Paper
Monday, November 5, 2007

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This presentation is part of : Applying Evidence to Practice
Multidisciplinary Approach with Failure to Thrive in Children
Kathleen Falkenstein, PhD, PNP1, Emily Paul, BA2, Hans Kerstan, MD3, and Mariana Chilton, DRPH2. (1) Nursing, Drexel University, Phila, PA, USA, (2) public health@drexel.edu, Drexel University, philadelphia, PA, USA, (3) Pediatrics, Drexel University/Saint Christopher's Hospital, philadelphia, PA, USA
Learning Objective #1: Understand the importance of diagnosis and treatment of children with failure to thrive
Learning Objective #2: Discuss the impact of Failure to thrive on longterm sequela
Failure to thrive (FTT) has a prevalence of between 3% and 10% in both rural and urban populations. FTT is seen as an indicator of physical and psychosocial problems and is associated with subsequent growth delay and cognitive deficiencies. FTT in low income communities can represent the “tip of the iceberg” and many children experience food insecurity which may act as a precursor to FTT. Children with FTT require prompt multidisciplinary management in order to prevent the long term consequences on brain and growth development.

The goal of the GROW Clinic is to prevent the long-term health and developmental effects from FTT and its associated family dysfunction. The GROW Clinic is unique in that it employs a multi-disciplinary, team-based approach to child malnutrition that addresses the psychosocial and economic issues of nutrition.

Results

Operational since 2005, the clinic has evaluated 146 children/families.100% of the children have weights in less than the 5th percentile at the time of referral (mean age is 18 months). More than 85% of the children at the GROW Clinic have gained an appropriate amount of weight for age (g/d) and have improved behaviors (mealtime structure, juice intake). 20% have been diagnosed with organic FTT (GER, asthma); 92% have psychosocial issues impacting their FTT(unstructured meals, food insecurity, behavior); 96% of patients have excessive fluid intake. One third of the children have developmental delays or behavior issues (ADHD). Social services have been implemented in more than 60% of the families from the GROW Clinic. About 80% of patients have been referred to community organizations (Early Intervention Services; skilled day care providers; DHS).

ConclusionThe multidisciplinary approach to FTT implemented by the GROW team has made a major impact on both anthropometric and behavior change in the children/families. The GROW Clinic is working to test the impact of the multidisciplinary approach

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