13 cases of crib strangulation of infants. In testimony before the National Commission on Product Safety he estimated that 100 to 200 deaths might occur annually due to neck impingement in cribs. This opinion was confirmed by Kravitz in Chicago; and in 55 cases in Orange County, California, five were attributed to faulty design in infant furniture [23].

Six case histories in Rochester, New York, over a two-year period of accidental crib and high chair strangulations were reported by Greendyke [24], who concluded that "Crib sides should be constructed in such a way as to preclude the remotest possibility of a baby's head passing between them." Observations concerning the potential hazards of restraining devices in cribs and high chairs were in agreement with previous studies by L'Hirondel [25,26] and by Zachow- Christiansen and Jensen [27]. Haddon has indicated the need of obtaining further data on crib injuries from Fin epidemiological point of view [28]. A 1970 staff report of the National Commission on Product Safety found that cribs accounted for an estimated 144 deaths [29]. Of these deaths, the mechanism of fatality was attributed to suffocation in 75% of the cases.

In regard to this problem an anthropometric study was conducted by the authors in conjunction with the larger anthropometric survey reported upon herein for the Consumer Product Safety Commission. This report was submitted to the Commission in January, 1973 [30]. These data were utilized by the commission to determine the subject dimension limitations between crib slats that will not permit infants to slide through [31]. Other functional safety-oriented dimensions are still urgently needed in this regard, particularly with respect to body segments. Recently, for example, inquiries have been made to the Department of Transportation regarding the use of their infant anthropomorphic test device in evaluating the stability charac- teristics of high chairs, strollers, and other infant and child seating and resting devices. However, specifications for a representative anthropomorphic test device which has shape and biomechanical properties based on infant sample data are still unavailable.

To date, only limited information as related to the U.S. population has been available to the manufacturer and to those concerned with Federal Standards for the safe design of toys, equipment, furniture or other products used by children. Numerous illustrations of needed measurement data have been identified by the National Commission on Product Safety's analysis of common products associated with injuries and fatalities [9].

2. Infant and Child Anthropometry Sources

The major purpose of this study has been to provide basic selected measurement data on infants and children, particularly functional measurements essential for the development of adequate product safety design standards. A comprehensive review of the literature was undertaken during the initial phase of this program. Some 800 studies are referenced in the publication Source Data of Infant and Child Measurements: Interim Data 1972 [32]. Since anthropometric studies may be either cross-sectional (taken on different subjects of a population at about the same time) or longitudinal (taken on the same group of subjects periodically over a long period of time), data were tabulated by American or foreign populations and by author in sections relating to cross-sectional or longitudinal. In addition, existing data from 35 studies conducted from 1929 through 1972 were tabulated for 23 selected measurements most frequently found in the literature.

Despite the profuse literature, this extensive review of the existing data indicated a number of serious limitations in usage of available data and documented the complete lack of many needed functional measures, con- curring with previous surveys of child measurement data. Only one-third of the selected 35 studies provided data from the preceding 10 years. Many growth studies (as recently as Marshall and Carter, 1975) [33] have found that children have been getting taller (larger) than their parents through several generations, and that there are regional differences. Early studies taken in one geographic location, therefore, such as white Philadelphia school children, white Alabama school girls, or Iowa children may not be representative of the current U.S. population. Regional variations as well as socioeconomic, nutritional, and ethnic or racial variations have been found. There is considerable literature on infant or child height (stature or crown-rump; crown-heel) and weight, particularly in clinical references. But even for these measurements, data have often been taken by several different measurers in the same study, and often there was found to be questionable accuracy. In many longitudinal studies new subjects were added in the middle of a study as old subjects were lost. Many studies are not directly comparable, not only because of differences in precisely defining measurements (or lack of any definition), but because of age differences. While age 5 in one study may mean exactly 5 years post-birth, another study may include subjects from 4 1/2 to 5 112 years; or, in another, age 5 may mean from age 5 to 6 years. Such discrepancies provide a number of proolems to the user of anthropometric data on children, particularly if the validity and applicability of each source is not carefully examined.

This comprehensive review of the child and infant anthropometry data available to date shows that while large numbers of limited studies have been conducted, including routine clinical measurements of a few measures such as body weight, stature, and chest or head circumference, the type of dimensional data urgently needed for a number of current safety applications is non-existent. Until the present study, no body of data has been published which validly describes such functional measures as the range of size openings an infant or child's hand or fist can penetrate for various "age" levels, the distance the arm or leg can extend, or the size opening the buttocks can slide through. A meticuously conducted survey to obtain 18 facial measurements for oxygen mask design on 978 infants and children from 1 month through 17 years was completed by Young in 1966 [34]. Although the sampling was composed entirely of subjects in Oklahoma County, Oklahoma, this remains the most useful data relative to facial anthropometry on children. In 1971, Stoudt, in a study conducted for the National Highway Traffic Safety Administration, reviewed "anthropometric inputs to describe children for purposes of crash kinematic modeling and construction of anthropometric dummies for use in crash tests" [35]. He concluded that "existing data were found to be far from adequate for either of these two purposes" [35 p. 53] In 1975 Young, McConville, Reynolds, and Snyder provided the most recent review and analysis of anthropometric requirements for NHTSA three- and six-year-old child anthropometric test devices, finding that some 60% of the anthropometric measurements necessary were not available in the literature, and many of the remainder were represented by questionable, inadequate, or outdated data [36].

Aside from the relatively few attempts, such as the studies cited, to obtain functional measurements, most of the literature pertains to more classical types of measurements. Studies prior to 1938 have been comprehensively covered by Krogman, who summarized in some 967 pages the results of child growth data to that time [37]. Some 40 years have now elapsed since even the most recent of these measurements were collected, and there could be question as to how representative such data are relative to the current U.S. population.

There is also the difficulty of attempting to determine specifically how a measurement was defined by the author and how it may differ from those of comparable studies with the same measurement names. A classic example of this is the use of the term "hip breadth" in the literature, which could, in fact, be two very different skeletal measurements, the bi-iliac or bitro- chanteric diameter, or in other cases the maximum breadth across the soft tissue. Even if it refers specifically to the "bitrochanteric" measurement, there may be a difference in technique between authors as to how they measure from this landmark. In the instance of an obese individual it may be extremely difficult to locate (palpate) the landmark, and in the case of an infant or child the bony landmark may not yet be fully formed. Further, "hip breadth" can be taken in a standing or seated position (it is larger when seated), or clothed or unclothed. Often these factors of different techniques make studies non-comparable, and this is a primary reason why the major two-volume reference source in the field of anthropometry, A Collation of Anthropometry, was compiled by Garrett and Kennedy in 1971 [38]. This lists over 2000 dimensions from 48 U.S. and 16 foreign studies, but does not include data from infant or adult surveys.

Several of the major American cross-sectional anthropometric studies would include Collins and Clark's 1929 study of chest, sitting height, stature, and weight for 6-14 year olds [39]; Gray and Ayres' 1931 study of 15 dimensions of 4,583 1-14-year-old children [40]; Wise and Meredith's 1942 study of 15 measurements on 112 2- to 5-year-old white Alabama girls [41]; Meredith's 1953 study of 11 measurements on 7- and 10-year-old boys and 7-, 9-, and 11-year-old girls [42]; Eppright and Sidwall's 1954 study of 5 measurements of 6- to 14-year-old Iowa Children [43]; Meredith and Knott's 1962 study of 8 measurements on 390 9-, ll-, and 13-year-old girls [44]. More recently, data has been published on 10 measurements for children to age 14, [45] obtained in the ten-state nutritional survey.

Stature and weight have been most commonly taken, and many studies have been confined solely to these two dimensions. One of the most recent examples is the 1967 study of height and weight by Rauh et al. on 8,480 Cincinnati school children aged 5 through 16 years [46]. Although numerous studies, particularly in the clinical- literature, have noted weight, height, and head and chest circumference in new-borns, more complete data have seldom been obtained or published. Only two studies of applicable infant anthropometry on a U.S. population were previously available in the literature, and each of these have distinct limitations. In 1934, Bakwin and Bakwin reported measurements of 24 dimensions on 1,653 new-borns and 9 additional dimensions on 281 infants [471. These were taken by classical techniques described in 1931 [48]. These data are not representative of the new-born infant of 1975, some 40 years later, due to a generational increase in both height and weight at various age levels. A subsequent study of body dimensions at birth, 3, 6, and 12 months was reported in 1957 by Kasius et al. for 1,391 infants whose mothers attended the Nutrition Clinic of the Pennsylvania Hospital between 1947 and 1952 [49]. Limitations of this study include the fact that only eight body dimensions were included, the sample was probably not representative of a general U.S. population for these ages, and these limited data are now nearly 30 years old. Burdi et al. recently brought together general growth and morphological data, but they could not find sufficient applicable measurement information [50], due to the almost complete lack of basic information regarding the anatomical differences between the child and the adult generally available to the engineer in safety design.

Several early studies have attempted to obtain functional child measure- ments, primarily for seating and school furniture, or for clothing requirements. Bennett measured 3,615 school children (kindergarten through grade 12) in 1928, using an adjustable chair and desk, but published only erect seated body measurements [51]. O'Brien reported on 35 standard measurements taken on 147,088 children, aged 4 to 17 years between 1937 and 1939, for sizing garments [52,53]. However, measurements were taken by 266 individuals, and the potential for inter-measurer error was very large.

In 1938, Stay-ton measured 100 ninth- to twelfth-grade girls, from 14 to 21 years of age, in Sebastopol, California, for sewing table activities [54]. Anderson, in 1941, measured 87 ninth grade girls from 13-17 years of age, and 100 twelfth-grade girls 16 to 22 years of age, in Corvallis, Oregon, primarily relative to kitchen activities [55]. Martin published data in 1953 [56] and 1954 [57] for use by school furniture manufacturers, but provided only average measurements for children between 4 and 17 years. The data were not obtained directly by measurement, but instead were derived from 11 previous studies conducted between 1922 and 1942. In 1955 this work was updated, using an adjustable chair, on children 5 to 14 years [58]. However, caution must be used with these data, since all measurements, including stature and weight, were taken with the subject dressed in the indoor clothing, and wearing the type of shoes ordinarily worn in school"[58, p. 100].

One of the most authorative and useful general sources of applied human requirements is found in the compendium by Damon et al. 1966 (revised 1974) [591. This work has brought together results from a large number of studies, including the anthropometric portion of the U.S. National Health Examination Survey, and includes sections summarizing the state of knowledge of anthro- pometry and human engineering, biomechanics and equipment design, human body composition and tolerance to physical and mechanical force, and design recommendations. However, despite an enormous and extremely useful compilation of anthropometric data, the only measurements listed for infants and children consist of one table of mean heights and weights of white Americans from birth through one year at one-month intervals, from one year to 5 1/2 years at 6 month intervals, and annually from 6 to 19 years [60]. No other information, except for these two dimensions representing a selected population, is listed for either infants or children under age 16. This reflect,-, the fact that reliable design data for this population have not been available.

In l964, a comprehensive search with the objective of bringing together all available child data was initiated for the Division of Accident Prevention of the U.S. Department of Health, Education, and Welfare "... to meet the urgent need for child measurements to be used in testing dummies." The resulting literature survey by McConville and aurchill [61], Source Data for the Design of Simulated Children's Body Forms, attempted to collect design data that would describe the circumference, breadth, and depth of the body at specific levels, the length of body segments, and the location of primary hinge points for the infant at birth and 6 months, and the unisex child at 3, 6, 8, and 12 years, and males and females at age 18. Of 87 proposed anthropometric dimensions, 22 were completely unavailable in the literature. Only 25 dimensions were found for the 6 month olds, 29 for three year olds, and 39 for 6-year-old children. It was observed that "This lack of detailed anthropometric information is somewhat suprising in view of the number of such studies which have been carried out in the past few decades." Few studies provided all of the desired statistics, and it was necessary to take "...certain liberties..." in the treatment of those available [61, p. 7]. Infant data were found to be extremely limited.

