Toward a Semispecific, Multidimensional, Threshold Model of Maltreatment

Abstract

Nonorganic failure to thrive (NOFT) is not well understood. Among the few points that are accepted are the idea of the severity of the problem, defined in terms of number of children affected (Altemeier, O’Connor, Sherrod & Vietze, in press) and sequelae (Hufton & Oates, 1977; White et al., 1980). One of the definitional aspects that is fairly generally accepted is that NOFT that occurs in very young infants is different from NOFT (often called psychosocial dwarfism) that occurs in toddlers or young children (Green, Campbell & David, 1984; Money, Annecillo & Kelley, 1983). Beyond that, NOFT appears to be a form of maltreatment, sometimes viewed as related to abuse or as a precursor to abuse (Koel, 1979; Oates, 1982), but more aptly viewed as a form of neglect, probably because it arises more through acts of omission than commision. However, the manner in which NOFT relates to other forms of maltreatment has not adequately been clarified or addressed thoroughly. Books giving a general overview of maltreatment invariably mention NOFT, although, unfortunately, few devote much space to it (e.g., Giovannoni & Becerra, 1979; Oates, 1982; Pelton, 1981). There are no books entirely focused on the psychological aspects of NOFT, although there are medically oriented ones (e.g. Accardo, 1982; Patton & Gardner, 1963).