Early Psychological Outcomes in Failure to Thrive: Predictions from an Interactional Model

Abstract

Children diagnosed with environmentally based failure to thrive (FTT) early during their first year of life were seen at 12 and 18 months for assessment of psychological development (i.e., cognition, language, symbolic play, and behavior during testing) following hospitalization and intervention. Based on an interactional model of outcome, factors reflecting biologic vulnerability (i.e., wasting and stunting) and family ecology (i.e., income level, family size, and ratio of adults to children) were assessed. Predictions that outcomes would reflect a combination of biological vulnerability and family ecology were upheld for Bayley Mental Development Index (MDI) and Symbolic Play scores at 18 months but not at different ages or for other measures. Instead, wasting alone predicted the 12- and 18-month behavioral ratings and ratio of adults to children predicted the 12-month Bayley MDI and 18-month language measures. These findings underscore the utility o fan interactional model in predicting psychological outcome for childhood disorders such as failure to thrive (FTT). Models of research and clinical interventions in FTT should consider the conjoint influences of nutritional status and family ecology on psychological outcomes.