A randomised controlled trial of specialist health visitor intervention for failure to thrive

AimS To determine whether home intervention by a specialist health visitor affects the outcome of children with failure to thrive. Methods-Children referred for failure to thrive were randomised to receive conventional care, or conventional care and additional specialist home visi ting for 12 months. Outcomes measured were growth, diet, use of health care resources, and Bayley; HAD (hospital anxiety and depression), and behaviou ral scales. Results-Eighty three children, aged 4-30 months, were enrolled, 12 received specialist health visitor intervention. Children in both groups showed goo d weight gain (mean (SD) increase in weight SD score for the specialist hea lth visitor intervention group 0.59 (0.63) upsilon 0.42 (0.62) for the cont rol group). Children <12 months in the intervention group showed a higher m ean (SD) increase in weight SD score than the control group (0.82 (0.86) up silon 0.42 (0.79)). Both groups improved in developmental score and energy intake. No significant differences were found for the primary outcome measu res, but controls had significantly more dietary referrals, social service involvement, and hospital admissions, and were less compliant with appointm ents. Conclusions-The study failed to show that specialist health visitor interve ntion conferred additional benefits for the child. However, the specialist health visitor did provide a more coordinated approach, with significant sa vings in terms of health service use. Problems inherent to health service r esearch are discussed.