OBJECTIVE. This pilot study explored the use of a parent–child interaction scale during a nonfeeding event and a systematic method for recording children’s sleep and feeding routines at home to determine if these two measures could be useful additions to the occupational therapy assessment of young children with failure to thrive.

METHOD. Five mother–child dyads were administered the Nursing Child Assessment Teaching Scale (NCATS) and the mothers completed a 24-hour, 7-day Sleep Activity Record (SAR).

RESULTS. Two of the five dyads scored below the 10th percentile cutoff on the NCATS indicating low levels of mutually adaptive interactions. The NCATS subscale scores revealed low performance in three of the mothers, but none of the children. The SAR documented concerns in the sleep and feeding patterns in 4 of the 5 children, including irregular bedtimes, frequent nighttime wakening, and irregular feeding times.

DISCUSSION. The NCATS and SAR revealed a wide range of strengths and concerns in this sample. Findings suggest that occupational therapists evaluating the complex nature of failure to thrive in young children should consider including measures to assess parent–child interactions during nonfeeding situations, as well as obtain information on the children’s sleep and feeding routines.