The Failure To Thrive Up To Age 3

Social Security has a separate category of impairments for children who may be eligible for Supplemental Security Income (SSI). One of these categories is a failure to thrive in children from birth to attainment of age 3. A failure to thrive can include many different kinds of impairments, it is not a well known listing, but below is the requirements and expectations needed to meet the listing.

Failure to thrive in children from birth to attainment of age 3, documented by A and B, or A and C

  1. Growth failure as required in 1 or 2:
  2. For children from birth to attainment of age 2, three weight-for-length measurements that are:
  3. Within a consecutive 12-month period; and
  4. At least 60 days apart; and
  5. Less than the third percentile on the appropriate weight-for-length table under 105.08B1; or
  6. For children age 2 to attainment of age 3, three BMI-for-age measurements that are:
  7. Within a consecutive 12-month period; and
  8. At least 60 days apart; and
  9. Less than the third percentile on the appropriate BMI-for-age table under 105.08B2.

AND

  1. Developmental delay (see 100.00C1 and C3), established by an acceptable medical source and documented by findings from one current report of a standardized developmental assessment (see 100.00C3b) that:
  2. Shows development not more than two-thirds of the level typically expected for the child’s age; or
  3. Results in a valid score that is at least two standard deviations below the mean.

OR

  1. Developmental delay (see 100.00C3), established by an acceptable medical source and documented by findings from two narrative developmental reports (see 100.00C3c) that:
  2. Are dated at least 120 days apart (see 100.00C1); and
  3. Indicate current development not more than two-thirds of the level typically expected for the child’s age.

How Social Security Evaluates this Listing

  1. General. We establish FTT with or without a known cause when we have documentation of an infant’s or toddler’s growth failure and developmental delay from an acceptable medical source(s). We require documentation of growth measurements and developmental delay within the same consecutive 12-month period. The dates of developmental testing and reports may be different from the dates of the growth measurements. After the attainment of age 3, we evaluate growth failure under the affected body system(s).
  2. Growth failure. We use the appropriate table(s) for the digestive system to determine whether a child’s growth is less than the third percentile. The child does not need to have a digestive disorder.
  3. Developmental Delay. We use reports from acceptable medical sources to establish delay in a child’s development.
  4. We document the severity of developmental delay with results from a standardized developmental assessment, which compares a child’s level of development to the level typically expected for his or her chronological age. If the child was born prematurely, we may use the corrected chronological age (CCA) for comparison. CCA is the chronological age adjusted by a period of gestational prematurity. CCA= (chronological age) – (number of weeks premature). Acceptable medical sources or early intervention specialists, physical or occupational therapists, and other sources may conduct standardized developmental assessments and developmental screenings. The results of these tests and screening must be accompanied by a statement or records from an acceptable medical source who established the child has a developmental delay.
  5. When there are no results from a standardized developmental assessment in the case record, we need narrative developmental reports from the child’s medical sources in sufficient detail to assess the severity of his or her developmental delay. A narrative developmental report is based on clinical observations, progress notes, and well-baby check-ups. To meet the requirements, the report must include: the child’s developmental history; examination findings (with abnormal findings noted on repeated examinations); and an overall assessment of the child’s development (that is, more than one or two isolated skills) by the medical source. Some narrative developmental reports may include results from developmental screening tests, which can identify a child who is not developing or achieving skills within expected timeframes. Although medical sources may refer to screening test results as supporting evidence in the narrative developmental report, screening test results alone cannot establish a diagnosis or the severity of developmental delay.