Many researchers believe that child neglect, or a failure to provide for some basic need of a child, is one of the most common forms of child abuse. Although society has advanced in many ways in addressing child abuse, neglect, which is related to the care of children, has not been an area that has kept pace with those advances. Parents still fail to seek medical assistance, provide proper nutritional meals, and ensure that their children attend school. Whether it is explained as ignorance on the part of parents or callousness, many individuals in America today feel that there is some degree of responsibility on the part of society to protect all children (McCabe 2003).
II. Types of Neglect
III. Indicators of Neglect
IV. Explaining Neglect
Of all the categories of child abuse (physical, sexual, emotional abuse, and neglect), neglect has probably received the least amount of attention from researchers. The reasons for this lack of attention include the fact that neglect is not seen as being as important or as detrimental to the child’s well-being as other forms of abuse. Another reason is that neglect is less dramatic and fails in the shock factor that is often required to ‘‘STOP ABUSE’’ (Garbarino and Collins 1999). In addition, neglect does not lend itself to a quick solution or short-term evaluations of success. Addressing neglect involves a long process of teaching parents to identify, first, the basic needs of a child and then avenues for satisfying those basic needs (Crosson- Tower 2002); thus, researchers interested in empirical assessments opt for focusing on another category of abuse. Finally, neglect, although defined in some of the literature, is still quite subjective in its identification in that what one individual may recognize as neglect, another individual may not. However, this does not infer that neglect is less important than the other categories of child abuse.
It has been estimated that the majority of all child victims of physical, sexual, and emotional abuse are also victims of neglect and that more child deaths from maltreatment or abuse are associated with neglect than with any other type of abuse (McCabe 2003). In addition, it is estimated that over one-half of the child abuse cases reported to law enforcement agencies within the United States are cases of neglect. Unfortunately, neglect does not lend itself to an easy confirmation.
All children are potential victims of neglect; however, certain children have been identified as being at a higher risk. In considering gender, boys are at a higher risk for physical neglect than girls (McCabe 2003). In considering the family characteristics of neglected children, those of single parents are at a greater risk of physical neglect than children of two-parent families; children in large families are more likely to be victims of physical neglect; and children from the lowest-income families are more likely victims of educational neglect (Barkan 2001). One must be aware of the fact that there are many types of neglect, with each type addressing a specific area in the child’s life, and that often some of these types of neglect continue to be unrecognized or ignored.
Types of Child Neglect
The types of child neglect can be divided into four general categories: physical, educational, emotional, and supervisional. These categories, although appearing mutually exclusive, may overlap, as most children who are victims of neglect are actually victims of one or more different categories of neglect. For example, a child who is not being supervised on a regular basis is also probably not being sent to school on a regular basis.
By definition, physical neglect refers to the caretaker’s inability to reduce or prevent the child’s likelihood of physical harm (Crosson-Tower 1999). This form of neglect includes a refusal to allow or a delay in the seeking of health care for the child; failing to provide adequate nutrition for the child; a disregard for the child’s personal hygiene and/or an inability to provide a sanitary home for the child; a disregard for the child’s safety; and the risk to an unborn child due to the use of drugs and/or alcohol by the mother during pregnancy. In other words, physical neglect addresses the neglect of any part of a child’s life that may result in physical injury or illness to that child.
Historically, and from a legal perspective, the most common example of physical neglect is a caretaker’s choice to refuse medical treatment of an ill or injured child (Wallace 1999). Established in the late 1800s in the case of In Heinemann’s Appeal, the Supreme Court of Pennsylvania (1880) supported the principle that states may intervene in the best interest of the child when parents fail to provide medical care. Through this ruling, a child does not have to suffer without relief from illness or injury if the parents refuse medical treatment; in these cases, the state may order the treatment of the child.
A failure to provide adequate nutrition and personal hygiene is another example of neglect and is of common concern for law enforcement and social services. One memoir on the topic of child physical neglect is David Pelzer’s (1995) best-selling A Child Called It. Pelzer’s account of starvation at the hands of his mother brought to the public consciousness the existence of child neglect and the importance of agency intervention.
