Individuals who had failed-to-thrive for non-organic reasons received psychosocial intervention which was tailor-made to their particular needs during childhood. Their progress was followed up over 20 years later, including their physical growth and social and cognitive functioning. Not all clients showed the same outcomes. The quality of the parental relationship and the reason for the growth-faltering were found to be related to the outcomes at 20 years. Unless they experienced a positive and sustained change in their life or circumstances, individuals who had experienced abuse showed poorer outcomes than those whose growth-faltering had been thought due to neglect, lack of parenting or feeding difculties. Abuse tended to be a contributing factor to growth-faltering more frequently in families where the parents were observed to have a poor relationship with each other. However, a signicant change in the quality of care given to the child and the emotional environment experienced by them resulted in positive outcomes 20 years later despite experiencing abuse during childhood.