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To what extent is failure to thrive in infancy associated with poorer cognitive development? A review and

S S Corbett1, R F Drewett

  • 1Department of Psychology, University of Durham, UK. sally.corbett@northumbria-healthcare.nhs.uk

Journal of Child Psychology and Psychiatry, and Allied Disciplines
|April 2, 2004
PubMed

Insights

Infants experiencing failure to thrive (FTT) show cognitive deficits, particularly when identified in specialist clinics. Early identification in primary care reveals smaller, yet significant, long-term intellectual impairments equivalent to 4.2 IQ points.

Area of Science:

  • Pediatric Health
  • Developmental Psychology
  • Public Health

Background:

  • Empirical studies on the cognitive effects of infant failure to thrive (FTT) have yielded inconsistent findings.
  • Previous research has not adequately differentiated outcomes based on case identification methods or study design.

Purpose of the Study:

  • To systematically review and synthesize existing evidence on the cognitive sequelae of failure to thrive in infancy.
  • To investigate how case identification settings (specialist vs. primary care) and study designs influence cognitive outcome estimates.

Main Methods:

  • A comprehensive literature search was conducted using MEDLINE and published bibliographies.
  • Studies were categorized by case identification setting, control status, and study design (cross-sectional vs. longitudinal).
  • Effect sizes (D statistics) for cognitive outcomes were calculated and pooled using weighted standardized mean differences.

Main Results:

  • Studies identifying FTT cases in specialist clinics showed a larger pooled effect size for cognitive deficits (-0.85) compared to those identified in primary care (-0.30).
  • Longitudinal studies indicated that cognitive deficits lessened with age.
  • Controlled studies with primary care identification in older children estimated a mean difference of -0.28, equivalent to a 4.2 IQ point deficit.

Conclusions:

  • Failure to thrive in infancy is associated with significant adverse intellectual outcomes.
  • The magnitude of cognitive impairment is influenced by the setting of case identification.
  • These population-level cognitive deficits associated with FTT warrant attention in public health strategies.
Abstract

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