In addition, the medical community has identified a condition called nonorganic failure to thrive syndrome, in which a caretaker’s not knowing how to properly feed a baby or failing to provide an adequate amount of milk/formula for the baby results in the delayed development of the child or in some cases the death of the child (English 1978). Failure to Thrive recognizes that all neglect is not intentional; however, with or without intent, the outcome for a neglected child may be death, and Failure to Thrive constitutes physical neglect.
The failure to maintain a safe home, to ‘‘baby-proof’’ a home, or to ensure that a child utilizes a car safety seat may also constitute neglect. Children may ingest common poisons in the home, fall from the top of staircases, or drown in a couple of inches of bath water. The caretakers who choose not to take the proper precautions to protect their children may face prosecution in family court, and lawsuits can be filed in civil court even though the neglect may not be intentional. In Washington, D.C., in November of 2001, the family of a disabled child who died in a Delaware nursing home filed a $120 million lawsuit against the nursing home based upon neglect, on the claim that caretakers at the facility failed to provide for the special needs of the child.
Finally, one of the latest concerns is in the area of prenatal care. In particular the failure of a mother to seek prenatal care for her unborn baby and the use of drugs and alcohol by the mother while pregnant may also be reasons for the criminal charge of physical neglect. This is a topic of liability in the criminal courts, and in many states the definition of a child has been rewritten to include an unborn child (or fetus), which introduces another dimension to child neglect—the drug addicted mother.
Educational neglect refers to the caretaker’s failure to provide an education or a means of education to the child (Crosson-Tower 1999). Included in this category of neglect are allowing chronic school truancy, failing to enroll the child in school, and disregarding a child’s special education needs. Each of these examples of educational neglect is reason for prosecution in U.S. court systems.
All children in the United States are required to attend school. In turn, parents are required to register their children for school. In some cases of educational neglect, parents fail to register their children or fail to send them to school. Thus, as seen from a legal perspective, the parent, who fails to ensure that his or her child attends school, is guilty of educational neglect.
Finally, another aspect of educational neglect involves the situation of a mentally challenged child or a child with a learning disability and a parent or caretaker who makes little or no effort in an attempt to ensure that child an education or educational progress (Crosson-Tower 1999). Their rights as U.S. citizens afford all children the opportunity of education. Parents are responsible for ensuring that their children seize that opportunity.
The emotional neglect of children may be, in the case of threats or intimidation, classified as emotional abuse. However, for the purpose of this discussion, emotional neglect includes inadequate nurturance and affection, the abuse of another person in the presence of the child, and a refusal to provide psychological care by the parent or caretaker (National Center on Child Abuse and Neglect [NCCAN] 1993). Child development consists of a series of stages, and each stage provides a new or additional set of circumstances for the emotionally neglected child. The child who is not nurtured and shown affection but simply ignored has an unstable foundation for a ‘‘normal’’ relationship. The child who never experiences positive contact between parent and child is unaware of this type of relationship and, in many cases, is unable to initiate the process of bonding with other individuals.
In some cases of emotional neglect, an older child who did not receive the love and attention from his/ her parents makes a conscious effort to fulfill that role for the younger siblings. In these cases, the child becomes the nurturer and essentially the caretaker to the younger siblings. In other families where emotional neglect exists, the roles of parent and child are undefined and blurred; thus, the child becomes the nurturer to the parents. However, despite this initiative to maintain family closeness, such children usually have little self-value and will oftentimes view themselves as not capable of attracting or maintaining a loving relationship. It is not unusual for these children to drift in and out of relationships as adults, as they were not exposed to the stability of a family life.
Some researchers view emotional neglect as one of the most damaging phenomena in a child’s life (Wallace 1999). In addition to the physical condition of Failure to Thrive, which may result from emotional neglect, many researchers have asserted that children who are unloved demonstrate neediness and general feelings of fear of abandonment or rejection later in life (Miller-Perrin and Perrin 1999). These children, who have little value in themselves, often become either the victims or perpetrators of domestic violence (Barkan 2001).
