CONTACT: C. LINDON LARSON
283 Medical Laboratories
Iowa City IA 52242
(319) 335-9569; fax (319) 335-8034
UI research helps children attain normal growth
IOWA CITY, Iowa -- For many parents, getting children to eat certain foods
can be a challenge. But what happens when a child refuses to eat just about
everything, to the point where he or she falls behind in normal growth?
Researchers at the University of Iowa College of Medicine are studying behaviors
associated with failure to thrive (FTT), a term applied when children do not
gain weight at an expected rate and persistently weigh less than normal for
their age. They hope to identify strategies that parents can use to keep their
children's growth on track.
Much more than just finicky eating, the meal behaviors associated with FTT
may require hospitalization to change. "When these children are admitted,
their parents have tried everything," says Linda Cooper, a pediatric
psychologist at the UI Hospitals and Clinics. "It usually takes 14 to
16 days to get a good handle on treatment."
Cooper's research, funded by the National Institute of Mental Health, centers
on eight children hospitalized for FTT, ages 18 months to 4 years. Though
each case is different, children with FTT often resist other parental demands
in addition to eating. They may refuse to pick up toys or brush their teeth,
suggesting a problem deeper than just aversion to food.
"More kids than expected showed problems outside of meal times,"
Cooper says, adding that only two children refused to comply almost exclusively
at meals. Still, getting children to eat posed greater challenges than other
activities in all cases.
"There may be factors unique to meals," Cooper says. "One direction
for future research might be to focus on other reinforcers during meals or
physiological interventions like appetite stimulants."
Working with parents, Cooper and other researchers sought strategies to increase
children's compliance during meals and in other situations. They compared
different degrees of positive reinforcement, from simple praise to play with
favorite toys, when children obeyed requests.
Cooper found that children were more likely to comply with requests that carried
a greater degree of positive reinforcement and that the strategies used at
meal time were also effective with other tasks. Her study shows that effective
reinforcers can be identified during meals and applied across situations.
The root causes of FTT remain elusive and are likely different for different
children, but the problem can be treated. Cooper notes that of 22 children
admitted to the UIHC, 20 showed catch-up growth while in the hospital. Of
the 17 surveyed after discharge, 16 continued to show progress.
Cooper hopes to help parents keep using treatment strategies once their children
go home from the hospital. "Once we have a plan in place, we have no
mechanism of going into the homes," she says. Nevertheless, her research
shows that parents can adopt methods that lead to greater compliance and improved