The Social Emergency: A Narrative Review of the Interdisciplinary Management of Pediatric Failure to Thrive and Neglect from Crisis to Recovery
Abstract
Background: Pediatric Failure to Thrive (FTT), characterized by inadequate growth, is a common presentation of child neglect and a medical emergency with profound developmental implications. Its management necessitates a coordinated response across acute, primary, and community care sectors. Aim: This narrative review investigates the multi-agency, interdisciplinary response to pediatric FTT as a potential sentinel event for neglect, mapping the pathway from emergency medical intervention through to community-based recovery and support. Methods: A comprehensive search of PubMed, CINAHL, PsycINFO, and Social Work Abstracts (2010-2024) was conducted, integrating literature from pediatrics, emergency services, nursing, laboratory medicine, social work, and public health. Results: Effective management requires seamless transitions between distinct phases: EMS for safe transport, hospital-based teams (NICU nurses, laboratory) for medical stabilization and diagnostic clarification, and community-based teams (Family Medicine, Home Care, Community Health Workers) for longitudinal monitoring and in-home family support. Communication breakdowns and fragmented systems between these sectors are significant barriers to child safety and family preservation. Conclusion: Pediatric FTT demands a unified, child-centered, and family-focused interdisciplinary model. Success hinges on integrating medical diagnostics with social support through robust communication systems and shared care plans that prioritize safe, therapeutic intervention over punitive approaches.
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References
Agrawal, A., Janjua, D., Zeyada, A. A. A. A., & Elsheikh, A. T. (2023). Heart failure in children and adolescents: an update on diagnostic approaches and management. Clinical and Experimental Pediatrics, 67(4), 178. https://doi.org/10.3345/cep.2023.00528
Ahmad, H., Yacob, D., Halleran, D. R., Gasior, A. C., Di Lorenzo, C., Wood, R. J., ... & Levitt, M. A. (2022, April). Evaluation and treatment of the post pull-through Hirschsprung patient who is not doing well; update for 2022. In Seminars in pediatric surgery (Vol. 31, No. 2, p. 151164). WB Saunders. https://doi.org/10.1016/j.sempedsurg.2022.151164
Alphonso, A., Auerbach, M., Bechtel, K., Bilodeau, K., Gawel, M., Koziel, J., ... & Tiyyagura, G. K. (2017). Development of a child abuse checklist to evaluate prehospital provider performance. Prehospital emergency care, 21(2), 222-232. https://doi.org/10.1080/10903127.2016.1229824
Bartlett, J. D., Raskin, M., Kotake, C., Nearing, K. D., & Easterbrooks, M. A. (2014). An ecological analysis of infant neglect by adolescent mothers. Child abuse & neglect, 38(4), 723-734. https://doi.org/10.1016/j.chiabu.2013.11.011
Cole, S. Z., & Lanham, J. S. (2011). Failure to thrive: an update. American family physician, 83(7), 829-834.
David, J. G., Kiely, J. R., Kersten, H. B., & Bennett, D. S. (2022). The Development of an Adherence Measure for Pediatric Failure to Thrive/Faltering Growth. Clinical Practice in Pediatric Psychology, 10(4), 362-371. https://doi.org/10.1037/cpp0000466
Denker, K., Dean, M., Chapman, D., & Sump, C. (2023). Using a centralized nursing team to implement multi-specialty pediatric remote patient monitoring programs. Journal of Pediatric Nursing, 69, 10-17. https://doi.org/10.1016/j.pedn.2022.12.028
Dettlaff, A. J., Weber, K., Pendleton, M., Boyd, R., Bettencourt, B., & Burton, L. (2020). It is not a broken system, it is a system that needs to be broken: The upEND movement to abolish the child welfare system. Journal of Public Child Welfare, 14(5), 500-517. https://doi.org/10.1080/15548732.2020.1814542
Dubowitz, H. (2014). The Safe Environment for Every Kid (SEEK) Model: helping promote children's health, development, and safety: SEEK offers a practical model for enhancing pediatric primary care. Child Abuse & Neglect. https://psycnet.apa.org/doi/10.1016/j.chiabu.2014.07.011
Engström, M., Randell, E., & Lucas, S. (2022). Child health nurses' experiences of using the Safe Environment for Every Kid (SEEK) model or current standard practice in the Swedish child health services to address psychosocial risk factors in families with young children–A mixed-methods study. Child abuse & neglect, 132, 105820. https://doi.org/10.1016/j.chiabu.2022.105820
Flaherty, E. G., Schwartz, K., Jones, R. D., & Sege, R. D. (2013). Child abuse physicians: Coping with challenges. Evaluation & the health professions, 36(2), 163-173. https://doi.org/10.1177/0163278712459196
Fleming, L., Knafl, K., Knafl, G., & Van Riper, M. (2017). Parental management of adrenal crisis in children with congenital adrenal hyperplasia. Journal for Specialists in Pediatric Nursing, 22(4), e12190. https://doi.org/10.1111/jspn.12190
Gausche-Hill, M., Eckstein, M., Horeczko, T., McGrath, N., Kurobe, A., Ullum, L., ... & Lewis, R. J. (2014). Paramedics accurately apply the pediatric assessment triangle to drive management. Prehospital Emergency Care, 18(4), 520-530. https://doi.org/10.3109/10903127.2014.912706
Golembiewski, J. A. (2023). Using ecological theory to manage behaviour and symptoms in people living with dementia: a transdisciplinary approach to design. Architectural Science Review, 66(5), 406-415. https://doi.org/10.1080/00038628.2023.2232349
Henwood, T., Channon, S., Penny, H., Robling, M., & Waters, C. S. (2020). Do home visiting programmes improve children's language development? A systematic review. International journal of nursing studies, 109, 103610. https://doi.org/10.1016/j.ijnurstu.2020.103610
Homan, G. J. (2016). Failure to thrive: a practical guide. American family physician, 94(4), 295-299.
