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This paper describes the characteristics of thriving and failure to thrive (FTT) children and their mothers and examines the effect of short-term lay health visitor intervention in cases of nonorganic failure to thrive (NO FTT). Twenty-five FTT children and mothers received lay health visitor (LHV) intervention in addition to other community and medical treatment; 25 other FTT children and mothers did not receive the LHV intervention but did receive all other medical and community treatment. Twenty-five thriving children and mothers were matched with the FTT children and mothers in the LHV group on the child's age at intake, sex, birth weight, and the mother's age, ethnicity, and number of living children. At initial assessment, the FTT and thriving groups were found to be comparable on demographic factors, infant birth weight percentiles, apgar scores, complications of pregnancy or delivery, and separations in the newborn period. There were more premature births in the LHV group although the proportion of premature births for the FTT and thriving groups overall were similar. A majority of mothers in the FTT groups had negative memories of childhood in contrast to more positive memories in the thriving group. At initial assessment, the majority of thriving children were developmentally normal and had increased from their birth weight percentiles whereas all of the FTT children had decreased from their birthweight percentiles and over half were developmentally delayed. There were clear differences in mother-child interaction patterns in the thriving and FTT groups. Three patterns of interaction were identified in the FTT group: benign neglect, incoordination, and overt hostility. Intervention had no measurable effect on the child's weight, development, or interaction patterns. Only 8 of 37 FTT children reevaluated 6 months later showed "catch up" growth and only 7 had improved in developmental score category. Patterns of interaction were found to persist over the 6 months in all cases. One to three year follow-up of 44 families emphasized the severity of the condition and the need for differentiation of the severity of the disturbance in the mother-child relationship and for more intensive intervention than was available in this study. Of these 44 cases, 2 children had died, 5 had been physically abused or further neglected, and 10 were in alternative care arrangements. 相似文献
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Clare F. Haynes Christy Cutler Jane Gray Kirstin O&#x;Keefe Ruth S. Kempe 《Child abuse & neglect》1983,7(3):309-319
Infants hospitalized for non-organic failure to thrive in the first six months of life are in a life-threatening situation and are already at risk for poor bonding with mother. In light of this, the meaning and use of foster care and how this separation affects the developing mother-child relationship are the issues addressed through examination of 16 cases in which 8 of the infants were placed in foster care and 8 discharged home after the failure to thrive hospitalization. This paper examines (1) maternal histories of pregnancy, labor and delivery and the neonatal status of placed and non-placed infants; (2) the developmental and weight status of placed children; (3) the nature of the decision criteria for after-hospital care; and (4) the mother-infant relationship at initial intake in terms of mother's report of events and observations of feeding and play interactions during a videotaped assessment process. The study found that the interactions between mother and infant in those situations which required foster care were clearly more dysfunctional when compared to those in which the baby was discharged home to mother. Babies in the two groups were comparable in weight status at the time of hospitalization although babies in foster placement had slightly lower scores on the Bayley Scales. Maternal histories of pregnancy, labor, and delivery were similar for the two groups as were the birth and neonatal histories of the infants. 相似文献