Study of environmental factors in nonorganic failure to thrive children

Nonorganic, or environmental failure to thrive (FTT) is a devastating syndrome of childhood. It is a problem that is prevalent among today's society. It has been identified in the literature since the late 19th century. Recognition of the complexity and the devastating effects of this problem has developed since the 1940's. The causative factor is not a single one, nor is it a clearly identifiable factor. Much of the research identified multiple factors, with mother-infant interaction and environment playing key roles. Authorities in this field advocate prevention of the syndrome through early identification. This study was undertaken to determine any significant differences between the environment and maternal-infant interaction of FTT children and thriving children. The theoretical framework for the study was based on the Barnard predictive nursing model. The design of the research study was descriptive, comparative and the sample population included 19 nonorganic FTT children and their mothers and 19 thriving children and their mothers from the Salt Lake area. Instruments utilized to obtain data were the Caldwell HOME Observation for Measurement of the Environment Scale (Birth to Three Years) and the Barnard Feeding Scale (Birth to One Year). The tools utilized in this study were specific for observational assessments of the child*s environment and the maternal-infant interaction. Findings from the study indicate that there are significant differences between scores on the HOME and Barnard Feeding Scale of the FTT group and the comparison group. The FTT group generally achieved lower scores on the scales than did the comparison group. Significant differences were observed in all areas on the Caldwell HOME scale except in the areas of avoidance of restriction and punishment and organization of environment. Differences between the two groups were noted in ail areas on the Barnard Feeding Scale except response to distress and responsiveness to parent. Nursing implications address the importance of prevention of this syndrome through early identification. By preventing the syndrome from occurring, the devastating effects can be prevented. Applications to the nurse clinician role were discussed. Recommendations for further research were presented.