When it comes to kids, embrace the average

In establishing boundaries for what's normal, the starting point is typically the child who falls smack in the middle of the pack. From there, the limits are moved outward in both directions to include children who are somewhat above and those somewhat below average.

From a medical perspective, the tricky part comes in deciding how far out from average the "normal" boundaries are set, and at what point help may be necessary. A common-sense approach -- rather than a standard formula -- is often what's needed. If being above or below average affects a child's ability to perform in day-to-day life, it's difficult to consider it normal.

The upper and lower limits on normal can vary from one characteristic to the next. Being 40% shorter than most peers might not bother a child; being that far below average in language development could embarrass him to the point that he starts to withdraw socially.

In fact, it's often difficult to establish rigid boundaries for a given characteristic because what works for one child may not work for another. Some children, like my own son, shrug off differences; others are devastated by them.

-- Valerie Ulene