Neglect and Failure to Thrive

  • Tal Ben-Galim
  • Penelope T. Louis
  • Angelo P. Giardino


Neglect is the most common form of child maltreatment, representing approximately 64% of the 905,000 substantiated cases of maltreatment in the United States in 2006 (U.S. Department of Health & Human Services, 2008). It represents a situation in which there is a risk of harm to a child because the child’s basic physical, supervisional, medical, emotional, and/or educational needs are not being met (DePanfilis, 2006) (see Table 7.1 for categorization of different forms of neglect). State laws define child neglect in various ways but conceptually neglect may be defined as


Health Care Provider Growth Failure Growth Chart Child Protective Service Psychosocial Assessment 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. American Academy of Pediatrics. (2003). Failure to thrive (pediatric undernutrition). In R. E. Kleinman (ed.), Pediatric nutrition handbook (5th ed., pp. 443–457). Elk Grove Village, IL: American Academy of Pediatrics.Google Scholar
  2. Ayatollahi, S.-M.-T., & Mostajabi, F. (2008). Triceps skinfold thickness centile charts in primary school children in Shiraz. Archives of Iranian Medicine, 11(2), 210–213.PubMedGoogle Scholar
  3. Barbero, G. J., & Shaheen, E. (1967). Environmental failure to thrive: A clinical view. Journal of Pediatrics, 71, 639–644.PubMedCrossRefGoogle Scholar
  4. Berwick, D. M., Levy, J. C., & Kleinerman, R. (1982). Failure to thrive: Diagnostic yield of hospitalization. Archives of Diseases of Childhood, 57, 347–351.CrossRefGoogle Scholar
  5. Bithoney, W. G., Dubowitz, H., & Egan, H. (1992). Failure to thrive/growth deficiency. Pediatrics in Review, 13, 453–459.PubMedGoogle Scholar
  6. Block, R. W., Krebe, N. F., & The Committee on Child Abuse and Neglect, and the Committee on Nutrition. (2005). Clinical report. Guidance for the clinician in rendering care. American academy of pediatrics. Pediatrics, 116, 1234–1237.PubMedCrossRefGoogle Scholar
  7. Boxer, G. H., Carson, J., & Miller, B. D. (1988). Neglect contributing to tertiary hospitalization in childhood asthma. Child Abuse & Neglect, 12, 491–501.CrossRefGoogle Scholar
  8. Brandt, L. (1979). Growth dynamics of low birthweight infants with emphasis on the perinatal period. In F. Faulkner & J. Tanner (Eds.), Human growth neurobiology and nutrition. New York: Plenum.Google Scholar
  9. Chapin, H. D. (1908). A plan for dealing with atrophic infants and children. Archives of Pediatrics, 25, 491–496.Google Scholar
  10. Chatoor, J., & Egan, J. (1983). Nonorganic failure to thrive and dwarfism due to food refusal: A separation disorder. Journal of the American Academy of Child Psychiatry, 22, 294.PubMedCrossRefGoogle Scholar
  11. DePanfilis, D. (2006). Child neglect: A guide for prevention, assessment, and intervention. U.S. department of health and human services. Administration for children and families. Administration on children, youth and families children’s bureau. Office on child abuse and neglect.
  12. Dubowitz, H., Black, M., Starr, R. H., & Zuravin, S. (1993). A conceptual definition of child neglect. Criminal Justice and Behavior, 20, 8–26.CrossRefGoogle Scholar
  13. Dubowitz, H., Giardino, A. P., & Gustavson, E. (2000). Child neglect: Guidance for pediatricians (Review). Pediatrics in Review, 21(4), 111–116.PubMedCrossRefGoogle Scholar
  14. El-Baba, M. F., Bassali, R. W., & Benjamin, J. (2009, May 4). Failure to thrive. eMedicine.
  15. Fontana, V. J., & Besharov, D. J. (1979). The maltreated child: The maltreatment syndrome in children—a medical, legal, and social guide (4th ed.). Springfield, IL: Charles C Thomas.Google Scholar
  16. Fontana, V. J., Donovan, D., & Wong, R. J. (1963). The maltreatment syndrome in children. New England Journal of Medicine, 269, 1389–1394.PubMedCrossRefGoogle Scholar
  17. Franklin, W., & Klein, R. E. (1987). Severe asthma due to household pets: A form of child abuse or neglect. New England Regional Allergy Proceedings, 8, 259–261.CrossRefGoogle Scholar
  18. Gahagan, S. (2006). Failure to thrive: A consequence of undernutrition. Pediatrics in Review, 27, e1–e11.PubMedCrossRefGoogle Scholar
  19. Gaudin, J. M. (1993). Child neglect: A guide for intervention. U.S. Department of Health and Human Services: Administration for Children and Families: National Center on Child Abuse and Neglect.Google Scholar
  20. Goldbloom, R. B. (1987). Growth failure in infancy. Pediatrics in Review, 9(2), 57–61.PubMedCrossRefGoogle Scholar
  21. Himes, J. H., Roche, A. F., Thissen, D., & Moore, W. M. (1985). Parent-specific adjustments for evaluation of recumbent length and stature of children. Pediatrics, 75, 304–313.PubMedGoogle Scholar
