Nonorganic failure to thrive: developmental outcomes and psychosocial assessment and intervention issues.
NFTT needs a team—start with medical clearance, then run caregiver-led feeding treatment, even on Zoom.
01Research in Context
What this study did
Allan et al. (1994) pulled together every paper they could find on non-organic failure to thrive.
They looked at why babies stop growing, what happens later, and how teams should check and help.
The review covers medical, family, and child pieces—no new data, just a map of the field.
What they found
The authors say NFTT is never just one thing.
Poor feeding, parent stress, and delayed skills twist together, so single-shot fixes flop.
They call for a team: doctor, dietitian, behavior analyst, and social worker all at the table.
How this fits with other research
Williams et al. (2023) sweep in 29 years later and show ABA feeding work now lives online.
Their 2023 review keeps the same team spirit but adds telehealth and caregiver coaching—an update, not a fight.
Patel et al. (2023) prove the model works on Zoom: big gains, still there one year later.
Lim et al. (2016) zoom down to one toddler with autism and show the combo—medical plus behavioral—succeeds in real life.
Why it matters
If you see slow growth plus food refusal, think NFTT and shout for a team.
Use the 1994 checklist to rule out medical causes first, then borrow Keith’s telehealth tools to train parents at home.
One call to the pediatrician and one Zoom parent session can replace weeks of office visits.
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02At a glance
03Original abstract
Serious growth problems, such as Nonorganic Failure to Thrive (NFTT), place an infant/toddler at significant risk for poor developmental outcomes. Evidently, an NFTT child's malnutrition and subsequent poor growth and development are accentuated by a family context of impoverishment, dysfunctional relationships, inadequate education, and a dearth of developmentally enriching experiences. The purpose of this review is to describe NFTT, to present development outcomes, and to discuss psychosocial assessment and intervention issues relevant to this developmental disability of early childhood. An ideographic approach to case conceptualization, evaluation, and treatment is suggested to achieve successful developmental outcomes and to guide research endeavors.
Research in developmental disabilities, 1994 · doi:10.1016/0891-4222(94)90006-x