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PEDIATRICS Vol. 113 No. 5 May 2004, pp. e440-e447

ELECTRONIC ARTICLE

Failure to Thrive and Cognitive Development in Toddlers With Infantile Anorexia

Irene Chatoor, MD^*, Jaclyn Surles, BA^*, Jody Ganiban, PhD, Leila Beker, PhD^*, Laura McWade Paez, CPNP^*, Benny Kerzner, MD^*

^* Children's National Medical Center, Washington, DC
George Washington University, Washington, DC

Objective. The goal of this study was to examine the relative contributions of growth deficiency and psychosocial factors to cognitive development in toddlers with infantile anorexia.

Methods. Eighty-eight toddlers, ranging in age from 12 to 33 months, were enrolled in this study. Toddlers were evaluated by 2 child psychiatrists and placed into 1 of 3 groups: infantile anorexia, picky eater, and healthy eater. All 3 groups were matched for age, race, gender, and socioeconomic status (SES). Toddlers underwent nutritional evaluations and cognitive assessments with the Bayley Scales of Infant Development. Toddlers and their mothers were also videotaped during feeding and play interactions, which later were rated independently by 2 observers.

Results. On average, toddlers with infantile anorexia performed within the normal range of cognitive development. However, the Mental Developmental Index (MDI) scores of the healthy eater group (MDI = 110) were significantly higher than those of the infantile anorexia (MDI = 99) and picky eater (MDI = 96) groups. Within the infantile anorexia group, correlations between MDI scores and the toddlers' percentage of ideal body weight approached statistical significance (r = .32). Across all groups, the toddlers' MDI scores were associated with the quality of mother–child interactions, SES level, and maternal education level. Collectively, these variables explained 22% of the variance in MDI scores.

Conclusions. This study demonstrated that psychosocial factors, such as mother–toddler interactions, maternal education level, and SES level, are related to the cognitive development of toddlers with feeding problems and explain more unique variance in MDI scores than nutritional status.

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Key Words: failure to thrive • feeding disorder • infantile anorexia • cognitive development • growth deficiency • mother-toddler interactions

Abbreviations: FTT, failure to thrive • SES, socioeconomic status • MDI, Mental Developmental Index • BSID, Bayley Scales of Infant Development

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Received for publication Aug 3, 2003; Accepted Dec 1, 2003.

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