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Oral-motor dysfunction in children who fail to thrive: organic or non-organic?
S M Reilly1, D H Skuse, D Wolke
1Behavioural Sciences Unit, Institute of Child Health, London, UK.
Insights
Children with non-organic failure to thrive (NOFT) and oral-motor dysfunction (OMD) show poorer cognitive stimulation. This suggests NOFT may have biological underpinnings, questioning the
Area of Science:
- Pediatric Health
- Developmental Pediatrics
- Neurodevelopmental Disorders
Background:
- Non-organic failure to thrive (NOFT) affects child growth and development.
- Oral-motor dysfunction (OMD) is frequently observed in children with NOFT.
- The underlying causes of NOFT, particularly the role of OMD, require further investigation.
Purpose of the Study:
- To investigate neurodevelopmental differences between NOFT children with and without OMD.
- To explore potential biological vulnerabilities contributing to NOFT.
- To re-evaluate the classification of 'non-organic' failure to thrive.
Main Methods:
- A whole-population survey identified 47 children with NOFT.
- Oral-motor function was assessed using a validated tool.
- Children with and without OMD were compared for neurodevelopmental and psychosocial factors.
Main Results:
- 17 out of 47 NOFT children exhibited OMD.
- Children with NOFT and OMD had significantly poorer cognitive stimulation at home and during mealtimes.
- Few psychosocial variables differentiated the groups, suggesting other factors may be involved.
Conclusions:
- OMD in NOFT children may be linked to subtle neurodevelopmental issues.
- Environmental factors like cognitive stimulation appear crucial.
- The term 'non-organic' for failure to thrive in these cases may be inaccurate and requires redefinition, considering potential biological vulnerabilities.
Abstract:
Forty-seven children with non-organic failure to thrive (NOFT) were identified from a whole-population survey of children's growth and development. A significant proportion (N=17) of these 47 children were found to have oral-motor dysfunction (OMD) identified using a previously validated assessment tool. NOFT children with OMD and those with normal oral-motor function (N=30) were compared in order to ascertain whether there were any neurodevelopmental differences which might explain this finding. We hypothesized that children with OMD might have a subtle neurodevelopmental disorder. Few psychosocial variables discriminated the two groups. However, cognitive stimulation within the home and cognitive-growth fostering during mealtimes was much poorer for children with OMD. Some evidence has suggested that NOFT children with OMD may be 'biologically' more vulnerable from birth. We suggest that the continued use of the term 'non-organic' to describe failure to thrive in such children is questionable and requires redefining.