Neglect

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Photo by: Pojoslaw

Definition

Neglect occurs when a parent or other primary caretaker chooses not to fulfill their obligations to care for, provide for, or adequately supervise and monitor the activities of their child. Parental and caregiving obligations include the physical, emotional, and educational well-being of the child. Thus, neglect can also occur when the parent or caretaker does not seek adequate medical or dental care for the child. Another definition of neglect is when the parental figure does not provide sufficient food, clothing, or shelter.

Parents are also expected to provide for the emotional needs of the child. Thus, neglect can occur when parents abandon the child, or simply have no time to spend with the child, in essence leaving the child to raise himself. If the child is actually left without supervision, this certainly constitutes neglect as well.

The final feature of neglect includes educational neglect, which often occurs when one child is responsible for other children in the family. Shifting the responsibility of caring for younger children to another child in the family prevents the caregiving child from participating in age-appropriate activities for themselves, such as attending school. This is a relatively common situation that makes it difficult for the oldest—and perhaps all of the children—to attend school. Parental responsibility includes providing adequate guidance and supervision for the children to regularly attend school. Truancy is not only a problem for children, but may be part of the picture of neglect as well.

Effects of neglect

Consequences of neglect are generally cumulative, and often negatively affect the child's development. For example, poor nutrition has negative consequences on the child's physical and psychological development. If proper nutrients are not available at critical growth periods, the child's development will not follow the normal and usual pattern. Common physical and psychological reactions to neglect include stunted growth, chronic medical problems, inadequate bone and muscle growth, and lack of neurological development that negatively affects normal brain functioning and information processing. Processing problems may often make it difficult for children to understand directions, may negatively impact the child's ability to understand social relationships, or may make completion of some academic tasks impossible without assistance or intervention from others. Lack of adequate medical care may result in long-term health problems or impairments such as hearing loss from untreated ear infections.

Long-term mental health effects of neglect are inconsistent. Effects of neglect can range from chronic depression to difficulty with relationships; however, not all adults neglected as children will suffer from these results. Some individuals are more resilient than others and are able to move beyond the emotional neglect they may have experienced. Characteristics of resilient individuals include an optimistic or hopeful outlook on life, and feeling challenged rather than defeated by problems.

Factors associated with neglect

Although each family's situation is unique with regard to stressors and characteristics that might precipitate neglect, there are some general factors that have been associated with neglect of a child. These factors include characteristics of the parental figure, and socioeconomic status.

Parental figures who neglect may have been neglected or abused themselves. There is a tendency for parental figures that neglect their children to have low self-esteem, poor impulse control, and to experience anxiety or depression. Other factors associated with neglect often include inadequate information about child development, including age-appropriate expectations of what children may be able to do. The parents may also feel overwhelmed by parenting responsibilities, and feel negatively about the child's demands on them. Such parents may never have fully adopted the role of parent or the caregiving the parental role requires. Internal pressures often push the caregivers to take care of their own needs (perhaps inappropriately), while ignoring the needs of the child. Substance abuse is often associated with neglect, particularly for those parents who are more self-absorbed and focused on their needs rather than their child's. This characteristic is also consistent with the findings of other studies indicating that some neglectful parents have an inability to be empathic, or to understand the feelings and needs of others.

Although abuse may occur across all levels of income and education, neglect is more often associated with severe levels of poverty and lower educational level. The external stressors may feel more extreme in single parent families as well, leading to neglectful behavior. Even in families where the parent is attempting to provide for the children, absence due to multiple work demands may lead to a neglectful situation. Families that are disorganized and socially isolated are more likely to neglect the children in their care.

Unlike victims of abuse, there are few consistent characteristics associated with victims of neglect. Retrospective studies of adults neglected as children indicate that females are slightly less resilient to neglect than men.

Prevalence

The number of children nationwide who are harmed or endangered by neglect is greater than any type of abuse. Neglect is consistently reported in more than half of the substantiated reports of mistreatment handled by the authorities.

Prevention and treatment

Interventions are usually aimed at two levels: community prevention efforts and individual parenting skills. A community-based program that actually combines the two facets of intervention is the "Parents as Teachers" program, which is available through many local school districts throughout the nation and is free of charge. Benefits of the program include its accessibility—parents simply need to call for the free service—and the in-home interventions provided by the program. Although the program is not part of the social service network of agencies, the fact that workers go into the home replicates that aspect of caseworker interventions. The simple act of having a paraprofessional in one's home can reduce the likelihood of neglect. Specific interventions that further reduce the likelihood of neglect include focusing on the parent-child relationship, reviewing appropriate expectations for the child's behavior (based on child development principles), and teaching basic parenting skills.

Other treatment options are generally more formal, and may be initiated by a call from a mandated reporter with concerns about neglect. Mandated reporters include physicians, teachers, and counselors. Any of these professionals may make the initial call if neglect is suspected. Concerned individuals may also call social services to report suspected neglect. In these cases of forced treatment, parents may be less willing participants in treatment efforts aimed at behavioral change for themselves and their families. In other instances, the parent or child may already be in treatment, and the focus on reducing neglectful behaviors may be incorporated into the existing treatment relationship. Factors to focus on in formal treatment aimed at reducing the likelihood of neglect may include specific parenting skills, home visits to allow monitoring of the relationship, as well as other individual needs such as substance abuse treatment, or empathy skill training.

Treatment efforts for the child should include family counseling aimed at communication skills and appropriate expression of affection and emotion within the family. Assertiveness skills training may be helpful for older adolescents in asking for their perceived needs.

See also ; Family therapy

Resources

BOOKS

McKenry, P. C., and S. J. Price, eds. Families & Change. Thousand Oaks, CA: Sage Publications, 2000.

PERIODICALS

English, D. J. "The extent and consequences of child maltreatment." The Future of Children 8, no. 1 (Spring 1998): 39-53.

Horwitz, A. V., C. S. Widom, J. McLaughlin, H. R. White. "The impact of childhood abuse and neglect on adult mental health: A prospective study." Journal of Health & Social Behavior 42, no. 2 (Jun 2001): 184-201.

Deanna Pledge, Ph.D.