Cognitive development of children in poverty with failure to thrive: a prospective study through age 6

Background: This study examined the cognitive development of children in poverty with normal growth and those with a history of failure to thrive (FTT) prospectively from infancy through age 6. Method: Participants were 226 low-income infants with normal birthweight and no perinatal complications, congenital problems, or chronic illnesses. One hundred and twenty-eight children experienced FTT and were treated in an interdisciplinary clinic, and 98 had normal growth. Results: Cognitive development declined in both groups to 1.0-1.5 SD below the norm. Children with FTT had lower cognitive scores than children with adequate growth through age 4, followed by recovery. By ages 5 and 6, there were no differences in cognitive scores based on the children's growth history. Using hierarchical linear modeling, child-centered home environment and small family size were related to better cognitive performance. Conclusions: The low scores of both groups point to the need for programs promoting a child-centered home environment.