Neglect in terms of supervision is the failure to adequately supervise a child (NCCAN 1993). Supervisional neglect includes abandonment (both long-term and short-term) as well as the expulsion of the child from his/her residence without providing adequate alternative housing. Also included under the category of supervisional neglect are cases in which a child is allowed to stay away from the home overnight or for extended periods of time without the caretaker’s knowledge of the child’s location (NCCAN 1993). In many cases of supervisional neglect, children will simply leave home and, as the parents/caretakers are not in the habit of attending to his/her whereabouts and do not even miss them at first, are not reported to law enforcement officials as missing or as runaways (Crosson-Tower 2002).
Probably one of the most debated hypotheses in the discussion of supervisional neglect is the notion that decreased supervision increases the likelihood of delinquency. The notion that unsupervised youths are more likely to be involved in illegal activities (Bynum and Thompson 2002) or, more generally stated, that inadequate supervision in the home helps to explain delinquent behavior outside of the home is a common philosophy. In the absence of caretaker supervision, the child becomes accustomed to acting as he/she desires without giving thought to the consequences. It is an unfortunate case of a lack of adequate supervision when a child is injured or killed or inflicts injury upon or kills another person.
Indicators of Child Neglect
Just as there are many indicators of child physical, sexual, and emotional abuse, there are also many indicators of neglect. School officials are most likely to be involved in identifying a neglected child. In fact, in most states, educators, because of their positions, are mandated reporters of child abuse and neglect and must accept their responsibility in reporting possible cases of abuse.
Neglect manifests itself in two forms—either in physical injury or through behavioral indicators. However, it must be acknowledged that although the following characteristics are indicators of neglect, they are not always the result of neglect. Just as with any type of child abuse, those investigating such charges should weigh all the facts prior to pronouncing neglect.
One of the more common physical indicators of neglect is poor physical development. Research has revealed that neglected children often produce poor growth patterns (Crosson-Tower 1999; Wallace 1999). These children will be smaller than other children of the same age, and neglected children will often be below the fifteenth percentile of their growth range for their age and sex. In many cases, related to lack of physical development, a neglected child may appear to be constantly hungry or even to suffer from malnutrition. These children may steal food or hoard food and eat (when they are allowed) as though they were starved. In many cases of neglect, the children are in various stages of starvation. In addition, and as is commonly the case, the child’s hygiene is also a good indicator of neglect. In particular, a child with poor hygiene, a smell of urine, rotten teeth, head lice, and/or other unattended physical or medical problems may also be a victim of neglect (Crosson-Tower 2002).
Finally, in many cases, child neglect produces a child who suffers from constant fatigue or sleepiness. This child, because of lack of food or of shelter, may seem always tired and in need of sleep. Again, in most cases, the individuals who are in the positions to recognize the physical signs of neglect are the child’s teachers.
Often, long before the physical indicators of neglect are revealed, the behavioral indicators will be present. A child who lacks self-confidence or self-worth and has poor relationships with peers may be a victim of neglect (Wolfe, McMahon, and Peters 1997). Behavioral indicators of neglect include begging for food, being socially withdrawn or destructive, and eliciting negative responses to gain attention (Crosson-Tower 2002). Other behavioral indicators related to the education of the child include being developmentally behind other children in the same age group in the understanding of concepts or the advancement of motor skills, difficulties with language comprehension (as generally their interactions have been through one- or two-word statements such as ‘‘No,’’ ‘‘Get out,’’ or ‘‘Shut up’’), and overall lower intelligence (Crosson-Tower 2002). Finally, neglected children are often self-destructive, destructive to other people, or destructive to other’s property (Wallace 1999).
In many cases, neglected children are expected to assume the role of caretaker for their younger siblings. A child who appears to be mature for his/ her age in actions or who acknowledges responsibilities in the home such as cooking dinner for the family or the bathing of siblings may be neglected. Children who are neglected rarely see school as a necessary part of their lives; therefore, a child who is often tardy or absent from school may also be a victim of neglect. Later, of course, most of these neglected children simply drop out of school completely. Finally, a child who appears to be generally depressed or withdrawn may be a victim of neglect.
Just as the parents are responsible for the care of their children, they are also the most likely source of neglect. However, one cannot discuss neglect by parents or caretakers as simply a result of a failure to fulfill their role. Neglect must be addressed in regard to the dynamics behind the caretaker inability to care for their child. From that perspective, most research would assert that child neglect is a result of three different types of parental and family characteristics: the parent/caretaker’s developmental history and personality, the characteristics of the family and child, and environmental influences (Crosson-Tower 1999).
