Reprinted with permission from LPA Online

Q: What is the definition of dwarfism?

A: Little People of America (LPA) defines dwarfism as a medical or genetic condition that usually results in an adult height of 4'10" or shorter, among both men and women, although in some cases a person with a dwarfing condition may be slightly taller than that.

Q: What are the most common types of dwarfism?

A: By far the most frequently diagnosed cause of short stature is achondroplasia, a genetic condition that results in disproportionately short arms and legs. (The term "disproportionate" is meant only as a point of comparison with people who do not have achondroplasia or any other type of skeletal dysplasia. The arms and legs of a person with achondroplasia are perfectly appropriate for someone with that genetic condition.) The average height of adults with achondroplasia is 4'0". Other genetic conditions that result in short stature include spondyloepiphyseal dysplasia congenita (SED), diastrophic dysplasia, pseudoachondroplasia, hypochondroplasia, and osteogenesis imperfecta (OI). As one might expect from their names, pseudoachondroplasia and hypochondroplasia are conditions that are frequently confused with achondroplasia; diastropic dysplasia occasionally is, too. OI is characterized by fragile bones that fracture easily.

According to information compiled by the Greenberg Center at Johns Hopkins Medical Center and by the late Lee Kitchens, a past president of LPA, the frequency of occurrence of the most common types of dwarfism is as follows:

Achondroplasia (one per 26,000 to 40,000 births) SED (one per 95,000 births) Diastrophic dysplasia (one per 110,000 births)

These conditions are essentially untreatable, although some people with achondroplasia and hypochondroplasia have undergone painful (and controversial) limb-lengthening surgery. LPA's position on limb-lengthening is that it is unnecessary surgery with unknown long-term results, and that it is far more useful to build a dwarf child's self-esteem. (More information below.)

Proportionate dwarfism - that is, a short-stature condition that results in the arms, legs, trunk, and head being the same size in relation to each other as would be expected with an average-size person - is often the result of a hormonal deficiency, and may be treated medically.

Although achondroplasia accounts for perhaps 70 percent of all cases of dwarfism, there are approximately 200 diagnosed types, and some individuals with dwarfism never receive a definitive diagnosis.

Q: What is a midget?

A: In some circles, a midget is the term used for a proportionate dwarf. However, the term has fallen into disfavor and is considered offensive by most people of short stature. The term dates back to 1865, the height of the "freak show" era, and was generally applied only to short-statured persons who were displayed for public amusement, which is why it is considered so unacceptable today.

Such terms as dwarf, little person, LP, and person of short stature are all acceptable, but most people would rather be referred to by their name than by a label.

Q: What is the medical prognosis of a person with short stature?

A: It varies from condition to condition, and with the severity of that condition in each individual. However, it's safe to say that the overwhelming majority of LPs enjoy normal intelligence, normal life spans, and reasonably good health.

Orthopedic complications are not unusual in people with disproportionate dwarfism such as achondroplasia and diastrophic dysplasia, and sometimes surgery is required. A common problem, especially in adults, is spinal stenosis -- a condition in which the opening in the spinal column is too small to accommodate the spinal cord. People with this condition suffer from numbness and/or pain. It can be treated with a type of surgery called a laminectomy.

Q: Is dwarfism considered a disability?

A: Opinions vary within the dwarf community. Certainly a number of short-statured people could be considered disabled as a result of conditions, mainly orthopedic, related to their type of dwarfism. In addition, access issues and problems exist even for healthy LPs. Consider, for example, the simple fact that most achondroplastic adults cannot reach an automated teller machine. Dwarfism is a recognized condition under the Americans with Disabilities Act. Information on the ADA is also available directly from the US Department of Justice, which administers the law.