Influences on the home environment of preschool children with early histories of nonorganic failure-to-thrive.

The home environments of 58 children with early histories of nonorganic failure-to-thrive (NOFTT) who received time-limited outreach intervention after hospitalization were assessed from 12 to 36 months of age. The type of outreach intervention did not affect the quality of home environment as assessed by the Home Observation for Measurement of the Environment inventory (HOME). We tested the efficacy of three sets of variables: characteristics of NOFTT (age of onset and duration), nutritional status (weight for height) at time of diagnosis, and family characteristics (maternal IQ and income) in predicting HOME scores at 36 months. Family characteristics (income and maternal IQ) were the only variables to predict HOME scores. HOME scores were less stable than in the standardization sample. A subgroup of NOFTT children (n = 7) whose HOME scores decreased over the 2-year follow-up period were more likely to have subsequent siblings than children whose HOME scores improved over the same time period (n = 11). Findings suggest the need to identify and provide preventive intervention for NOFTT children whose home environments are vulnerable to deterioration following diagnosis.