ArticlesThe reference
Growth science

Beyond the reference curve

Khamis-Roche places every athlete on a population reference curve. But athletes do not all traverse that curve at the same speed. Here is how repeated measured tests unlock a personalised trajectory.

Scroll to explore
Population reference
Test measurements
K-R projection
Personalised projection
Wide band (1 test)
Narrow band (4 tests)
1The reference

The population growth rate curve

This is the rate of height gain, in cm per year, across adolescence for a general population. The spike around age 13 to 14 is Peak Height Velocity (PHV), the point of fastest growth in the pubertal spurt. Every Khamis-Roche assessment takes an athlete's height, weight, and parental heights and places them somewhere on this curve.

1 / 5

What this means in practice

Measure consistently

Stadiometer or careful home measurements every three to four months give enough signal to compute a reliable velocity estimate. Two tests at least 90 days apart is enough to activate the projection.

The fork activates automatically

Once an athlete has two eligible measured tests at least 90 days apart, the personalised fork appears on their Rate Timing graph. No extra input needed. It builds in the background as tests accumulate.

K-R always runs unchanged

The personalised fork is additive. It does not replace the Khamis-Roche assessment. Every athlete still gets a full maturation report regardless of their measurement history.

How the projection is built

The system runs two complementary methods in parallel, each contributing something the other cannot do alone.

Khamis-Roche predicts adult height from a single measurement using height, weight, and parental heights. It places the athlete on a population reference percentile and produces a maturation stage, a biological age, and a percentage of predicted adult height. This works from the very first test. No longitudinal history is required.

The velocity layer activates once an athlete has two or more stadiometer or home-measured tests at least 90 days apart. By comparing how fast the athlete actually grew between tests against how fast the reference curve grows at that same age, the system estimates a personal tempo factor. An athlete moving through puberty faster than the reference has a factor above 1. Slower than average gives a factor below 1. This factor then adjusts where on the reference curve the athlete is projected to be at any future age, shifting PHV earlier or later accordingly.

Why use a population reference rather than fitting a model to the athlete alone? Statistical models like SITAR, used in research settings, fit a mean growth curve to a full longitudinal cohort and estimate individual deviations from it. They require many measurements per person to be stable and cannot produce maturity or adult-height estimates from a single test. For academy use, where an athlete might arrive with one measurement and no history, a population reference anchors the system from day one while the velocity layer personalises it over time.

A note on reference data. The population growth curves used here are derived from CDC reference data using LMS values to calculate every percentile. Like all cross-sectional references, these curves slightly underestimate the true height of the growth velocity spike at PHV compared to longitudinal datasets such as the Berkeley Growth Study. The velocity factor is calculated as a ratio against this same reference, so both the observed velocity and the expected velocity share the same baseline. The relative signal, whether an athlete is ahead of or behind their own reference trajectory, is preserved. What this means in practice is that the direction and timing of the personalised projection are sound, while the absolute peak height of the velocity spike shown on the graph may be modestly conservative.

The confidence band reflects two sources of uncertainty. Before PHV, where the growth curve is rising steeply, a small difference in timing produces a large difference in projected rate, so the band is wider. After PHV, the trajectory is more predictable and the band narrows. With a single inter-test interval the band uses a conservative fixed width. With each additional measured test the band tightens as the velocity estimate becomes more consistent.

This approach draws on the SITAR model (Cole et al. 2010) and is supported by findings in Monasterio et al. (2026), which showed SITAR correctly classifies 80 to 84% of athletes as pre, circa, or post-PHV from incomplete growth records, compared to roughly 60% for cross-sectional maturity offset equations. The Khamis-Roche method (1994) forms the single-test foundation, with adult height predictions consistent in accuracy with skeletal age assessments that require radiographs.