Many excellent longitudinal growth studies have been conducted. However, these have generally been reported for a limited geographic area or socio- economic group. Examples of these are the longitudinal studies of Phila- delphia children by Krogmam 1959 [62]; 1970 [63], and Krogman and Johnston, 1965 [64]. Vickers and Stuart measured Boston school children for 10 body measurements reported in having made periodic measurements on the same individuals from childhood to adulthood [65]. A comprehensive compilation of such studies through 1972 can be found in Snyder, et al., 1972 [32].

Longitudinal studies, while very useful for child growth investigations, generally do not provide the type of measurements necessary for functional applications. In addition, there usually is a lack of uniformity in how the measurements were taken. This precludes meaningful comparisons of particular dimensions reported in various studies. And since longitudinal projects usually involve a specific geographic location and particular socioeconomic, ethnic, and racial populations, such data are difficult to pool as descriptive of the U.S. population. Where data are taken from longitudinal studies, N values are commonly not the same across time, due to attrition of subjects and loss of follow-up data. In long-term studies, new subjects are often added in the middle of the study. Such considerations, often not known or obvious to the user, make it difficult to evaluate and compare data in the literature.

The location of the center of gravity of infants or children has rarely been identified. In a 1927 to 1929 study not reported until- 1944, Palmer measured 1,172 subjects ranging in age from birth to 20 years, including 18 fetal cadavers [661. Of those subjects, 673 were infants and children, newborn through age 12, located in St. Paul and Minneapolis, Minnesota, and Mooseheart, Illinois. More recently (1965) Swearingen and Young [67] using a mechanical balancing apparatus for children, determined the seated and standing C.G. on l200 Oklahoma school children aged 5 to 18 years (with shoes and clothes on). Swearingen et al. in 1909 obtained the center of gravity of 135 "crying, wiggling" clothed infants to 36 months of age using, a simple scale balancing device [68].

In 1956 the National Center for Health Statistics was authorized to conduct a nationwide Health Examination Survey (HES). The first cycle, conducted between 1959 and 1962, measured adult individuals age 18 to 79 years. The second program was aimed at growth and development aspects of 6- to 11-year-old children. It continued from July 1963 to December 1965, with 21 body measurements reported in 1973 [69]. Two previous reports analyzed eight and weight measures by age, sex, race and various socio- economic indicators (1972) [70, 71]. A fourth report (1972) presented data on skinfold thickness [72], and the most recent report (1974) compared the growth patterns of White and Negro children for 20 body measurements [73]. A third cycle which began in March 1966 and was concluded in 1970 was con- cerned with youths aged 12-17 years. As part of this health survey for 12- to 17-year-youths, body measurements were included; but, unlike the body measurements selected in cycles I and II, these excluded human engineering type measures ("...it was decided for cycle III that accurate biological data on growth and development in U.S. Children had a higher priority than human-engineering data, so the battery of body measurements is basically the traditional anthropometry used in the longitudinal studies of growth and development conducted in this country over the past 40 years") [74, pp. 5-6]. Since physical measurements were not the primary purpose of the HES study, some severe limitations were placed on those that could be taken, due to a time restriction of about 10 minutes per subject. Never- theless, some 38 measurements were obtained, although as of this date (over 4 years later) only weight and stature (1973) [75], sitting height (1973) [76], and skinfold thickness (1974) [77] data have been published. Exam- ination of those measurements indicates that there remains a need for functional anthropometric measurements for use in design above the traditional growth measures taken in the HES study.

3. Objectives and Scope

The objectives of the project was to: (1) determine and define measurements to be taken, (2) design, develop, fabricate, and test special- ized instrumentation and measuring techniques, (3) determine the experi- mental biostatistical design, (4) collect anthropometric data on a statis- tically significant sample representative of the U.S. population for age groups from birth through 12 years, and (5) reduce, statistically analyze, and report the data in a format most usable and applicable to children's product safety design. In additicn to these primary objectives, four subtasks were also completed: (a) publication of' a handbook bringing together available pertinent previous studies and data on infant and child measure- ments for both U.S. and foreign sources [32]; (b) production and delivery of one 16-mm color movie providing preliminary information about how measurements are taken and illustrating instrumentation (8 minutes); (c) the design and conduct of a sub-study of infants between 3 and 6 months of age to provide appropriate information to safely restrain infants relative to crib slat interspaces; and (d) production and delivery of one 20 minute 16-mm color sound movie which describes and illustrates the overall study.

It should be noted that the summary data have been reported and sub- mitted in two forms. In addition to this report which describes the measurements and instrumentation, background, and a statistical summary of the data in both tabular and graphical format, these data have also been submitted on digital computer magnetic tape (9-track l600 BPI Standard Label) for use in further data analysis and retrieval with automated data systems.

II. METHODS AND TECHNIQUE

1. Design of the Study

This study was initiated in April, 1972, under sponsorship of the Children's Hazards Division of the Bureau of Product Safety, Food and Drug Administration, and continued through 31 March 1975 by the Consumer Product Safety Commission, which was activated 14 May 1973. The need for a nation- wide anthropometric study of infants and children had become evident by the predecessor National Commission on Product Safety, and preliminary discussions for planning such a study had been initiated with that group in 1969. Although there is an extensive literature reporting infant and child anthropometry, the bulk of the available data relate to measures of height (crown-heel), weight, and a few traditional dimensions useful to pediatricians, anthropologists, and others studying child growth. However, for designers of consumer products, developers of Federal Safety Standards, or other groups needing specific child body size data, the literature does not provide the functional data necessary. The only exceptions to date have been several studies described in the preceding section, mainly related to furniture, seating, or clothing requirements. The National Health Survey of the Public Health Service, which has provided the best data to date, also fails to include sufficient functional measurements due to limitations in time, anthropometry being only one of a series of examinations conducted. The rurpose of the present study was to collect representative-population data most needed for application to product design on a population representative of the U.S.

Toward this purpose, initial discussions were held with representative manufacturers, Consumer Product Safety Commission and National Bureau of Standards representatives, and other professionals experienced in applied anthropometry and design requirements. As a result, many of the measurements represent new information not previously available for infants or children. Several measurements were for direct application to specific problem areas. For example, infant buttocks depth was determined to be the most critical measurement for application to safe crib-slat interspace design; crotch height may be useful for bicycle frame height determination; and minimum hand clearance is a unique dimension needed for determining what size openings a child or infant can squeeze a hand through. Similarly, selected finger dimensions and inside and outside grip diameters represent functional types of measurements not previously available. As often occurs in studies involving innovation and new techniques, the experimental design evolved during the initial phases. It was modified from the original plan of a straight-forward anthropometric survey by the discovery that the objectives could not be accomplished by traditional techniques. The basis for this is the difference in anatomical structure and morphology between the infant, child, and adult (Burdi, et al. 1973) [50]. In the adult measurements may be taken with standard anthropometry instruments with great accuracy and reproducibility by trained and experienced specialists, utilizing recognized skeletal landmarks. The results of measurements taken on different populations, measured by different measurers, may often be compared with great confidence in adult populations. However, this is not so in the case of sub- adults -primarily due to two important physical differences in "he subjects. In young children and especially infants, the body may be characterized by more extensive soft tissue. Bone growth is not completed for some important features of the skeletal framework until age 18-20 in boys and 17-10 in girls, or later, including union of important epiphyses (distal epiphyses of radius, ulna, tibia and fibula, acromion and femur, head and greater tuberosity to the humerus proximal epiphyses of tibia and fibula). Thus the standard skeletal land- marks (distal portions or points involving tubercles or body projections may not yet exist in the largely cartilaginous structure of younger children. These two factors combine to make accurate and reproducible measurements for some dimensions difficult, if not meaningless, for even the professional anthropometrist. The question of how much pressure to exert on the soft tissue of an infant makes such measurements very subjective when attempted with standard anthropometric instruments. For these reasons, the initial plan was modified to extend the period needed to design, fabricate, test and develop the basic measurement tools found necessary.

The study had been designed as a multi-disciplinary program, with co- investigators initially representing the fields of physical anthropology (Dr. Snyder) and pediatrics (Dr. Spencer), augmented by faculty consultants from the Center for Human Growth and Development and Anthropology (Dr. Garn), the Department of Biostatistics, School of Public Health (Dr. Schork), Developmental Anatomy, Medical School (Dr. Burdi), and outside consultation with physical anthropologists Dr. McConville (Webb Associates) and J. Young (Civil Aeromedical Institute, FAA). Subsequently two additional co-investi- gators Joined the study as the need for their specialized (and broad) talents became evident. Dr. Owings, a specialist in minicomputers, holds joint pro- fessorial appointments in the Department of Electrical and Computer Engineering, College of Engineering, and in the Department of Pediatrics, School of Medicine; while Dr. Schneider, a bioengineer, is a researcher in the Biomedical Department, the Highway Safety Research Institute. A large number of additional scientists and specialists also made substantial contributions to the program, as noted in the acknowledgements. This teamwork greatly enhanced the professional conduct of the study, which would have been difficult to accomplish as a single disciplinary research effort.

Originally, a sample size of 3000 had been projected. However, the data collection period was extended to allow a total population of 4,000 subjects to be measured from birth (two weeks) to age 13. In all, children were measured at 76 different locations. As noted in Appendix A, geographical locations included schools, day care centers, nurseries, and clinics in Florida, Massachusetts, Ohio, Connecticut, Oregon, California, Arizona, and Michigan. Determination of geographic locations, ethnic and racial affiliations, and socioeconomic criteria was important in order to assure a representative nationwide population sample, and was projected by use of HEW and census data guidelines. However, as a practical matter, the theoretical projections never work out in the field situation exactly as anticipated and it was necessary to continuously make adjustments as the study progressed.

For example, after projected locations were determined from census data on racial and socioeconomic composition of the population and other factors at various age levels, specific information concerning all the schools in the district, including racial and socioeconomic 'breakdowns for each individual school was generally obtained. The particular schools at a location (such as Worchester, Mass., or Sacramento, Calif.) could then be selected to provide the best population sample cross-sections desired. However, even knowing the specific student composition of a school would not ensure that the children actually measured were as projected, since measurements were taken in the public schools only by informed written consent of parents, and it could not be determined beforehand which potential subjects would respond. Also, even though a parent had signed a consent form, there was no guarantee that the child would consent to be measured as, at older ages (particularly for boys), peer actions often were observed to be an influence. At several projected locations unforeseen events forced changes in the original- biostatistical design. For example, Memphis, Tennessee had to be omitted when disastrous tornadoes struck the city just prior to our scheduled arrival; and Manhattan, Kansas was also omitted due to a teacher's strike. Nevertheless, even with continuous adjustments in the strategy of the design of the field work, the outcome was close to that projected as representative.

The HEW racial guidelines indicate that 11% of the U.S. population is Black. Data obtained from questionnaires (Figure 1) used in this study indi- cate about 10% Black, 86% White, 2% Mongoloid, and 2% of mixed racial parentage. Unfortunately, HEW fails to indicate any definition of the term Black (which is defined differently in legal and biological terms) or any other racial affiliation. In some locations the term "Negro" had to be substituted for "Black" and vice versa, as one or the other would be locally unacceptable. Few people seemed to understand the anthropological terms "Negroid", "Caucasoid", and "Mongoloid", and so the early version of the form was changed to read as shown in Figure 2. Also, the economic grouping from data provided by the Institute for Social Research (i.e. family income) proved to be a non- responsive item (See Figure 1) and it was removed from the later forms (Figure 2). The term "Oriental" in the later forms included American Indians. To assist in areas of the Southwest where Spanish was spoken in homes more often than English, some forms were made bilingual. An example of the form used in Tucson and some schools in Sacramento is shown in Figure 3.

Included with the questionnaire given to the parents were a parental consent form (Figure 4) and a letter explaining the purpose and importance of the study (Figure 5). These forms were also printed as bilingual for certain areas of the country as shown.


