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Updated: Aug 15, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Behavior as a diagnostic aid in failure-to-thrive
Insights
Behavioral assessments can help suggest nonorganic failure-to-thrive (NOFTT) in infants when organic causes are ruled out. High intensity and frequency of certain behaviors, alongside treatment response, aid diagnosis.
Area of Science:
- Pediatrics
- Child Psychology
- Developmental Biology
Background:
- Failure-to-thrive (FTT) in infants presents diagnostic challenges.
- Distinguishing between organic FTT (OFTT) and nonorganic FTT (NOFTT) is crucial for effective intervention.
- Behavioral patterns may offer insights into the etiology of FTT.
Purpose of the Study:
- To examine a defined set of behaviors in hospitalized infants.
- To evaluate the utility of behavioral assessment in differentiating NOFTT from OFTT.
- To identify specific behaviors indicative of NOFTT.
Main Methods:
- A cohort of 67 hospitalized infants (3-24 months) was studied.
- Infants were categorized into OFTT (n=17), NOFTT (n=17), and control (n=33) groups.
- The frequency and intensity of specific behaviors were recorded and compared across groups.
Main Results:
- Infants with NOFTT exhibited greater frequency and intensity of behaviors compared to OFTT infants.
- The prevalence order of behaviors was similar between OFTT and NOFTT groups.
- Four of the seven most common behaviors were significantly more frequent in NOFTT infants.
Conclusions:
- While specific behaviors do not definitively rule in NOFTT or out OFTT, their presence, especially with high intensity, suggests NOFTT when organic causes are absent.
- Positive response to targeted treatment remains the most definitive diagnostic confirmation for NOFTT.
Abstract:
The presence of a defined set of behaviors was examined in 67 hospitalized infants, 3-24 months old; 17 with organic failure-to-thrive (OFTT), 17 with nonorganic failure-to-thrive (NOFTT), and 33 with no signs of failure-to-thrive. The usefulness of assessing these behaviors to distinguish nonorganic from organic failure-to-thrive infants was evaluated. The frequency of behaviors per infant as well as the intensity of behaviors was greater for NOFTT. The order of decreasing frequency of behaviors was similar in both OFTT and NOFTT infants. Four of the 7 most prevalent behaviors occurred significantly more frequently in NOFTT than OFTT infants. The presence of these behaviors does not rule in NOFTT or rule out OFTT. However, when a number of the behaviors are present, particularly if they occur in high intensity, and when no organic disease is found, a diagnosis of NOFTT is suggested. Response to appropriate treatment remains the most reliable confirmation of the diagnosis.
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