by Thom Rudegeair

Created on: January 31, 2009

As a psychiatrist, I have an unusual take on the notion of "catch-up growth".

The development of a child, both his or her physical growth as well as the emergence of increased social mastery, depends upon nourishment from a variety of sources. We usually measure height and weight then plot the numbers on a graph to see how a child is progressing, and we have come to realize that a child who is "failing to thrive" physically can recover and "climb the charts" until he or she reaches an acceptable percentile once the necessary nutritional building blocks are supplied in sufficient quantities.

But the status of a child's emotional and social growth curves is not as easily charted. And even if we establish a clear measure of emotional failure to thrive, what kind of nourishment is required to fuel the maturation of the myriad of interactive complexities within the emerging person towards the essential caregivers? We are learning that the attachment a baby forms with his or her principle caregiver is the umbilical cord for the flow of interpersonal nourishment, and the amount and quality of that flow will dramatically affect the child's capacity to feel reassured of his or her own worth and safety. The confident child can explore and express, alerting the world about his needs and learning from the input of her loving and responsive caregivers. An emotionally undernourished child, on the other hand, can all-too-easily act as if oblivious to social expectations or, perhaps even more ominously, can in such an intimidating environment, withdraw from the social effort.

In this context, a failure to thrive means a derailment of the child's emerging integrated sense of self. Emotional neglect or abuse retards the maturation of the child's socially adroit mind, much like starvation or physical trauma distorts the maturing body. Can the mind's growth catch-up? If there was a graph of developing psychological growth, could we watch an initially-undernourished child climb the charts? The answer is undoubtedly "yes," but with some cautionary provisions. The longer a child is exposed to the neglect, inconsistency or abusiveness of caregivers, the more firmly established will be the distortions of his or her sense of self and the unreliability of the social world. The presence of even one benign and nurturing caregiver can have a dramatically positive impact - and the earlier the better.

The resiliency of young minds is remarkable, but not limitless, and the intra-psychic scars of early childhood emotional deprivation can be profound. Young adults who have endured an entire childhood of such deprivation are inevitably compromised, but even at this developmentally late date, exploring skills for managing feelings and insight into the sources of self doubt (for example) can foster emotional "catch-up growth." As with physical growth, however, the best chance of becoming a robust adult is through a well-nurtured childhood experience.

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