Robert W. Block, MD; Nancy F. Krebs, MD; and the Committee on Child Abuse and Neglect, and the Committee on Nutrition
Note: The article referenced here is a Clinical Report by the American Academy of Pediatrics meant for pediatricians to guide them in the assessment and evaluation of Failure to Thrive.
“Psychosocial short stature, a variant of FTT, has been described as short stature out of proportion to the decreased weight. This syndrome is thought to result from major emotional and psychological trauma. It has been associated with pituitary and hypothalamic dysfunction, possibly with interactions with nutrient deficiencies, which is frequently reversible when the child is placed in a nurturing environment.”

This variation should be cautiously considered by the defense counsel if there is evidence of a medical cause for the FTT. Prosecution may state that the defense theory’s medical causes of the FTT are actually Psychosocial Short Stature, which is still a form of neglect or abuse.

Risk Factors: “parental depression, stress, marital strife, divorce; parental history of abuse as a child; mental retardation and psychological abnormalities in the parent(s); young and single mothers without social supports; domestic violence; alcohol or other substance abuse; previous child abuse in the family; social isolation and/or poverty; parents with inadequate adaptive and social skills; parents who are overly focused on career and/or activities away from home; failure to adhere to medical regimens; lack of knowledge of normal growth and development; and/or infant with low birth weight or prolonged hospitalization.”

When building the defense case, all risk factors for FTT should be evaluated and prepared for argument, keeping in mind that these risk factors apply regardless of the nature of the FTT.

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