Assessment & Research

Nonorganic failure to thrive: developmental outcomes and psychosocial assessment and intervention issues.

Heffer et al. (1994) · Research in developmental disabilities 1994
★ The Verdict

NFTT needs a team—start with medical clearance, then run caregiver-led feeding treatment, even on Zoom.

✓ Read this if BCBAs who treat food refusal in infants and toddlers.
✗ Skip if Those who only work with verbal, typically developing school-age kids.

01Research in Context

01

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.

02

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.

03

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.

04

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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→ Action — try this Monday

Send a three-question medical screen to the child’s pediatrician before the next feeding session.

02At a glance

Intervention
not applicable
Design
narrative review
Population
developmental delay
Finding
not reported

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