2. Procedure at Measurement Sites

Once a geographic location had been decided upon, initial contacts were by telephone, personal visits of a co-investigator, and/or written correspondence. At that time listings of all schools (with background information), child care centers and nurseries, and well child clinics in the area were obtained. In most nursery schools and day care centers the director had the authority to accept or reject the study, while in public schools the Superintendent of Schools usually presented our request to a School Board Committee. In some cases this would be a research committee, requiring a personal presentation. In our experience, rejections were rare, but understandably occurred under conditions such as being too close to the end of the school year, when the study would interfere with scheduled activities. In one case, a Public Health study had taken over all available space. In general, it took several weeks to obtain permission for public schools. Once the study was approved by the Superintendent of Schools or School Committee, specific schools were selected on the basis of the particular student makeup of the various schools (socioeconomic, racial, and area) and the availability of a room of suitibly private space for measuring. Often sites at widely scattered locations within a city were chosen. It was then necessary to contact and obtain approval from the principal of the selected schools, and this often was followed by making a presentation to the faculty of the chosen schools. These presentations also were beneficial, in that teachers having a clear understanding of the study would ensure a higher return of consent forms. At this point the three-page form (Figures 1-5) consisting of a letter to parents explaining the project, a parental consent form, and a question form, were distributed to teachers, who subsequently parceled them out to students to be filled out and returned. Two or more days were usually required before forms returned, and this had to -he taken into account in advance planning.

Each of two measuremement teams consisted of two research assistants, each able to do the tasks of the However, an attempt was made for the same individual on each team to do the majority of the measuring, while the other recorded the data or operated the mini-computer, and assisted with the positioning of the subject for measuring. Besides being highly trained anthropometrists for the selected, the female members of these two teams had considerable background either as former teachers or in child work, so that they could interact well with children, teachers, physicians, and parents. Team members were highly selected from over 80 applicants. While one team worked primarily in the Ann Arbor Area, the travel team utilized a specially modified Dodge maxi-van to carry the equipment (Figure 6).

It is significant that although there were three flat tires and other minor problems with the van, the portable computer system endured the data collection phase of this study without a major breakdown, even though it often had to be moved in and out of buildings on a daily basis. The measurers found that the children responded more positively to the study if it was explained fully to them before they took the letter forms home to parents. Therefore, wherever possible they went from class to class with the instruments and demonstrated the measuring process, answering questions, and explaining the purpose of the study. Response was found to increase proportionately to the amount of time spent briefing the children. Infants were generally measured either at the University of Michigan well-child clinic or at the Highway Safety Research Institute in Ann Arbor, and at various clinic locations elsewhere. The procedure differed from that of nursery schools or public schools in that the participating parents filled out the questionnaire and consent form at the time of measuring and no preliminary distribution of forms was necessary.

The travel team had to be flexible and make numerous decisions relative to their measurement schedule upon arrival at their destination. Often, it was necessary to improvise in order to collect the most data possible in a short period of time. Since many schools did not open until 9:00 and let out for the day by 3:00, it was important to utilize the available measurement time as efficiently as possible. By using a system of periodic summary data tabulations for race, age, and other criteria, the measurement teams were able to balance the subjects measured to ensure approximate proportions of the projected experimental design as they went along.

3. Measurement Procedures

Most frequently, and ideally, the measurement team worked in a private room, which often was a nurses office or unused classroom in schools, or a partitioned-off room in nursery schools and day care centers. It was critical that the measurer and recorder worked closely and compatibly together as a team. The procedure generally went as follows:

A single child was brought from his classroom into the measuring room. The measurer instructed or helped the child to remove his/her clothing, leaving on underwear, while the recorder "processed" the questionnaire data for that child. Each task took approximately the same amount of time. The measurer then measured the child with the aid of the recorder. As the child was dressing after being measured, the assistant measurer or recorder would go to a classroom to get another child. By the time they returned to the measuring room, the first child was usually dressed and the process started anew. Younger children often liked to be taken to the measuring room in pairs and this quickened the process somewhat. For the most part, however, the above system proved to be the most satisfactory to the measurement team and to the children participating.

When measuring infants at clinics, a member of the team would simply approach the parent, explain the project, and either obtain approval or not. As privacy is not an all-consuming concern of the very young, and as clinics rarely have a room to spare, clinic lobbies, hallways, or semi-private rooms were often used for these subjects.

Even in the best of circumstances a constant flow of children for measuring was not possible, as the measurement team had to work around the schedules of the school in which they were working. Recesses, naps, and special assemblies were among the interruptions to a daily measuring schedule. On a good day the teams averaged 16 to 20 subjects.

Individual subject consent and questionnaire forms were filed by subject number and computer number for children measured by the automatic data acquisition system.

4. Inter- and Intra-Measurement Tests

During the course of the study two procedures, with variations, were utilized to ensure measurement reliability and consistency. Periodically, members of the two measurement teams would measure the same children and/or infants. They were informed that the results would be analyzed to determine if any specific measurements were giving problems, and to check on technique. Since this also provided a good opportunity to identify any divergences in measurement technique, each was observed and aware that it was a procedural check. In these instances measurements were taken independently in turn by each measurer on each child. However, measurers were also encouraged to periodically check themselves by making multiple measurements on the same Individual, with a period of time or other measurements intervening.

A second and more critical technique involved checks on the measurers without their knowledge. This was often difficult to do, since the team would have approximately 20 minutes of contact with each child, providing time for some rapport to build up so that for a considerable time they could recognize children previously measured. Infants were the easiest to make substitutions for without suspicion, but were very difficult to arrange for, since two or more"mothers" would have to be involved. The most successful checks occurred during a period when a large series of twins were being measured for a concurrent strength study. In these instances multiple substitutions were possible, using a non-twin, which would be measured on two separate occasions by each team. This procedure was also difficult to set up, since the subject had to be carefully briefed. However, the technique presented an excellent opportunity to make both inter- and intra-measuring comparisons.

Statistical analysis of these tests was provided by the Department of Biostatistics, and paired t-tests were conducted. It was concluded for the "twin" tests that there were no significant differences (at a = .05 level), each measurer was precise (same measurers on repeated trials) and consistent (same measurements found between measurers). However, because of the small samples involved, more extensive sampling would be desirable to thoroughly explore these observations. From these various procedures conducted during the data collection phase, the measurers appeared highly motivated and conscientious in the data taking.

5. Measurement Devices and Automated Equipment

Automated Anthropometric devices have been suggested [78-79] and developed by Garn et al.[80] for use in odontometry, and at present work is being conducted using such techniques at the University of Queensland, Brisbane, Australia [81] by Bullock, and at the University of Nymegen, the Netherlands, by Prahl-Anderson [82,83], among others. However, the current system in use by the University of Michigan is believed to be the most extensive systematic use of automated anthropometry, the first use of the NOVA minicomputer data acquisition system, and the first Practical portablecomputerized means of obtaining C.G. measures on both children and infants. Detailed description of the measurement devices developed for use in this program have been previously published [84-88].

The task of measuring squirming infants and small children involves problems not present when measuring adults. Measurements must be taken quickly and efficiently without sacrificing accuracy; and if reproducibility of measurements on soft tissue is to be achieved, a means of standardizing these measurements must be provided. With infants and young children the lack of skeletal landmarks and the number of measurements that must be made on soft tissue make it especially difficult to achieve accuracy and reproducibility. For these reasons, it was decided at the outset that the development of new anthropometric measuring equipment utilizing an automatic data acquisition system would be necessary and critical if reliable data were to be obtained.

In order to obtain body segment lengths, GPM (Siber Hegner & Co., Ltd) Swiss standard anthropometers and calipers were modified to provide electrical readout of the length by means of a 10-turn potentiometer connected to the moving blade by means of a pulley and cable system. These instruments are illustrated in the drawings of Figures 7a and 7b, respectively.

A miniature pressure transducer placed in the special plexiglass blade provides a means of standardizing the measurements on soft tissue by simultaneous recording of both length and pressure. Figures 8a and 8b show the actual instruments.

A third device to measure body circumferences, shown in Figure 9, also provides an electrical readout of the measure by means of a 10-turn potentiometer incorporated in the handle of the device. Tension in the loop of a standard measuring tape wound around a pulley is maintained and controlled by means of a coil spring in the device. To make a measurement the tape is looped around the body segment and clipped back on the device.

These devices are interfaced through a 12-bit A/D converter to a minicomputer data acquisition system, which consists of a NOVA 1220 minicomputer, two magnetic tape drives, a keyboard, terminal, and TV display unit contained in the portable package shown in Figures 10a and 10b.

The pressure signals from the anthropometers and calipers are amplified by instrumentation amplifiers prior to the A/D converter. A program called MAP (Michigan Anthropometric Processor) (Figure 11) controls the measurement acquisition process, including daily instrument calibration, measurement sequencing, information retrieval, and data storage on Linc tape.

In addition to the measurement data, information related to the child's age, sex, race, etc., is obtained and input to the system via the keyboard.

A second method of data collection uses a portable instrument package which contains signal amplifiers and provides for length measurement readout on a digital meter and pressure readout on an analog meter. This system is advantageous for anthropological field measurements where cost and portability are critical, since the entire unit can be hand-carried by the measuring team (Figure 12). However, since the digital readouts must be recorded by hand, there is a greater chance of recording error. Furthermore, center-of-gravity measurements can only be obtained by the computer system.

In either system, measurements are transmitted by the instrument being used by depressing a button on the device. For measurements involving pressure, the computer system records a set of 20 lengths at 20 pressure values from 0 to 1PSI during a pressure "squeeze" and displays the results in a graph on the TV display. For thepurposes of this report, values at .5 PSI have been extracted from these data. For the meter readout system, measurements are read from the digital meter when the button on the instrument is depressed and when the needle on the analog meter points to the desired pressure (.5 PSI). These readings are recorded by hand and later keypunched to IBM cards. Data from the two systems have thus been combined and edited into a common file for the results of this report.

Devices for obtaining other measurements include a standard anthropometer for stature, sitting height, and sitting mid-shoulder height; measurement cones for inside and outside grip diameter measurements; templates for measuring finger diameters; and hinged hole boards for minimum hand clearance dimensions. Measurements from these devices are read directly and/or coded and input to the computer system via the keyboard. All the measuring instruments are contained and transported in a single case shown to the left of the computer in Figure 10a.

Instrumentation which allows for measuring whole body center of gravity has also been developed and interfaced with the computer system. Two separate devices have been designed, one for infants and one for children up to 220 pounds. The principle of operation of both is the same and is illustrated in Figure 13.

A platform in which the child is placed is supported by three precisely calibrated load cells. Output signals from these transducers go to the computer via instrumentation amplifiers and the A/D converter. By placing the subject against a known reference plane, the center of gravity is computed from the relative weights on the load cells. Subjects are placed both in the supine position for standing C.G. measures (Figures 14a and 14b) and in the supine position with the legs supported over a platform and knees at right angles for sitting position C.G. (Figures 15a and 15b). In this report, measures are reported as a percent of stature and sitting height, respectively. The infant device uses a plexiglass cradle to hold the infant, while the child device uses a flat rigid platform constructed of a light weight aluminum-styrofoam sandwich structure.

The entire package of equipment including computer system, measuring instruments, TV display, and center of gravity devices is portable and capable of being transported to measuring sites in a specially modified van. Special lightweight ramps have been designed to easily roll the computer cart in and out of the van (Figure 16) and other fixtures and straps are used to secure equipment in place during transport.

6. Data Handling, Reduction, and Analysis

The results presented in Chapter IV were obtained from data acquired by both the computer system (i.e., stored on Linc tape) and the portable readout unit (i.e., recorded by hand on prepared forms). These data were edited and combined into a common file on the Michigan Terminal Computer System (MTS) from which the statistics were computed for each age group and each measure.

Data stored on Linc tape were transferred to MTS via a 1200 baud (bits/sec) Modem. These data include both coded and written interview data regarding the subject's race, age, socioeconomic status, geographic location, etc., as well as the measurement, pressure, and center-of-gravity data. Data recorded by hand were keypunched on IBM computer cards for input to MTS. These data include the socioeconomic information on the subject which had been precoded as well as the measurement data. The primary difference between these two sets of data was in the pressure measurements. The Linc tape data contained 20 lengths at 20 pressures for some measurements, while the hand recorded data contained only a single length recorded at a pressure of .5 PSI. These files were made compatible by extracting a single measurement distance at the pressure value closest to .5 PSI in the Linc tape data, and the two files were then combined after editing each separately.

