Diagnosis Paper | Diagnosis Paper: Failure to Thrive | | | Linda DeMartinis | 7/17/2012 |

|

Failure to thrive has been recognized as a medical condition since the early 1900s. There is no universally excepted definition for the term “failure to thrive”. It is a term that describes a condition rather than a specific disease. Failure to Thrive is exactly what it sounds like; it is a failure of the body to perform the functions needed to survive. In infants and young children it is defined as a significant interruption in the expected rate of growth. It is important to note that the term “failure to thrive” is used to describe elderly individuals with declining health, and individuals who are losing the ability to perform the functions need to survive.
Children are deemed as individuals who are failing to thrive when their rate of growth does not meet the expected growth rate for a child their age. Reasons for children’s failure to thrive can be medical, such as Anorexia or their refusal to eat from chronic medical problems, such as Renal Disease, Cancer, Congenital Heart Disease, Metabolic Disorders, liver disease, HIV infection, or gastrointestinal reflux. It can range from mild to moderate to severe in individuals with diagnoses such as cerebral palsy, autism, and fetal alcohol syndrome. Other reasons that can lead to a child’s failure to thrive can be emotional or behavioral in origin. When a child is not receiving adequate nutrition or the child has an inability to receive adequate nutrition the child is unable gain weight and grow in a healthy manner. Failure to thrive has an enormous impact on the child's physical and mental growth. If the underlying conditions are not taken care of, a child who is experiencing failure to thrive will become irritable and apathetic and my not reach developmental markers at the usual ages for most children.
When evaluating a child with failure to thrive it is important to gather information about the causes, (medical, emotional, behavioral) and how they contribute to the functional problems the child is experiencing. Doctors perform physical exams and check the height, weight, and body shape. The medical and family history is also looked over and factors in the environment, such as abuse or neglect.
Whether Failure to Thrive results from medical, emotional, behavioral reasons, children with this condition require aggressive calorie supplementation. Some cases may lead to significant developmental delays in children. The cognitive outcome of children who have had Failure to Thrive is not clear, and this may lead to emotional and behavioral problems later on in life. However, carefully looking for the causes of failure to thrive and implementing calorie supplementation is important for obtaining a positive outcome in these children.
When working with children and adults with failure to thrive, it is important to have compassion and patience. You will often be educating and providing information and resources for parents and care giver on proper care of their child or loved one. With proper care and education of care givers some of the underlying cause of Failure to Thrive can be helped.

DIAGNOSIS PAPER PART 2
OT Intervention Approaches and Methods used. Within Occupational Therapy failure to thrive is a large concern. Failure to thrive is most often found in the practice areas of children and youth. It is also found in areas related to Health and Wellness, and Rehabilitation. The Occupational Therapy used for individuals who have failure to thrive tries to expose them to stimuli to help normalize sensory input and to encourage them to actively participate and develop motor control needed for their own survival. This type of therapy is needed because often an individual with failure to thrive is unable to perform basic functions such as eating on their own, and they are under developed mentally and physically. Evaluation tools are used to establish a baseline. Occupational therapy protocol is presented to facilitate a thorough assessment. The therapy assessment will emphasize feeding issues and care taker-child interaction. The protocol questions are relevant to the child's age group as well as to specific clinical issues commonly observed in the failure to thrive population. The occupational therapy protocol that is most often used in these cases is the product of three years of clinical practice during which comprehensive team evaluations were performed with a large failure to thrive patient population.( Rick Denton 1986) The protocol aims are to identify problems and characteristics of the condition that are observed repeatedly. The protocol has two sections, one for infants and one for toddlers. The protocol lists questions relevant to the child's age group as well as to specific clinical issues commonly observed. Infant assessments determine the etiology of their growth failure. The infants are observed in a variety of situations and undergo a developmental assessment.
A toddler assessment determines the clinical picture of failure to thrive in a toddler. This is characterized by poor feeding skills, which appear to be the result of behavioral deficits. A thorough assessment of past and present feeding abilities is beneficial in determining whether the feeding problem is a result of environmental factors alone or whether undetected (or untreated) neuromotor deficits are partially responsible. (Rick Denton1986)
How does a frame of reference help with identifying appropriate treatment? Mostly, there is no cure for failure to thrive because the researchers who examine the conditions of individuals with failure to thrive and the OTs who work with these children do not know why the developmental process have been blocked or slowed down. Because those researching or treating the disorder do not know what drives the developmental process and what might interfere with that process for an individual, they only have the scope (frame of reference) of training for treating symptoms.
The Frames-Of-Reference used for most cases of failure to thrive is the Universal Aspects of Developmental Disorders. This frame of reference states that “Children with Developmental Disorders have two things in common. There is no cure and the developmental process is blocked. These two universal aspects of developmental problems hold a clue about what you must do as a parent or care giver to get your child back on track.”(Rodger, 2012)
Conclusion
When dealing with clients with failure to thrive it is important to focus on the quality of life for both the child and the care giver. This is not an easy diagnosis, and the care giver must come to understand that there at this time is no cure for failure to thrive. A child with this diagnosis will most likely experience developmental delay. The results of treatment/ therapy will take time and maybe limited by the ability of the patients ability to understand or respond to these treatments. There is some hope that these failures to thrive may be cured if the cases are due to outside sources but it is also possible that improvement in these patients may never be seen.

Bibliography
Swartout-Corbeil, Deanna. "Failure to Thrive." Gale Encyclopedia of Children's Health: Infancy through Adolescence. 2006. Retrieved June 04, 2012 from Encyclopedia.com: http://www.encyclopedia.com/doc/1G2-3447200227.html

"Failure to Thrive." International Encyclopedia of Marriage and Family. 2003. Retrieved June 04, 2012 from Encyclopedia.com: http://www.encyclopedia.com/doc/1G2-3406900143.html

"Health Guide." Failure to Thrive. Web. 04 June 2012. <http://health.nytimes.com/health/guides/disease/failure-to-thrive/overview.html>.

Rick Denton, MA, L/OTR, is Assistant Professor of Occupational Therapy, Louisiana State University Medical Center, New Orleans, LA 70112. (n.d.). An occupational therapy protocol for assessing infants and toddlers who fail to thrive.

Rodger, A. (2012). No cure for failure to thrive. Back on track