Unlike other forms of abuse, emotional maltreatment can include both acts of omission and commission. Defining, assessing and dealing with psychological maltreatment is complicated further by uncertainty regarding whether the emphasis should be on abusive parental behavior or on the development of the child. Intervention should start with establishing the causes of emotional maltreatment. However, different cultures vary in what they consider psychologically abusive. A child's failure to thrive is a variable syndrome of severe growth retardation, delayed skeletal maturation and problematic psychomotor development. These difficulties can be associated with illness, inadequate nutrition, acute feeding difficulties, disturbed mother-child interaction and relationship, insecure or disorganized attachment, family dysfunctioning and poverty. A child who fails to thrive might also be rejected, neglected and severely deprived of attention and care, so the primary causes are exacerbated by parental maltreatment. References