Editing was accomplished by using visual scans of frequency printouts for the measurement values in each age group and by running computer checks for size relations between different measurements on each subject. The former procedure involved examination of extreme values to determine the cause of their value (e.g., a bad measure, a wrong birthdate causing a wrong age computation, a recording error in the hand-recorded data, or an unusually small or large measurement). Printouts of each subject's data were available for determining the cause of the extreme values. The latter procedure involved checking the data on each subject for obvious impossibilities in the size of various measurements. For example, it is impossible for sitting height to be less than sitting mid-shoulder height or for rump-sole to be less than knee-height, etc. These and other relations were checked by computer and inconsistent relations and subject numbers printed out and investigated. After editing, the two files were combined and the statistical results compiled.

III. RESULTS

1. Description of Data Presentation

The following section presents the summary data for each of the 41 measurements. Although a total of 4027 infants and children were measured, the total N for some measurements is less because of incomplete measurement sets on individuals (as can occur with a crying, wriggling infant) and reductions due to data editing. For each measurement, the results are presented in an identical format, providing a technical description of how the measurement was taken together 'with a photograph and an illustration for both the infant measurement and the child measurement (since there may be differences in techniques even though the name of the measurement is the same). This is important for others who wish to conduct comparable measurements. In addition, both summary data tabulations and graphs are provided for males, females, and combined sexes, by age intervals as described in the next section. Information includes the size of the specific sample (N),the mean (x), the standard deviation ( ), and the 5th, 50th, and 95th percentiles. The latter tabulations have been found most useful for design problems, in cases where a product cannot be reasonably designed to accomodate the full range of a particular body size or dimension possible within the population.

Two measurements, hip depth and buttocks depth, were taken only on infants and children under 24 months. Three other measurements, neck circumference, crotch height, and sitting-mid-shoulder height were taken only on children over 24 months. As a result, the tables for these measurements contain fewer age groups since the ages not measured are excluded. Other measures, which have different names for infants than for children, such as crown-sole and stature, are combined into one table, under one name. For purposes of this study an infant is defined as under 24 months.

2. Interpreting the Tables and Graphs

The age groups for the tables are by months and the tables list the range of months for each group. For infants under 18 months the breakdown is by 3 month intervals (0-3, 4-6, 7-9, 10-12, 11-13, 14-16, and 17-18). From then on it is by 6 month intervals (19-24, 25-30, 31-36, 37-42, 43-48, 49-54, 55-60, 61-66, 67-72, 73-78, 79-84) until 84 months (7 years), after which the breakdown is by 12-month intervals (85-96, 97-108, 109-120, 121-132, 133-144, 145-156). There are, therefore, a total of 22 age groups for measurements where all ages were measured. For the two measures, hip depth and buttocks depth, 'which were taken only on infants (0-24 months), the breakdown is by 2 month intervals (i.e. 0-2, 3-4, 5-6, 7-8, 9-10, 11-12, 13-14, 15-16, 17-18, 19-20, 21-22, 23-24). In the column following the age in months for those months corresponding to interger numbers of years, the age in years is also given.

The particular group a child is in is determined by rounding the age in months off (up or down) to an integer month. (Using 15 days as 1/2 month). Therefore, if a child is 3 months and 16 days, the age will be rounded off to 4 months and the child's data will be placed in the 4-6 month age group. If the child were 3 months and 14 days when measured, the data 'Would be in the 0-3 month age group. Similarly 108 months and 16 days = 109-120 month age group, 84 months and 13 days = 79-84 month age group, etc. For 15 days the age is rounded up. In other words each age group is bounded by the listed ages in months minus one half month.

Below each table, the results are presented graphically by three curves representing the 5th percentile, mean, and 95th percentile values of the representing the 5th percentile, mean, and 95th percentile values of the measurement. These graphs are intended only as a pictorial overview of the pattern of change across age intervals and were generated by a least squares fit of fourth order polynominals of the measurement variable (y) in each age interval on the median (x) of that age interval. Figure 17 illustrates the curves fitted to the data points for the waist circumference measurement and shows the manner in which the curves fit the data points. In order to present a less confusing picture, the data points have been omitted from the graphs in the data summary. It should be clearly indicated that these graphs are not intended for use in finding specific numeric values or statistical inferences. The tables are presented for this more precise and detailed interpretation.

It should also be noted that the graphs sometimes suggest anomalous values, particularly in the extremes for the 5th and 95th percentiles 1 (e.g., large 95th percentile and small 5th percentile) at low and high age groups. Caution should be used in extrapolating from these extremes as they are generally based on small sample sizes. If, for example the sample size is near or less than 20, then the 5th and 95th percentiles become the range, and if an extreme (lst percentile or 99th percentile) individual is in the sample the values may appear out of line with the rest of the graph. It is also true, however, that the least squares fit curves tend to smooth out such sampling errors (and other random errors) thereby presenting a more accurate picture of the true population than is represented by the tabulated data.

One further word of caution in utilizing these, or any other anthropometric data is suggested. There is no such thing as an "average" infant or child. That is to say, for example, that for a given age one cannot take the 50th percentile (median) measurement for the separate body segments which combine to make up stature, add them together, and come out with a "50th percentile" child in stature. This is due to the variation that exists in growth of childrens body segments (or "links"). An excellent discussion of the statistical basis for this is provided in Daniel's "The Average Man", 1952 [89]. Due to variability within individuals, there are relatively few dimensions that are highly correlated (r >.90). How this effects the design of a workspace has been considered in a two-part publication by Moroney (1972)[91].


1 The manner of computation for the 5th and 95th percentile values involves an interpolation between occuring values of the measurement which lie on either side of the percentile of interest. For example if a measurement value up to 6.5 includes 3 percent of the sample and the next higher value of 10.5 includes, 7 percent of the sample, then the 5th percentile value is computed as 6.5 + 4 [(5-3) / (7-3)] = 8.5

3. Measurement Descriptions and Results

The following pages contain the measurement descriptions for the 41 measurements taken, each followed by three pages of tabular and graphical results for combined sexes, males, and females respectively. Since these measurements are grouped into similar types of measurements (e.g., depth, breadth, or circumference measurements, hand and foot measurements, etc.) rather than listed alphabetically, the following list is provided as an index to these results. The measurement name given in brackets refers to the name for infants if it is different than for the child. Measurement Page

General Body Measurements

  • Weight
  • Stature [crown-sole]
  • Sitting height
  • Sitting mid-shoulder height (child only)
  • Crotch height (child only)

    Body Link Length Measurements

  • Buttock-knee [rump-knee]
  • Knee height [knee-sole]
  • Buttock-foot [rump-sole]
  • Shoulder-Elbow length
  • Lower Arm length

    Hand, Foot and Finger Measurements

  • Hand length
  • Hand width
  • Foot length
  • Foot breadth
  • Little finger length
  • Little finger diameter
  • Middle finger length
  • Middle finger diameter
  • Minimum hand clearance diameter
  • Inside grip diameter
  • Outside grip diameter
  • Body Breadth Measurements

  • Head breadth
  • Maximum shoulder breadth
  • Chest breadth
  • Waist breadth
  • Lower torso breadth

    Body Depth Measurements

  • Head length
  • Chest depth
  • Buttock depth (infant only)
  • Hip depth (infant only)

    Body Circumference Measurements

  • Head circumference
  • Neck Circumference (child only)
  • Chest circumference
  • Waist circumference
  • Forearm circumference
  • Upper arm circumference
  • Mid-thigh circumference
  • Max. calf circumference
  • Ankle circumference

    Center of Gravity-Measurements

  • Standing c.g. - % stature
  • Sitting c.g. - % sitting height


    WEIGHT (INFANT)

    Device: Clinic scale and/or infant center of gravity device. The measurement obtained from the scale is typed into the computer via the keyboard. This result is compared with the weight calculated from the readings of the three load cells on the center of gravity device (see center of gravity measurement).

    Description: INFANT: The infant is weighed on clinical scales to the nearest tenth of a kilogram and/or placed in the plexiglas cradle of the center of gravity device from which the weight is computed automatically by the computer.

    WEIGHT (CHILD)

    Device: Health-O-Meter metric scale and/or child center of gravity device. The measurement obtained from the scale is typed into the computer via the keyboard. This result is compared with the weight calculated from the readings of the three load cells on the center of gravity device (see center of gravity measurement).

    Description: CHILD: The child is weighed on clinical scales to the nearest tenth of a kilogram and/or placed horizontally on the child center of gravity platform from which the weight is computed automatically by the computer.


    CROWN-SOLE LENGTH

    Device: Automated anthropometer. Measurements are recorded automatically by computer.

    Description: INFANT: Infant lies on back with legs extended; the head is aligned in the Frankfort Plane relative to the extended torso. Measure the parallel distance from vertex to the heel of the right foot with an automated anthropometer. An assistant is required to assure that the infant is in the correct position.

    STATURE

    Device: Standard anthropometer. Measurements are read from the instrument and typed into the computer via keyboard.

    Description: CHILD: Child stands erect with head in the Frankfort Plane, arms hanging at side. Measure the perpendicular distance from floor to vertex with a standard anthropometer.


    CROWN-RUMP LENGTH

    Device: Automated anthropometer equipped with pressure transducer in paddle blade. Measurements are recorded automatically by computer at fixed pressure values.

    Description: INFANT: Infant lies on back with leg flexed 90' to torso so that rotation of the pelvis is minimal. Measure the parallel distance from vertex to the surface of the right buttock with an automated anthropometer. Pressure is momentarily applied with the pressure transducer paddle-blade on the interior surface of the buttock. An assistant is required to assure that the infant is in the correct position.

    SITTING HEIGHT

    Device: Standard anthropometer. Measurements are read from the instrument and typed into the computer via keyboard.

    Description: CHILD: Child sits erect with head in the Frankfort Plane, arms hanging at side, hands resting on thigh. Measure the perpendicular distance from the seat to vertex with a standard anthropometer.


    SITTING MID-SHOULDER HEIGHT

    Device: Standard anthropometer. Measurements are read from the instrument and typed into the computer via keyboard.

    Description: CHILD: Child sits erect with head in the Frankfort Plane, arms hanging at side, with hands resting on thighs. Measure the perpendicular distance from the seat surface to a point on the superior surface of the right shoulder midway between the neck-shoulder junction and the lateral surface of the shoulder with a standard anthropometer.


    CROTCH HEIGHT

    Device: Standard anthropometer. Measurements are read from the instrument and typed into the computer via keyboard.

    Description: CHILD: Child stands erect facing the anthropometrist with feet spread apart slightly. The blade is placed against the medial-superior surface of the right thigh and the subject is asked to bring feet together. Measure the perpendicular distance from the floor to the point in the crotch where firm contact between anthropometer blade and flesh is made with a standard anthropometer.


    BUTTOCK-KNEE (RUMP-KNEE) LENGTH

    Device: Automated anthropometer equipped with pressure transducer in paddle blade. Measurements are recorded automatically by computer at fixed pressure values.

    Description: INFANT: Infant lies on left side with 900 right hip flexion and 90' right knee flexion. Measure the parallel distance from posterior surface of the right buttock to the anterior surface of the right knee with an automated anthropometer. Pressure is momentarily applied with the pressuretransducer paddle-blade on the posterior surface of the buttock. An assistant is required to assure that the infant is in the correct position.

    Description: CHILD: Child sits erect, feet resting on platform adjusted for 90 knee flexion, arms resting at side with hands resting on thighs. Measure the parallel distance from posterior surface of right buttock to anterior surface of right knee with an automated anthropometer. Pressure is applied momentarily with the pressure-transducer paddle-blade on the posterior surface of the buttock.


    KNEE-SOLE LENGTH

    Device: Automated anthropometer equipped with pressure transducer in paddle blade. Measurements are recorded automatically by computer at fixed pressure values.

    Description: INFANT: Infant lies on back with 90 right knee flexion. Measure the parallel distance from top of right knee to the heel of the right foot with an automated anthropometer. Pressure is momentarily applied with the pressure-transducer paddle-blade on the superior surface of the knee. An assistant is required to assure that the infant is in the correct position.

    KNEE HEIGHT

    Device:Automated anthropometer. Measurements are recorded automatically by computer.

