Here is Charlie next to a classmate of a similar age.
His parents report that he was born big but just seemed to get bigger. He is an active little boy although he can struggle to play with other children of his age because he is so much bigger than them. His mother complains that he wears clothes for 5 year olds and that people worry that he might have developmental delay because he is behind for a boy of his size.
He is occasionally more tired in the daytime than his peers and he snores at night but so does his father.
Charlie is happy in the clinic room and quietly eats a packet of crisps whilst you talk with his mother. There is no evidence of dysmorphic features. His mother mentions her concerns about his penile size but pressing on the supra-pubic area immediately above it reveals a normal penis.
He is putting together words to form short sentences, he has been walking from 14 months and his play appears appropriate for a 2-year-old.
Image from Pharmacia & Upjohn teaching resources