Oral‐motor dysfunction in children who are failing to thrive

Abstract

ABSTRACT A whole population prospective survey of inner‐city infants (N=2510), aged from birth to 15 months, found the prevalence of failure to thrive (FTT), unassociated with any medical aetiology, to be 3.3%. A speech therapist, blind to case status, used the Schedule for Oral Motor Assessment (SOMA) to rate abilities across a range of food textures and fluids. One in four FTT cases, but only 11% of comparisons, obtained dysfunction scores outside the normal range. Most difficulty was observed with purees, least with liquids. Oral‐motor dysfunction did not simply reflect developmental delay. SOMA scores did not correlate with either the mental or psychomotor index of the Bayley Scales of Infant Development (BSID), but did correlate negatively with birth weight (r=−0.3, p<0.01); weight at 3 months (r=−0.28, p<0.003); 6 months (r=−0.3, p<0.01); and 9 months (r=−0.28, p<0.02), but not with weight at follow up. Children with the highest dysfunction scores weighed least at all ages and had smaller head circumferences. High oral‐motor dysfunction scores were not linked to overt feeding difficulties, by maternal report. It was hypothesised that the disorder reflects the influence of early post‐natal growth failure (presumably due to undernutrition) upon developing brain structures, rather than a congenital abnormality.