    Description: CHILD: Child sits erect, 1eft foot resting on platform adjusted for 90 knee flexion, arms resting at side, with hands on thighs. The heel of the right foot rests on the immobile paddle blade of the automated anthropometer. Pressure is applied momentarily with the pressure-transducer paddle-blade on the superior surface of the knee.


    BUTTOCK-FOOT (RUMP-SOLE) LENGTH

    Device: Automated anthropometer equipped with pressure transducer in paddle blade. Measurements are recorded automatically by computer at fixed pressure values.

    Description: INFANT: Infant lies on left side with 90 hip flexion. The right leg is fully extended. Measure the parallel distance from posterior surface of the right buttock to the heel of the right foot with an automated anthropometer. Pressure is momentarily applied with the pressure-transducer paddle-blade on the posterior surface of the buttock. An assistant is required to assure that the infant is in the correct position.

    Description: CHILD: Child sits erect with legs fully extended and 90 hip flexion, arms hanging at side. Measure the parallel distance from buttock to heel of right foot with a standard anthropometer.


    SHOULDER-ELBOW LENGTH

    Device: Automated anthropometer or sliding caliper. Measurements are recorded automatically by computer.

    Description: INFANT: Infant lies on back with upper arm resting against body and elbow flexed 90. Measure the parallel distance from the superior surface of the right shoulder to the interior surface of the right forearm with an automated sliding caliper. The paddle blades firmly contact the two body surfaces for measurement. An assistant is required to assure that the infant is in the correct position.

    Description: CHILD: Child sits erect, upper arms resting at side with elbow flexed 90. Measure the parallel distance from the superior surface of the right shoulder to the interior surface of the right forearm with an automated anthropometer. The paddle-blades firmly contact the two body surfaces for measurement.


    LOWER ARM LENGTH

    Device: Automated anthropometer. Measurements are recorded automatically by computer.

    Description: INFANT: Infant lies on back with elbow flexed 90 and right hand and fingers extended. Measure the parallel distance from the posterior surface of the right upper arm, just above the elbow, to the tip of the third digit with an automated anthropometer. The paddle-blades firmly contact the two body surfaces for measurement. An assistant is required to assure that the infant is in the correct position.

    Description: CHILD: Child sits erect, upper arms resting at side, elbow flexed 90 with hands and fingers extended. Measure the parallel distance from the posterior surface of the right upper arm just above the elbow to the tip of the third digit with an automated anthropometer. The paddle-blades firmly contact the two body surfaces for measurement.


    HAND LENGTH

    Device: Automated sliding caliper. Measurements are recorded automatically by computer.

    Description: INFANT: Infant lies on back with right hand fully extended, palm up. Measure the parallel distance from the wrist crease to the tip of the third right digit. Paddle-blades firmly contact the two body surfaces for measurement. An assistant is required to assure that the infant is in the correct position.

    Description: CHILD: Child sits erect, right hand is extended with palm up. Measure the parallel distance from the wrist crease to tip of third digit with an automated sliding caliper. The paddle-blades firmly contact the two body surfaces for measurement.


    HAND WIDTH

    Device: Automated sliding caliper equipped with pressure transducer in paddle blade. Measurements are recorded automatically by computer at fixed pressure values.

    Description: INFANT: Infant lies on back with right hand fully extended, palm up, thumb abducted from hand. Measure the maximum width across the metacarpal-phalongeal with an automated sliding caliper. The paddle-blades firmly contact the two body surfaces for measurement. An assistant is required to assure that the infant is in the correct position.

    Description: CHILD: Child sits erect, hand and fingers extended with palm up, thumb abducted from hand. Measure the maximum width across the metacarpal-phalangeal joints II and V with an automated sliding caliper. The paddle blades firmly contact the two body surfaces for measurement.


    FOOT LENGTH

    Device: Automated sliding caliper or anthropometer. Measurements are recorded automatically by computer.

    Description: INFANT: Infant lies on back. Measure the parallel distance from the heel to the foremost toe of the right foot with an automated sliding caliper. The paddle-blades firmly contact the two body surfaces for measurement. An assistant is required to assure that the infant is in the correct position.

    Description: CHILD: Child sits erect, feet resting on platform for 90 knee flexion, arms resting at side. Measure the parallel distance from heel to the foremeost toe of the right foot with an automated anthropometer. The paddle-blades firmly contact the two body surfaces for measurement.


    FOOT BREADTH

    Device: Automated sliding caliper equipped with pressure transducer in paddle blade. Measurements are recorded automatically by computer at fixed pressure values.

    Description: INFANT: Infant lies on back. Measure the maximum breadth across the ball of the right foot with an automated sliding caliper. The paddle-blades firmly contact the two body surfaces for measurement. An assistant is required to assure that the infant is in the correct position.

    Description: CHILD: Child sits erect, arms resting at side. Measure the maximum breadth across the ball of the right foot with an automated sliding caliper. Pressure is applied momentarily with the pressure transducer paddle-blade on the lateral surface of the foot.


    LITTLE FINGER LENGTH

    Device: Automated sliding caliper. Measurements are recorded automatically by computer.

    Description: INFANT: Infant lies on back with right hand and fingers extended, palm up. Measure the parallel distance from the skin crease at the base of the fifth right digit to the tip of the fifth digit with an automated sliding caliper. The paddle-blade firmly contacts the two body surfaces for measurement. An assistant is required to assure that the infant is in the correct position.

    Description: CHILD: Hand and fingers are extended palm up. Measure the parallel distance from the skin crease at the base of the fifth digit to the tip of the fifth digit with an automated sliding caliper. The paddle-blades firmly contact the two body surfaces for measurement.


    LITTLE FINGER DIAMETER

    Device: Plastic hole template. Measurements are coded and typed into computer via keyboard.

    Description: INFANT: Fifth finger of right hand is extended. Measure the greatest diameter through which the first joint of the fifth finger cannot pass with a finger measurement board (see text for description of finger measurement board). An assistant is required to assure that the infant is in the correct position.

    Description: CHILD: Fifth finger of right hand is extended. Measure the greatest diameter with a finger measurement board (see text for description of finger measurement board) through which the first joint of the fifth finger cannot pass.


    MIDDLE FINGER LENGTH

    Device: Automated sliding caliper. Measurements are recorded automatically by computer.

    Description: INFANT: Infant lies on back with right hand and fingers fully extended, palm up. Measure the parallel distance from the skin crease at the base of the third digit to the tip of the third digit with an automated sliding caliper. The paddle-blade firmly contacts the two body surfaces for measurement. An assistant is required to assure that the infant is in the correct position.

    Description: CHILD: Hand and fingers are extended, palm up. Measure the parallel distance from the skin crease at the base of the third digit to the tip of the third digit with an automated sliding caliper. The paddle-blades firmly contact the two body surfaces for measurement.


    MIDDLE FINGER DIAMETER

    Device: Plastic hole template. Measurements are coded and typed into the computer via keyboard.

    Description: INFANT: Third finger of right hand is extended. Measure the greatest diameter with a finger measurement board (see text for description of finger measurement board)through which the first joint of the third finger cannot pass.

    Description: CHILD: Third finger of right hand is extended Measure the greatest diameter with a finger measurement board (see text for description of finger measurement board)through which the first joint of the third finger cannot pass.


    MINIMUM HAND CLEARANCE

    Device: Hinged plastic hole board. Measurements are coded and typed into the computer via keyboard.

    Description: INFANT: Infant's right hand is extended. Measure the smallest diameter with the hand measurement board (see text for description of device) through which the measurer can pull the infant's hand. An assistant is required to assure that the infant is in the correct position.

    Description: CHILD: Subject extends right hand reduced to its narrowest configuration. Measure the smallest diameter with a hand measurement board (see text for description of device) through which the subject's hand can pass without forcing it.


    INSIDE GRIP DIAMETER

    Device: Grip measurement cone. Measurements are coded and typed into the computer via keyboard.

    Description: INFANT: Infant's right hand is placed and held on measurement cone (see text for description of measurement cone) at the maximum diameter at which the tips of thumb and middle finger just touch. Record the maximum diameter indicated on the measurement cone. An assistant is required to assure that the infant is in the correct position.

    Description: CHILD: Child grasps the measurement cone with right hand at the maximum diameter at which the tips of the thumb and middle finger touch. Record the maximum diameter indicated on the measurement cone.


    OUTSIDE GRIP DIAMETER

    Device: Automated sliding caliper and measurement cone. Measurement is made with sliding caliper and recorded automatically by computer.

    Description: INFANT: Infant grips the measurement cone with the right hand at maximum diameter (see text for description of inside grip diameter). Measure the maximum outside grip diameter from the proximal phalanx-medial phalnx joint of the middle finger to the metacarpo-phalangeal joint of the thumb with the automated sliding caliper. An assistant is required to assure that hand maintains its correct position.

    Description: CHILD: Child grips the measurement cone with the right hand at maximum diameter (see text for description of inside grip diameter). Measure the maximum outside grip diameter from the proximal phalanx-medial phalanx joint of the middle finger to the metacarpo-phalangeal joint of the thumb with the automated sliding caliper.


    HEAD BREADTH

    Device: Automated sliding caliper. Measurements are recorded automatically by computer.

    Description: INFANT: Infant lies on back. Measure the maximum breadth of the head above and behind the ears with the automated sliding caliper. The paddle-blades firmly contact the two body surfaces for measurement.

    Description: CHILD: Child sits erect, arms hanging at side. Measure the maximum breadth of the head above and behind the ears with an automated sliding caliper. The paddle-blades firmly contact the two body surfaces for measurement.


    SHOULDER BREADTH

    Device: Automated anthropometer equipped with pressure transducer in paddle blade. Measurements are recorded automatically by computer at fixed pressure values.

    Description: INFANT: Infant lies on back with arms held at side. Measure the maximum horizontal breadth across the shoulders with an automated anthropometer. Pressure is momentarily applied with the pressure-transducer paddle-blade. An assistant is required to assure that the infant is in the correct position.

    Description: CHILD: Child stands erect, arms hanging at side. Measure the maximum horizontal breadth across the shoulders with an automated anthropometer. Pressure is momentarily applied with the pressure transducer paddle-blade on either side.


    CHEST BREADTH

    Device: Automated anthropometer or sliding caliper equipped with pressure transducer in paddle blade. Measurements are recorded automatically by computer at fixed pressure values.

    Description: INFANT: Infant lies on back. Measure the horizontal breadth of the chest at the level of the nipples with an automated anthropometer. Pressure is momentarily applied with the pressure-transducer paddle-blade. An assistant is required to assure that the infant is in the correct position.

    Description: CHILD: Child stands erect, arms hanging slightly away from sides. Measure the horizontal breadth of the chest at the level of the nipples with the pressure transducer paddle-blade on either side.


    WAIST BREADTH

    Device: Automated anthropometer or sliding caliper equipped with pressure transducer in paddle blade. Measurements are recorded automatically by computer at fixed pressure values.

    Description: INFANT: Infant lies on back with legs fully extended. Measure the minimum breadth just below the level of the iliac crest and above the level of the greater trochanter with an automated anthropometer. Pressure is momentarily applied with the pressure-transducer paddle blade on either side of the hips. An assistant is required to assure that the infant is in the correct position.

    Description: CHILD: Child stands erect, arms hanging at side. Measure the maximum breadth at the level of the natural waist with an automated anthropometer. Pressure is momentarily applied with pressure-transducer paddle-blade on either side of the subject.


    LOWER TORSO BREADTH

    Device; Automated anthropometer or sliding caliper equipped with pressure transducer in paddle blade. Measurements are recorded automatically by computer at fixed pressure values.

    Description: INFANT: Infant lies on back with legs fully extended. Measure the maximum breadth below the minimum breadth of the torso (this measurement is usually taken at the approximate level of the crotch and ischial tuberosities) with an automated anthropometer. Pressure is momentarily applied with the pressure-transducer paddle-blade on the upper thigh. An assistant is required to assure that the infant is in the correct position.

    LOWER TORSO BREADTH

    Device: Automated anthropometer or sliding caliper equipped with pressure transducer in paddle blade. Measurements are recorded automatically by computer at fixed pressure values.

