New Directions in Failure to Thrive, 1985
Implications for Research and Practice

Failure to thrive affects the lives of many infants and young children at critical times in their development and represents a significant public health problem in the United States. Moreover, this condition is invisible and can affect children for long periods of time before it is recognized. The long-term psychosocial sequelae of failure to thrive have only begun to be recognized but may be more severe than first realized. We do know that the costs to society in terms of acute pediatric hospitalization and long-term rehabilitation, foster care, and mental health treatment of young children who present with failure to thrive are considerable. Children who are diagnosed with failure to thrive represent a special challenge and opportunity for intervention, especially preventive intervention, because it is quite possible that many of the long-term consequences of this condi­ tion on psychological development can be lessened via early recognition and intervention. However, the potential for preventive intervention in failure to thrive has been limited by the state of the art in scientific knowledge and practice. Despite the frequency with which failure to thrive is encounter­ ed in ambulatory and inpatient settings, there is little scientific infor­ mation to guide practitioners. Research on the causes and consequences of failure to thrive has been very much limited by small sample sizes, lack of common definitions, and short follow-up periods. Uncertainties in the science of failure to thrive coincide with the considerable practical difficulties involved in diagnosis and inte~vention.

Research on the Prevention of Psychological Disorders of Infancy: A Federal Perspective.- Biologic Risks in “Nonorganic” Failure to Thrive: Diagnostic and Therapeutic Implications.- Failure to Thrive and Preventive Mental Health: Knowledge Gaps and Research Needs.- Conceptual Models: Research Implications.- Organic Concomitants of Nonorganic Failure to Thrive: Implications for Research.- Failure to Thrive: An Expanded Conceptual Model.- Zinc Nutrition in Children Who Fail to Thrive.- Research Reports: Studies of Risk and Outcome.- Toward a Semispecif ic, Multidimensional, Threshold Model of Maltreatment.- A Transactional Model of Failure to Thrive: A Look at Misclassified Cases.- Early Preventive Intervention in Failure to Thrive: Methods and Early Outcome.- Extended Hospitalization of Failure to Thrive Infants: Patterns of Care and Developmental Outcome.- Research Reports: Methods.- Growth Data Analysis in Failure to Thrive Treatment and Research.- Home Observation of Parent-Child Transaction in Failure to Thrive: A Method and Preliminary Findings.- Diagnosis and Intervention: Pediatric Management.- Comprehensive Pediatric Management of Failure to Thrive: An Interdisciplinary Approach.- A Strategy for Managing Nonorganic Failure to Thrive Based on A Prospective Study of Antecedents.- Psychosocial Diagnosis and Intervention.- Diagnostic Classification: The Current Challenge in Failure to Thrive Syndrome Research.- A Developmental Classification of Feeding Disorders Associated with Failure to Thrive: Diagnosis and Treatment.- The Etiology of Failure to Thrive: An Interactional Developmental Approach.- Behavioral Approaches to the Treatment of Failure to Thrive.- The Family Context of Failure to Thrive.- Issues in the Treatment of Emotional and Behavioral Disturbances in Failure to Thrive.- Primary Prevention.- Primary Prevention of Failure to Thrive.- Primary Prevention of Failure to Thrive: Social Policy Implications.- Failure to Thrive and the Economically Depressed Community.- Conference Summary.- Summary of Discussion at NIMH Conference: “New Directions in Failure to Thrive Research: Implications for Prevention,” October, 1984.- Contributors.