ABSTRACT
Severe non-organic failure to thrive associated with physical and emotional abuse including food deprivation was diagnosed in a 9-y-old boy. Rapid catch-up growth (weight and height) followed change of carer. Recovery of poor growth hormone response to clonidine stimulation was associated with benign intracranial hypertension accompanied by headaches and vomiting. Possible mechanisms are discussed.
Subject(s)
Child Abuse , Failure to Thrive/complications , Failure to Thrive/psychology , Food Deprivation , Pseudotumor Cerebri/complications , Child , Growth Hormone/deficiency , Humans , MaleABSTRACT
Failure to thrive is a complex problem affecting long-term health and development of the child. This paper describes a multidisciplinary approach to management and treatment of children and families where there is a child who is failing to thrive. The experience described in this paper is based on many years work of an interdisciplinary nature involving a Paediatrician, Psychologist and Dietician which lead to the creation of a special clinic for these children in 1993.
Subject(s)
Child Health Services , Failure to Thrive/therapy , Patient Care Team , Child , Child, Preschool , Community Health Centers , Failure to Thrive/diagnosis , Female , Hospitalization/statistics & numerical data , Humans , Infant , Male , Patient Care Planning , Patient Compliance , Referral and Consultation/statistics & numerical data , Severity of Illness Index , Treatment Outcome , Videotape RecordingABSTRACT
Despite claims that beliefs held by abusive parents are important indicators of family functioning, few studies have explored the relationship between patterns of beliefs and severity of abuse. This study applies findings from marital research that demonstrate that maladaptive attributional patterns predict the level of distress experienced in adult relationships. It examines spoken attributions produced by 18 families during diagnostic therapy sessions following serious abuse of a child. Attributions were identified from transcripts and coded using a standard system. Patterns of attributions, defined on the basis of previous work, successfully predicted classification of families by therapists as Good, Uncertain, and Poor, in terms of prognosis for rehabilitation. Using this classification to test hypotheses based on attributional style, group differences were found. In families rated Good, parents were more likely to attribute more control to self than child for negative outcomes. They were also more likely to nominate themselves as causing negative events. Case accounts of families from each category are presented to illustrate how attributional analysis can contribute to an understanding of the individual nature of child abuse.