    Description: CHILD: Child stands erect, arms hanging at side. Measure the maximum horizontal breadth at the level of the upper thigh with an automated anthropometer. Pressure is applied momentarily with the pressure-transducer paddle-blade on either the left or right surface.


    HEAD LENGTH

    Device: Automated anthropometer or sliding caliper. Measurements are recorded automatically by computer.

    Description: INFANT: Infant lies on back with head held (supported) free from crib surface. Measure the distance between glabella and the most posterior point on the occiput with an automated sliding caliper. The paddle-blades firmly contact the two body surfaces for measurement. An assistant is required to assure that the infant is in the correct position.

    Description: CHILD: Child sits erect, arms hanging at side. Measure the length between glabella and the most posterior point on the occiput with an automated anthropometer. The paddleblades firmly contact the two body surfaces for measurement.


    CHEST DEPTH

    Device: Automated anthropometer or sliding caliper equipped with pressure transducer in paddle blade. Measurements are recorded automatically by computer at fixed pressure values.

    Description: INFANT: Infant lies on left side. Measure the depth (anterior-posterior distance) at the level of the nipples during normal breathing with an automated sliding caliper. Pressure is momentarily applied with the pressure-transducer paddle-blade on the back. An assistant is required to assure that the infant is in the proper position.

    Description: CHILD: Child stands erect, arms hanging at side. Measure the maximum horizontal depth (anterior-posterior distance) of the chest at the level of the nipples during normal breathing with an automated anthropometer. Pressure is applied momentarily with the pressure transducer paddle-blade on the back of the child.


    BUTTOCK DEPTH

    Device: Automated anthropometer or sliding caliper with pressure transducer in paddle blade. Measurements are recorded automatically by computer at fixed pressure values.

    Description: INFANT: Infant lies on left side with legs fully extended in the Grenouille position. Measure the depth from the maximum protrusion of the buttock to the surface of the upper leg at the level previously established for buttock breadth (No. 19) with an automated anthropometer. Pressure is momentarily applied with the pressure-transducer paddle blade on the buttock. An assistant is required to assure that the infant is in the correct position.


    HIP DEPTH

    Device: Automated anthropometer or sliding caliper with pressure transducer in paddle blade. Measurements are recorded automatically by computer at fixed values.

    Description: INFANT: Infant lies on left side with legs fully extended. Measure the depth (anterior- posterior distance) just below the iliac crests at the same level as the hip breadth measurement with an automated anthropometer. Pressure is momentarily applied with the pressure-transducer paddle blade on the buttock. An assistant is required to assure that the infant is in the correct position.


    HEAD CIRCUMFERENCE

    Device: Automated tape device. Measurements are recorded automatically at constant tension by computer.

    Description: INFANT: Infant lies or sits with head supported away from crib surface. Measure the circumference with an automated tape device that applies constant tension at the level of a plane passing through glabella, at the most posterior protrusion on the occiput, and perpendicular to the mid-sagittal plane. An assistant is required to assure that the infant is in the correct position.

    Description: CHILD: Child sits erect, arms hanging at side. Measure the circumference with an automated tape device that applies constant tension at the level of a plane passing through glabella, the most posterior protrusion on the occiput, and perpendicular to the mid-sagittal plane.


    NECK CIRCUMFERENCE

    Device: Automated tape device. Measurements are recorded automatically at constant tension by computer.

    Description: CHILD: Child sits erect with head in the Frankfort Plane, arms hanging at side. Measure the horizontal circumference at the base of the neck with an automated tape device that applies constant tension.


    CHEST CIRCUMFERENCE

    Device: Automated tape device. Measurements are recorded automatically at constant tension by computer.

    Description: INFANT: Infant lies on back. Measure the horizontal circumference of the chest during normal breathing at the level of the nipples with an automated tape device that applies constant tension. An assistant is required to assure that the infant is in the correct position.

    Description: CHILD: Child stands erect, arms hanging slightly away from side. Measure the horizontal circumference of the chest during normal breathing at the level of the nipples with an automated tape device that applies constant tension.


    WAIST CIRCUMFERENCE

    Device: Automated tape device. Measurements are recorded automatically at constant tension by computer.

    Description: INFANT: Infant lies on back with legs fully extended. Measure the horizontal circumference just below the level of the iliac crest and above the level of the greater trochanter with an automated tape device that applies constant tension. An assistant is required to assure that the infant is in the correct position.

    Description: CHILD: Child stands erect, arms hanging at side. Measure the horizontal circumference at the level of the natural waist with an automated tape device that applies constant tension.


    FOREARM CIRCUMFERENCE

    Device: Automated tape device. Measurements are recorded automatically at constant tension by computer.

    Description: INFANT: Infant lies on back with right arm extended. Measure the maximum circumference perpendicular to the long axis of the limb with an automated tape device that applies constant tension. An assistant is required to assure that the infant is in the correct position.

    Description: CHILD: Child sits erect with right arm extended. Measure the maximum circumference, perpendicular to the long axis of the limb with an automated tape device that applies a constant tension.


    UPPER ARM CIRCUMFERENCE

    Device: Automated tape device. Measurements are recorded automatically at constant tension by computer.

    Description: INFANT: Infant lies on back with right arm extended. Measure the circumference perpendicular to the long axis of the limb midway between shoulder and elbow with an automated tape device that applies constant tension. An assistant is required to assure that the infant is in the correct position.

    Description: CHILD: Child sits erect with right arm extended. Measure the circumference perpendicular to the long axis of the limb midway between the shoulder and elbow with an automated tape device that applies constant tension.


    MID-THIGH CIRCUMFERENCE

    Device: Automated tape device. Measurements are recorded automatically at constant tension by computer.

    Description: INFANT: Infant lies on back with right leg extended supported free of crib surface. Measure the horizontal circumference midway between the abdomen-thigh flexure crease and the knee with an automated tape device that applies constant tension. An assistant is required to assure that the infant is in the correct position.

    Description: CHILD: Child sits with right leg extended and relaxed. Measure the horizontal circumference midway between the abdomen-thigh flexure crease and the knee with an automated tape device that applies constant tension.


    MAXIMUM CALF CIRCUMFERENCE

    Device: Automated tape device. Measurements are recorded automatically at constant tension by computer.

    Description: INFANT: Infant lies on back with right leg extended and supported free of crib surface. Measure the maximum horizontal circumference at the level of the greatest posterior protrusion of the calf with an automated tape device that applies constant tension. An assistant is required to assure that the infant is in the correct position.

    Description: CHILD: Child sits with right leg extended and relaxed. Measure the maximum horizontal circumference at the level of the greatest posterior protrusion of the calf with an automated tape device that applies constant tension.


    ANKLE CIRCUMFERENCE

    Device: Automated tape device. Measurements are recorded automaticallv at constant tension by computer.

    Description: INFANT: Infant lies on back with right leg extended and supported free of crib surfaces. Measure the minimum horizontal circumference of the ankle above the malleoli with an automated tape device that applies constant tension. An assistant is required to assure that the infant is in the correct position.

    Description: CHILD: Child sits with right leg extended and relaxed. Measure the minimum horizontal circumference of the ankle above the malleoli with an automated tape device that applies constant tension.


    STANDING CENTER OF GRAVITY % STATURE

    Device: A plexiglas cradle supported by a frame balanced on three precisely calibrated load cells. Signals from the load cells are recorded automatically by the computer upon depression of a command key on the keyboard. Each load cell is sampled 500 times and the average value used to compute the location of the center of gravity.

    Description: INFANT: The infant lies supine with the apex placed against a reference plane. The arms are kept at the sides and the legs maintained as straight as possible. The distance of the center of gravity (D1) from the apex is computed from the relative weight carried by the load cells at each end. This distance is subtracted from the crown-sole measurement and expressed as a percentage of crown-sole from the soles of the feet [((crown sole - D1) / crown sole) x 100].

    STANDING CENTER OF GRAVITY % STATURE

    Device: A horizontal platform supported by a frame balanced on three precisely calibrated load cells. Signals from the load cells are recorded automatically by the computer upon depression of a command key on the keyboard. Each load cell is sampled 500 times and the average value used to compute the location of the center of gravity.

    Description: CHILD: The child lies supine with the feet placed squarely against a reference plane. The arms are placed at the sides with the legs straight. The distance of the center of gravity (D3) from the soles of the feet is computed and expressed as a percentage of the child's stature [(D3 / stature) x 100].


    SEATED CENTER OF GRAVITY % SITTING HEIGHT

    Device: A plexiglas cradle with leg support adjusted for infant. The cradle is supported by a frame balanced on three precisely calibrated load cells. Signals from the load cells are recorded automatically by the computer upon depression of a command key on the keyboard. Each load cell is sampled 500 times and the average values used to compute the location of the center of gravity.

    Description: INFANT: The infant lies supine with the legs placed over the adjustable support so that the knees form a 90 angle and the buttock is firmly against a reference plane. The arms are kept at the sides as well as possible. The distance of the center of gravity from the buttock reference plane (D2) is computed and expressed as a percentage of the crownrump measurement [(D2 / crown rump) x 100].

    SEATED CENTER OF GRAVITY % SITTING HEIGHT

    Device: Horizontal platform with adjustable leg support attached. The platform is supported by a frame balanced on three precisely calibrated load cells. Signals from the load cells are recorded automatically by the computer upon depression of a command key on the keyboard. Each load cell is sampled 500 times and the average values used to compute the location of the center of gravity.

    Description: CHILD: The child lies supine with the legs placed over the adjustable support so that the knees form a 90 angle and the buttock is firmly against a reference plane. The arms are placed at the sides (D4). The distance of the center of gravity from the buttock reference plane is computed and expressed as a percentage of the sitting height [(D4 / sitting ht.) x 100].


    IV. RELATED TECHNICAL REPORTS AND PUBLICATIONS

    The following publications, reports, technical presentations, and 16mm movie film have resulted to date from this study.
    Publications
    
    1975          Snyder, R. G., C. Owings, M. Spencer, L. W. Schneider, ANTHROPOMETRY
             OF U.S. INFANTS AND CHILDREN.  Society of Automotive Engineers, Report No.
             750423, May.
    
    1974          Snyder, R. G., C. L. Owings, M. L. Spencer, and L. W. Schneider,
             NEW TECHNIQUES FOR INFANT AND CHILD ANTHROPOMETRY:
    MINI-COMPUTER CONTROLLED ANTHROPOMETRY AND CENTER OF GRAVITY
             MEASUREMENTS (LA ANTROPOMETRIA Y LAS MEDIDAS DEL CENTRO DE
             GRAVEDAD DE LOS NINOS ESTADOUD IDENSES UTILIZANDO EL AVANZADO
             SISTEMA AUTOMATIZADO DE MICHIGAN DE LA MINI-CALCULADORA
             ELECTRONICA) Proceedings, American Anthropological Association, p. 133, Mexico
    City
             (November)
    
             Owings, C.L., L. W. Schneider, R. G. Snyder, and M. L. Spencer,
             A PORTABLE SYSTEM FOR INFANT AND CHILD CENTER OF GRAVITY
             MEASUREMENT. Proceedinas, Conference on Engineering, Medicine and Biology,
             Pg. 375, (October).
    
             Owings, C. L., L. W. Schneider, R. G. Snyder, and M. L. Spencer_, COMPUTER
             CONTROLLED ANTHROPOMETRY: A PORTABLE SYSTEM FOR USE WITH
             INFANTS AND CHILDREN, Proceedings, Conference on Engineering, Medicine and
             Biology, P. 385, (October).
    
             Snyder, R. G., M. L. Spencer, C. L. Owings, and L. W. Schneider, INFANTS AND
             CHILDREN ANTHROPOMETRY (L'ANTHROPOMETRIE DES ENFANTS ET
             DES NOURRISSIONS) Proceedings, International Research Committee on Biokinetics of
             Impacts, Biomechanics of Trauma in Children.  Pg. 139149.  Lyon, France, (September).
    
             Owings, C. L., R. G. Snyder, M. L. Spencer, and L. W. Schneider,
             NEW TECHNIQUES FOR INFANT AND CHILD ANTHROPOMETRY:
    MINI-COMPUTER CONTROLLED ANTHROPOMETRY AND CENTER OF GRAVITY
             MEASUREMENTS, Proceedings, American Journal of Physical Anthropology, (February).
    