Howell, S., Bailey, L., & Coffman, J. (2019). Evaluation of drug-endangered children: The yield of toxicology and skeletal survey screening. Child Abuse & Neglect, 96, 104081. https://doi.org/10.1016/j.chiabu.2019.104081
Ibrahim, B. B., Tuttle, M., Fritz, A. H., Interrante, J. D., & Kozhimannil, K. B. (2022, July). Racial inequities in the availability of evidence-based supports for maternal and infant health in 93 rural US counties with hospital-based obstetric care (Policy Brief). University of Minnesota Rural Health Research Center.
Lammers, R. L., Willoughby-Byrwa, M. J., Vos, D. G., & Fales, W. D. (2022). Comparison of four methods of paramedic continuing education in the management of pediatric emergencies. Prehospital emergency care, 26(4), 463-475. https://doi.org/10.1080/10903127.2021.1916140
Lévesque, S., Julien, D., Joubert, K., Clément, M. É., Lessard, G., & Flores, J. (2023). Exposure to intimate partner violence in children aged 6 months to 8 years: factors associated with mothers' awareness of children's exposure to this violence. Violence and gender, 10(2), 73-84. https://doi.org/10.1089/vio.2020.0083
McConnell, M. A., Rokicki, S., Ayers, S., Allouch, F., Perreault, N., Gourevitch, R. A., ... & Baicker, K. (2022). Effect of an intensive nurse home visiting program on adverse birth outcomes in a Medicaid-eligible population: a randomized clinical trial. Jama, 328(1), 27-37. doi:10.1001/jama.2022.9703
Molloy, C., Beatson, R., Harrop, C., Perini, N., & Goldfeld, S. (2021). Systematic review: Effects of sustained nurse home visiting programs for disadvantaged mothers and children. Journal of Advanced Nursing, 77(1), 147-161. https://doi.org/10.1111/jan.14576
Neuhauser, L., Brettler, T., & Boyle, D. (2020). Re-thinking failure: Using design science theory and methods, including design-thinking, for successful transdisciplinary health and social interventions. In Interdisciplinary and Transdisciplinary Failures (pp. 21-42). Routledge.
Olds, D. L., Kitzman, H., Knudtson, M. D., Anson, E., Smith, J. A., & Cole, R. (2014). Effect of home visiting by nurses on maternal and child mortality: results of a 2-decade follow-up of a randomized clinical trial. JAMA pediatrics, 168(9), 800-806.doi:10.1001/jamapediatrics.2014.472
Robling, M., Lugg-Widger, F. V., Cannings-John, R., Angel, L., Channon, S., Fitzsimmons, D., ... & Slater, T. (2022). Nurse-led home-visitation programme for first-time mothers in reducing maltreatment and improving child health and development (BB: 2-6): longer-term outcomes from a randomised cohort using data linkage. BMJ open, 12(2), e049960. https://doi.org/10.1136/bmjopen-2021-049960
Sawyer, S., Cahill, A., Bartlett, S., Smith, K., & Higgins, D. (2023). Do Australian paramedics understand their professional and legal obligations regarding child abuse and neglect?. International journal on child maltreatment: research, policy and practice, 6(1), 59-77. https://doi.org/10.1007/s42448-022-00144-7
Shiha, M. G., Zammit, S. C., Elli, L., Sanders, D. S., & Sidhu, R. (2023). Updates in the diagnosis and management of coeliac disease. Best Practice & Research Clinical Gastroenterology, 64, 101843. https://doi.org/10.1016/j.bpg.2023.101843
Vienni Baptista, B., Fletcher, I., Maryl, M., Wciślik, P., Buchner, A., Lyall, C., ... & Pohl, C. E. (2020). Final report on understandings of interdisciplinary and transdisciplinary research and factors of success and failure. ETH Zurich. https://doi.org/10.3929/ethz-b-000516065
Votto, M., De Filippo, M., Caimmi, S., Indolfi, C., Raffaele, A., Tosca, M. A., ... & Licari, A. (2023). A practical update on pediatric eosinophilic esophagitis. Children, 10(10), 1620. https://doi.org/10.3390/children10101620
Webb, M. R. (2022). Building a Guaranteed Income to End the" Child Welfare" System. Colum. J. Race & L., 12, 668.
Yousef, E., Korotkaya, Y., & Simpson, A. B. (2022, January). Eosinophilic esophagitis in children: updates and practical aspects of management for allergists in a non–tertiary care private practice setup. In Allergy and Asthma Proceedings (Vol. 43, No. 1, p. 5). https://doi.org/10.2500/aap.2022.43.210084
Authors
Copyright (c) 2024 Ali Ahmed Mohammed Hobani, Hussain Mohammed Abdullah Matabi, Khalid Mohammed Marshod Alabsi, Nourah Abdullah Ali Alslole, Ahmed Nasser Alqahtani, Fahad Mousa Wasili, Waleed Ali Ahmed Maghfuri, Adel Ali Abdu Harbi, Rwaidh Ali Barnawi, Fatimah Hadi Haddadi, Bayan Suliman Mohammed Haddad, Rawabi Hamdan Muklif Alshammari
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