Forty-four children were selected for the study according to the following eligibility criteria: a weight close to or under the third percentile; a history of at least 2 months of weight loss or inadequate weight gain; and extensive medical investigations that had excluded major organic reasons for abnormal physical development. Baseline measures were obtained prior to behavioral intervention. The initial investigation found several problem areas in parent-child interactions: mother-child feeding difficulties; disturbed mother-child interaction and relationship; maternal anxiety, low self-esteem, depression, and poor self-control; and conduct problems for the children. The intervention offered to each family was tailored to its particular needs. Treatment incorporated a range of therapeutic methods based on psychodynamic and cognitive/behavioral theories. As adults, the sample responded to semistructured and open-ended interviews to examine current relationships with family. Individuals were classified as having poor relationships with parents (low levels of contact, negative emotions expressed with respect to the parental relationship), or positive relationships with parents (high levels of contact and positive relationships). As individuals, the adults were classified as having poor outcomes (poor social support, avoidant attachment, and low self-esteem) or good outcomes (adequate social support, secure or ambivalent attachment, and reasonable self-esteem). The study found that when the childhood intervention resulted in a significant change in the quality of care given to the child and the emotional environment experienced by the children, then positive outcomes were found 20 years later. These individuals were more likely to have higher levels of self-esteem, higher educational attainment, increased levels of social support, and more positive relationships and social skills. Longer term outcomes were poorer when there was little improvement after the intervention or when the changes were not sustained for a long period of time. 3 tables and 21 references