Explaining Child Neglect
The first attempt to explain the causes of neglect is from the perspective of the caretaker’s own developmental history and personality (Gaudin 1993). Caretakers themselves who have grown up in an environment of neglect are likely to neglect their own children. Just as with other forms of abuse and the cycle of violence (Walker 1979), neglect is often a generational outcome. These acts of neglect are often a result of the parent not knowing or understanding, for example, that a three-year-old child is not an appropriate caretaker for an eight-month-old baby (Wolfe et al. 1997) or that by leaving a five-year-old alone in a home overnight or for several days constitutes abandonment (Wallace 1999). Many of these caretakers were raised in an environment of child ‘‘responsibility’’ and therefore see nothing wrong with repeating the pattern.
One must also consider the personality or physical condition of the caretaker in the explanation of neglect. Caretakers—in particular, mothers, who are the most likely perpetrators of neglect—may suffer from depression or have an impulsive personality in which such actions as sleeping for days or not providing meals for the child may result in child neglect. Some caretakers are apathetic and some are psychotic (Crosson-Tower 2002). A caretaker’s substance abuse or mental disadvantage may also promote neglect of the child in the household (Gaudin 1993). Finally, caretakers who themselves are physically ill may not be able to provide for the child’s basic needs; in turn, the child is neglected (McCabe 2003).
The second attempt to explain neglect focuses on the characteristics of the family and the child (Gaudin 1993). Just as the personality traits of the caretaker may be used to explain child neglect, so may the personality of the child and the characteristics of the family structure. Just as two adults may have a personality conflict, the child and his/her caretaker may also clash. In addition, children who are introverts (e.g., those who demand little attention) or who do not have the ability to request help from a caretaker (because of some physical or mental handicap) may become neglected. Children who are one of many in a family (especially if they are not the oldest or the youngest) may also be neglected, and children from single-parent homes, simply because of the limitations of time on one parent, may also be victims of neglect (Gaudin 1993). As applies to this text, children who are members of a family in which domestic violence is present may also be victims of child neglect.
The third explanation of neglect is related to environmental influences or sources of stress outside of the family. Families that are isolated from other family members or the community itself lack all outside resources when it comes to child care. In these families, the children are at high risk for neglect.
Finally, economics is another source of stress on the family (Gaudin 1993). With both parents working or, in the case of a single-parent household, with the one parent working perhaps multiple jobs, there is little time for the children. These so-called ‘‘latchkey children’’ are often victims of neglect.
It is unfortunate that neglect may result in children feeling hungry, in pain, or afraid to be alone; however, there are other consequences of neglect (both short- and long-term), of which society may not be fully aware. Often neglect manifests itself in actions other than disruptive school behavior or withdrawn personalities. Children who are neglected may suffer from sleep problems, weight loss or weight gain, and poor social relations. They may suffer from frequent illnesses or be labeled hypochondriacs (McCabe and Martin 2005). The neglected children may turn to drugs or alcohol as an escape from their situation or to promiscuous sexual behavior to gain attention. In addition, neglected children may become runaways or throwaways if their parents decide that their presence in the home is no longer convenient (Bynum and Thompson 2002).
Later in life, it is not uncommon for neglected children to become adults who are unable to relate to their own children or adult partners; thus, they continue the cycle of neglect. They may also be involved in drug or alcohol abuse, which again reduces the likelihood of their positive interactions with their families. Also, adults who were neglected as children may partake in violent activities such as crime or domestic violence.
Child neglect is not a new topic for those whose jobs place them in positions of daily contact with children; however, the problem has no simple solution. In cases of physical, sexual, or emotional abuse, interventions often focus on ending the abuse; however, neglect, because of its underlying dynamics of family structure, personalities, and environmental influences, does not equate with a simple fix.
In the United States, more child fatalities are associated with neglect than any other form of child abuse (McCabe 2003), and most efforts by law enforcement and departments of social services are focused simply upon physical neglect. Only through education and intervention may the problem of child neglect be addressed. Only through the involvement of interested parties will the problem of child neglect be solved.
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