Child Neglect

There are many children in our society who go through the day without eating or who fail to receive adequate medical services when ill. Others reside in homes without running water or electricity or homes infested with rodents and roaches. At times, young children are left at home without adequate supervision and are often responsible for watching a younger sibling as well. The above scenarios are but a few examples of what is termed child neglect. Child neglect is defined by a broad spectrum of actions that can range from leaving a 5-year-old at home alone for the afternoon to a child not eating for days as her parents are strung out due to heavy drug use. Although child neglect is a serious social problem affecting our society, neglect is often viewed as unfortunate but benign and often goes unnoticed because it occurs in the privacy of a home. Similarly, the issue of child neglect has received limited attention in the research community, studied far less than physical or sexual abuse, despite the fact that it is the most frequently substantiated form of child maltreatment.

According to the U.S. Department of Health and Human Services, approximately half of the substantiated cases of child maltreatment pertain to child neglect. Although the act of child neglect may not be readily apparent as compared with physical and sexual maltreatment, child neglect may do just as much damage to a child’s psychological and physical well-being. Contextually, child neglect is conceptualized as acts of omission, and the parent’s actions may be either intentional or unintentional. According to Erickson and Egeland, child neglect can be differentiated into subtypes that include physical neglect, emotional neglect, medical  neglect,  and  educational  neglect.  Of  these different subtypes of child neglect, physical and medical neglect are the most common. Physical neglect pertains to failure to protect a child from harm or danger and not being able to provide for the child’s basic human needs such as adequate housing, clothing, and food. This type of neglect is easier to substantiate due to the physical evidence involved (such as when a child attends school in tattered or inadequate clothes). Emotional neglect is sometimes categorized with emotional (i.e., verbal, psychological) abuse and is more difficult to substantiate since the harm that occurs to the child generally does not involve the presence of physical evidence. An example of emotional neglect would be a parent’s repetitive lack of response to a young child’s cries for warmth, support, and protection. Medical neglect relates to the failure to meet the medical needs of a child such as those procedures that would lead to the prevention or amelioration of disease or injury. Medical neglect also encompasses the failure to meet the mental health needs of a child if the child has serious emotional and/or behavioral disturbances. Finally, educational neglect occurs where a parent or guardian fails to meet the minimal state standards regarding educational needs for their child (e.g., having a child attend school on a consistent basis).

Consequences Of Abuse

There are numerous negative developmental consequences associated with child neglect. Generally, neglected children are at risk for delays in cognitive and language development, social and emotional withdrawal, anxiety symptoms, aggressive and inattentive behaviors, and lowered self-esteem. Neglected children are often unpopular, have difficulty forming and maintaining close attachments, have diminished capacity  for  coping  with  everyday  demands,  and by adolescence have been diagnosed with one or more psychiatric diagnoses. Academically, neglected children have lower scores on standardized tests, lower grades, and higher dropout rates. Extreme forms of neglect can lead to developmental delays, failure to thrive, and even death for younger and more vulnerable children. Both the short and long-term consequences of neglect on a child’s functioning have been found to be as severe and damaging to a child as other forms of maltreatment. Investigating the consequences of child neglect is difficult, however, because its impact is often compounded by other detrimental influences on child development such as poverty, accidental injury and trauma, and family dysfunction. Furthermore, the specific physical, psychological, interpersonal, and academic problems that result from neglect are dependent on the specific type of neglect, the chronicity and acuteness of neglect, and the child’s age and competence at the time of neglect.

Risk Factors

There is no identifiable single cause that leads to child neglect. Different contextual conditions (e.g., living in poverty, not having access to adequate health care) contribute to but are not consistent indicators of child neglect. Conceptually, risk factors can be categorized into three groups: (1) child risk factors, (2) family risk factors, and (3) social/environmental risk factors. For the child, risk factors related to disability and chronic illness may contribute to child neglect due to the increased needs of the child. Parent factors such as psychological problems (e.g., depression, substance abuse), having low social support, negative parent-child relationships, and high levels of parenting stress may place a child at risk for being neglected. Social and environmental factors such as poverty, homelessness, and lack of or inadequate medical and social services, while not causal, all contribute to an increased risk associated with child neglect. Although these risk factors are nonspecific, they provide useful information from which to develop policy and prevention programs to reduce the risk for child neglect.

Protective Factors

Child, family, and social factors have been identified as having a protective quality against child neglect. Children who are in good physical and psychological health are less prone to be neglected. Children with good social, coping, and problem-solving skills are less likely to be the victims of child neglect. Parents who have a warm, caring, and overall positive relationship with their child are less likely to neglect their child. Parents who have a good social support network that allows them to seek support when needed are also less likely to neglect their child. Parents with low levels of stress and good coping skills are also less likely to neglect their child. In the social context, access to adequate housing and medical and social services are factors that decrease the incidence of child neglect. Overall, a supportive environment where the parent is not experiencing physical and psychological problems and has access to adequate medical, school, and social services reduces the probability of a child being neglected.

Intervention Efforts

Identifying families who are at risk for child abuse and neglect is crucial for decreasing the prevalence of child neglect. Reporting suspected child neglect is required by law for many professions. All 50 states have mandatory reporting laws for any individual, regardless of profession, if child neglect is suspected. Suspected cases of child neglect should be reported to your local child protective services agencies. However, it is important to note that the reporting procedures and agency responsibilities may vary to some degree by state. Intervention can occur from one or several different agencies, such as child protective services, criminal  justice,  and  the  health-care  system. These interventions focus on ensuring the health and safety of the child and removing any threat to the child.

Assessment for child neglect is typically more challenging than for other forms of child maltreatment because there are often no specific physical markers that can be isolated to neglect. Thus, with the exception of extreme cases of neglect, it is difficult to isolate the pattern of symptoms that results from child neglect from that that may result from other health, behavioral, and social factors. Despite this challenge, increasing attention to prevention and early intervention efforts seem to be promising in engaging the family in treatment and reducing risk. School and medical personnel are probably in the best position to identify families at risk for child neglect. Early intervention efforts targeting families who have young children and infants is crucial for future prevention. The current literature, while limited, speaks to the effectiveness of early intervention, showing that approximately half of families respond favorably to treatments that are long term and comprehensive in nature.

References:

1. American Professional  Society  on  the Abuse  of  Children, http://www.apsac.org/
2. Center of  Child  Abuse  and  Neglect  (CCAN),  http://w3.ouhsc.edu/ccan/
3. Child Abuse Prevention Network, http://child-abcom/
4. Child Welfare League of America, http://www.cwla.org/
5. Erickson, F., & Egeland, B. (2002). Child neglect. In J. B.
6. Myers, Berliner, J. Briere, C. T. Hendrix, C. Jenny, & T. A. Reid (Eds.), The APSAC handbook of child maltreatment. Thousand Oaks, CA: Sage.
7. S. Department  of  Health  and  Human  Services.  (2003). Emerging practices in the prevention of child abuse and neglect. Washington, DC: U.S. Government Printing Office.
8. S.  Department    of    Health    and    Human    Services, Administration on Children, Youth and Families. (2002). Eleven  years  of  reporting  child  maltreatment  2000.
9. Washington, DC: S. Government Printing Office.
10. S. Department of Health and Human Services. Children’s Bureau, http://www.acf.hhs.gov/programs/cb/
11. S. Department of Health and Human Services. National Clearinghouse on  Child Abuse  &  Neglect  Information, http://nccanch.acf.hhs.gov/