    1972          Snyder, R. G., M. Spencer, C. Owings, and P. Van Eck, SOURCE DATA
             OF INFANT AND CHILD MEASUREMENT, Interim Data, 1972.  Prepared for U.S.
    Food
             and Drug Administration, Children's Hazards Division, Bureau of Product Safety, Bethesda,
             Maryland, by the University of Michigan,
             Ann Arbor, December.
    
             Snyder, R. G., M. Spencer, and C. Owings, SELECTED INFANT ANTHROPOMETRY
             CRIB SLAT STUDY, Food and Drug Administration, Bureau of Product Safety, Children's
             Hazards Division Bethesda Md., Report, 18 December.
    
             Monthly Reports 1-36, April 1972, 31 March, 1975.
    

    Oral Presentations

    1975
    NEW WAYS TO MEASURE CHILDREN: IMPLICATIONS FOR SAFETY. R. G. Snyder and C. L. Owings, University of Michigan Science Research Symposium. The Chrysler Center.

    1975 SAE Engineering Congress, Detroit, 28 February. Snyder, R. G., C. Owings, M. Spencer, L. W. Schneider, and H. Reynolds, ANTHROPOMETRY OF U.S. CHILDREN.
    1974
    27th Annual Conference on Engineering in Medicine and Biology, Phila., 6 October, 1974.

    Owings, C. L., L. W. Schneider, R. G. Snyder, and M. L. Spencer. A PORTABLE SYSTEM FOR INFANT AND CHILD CENTER OF GRAVITY MEASUREMENT.

    27th Annual Conference on Engineering in Medicine and Biology, Phila. 6 October 1974. COMPUTER CONTROLLED ANTHROPOMETRY: A PORTABLE SYSTEM FOR USE WITH INFANTS AND CHILDREN. Owings, C. L., L. W. Schneider, R. G. Snyder, and M. L. Spencer.

    American Anthropological Association, Mexico City, Mexico, 20 November 1974. Snyder, R. G., C. L. Owings, M. L. Spencer and L. W. Schneider, NEW TECHNIQUES FOR INFANT AND CHILD ANTHROPOMETRY: MINI-COMPUTER CONTROLLED ANTHROPOMETRY AND CENTER OF GRAVITY MEASUREMENTS.

    International Research Committee on Biokinetics of Impacts, Biomechanics of Trauma in Children, Lyon, France, 18 September 1974. Snyder, R. G., M. L. Spencer, C. L. Owings, and L. W. Schneider, INFANT AND CHILD ANTHROPOMETRY.

    Annual Meeting, American Association of Physical Anthropologists, University of Massachusetts, Amherst, 11 April. Owings, C. L., R. G. Snyder, M. Spencer, and L. W. Schneider, NEW TECHNIQUES FOR INFANT AND CHILD ANTHROPOMETRY: MINI-COMPUTER CONTROLLED ANTHROPOMETRY AND CENTER OF GRAVITY MEASUREMENTS.
    Films:
    1975
    NEW METHODS OF INFANT AND CHILD ANTHROPOMETRY FOR PRODUCT SAFETY. 18 minutes-color-sound-16mm. 31 March.
    1973
    CRIB-SLAT STUDY. TV release. 1 min. 30 sec.-color-sound-16mm-24 July.
    Automatic Data Processing:
    1975
    Consumer Product Safety Commission Final Summary data in both printed tabular format and IBM compatible Magnetic Tape (9-track 1600 BPI with standard label) for 41 measurements of 4,027 U.S. Children from age 2 weeks to 12 years. (31 March)


