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Does a fall down a centile chart matter? The growth and developmental sequelae of mild failure to thrive
S S Corbett1, R F Drewett, C M Wright
1Department of Psychology, University of Durham, UK.
Insights
Children experiencing failure to thrive (FTT) showed long-term cognitive deficits. Early screening for FTT identified a subgroup with adverse outcomes, indicating potential long-term developmental impacts.
Area of Science:
- Pediatrics
- Developmental Psychology
- Child Health
Background:
- Failure to thrive (FTT) is a concern in early childhood.
- Accurate identification of FTT is crucial for timely intervention.
- Long-term outcomes of children with FTT require further investigation.
Purpose of the Study:
- To assess the long-term cognitive and developmental outcomes of children identified with FTT in infancy.
- To evaluate the effectiveness of a centile shift-based screening criterion for FTT.
Main Methods:
- A cohort of 52 children identified with FTT at 18 months was compared to 52 controls.
- Children were followed up five years after the initial study.
- Cognitive function (IQ) and behavioral problems were assessed.
Main Results:
- Children with FTT were significantly shorter and lighter at follow-up.
- Four cases (but no controls) were placed in care.
- A significant association was found between FTT severity and lower IQ within the FTT group.
- No significant difference in mean IQ or behavioral problems between cases and controls was observed.
Conclusions:
- A centile shift-based definition for FTT, while over-sensitive, identified a subgroup with adverse long-term cognitive outcomes.
- Early identification and intervention for FTT may be critical for mitigating developmental impacts.
Abstract:
Fifty-two children aged 18 months who had fallen across two weight centile lines were compared to 52 controls. Five years after the initial study, 89% of these children were traced. At follow-up, four of the cases but none of the controls had been placed in care and cases were significantly shorter and lighter than controls. Reanalysis of the early weight data revealed that the screening criterion had been over-inclusive, identifying a majority with only borderline failure to thrive (FTT). Although the mean IQ was lower in the cases than in controls, the difference was not statistically significant. However, a significant association was found within the cases between severity of FTT and IQ. There was no difference in the number of behaviour problems reported. The use of a simple centile shift-based definition of FTT, while proving to be over-sensitive, has identified a subgroup of children who suffered adverse long-term cognitive outcomes.