Nonorganic failure to thrive (NFT), defined as weight for age below the fifth percentile in the absence of physical disease (Peterson, Rathbun, & Herrera, 1985), occurs in 10-20 percent of infants and young children in rural and urban care settings (Drotar, 1985). Untreated NFT results in physical, cognitive and socio-emotionally impaired children. Previous research data suggest that the major etiological factors are caregiver-child interactions in which the caregiver is unavailable emotionally to the child due to psychological problems, marital dysfunction, divorce, and/or stresses of poverty. The critical need is for studies which identify the maladaptive mother-child interactional patterns and identify interventions that specifically correct these patterns.

The purpose of this study was to determine the effect of Problem Assessment Intervention and two alternating treatment interventions (Calorie Management and Socio-emotional Growth Fostering) on: (1) the physical, cognitive and socio-emotional growth of the child diagnosed with NFT, (2) maternal coping, and (3) the maternal-child interaction behaviors. A ten-case, alternating treatments, experimental design (Barlow & Hersen, 1984) was used to determine the effect of interventions on the maternal-child interaction within a developmental structuralist framework. A convenience sample of 10 mothers with NFT children between the ages of 10 and 26 months was treated in the home setting over a four month period. Order of presentation of alternating treatments was randomly determined to counterbalance for order effects.

A treatment trend was observed in the greater gain in children's Z weight and length, and dyadic interaction behaviors as measured by the Barnard & Eyres Nursing Child Assessment Teaching Scale (NCATS), during the Socio-emotional Growth Fostering Intervention. The NFT subjects' total kg weight gain was significantly greater than the 50th percentile norm group (t = 4.96, p =.000) for the treatment period indicating catch-up growth was occurring. Maternal problem-focused coping as assessed by repeated measures of the Folkman & Lazarus Ways of Coping (Revised) increased during both treatment periods.