    V. REFERENCES CITED

    1. 1. National Safety Council. Accident Facts Chicago, Illinois, 1974, p. 8.
    2. 2. Benjamin, B. "Actuarial Methods of Mortality Analysis: Adaptations to Changes in the Age and Cause Pattern: Proceedings,, Royal Society (Biology) Vol. 159, December, 1963, pp. 48-49.
    3. 3. Keddy, J.A. "Accidents in Childhood: A Report on 17,141 Accidents" Le Journal de L'Association Medicale Canadiene Vol. 91 no. 13, September, 1964, pp. 675 - 680.
    4. 4. Neale, A.V. "The Changing Pattern of Death in Childhood: Then and Now" Med. Sci. Law Vol. 4 January, 1964, pp. 35-39.
    5. 5. Wegman, M.E. "Annual Summary of Vital Statistics for 1973 "Pediatrics Vol. 54, no. 6. December, 1974, pp. 677-781.
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    12. 12. Blake, R., Jr. Pedestrian and Bicycle Accidents. State of Idaho Department of Highways Planning of Traffic Division, September, 1973.
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    18. 18. Waller, J.A. Bicycle Ownership, Use and Injury Patterns Among Elementary School Children in Chitenden County, Vermont. August, 1970.
    19. 19. Waller, P.A. and D.W. Reinfurt Bicycles: An Analysis of Accidents in North Carolina. University of North Carolina High-way Safety Research Center. Contract No. CPF 69-30 (Sponsor: Food and Drug Administration, Rockville, Md.), 1969.
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    25. 25. L'Hirondel, J. "On the Safety of the Infant in Crib and High Chairs", Pediatrics, Vol. 15, 196o, p. 598.
    26. 26. L'Hirondel, J. "The Safety of the Infant in Its Crib and in High Chairs: Strangulation by Restraining Apparatus and in Falls", Revue d'Hygiene et Medecine Scolaires et Universitaires, Vol. 9, 1961, p. 653.
    27. 27. Zachaw-Christiansen, B. and J. Jensen. "Death by Suffocation in Children During the First Three Years of Life: With Special Reference to Suffocation in Children's Harnesses:,Ugeskrift for Laeger (Kobenhavn), Vol. 123, 1961, p. l049.
    28. 28. Haddon, W., Jr. "Approaching the Epidemiology of Head Injuries", Journal of Trauma, Vol. 10, no. 8, August, 1970, Pp. 712-714.
    29. 29. The National Commission on Product Safety. Product and Injury Identification. Supplemental Studies, Vol. 1. A Staff report, U.S. Government Printing Office, Washington, D.C., June, 1970.
    30. 30. Snyder, R.G., M.L. Spencer, and C.L. Owings Selected Infant Anthropometry: Crib Slat Sub Study, February, (unpublished report) 1973.
    31. 31. Federal Register "Requirements for Full-Size Baby Cribs" Part 1508 of The Hazards Substances Act published November 21, 1973 - effective February, 1974. Vol. 38, 1973 pp. 32129-32133.
    32. 32. Snyder, R.G., M. Spencer, C. Owings, and P. Van Eck. Source Data of Infant and Child Measurements Interim Data, 1972. Prepared for Children's Hazards Division, Bureau of Product Safety, Food and Drug Administration, Bethesda. The 'University of Michigan, Ann Arbor. January, 1973, (Reprinted January, 1975).
    33. 33. Marshall, W.A. and C.O. Carter "Child on Mid-Parent Regression for Full Adult Stature" Proceedings, Society for the Study of Human Biology London. April, 1975
    34. 34. Young, J.W. Selected Facial Measurements of Children for Oxygen-Mask Design. Office of Aviation Medicine, Federal Aviation Agency, Oklahoma City, Oklahoma. Report No. AM66-9. April, 1966.
    35. 35. Stoudt, H.W. Anthropometry for Child Restraints. U.S. Department of Transportation, National Highway Traffic Safety Administration, Washington, D.C. Report No. DOT-HS-800 535. July, 1971.
    36. 36. Young, J.W., J.T. McConville, E.M. Reynolds, and R.G. Snyder. Evaluation of Masterbody Forms for 3-year and 6-year old Child Dummies. Memorandum Report to National Highway Traffic Safety Administration; Civil Aeromedical Institute, Federal Aviation Administration, Oklahoma City. 28 March, 1975.
    37. 37. Krogman, W.M. "Growth of Man" Tabulae Biologicae. W. Junk Publishing Co. The Hague, Holland, Vol. xx, 1941
    38. 38. Garrett, J.W. and K.W. Kennedy. A Collation of Anthropometry Vols. 1 and 2. Aerospace Medical Research Laboratory, Air Force Systems Command, Wright-Patterson Air Force Base, Ohio. March, 1971.
    39. 39. Collins, S.D. and T. Clark. "Physical Measurements of Boys and Girls of Native White Race Stock (Third Generation Native Born) in the United States" Public Health Reports., Vol. 44, 1929, pp. 1059-1083.
    40. 40. Gray, H., and J.G. Ayres. "Growth of Private School Children (with Averages and Variabilities Based on 3,110 Measurements on Boys and 1,470 on Girls from the Ages of 1 to 19 years)" Behavior Research Fund Monographs, 1931.
    41. 41. Wise, F.C. and H.V. Meredith "The Physical Growth of Alabama White Girls Attending WPA Preschools" Child Development, Vol. 13, 1942, pp. 165-194.
    42. 42. Meredith, H.V. "Size and Form of Boys of U.S.A. - North European Ancestry Born and Reared in Oregon" Growth Vol. 15, 1951, pp. 39-55.
    43. 43. Eppright, E.S. and V.C. Sidwell. "Physical Measurements of Iowa School Children" Journal of Nutrition, Vol. 54, 1954, pp. 543-556.
    44. 44. Meredith, H.V. and V.B. Knott. "Descriptive and Comparative Study of Body Size of United States Schoolgirls" Growth Vol. 25, 1962, pp. 283-295.
    45. 45. Department of Health -Education and Welfare Ten State Nutritional Survey. PHS Publication no. 72-8130-33, 1972.
    46. 46. Rauh, J.L., D.A. Schumsky, and M.T. Witt, "Height, Weights and Obesity in Urban School Children" Child Development, Vol. 38, 1967, pp. 515-530.
    47. 47. Bakwin, H. and R.M. Bakwin. "Body Build in Infants: V. Anthropometry in the New-Born," Human Biology, Vol. 6, 1934, pp. 612-626.
    48. 48. Bakwin, B. and R.M. Bakwin. "Body Build in Infants: I. The Technique of Measuring the External Dimensions of the Body in Infants," Journal of Clinical Investigation, Vol. 10, 1931, pp. 369-375.
    49. 49. Kasius, R.V., A. Randall, W.T. Tompkins, and D.G. Wiehl. "Maternal and New-Born Nutrition Studies at Philadelphia Lying in Hospital," The Milbank Memorial Fund Quarterly, Vol. 35, 1957, pp. 323-372.
    50. 50. Burdi, A.R., D.F. Huelke, R.G. Snyder, and G.H. Lowrey. "Infants and Children in the Adult World of Automobile Safety Design: Pediatric and Anatomical Considerations for Design of Child Restraints," American Society of Mechanical Engineers, Paper no. 69-BHF-10, Journal of Biomechanics, Vol. 2, no. 3, 1969, pp. 267-280.
    51. 51. Bennett, H.E. School Posture and Seating. Ginn & Co., Boston, 1928.
    52. 52. O'Brien, R. Children's Body Measurements for Sizing Garments and Patterns. Bureau of Home Economics, U.S. Department of Agriculture, Washington, D.C. Misc. Publ. No. 365, 1939.
    53. 53. O'Brien, R. Body Size Measurements of American Boys and Girls for Garment and Pattern Construction. Bureau of Home Economics, U.S. Department of Agriculture, Washington, D.C. Misc. Publ. No. 366, 1941.
    54. 54. Stayton, M.E. Heights for High School Clothing Laboratory Tables Based On Measurements o 00 Girls. Unpublished master thesis. Oregon State College, Cornvallis, Oregon, 1938.
    55. 55. Anderson, D.I. Dimension Standards for a High School Foods Laboratory. Unpublished Master's Thesis. Oregon State College. Cornvallis, Oregon, 1941.
    56. 56. Martin, W.E. Basic Body Measurements of School Age Children. U.S. Department of Health Education, and Welfare, Office of Education. Washington D.C. June, 1953.
    57. 57. Martin, W.E. The Functional Body Measurements of School Age Children. The National School Service Institute, Chicago, 1954.
    58. 58. Martin, W.E. Children's Body Measurements for Planning, and Equipping Schools. U.S. Department of Health, Education, and Welfare, Office of Education. Washington, D.C. Special Publication No. 4, 1955.
    59. 59. Damon, A., H.W. Stoudt, and R.A. McFarland. The Human Body In Equipment Design. Harvard University Press, Cambridge, (revised 1974), 1966.
    60. 60. Stoudt, E.W., A. Damon, and R.A. McFarland. "Heights and Weights of White Americans, " Human Biology, Vol. 32, 1960, pp. 331-341.
    61. 61. McConville, J.T., and E. Churchill. Source Data for the Design of Simulated Children's Body Forms. U.S. Department of Health, Education and Welfare, Public Health Service, Washington, D.C., July, 1964.
    62. 62. Krogman, W.M. The Growth of Philadelphia School-Age Children. 6-14 Years, Studied Serially, 1948- 1958; a Decennial Report. Philadelphia Center for Research in Child Growth, Philadelphia, 1959.
    63. 63. Krogman, W.M. "Growth of head, Face, Trunk and Limbs in Philadelphia White and Negro Children of Elementary and High School Age." Monographs, of Society for Research in Child Development, Vol. 35, May 1970, Pp. 1-80.
    64. 64. Krogman, W.M. and F.E. Johnston. "The Physical Growth of Philadelphia White Children, Age 7-17 Years". Phiadelphia Center for Research in Child Growth, Philadelphia, 1965.
    65. 65. Vickers, U.S. and H.C. Stuart. "Anthropometry in the Pediatrician's Office: Norms for Selected Body Measurements Based on Studies of Children of North European Stock" Journal of Pediatrics, Vol. 22, 1943, p. 155.
    66. 66. Palmer, C.E., "Studies of the Center of Gravity in the Human Body" Child Development, Vol. 15, Nos. 2-3, June, September, 1944, pp. 99-148
    67. 67. Swearingen, J.J. and J.W. Young. Determination of Centers of Gravity of Children Sitting and Standing. Federal Aviation Agency Office of Aviation Medicine, Oklahoma City. Report No. AM 65-23. August, 1965.
    68. 68. Swearingen, J.J., J.M. Badgley, G.E. Braden, and T.F. Wallace. "Determination of Centers of Gravity of Infants," Preprints, Scientific Program, Aerospace Medical Association, San Francisco,, May 5, 1965, pp. 235-236.
    69. 69. Malina, Robert M., Peter V.V. Hamill and Stanley Lemeshow. Selected Body Measurements of Children 6-11 Years. U.S. Department of Health, Education and Welfare, Public Health Service, Health Resources Administration. NCHS Series 11, No. 123, January, 1973.
    70. 70. Hamill, P.V.V., F.E. Johnston, and S. Lemeshow. Height and Weight of Children: Socioeconomic Status. United States. U.S. Department of Health, Education and Welfare, Public Health Service, Health Services and Mental Health Administration, Rockville, Md. Public Health Series 1000, Series 11, No. 119, October, 1972.
    71. 71. Hamill, P.V.V., F.E. Johnston, and S. Lemeshow. Height and Weight of Children. U.S. Department of Health, Education and Welfare, Public Health Service, Health Services and Mental Health Administration, Rockville, Md. Public Health Series 1000, Series 11, No. 104, September, 1970.
    72. 72. Johnston, F.E., P.V.V. Hamill, and S. Lemeshow. Skinfold Thickness of Children 6-11 Years. United States. U.S. Department of Health, Education and Welfare, Public Health Service, Health Services and Mental Health Administration, Rockville, Md. Public Health Series 1000, Series 11, No. 120, October, 1972.
    73. 73. Malina,R.M., P.V.V. Hamill, and S. Lemeshow. Body Dimensions and Proportions. White and Negro Children 6-11 Years. U.S. Department of Health, Education and Welfare, Public Health Service, Health Services and Mental Health Administration, Rockville, Md. Public Health Series 1000, Series 11, No. 143, December, 1974.
    74. 74. National Center for Health Statistics, Plan and Operation of a Health Examination Survey of U.S. Youths 12-17 Years of Age. Vital and Health Statistics, Washington, D.C. Public Health Service Publication No. 1000, Series 1, No. 8, 1969.
    75. 75. Hamill, P.V.V., F.E. Johnston, and S. Lemeshov. Height and Weight of Youths 12-17 Years. United States. U.S. Department of Health, Education and Welfare, Public Health Service, Health Services and Mental Health Administration, Rockville, Md. Public Health Series 1000, Series 11, No. 124, January, 1973.
    76. 76. Hamill, P.V.V., F.E. Johnston, and S. Lemeshow. Body Weight, Stature and Sitting Height: White and Negro Youths 12-17 Years. United States. U.S. Department of Health, Education and Welfare, Public Health Service, Health Services and Mental Health Administration, Rockville, Md. Public Health Series 1000, Series 11, No. 126, August, 1973.
    77. 77. Johnston, F.E., P.V.V. Hamill, and S. Lemeshov. Skinfold Thickness of Youths 12-17 Years. United States. U.S. Department of Health, Education and Welfare, Public Health Service, Health Services and Mental Health Administration, Rockville, Md. Public Health Series 1000, Series 11, No. 132, May, 1974.
    78. 78. Garn, S.M. "Automation in Anthropometry" American Journal of Physical Anthropology, Vol. 20, 1962, pp. 387-388.
    79. 79. Garn, S.M. and R.H. Helmrich "Next Step in Automated Anthropometry" American Journal of Physical Anthropology, Vol. 26, 1968, pp. 97-99.
    80. 80. Garn, S.M. and R.H. Helmrich, and A.B. Lewis "Transducer Caliper with Readout Capability for Odontometry" Journal of Dental Research, Vol. 46, nos. 1-2 1967, p. 306.
    81. 81. Bullock, M.I. University of Greensland, Brisbane, Australia (personal communication), 1974.
    82. 82. Prahl - Andersen, B. "The Longitudinal Growth-Study of the University of Nijmegen" COMPTE RENDU DE LA X REUNION DES EQUIPES CHARGEES DES ETUDES SUR LA CROISSANCE ET LE DEVELOPPEMENT DE L'ENFANT NORMAL. CENTRE INTERNATIONAL DE L'ENFANCE. TOME II, 1970, pp. 39-41.
    83. 83. Prahl - Andersen, B.A., J. Pollman, D.J. Roaben, and K.A. Peters "Automated Anthropometry" Am. J. Phy. Anthrop., Vol. 37, 1972, pp. 151-154.
    84. 84. Owings, C.L., R.G. Snyder, M.L. Spencer, and L.W. Schneider, NEW TECHNIQES FOR INFANT AND CHILD ANTHROPOMETRY: MINI-COMPUTER CONTROLLED ANTHROPOMETRY AND CENTER OF GRAVITY MEASUREMENTS. Proceedings, American Journal of Physical Anthropology, February, 1974.
    85. 85. Snyder, R.G., M.L. Spencer, C.L. Owings, and L.W. Schneider, INFANTS AND CHILDREN ANTHROPOMETRY (L'ANTHROPOMETRIE DES ENFANTS ET DES NOURRISSIONS) Proceedings, International Research Committee on Biokinetics of Impacts, Biomechanics of Trauma in Clildren, Lyon, France, September, 1974, pp. 139-149.
    86. 86. Owings, C.L., L.W. Schneider, R.G. Snyder, and M.L. Spencer, COMPUTER CONTROLLED ANTHROPOMETRY: A PORTABLE SYSTEM FOR USE WITH INFANTS AND CHILDREN, Proceedings, Conference on Engineering, Medicine and Biology, October, 1974, p. 385.
    87. 87. Owings, C.L., L.W. Schneider, R.G. Snyder, and M.L. Spencer, A PORTABLE SYSTEM FOR INFANT AND CHILD CENTER OF GRAVITY MEASUREMENT. Proceedings, Conference on Engineering-, Medicine and Biology, October, 1974, p. 375.
    88. 88. Snyder, R.G., C.L. Owings, M.L. Spencer, and L.W. Schneider, NEW TECHNIQUES FOR INFANT AND CHILD ANTHROPOMETRY: MINI-COMPUTER CONTROLLED ANTHROPOMETRY AND CENTER OF GRAVITY MEASUREMENTS (LA ANTROPOMETRIA Y LAS MEDIDAS DEL CENTRO DE GRAVEDAD DE LOS NINOS ESTADOUD IDENSES UTILIZANDO EL AVANZADO SISTEMA AUTOMATIZADO DE MICHIGAN DE LA MINI-CALCULADORA ELECTRONICA) Proceedings, American Anthropological Association, Mexico City, November, 1974, p. 133.
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    APPENDIX PARTICIPATING SCHOOLS, DAY CARE CENTERS,NURSERIES AND CLINICS

    ALACHUA  COUNTY,  FLORIDA
    Baby Clinics:
        Alachua Well Baby Clinic
    
    
    ANN ARBOR, MICHIGAN
    Public Schools:
        Bach Elementary
        Carpenter Elementary
        Dicken Elementary
        Forsythe Junior High School
        Haisley Elementary
        King Elementary
        Pattengill Elementary
    
    Private Schools:
        Ann Arbor Montessori Center
        Children's House/Oak Trails Montessori
        Clonlara
        Gay-Jay Montessori
        St. Andrews Montessori
    
    Private Homes:
        B.G. Evenchick
    
    Baby Clinics:
        Child Health Baby Clinic, University Hospital
    
        Child Health Baby Clinic, St. Joseph's Hospital
    
    Nursery Schools and Day Care Centers:
        Children's Playschool
        Discovery Center
        Friendship International
        Island Country Day
        Jack and Jill Day Care
        Jack and Jill Nursery School & Kindergarten
        Little Angels
        Little Farms
        Little Folks Corner
        Little Lambs
        Meadowbrook Farm Learning Center
        Model Cities Day Care Center
        Perry Nursery
        Sherrill Cunningham
        Triangle Nursery School
        Washtenaw Community College Day Care
    
    
    CHELSEA, MICHIGAN
    Public Schools:
         Beach Middle School
         Chelsea North Elementary
         Chelsea South Elementary
    
    
    GAINESVILLE, FLORIDA
      
    Baby Clinics:
        Gainesville Baby Clinic
    
    Public Schools:
        Idylwild Elementary School
        Littlewood Elementary
    
    
    MANCHESTER, CONNECTICUT
    Nursery Schools and Day Care Centers:
        Delmont Child Day Care Center and Nursery School
        Lutz Children's  Museum
        Recreation Center
    
    
    
    PORTLAND, OREGON
    Day Care Centers:
        Fruit and Flower Day Care
        St. Mark's Day Care Center
        St. Vincent de Paul Day Care Center
        West Hills School
        YMCA Latch Key  Program
    
    
    ROCHESTER, MICHIGAN
    Day Care Centers:
        Oakland University Toddler Center
    
    
    SACRAMENTO, CALIFORNIA
    Public Schools:
        El Dorado Elementary School Summer Program
        Elder Creek Elementary School Summer Program
        Huntington Elementary School Summer Program
        Sierra Elementary School Summer Program
        Thomas Edison Elementary School Summer Program
    
    Private Schools:
        Oak Park Methodist Church
        Women's Civic Improvement Center
    
    
    TOLEDO, OHIO
    Nursery Schools:
        West Toledo Day Nursery
    
    
    TUCSON, ARIZONA
    Public Schools:
        Ft. Lowell Elementary School
        Tolson Elementary School
        Van Buskirk Elementary School
        White Elementary School
    
    Nursery Schools:
        Little Red Schoolhouse
        Mary Moppet's
    
    
    WORCHESTER, MASSACHUSETTS
    Public Schools:
        May St. Elementary School Summer Program
        Rich Square Elementary School Summer Program
    
    Day Care Centers:
        Living and Learning Center
    
    Baby Clinics:
        Woodland St. Clinic
    
    
    YPSILANTI, MICHIGAN
    Nursery Schools and Day Care Centers:
        Arbor Park Nursery
        Cherry Hill Nursery
        Hilltop House
        Little Red Schoolhouse
        St. Luke's Day Care Center
        Washtenaw County O.E.O. Day Care