  22. Hobbs, C. J., Hanks, H. G. I., & Wynne, T. M. (1993). Failure to thrive. In Child abuse and neglect: A clinician’s handbook (pp. 17–45). New York: Churchill Livingstone.Google Scholar
  23. Homer, C., & Ludwig, S. (1981). Categorization of etiology of failure to thrive. American Journal of Diseases of Children, 135, 848–851.Google Scholar
  24. Jenny, C., & Child, A. (2007). Recognizing and responding to medical neglect. Pediatrics, 120(6), 1385–1389.PubMedCrossRefGoogle Scholar
  25. Kempe, R. S., & Goldbloom, R. B. (1987). Malnutrition and growth retardation ("failure to thrive") in the context of child abuse and neglect. In R. E. Helfer & R. S. Kempe (Eds.), The battered child (4th ed., pp. 312–335). Chicago: University of Chicago Press.Google Scholar
  26. Kempe, R. S., Silverman, F. N., Steele, B. F., Droegmueller, W., & Silver, H. K. (1962). The battered child syndrome. Journal of the American Medical Association, 181, 17–24.PubMedCrossRefGoogle Scholar
  27. Krugman, S. D., & Dubowitz, H. (2003). Failure to thrive. American Family Physician, 68, 879–884.PubMedGoogle Scholar
  28. Ludwig, S. (1992). Failure to thrive/starvation. In S. Ludwig & A. E. Kornberg (Eds.), Child abuse: a medical reference (2nd ed.). New York: Churchill LivingstoneGoogle Scholar
  29. Ludwig, S. (2005). Psychosocial emergencies: Child abuse. In G. R. Fleisher & S. Ludwig (Eds.), Textbook of pediatric emergency medicine (5th ed., pp. 1761–1802). Baltimore: Williams and Wilkins.Google Scholar
  30. National Center on Child Abuse and Neglect. (1988a). Child neglect: A guide for intervention. Washington, DC: U.S. Department of Health and Human Services.Google Scholar
  31. National Center on Child Abuse and Neglect. (1988b). Study findings: Study of national incidence and prevalence of child abuse and neglect. Washington, DC: U.S. Department of Health and Human Services.Google Scholar
  32. Olson, E. M. (2006, January/February). Failure to thrive: Still a problem of definition. Clinical Pediatrics, 45, 1–6.CrossRefGoogle Scholar
  33. Pears, K. C., Kim, H. K., & Fisher, P. A. (2008). Psychosocial and cognitive functioning of children with specific profiles of maltreatment. Child Abuse & Neglect, 32(10), 958–971.CrossRefGoogle Scholar
  34. Peterson, M. S., & Urquiza, A. J. (1993). The role of mental health professionals in the prevention and treatment of child abuse and neglect. Washington, DC: U.S. Department of Health and Human Services.Google Scholar
  35. Satler, E. (1990). Childhood feeding problems. In Feelings and their medical significance. Columbus, OH: Ross Laboratories.Google Scholar
  36. Schmitt, B. D., & Mauro, R. D. (1989). Nonorganic failure to thrive: An outpatient approach. Child Abuse & Neglect, 13, 235–248.CrossRefGoogle Scholar
  37. Sills, R. H. (1978). Failure to thrive: The role of clinical and laboratory evaluation. American Journal of Diseases of Children, 132, 967–969.PubMedGoogle Scholar
  38. Spitz, R. A. (1945). Hospitalism: An inquiry into the genesis of psychiatric conditions in early childhood. Psychoanalytic Study of the Child, 1, 53–74.PubMedGoogle Scholar
  39. Spitz, R. A. (1949). The role of ecological factors in emotional development in infancy. Child Development, 20(3), 145–155.Google Scholar
  40. Stephens, M. B., Gentry, B. C., Michener, M. D. (2008). What is the clinical workup for failure to thrive? Journal of Family Practice, 57(4), 264–266.PubMedGoogle Scholar
  41. Tanner, J. M., Goldstein, H., & Whitehouse, P. H. (1970). Standards for children’s height at age 2–9 years allowing for height of parents. Archives of Diseases of Childhood, 45, 755–762.CrossRefGoogle Scholar
  42. Tunnessen, W. W., Jr., & Roberts, K. B. (1999). Signs and symptoms in pediatrics (3rd ed.). Philadelphia: Lippincott Williams & Wilkins.Google Scholar
  43. U.S. Department of Health and Human Services Administration for Children and Families. (2008). Child Maltreatment 2006. Accessed April 15, 2009.
  44. Wolock, I., & Horowitz, B. (1984). Child maltreatment as a social problem: The neglect of neglect. American Journal of Orthopsychiatry, 54, 530–543.PubMedCrossRefGoogle Scholar
  45. Zenel, J. A. (1997). Failure to thrive. Pediatrics in Review, 18, 371–378.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Tal Ben-Galim
    • 1
  • Penelope T. Louis
    • 1
  • Angelo P. Giardino
    • 2
  1. 1.Academic General PediatricsTexas Children’s HospitalHoustonUSA
  2. 2.Baylor College of MedicineTexas Children’s Health Plan, Inc.HoustonUSA

Personalised recommendations