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Updated: May 9, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
The nature and diversity of problems leading to failure to thrive
1Associate Professor, Division of OT, University of North Carolina, Chapel Hill, NC.
Insights
Failure to thrive (FTT) in infants poses risks for development, requiring intervention. A multi-systems model helps occupational therapists assess and address complex FTT factors for better outcomes.
Area of Science:
- Pediatrics
- Child Development
- Occupational Therapy
Background:
- Failure to thrive (FTT) in infants is linked to developmental delays and necessitates intervention.
- Infants with FTT and their families present multifaceted challenges impacting successful outcomes.
- The traditional organic versus nonorganic FTT classification is overly simplistic for effective assessment and intervention.
Purpose of the Study:
- To examine the literature on factors contributing to infant failure to thrive.
- To present a multi-systems model for organizing FTT contributing factors.
- To guide occupational therapists in assessment and intervention strategies for FTT.
Main Methods:
- Literature review on failure to thrive.
- Development of a multi-systems model.
- Emphasis on interactive systems for assessment and intervention planning.
Main Results:
- A multi-systems model provides a framework to organize diverse factors in FTT.
- The model highlights the interactive nature of systems influencing FTT.
- Occupational therapists can utilize this model for comprehensive assessment.
Conclusions:
- The multi-systems model offers a more effective approach than traditional FTT classifications.
- Understanding interactive systems is crucial for identifying FTT issues.
- This model enhances opportunities for targeted occupational therapy interventions in FTT.
Abstract:
Failure to thrive increases a child's risk for developmental problems and warrants intensive intervention. At the same time, infants with failure to thrive and their families can present a complex number of issues that need to be addressed for successful outcome. The traditional approach which draws a distinction between organic and nonorganic failure to thrive does not reflect current work in the area and can be too simplistic to help the therapist develop an effective assessment and intervention strategy. This article examines the literature and presents a multi-systems model to organize the factors that can contribute to failure to thrive. By emphasizing the interactive nature of systems the occupational therapist will be able to identify the range of issues for assessment with multiple opportunities for intervention.
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