Paeds Cases · clinical-assessment-and-reasoning
Failure to thrive and faltering growth: diagnostic approach — OSCE
OSCE counselling and management station for faltering growth.
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Target exams
MRCPCH ClinicalRACP DCE
Prompt
You have 8 minutes with a parent of a 9-month-old whose weight has fallen from the 50th to the 5th centile. A growth chart is provided. Counsel, outline assessment and agree a plan.
Station brief (candidate)
- Interpret the growth trajectory in plain language.
- Explain that faltering growth is a pattern needing a cause, not a final label.
- Take a focused feeding and social history (role-player).
- Outline examination priorities and when tests are needed.
- Agree a nutrition support plan, review timing and safety-net.
- Avoid blame; use teach-back. [1] [2] [6]
References7ShowHide
- [1]Homan GJ Failure to Thrive: A Practical Guide Am Fam Physician, 2016.PMID 27548594
- [2]Gonzalez-Viana E Faltering growth in children: summary of NICE guidance BMJ, 2017.PMID 28963099
- [3]Shields B Weight faltering and failure to thrive in infancy and early childhood BMJ, 2012.PMID 23014901
- [4]Boylen S Impact of professional interpreters on outcomes for hospitalized children from migrant and refugee families with limited English proficiency: a systematic review JBI Evid Synth, 2020.PMID 32813387
- [5]Burvenich R Effectiveness of safety-netting approaches for acutely ill children: a network meta-analysis Br J Gen Pract, 2025.PMID 39117428
- [6]Forkey H Trauma-Informed Care Pediatrics, 2021.PMID 34312292
- [7]Katz AL Informed Consent in Decision-Making in Pediatric Practice Pediatrics, 2016.PMID 27456510