Understanding the lived experiences of neglected children
Acting with urgency: responding to child neglect
No one asked me what was going on. I felt worthless and alone. Nothing was working in my life
Neglect occurs when a parent or carer fails to act and does not meet the physical and emotional needs of their child. Because neglect is an act of omission and rarely produces a crisis situation, it is difficult to identify and may be overlooked. Being neglected can have serious cumulative and long lasting impacts on the lives of children and young people.
To understand the impact of parental behaviour on children and young people, we must understand their lived experience.
If one child in the home is being neglected it is likely that all children may be affected. However, the behaviour of parents may affect individual children in the family differently based upon their age and developmental stage. Maintaining a child-centred approach to practice will help capture an understanding of how life at home may be contributing to the neglect of each individual child.
What do children say neglect looks and feels like?
What constitutes neglect is dependent upon the age and developmental stage of each child. The age of the child can also influence the willingness and capability of children to talk about and describe neglect. Older children are likely to be able to provide more detailed descriptions of neglect than those in early childhood. Where young children are being neglected, the impact of their experiences will require thorough observations of family life. What children and young people define as neglectful also depends upon how being neglected makes a young person feel and how it impacts on them.
When asked, children and young people describe neglect as the failure of parents / caregivers to:
- demonstrate love and affection
- give children time and protect them from harm
- care for their children and provide daily necessities such as adequate baths, food or clean and suitable clothing
- ensure that children attend school or receive medical care
- prepare children with essential life skills such as how to look after themselves, basic social skills, morals and manners.
Children can also describe what neglect feels like. Neglected children and young people often feel:
- fearful, sad, alone and uncared for
- unhappy or depressed. Neglected children may have low self-esteem and in some cases may self-harm or be suicidal
- socially isolated at school and in the community
- embarrassed, bullied and laughed at. They may truant and hide the signs that they are neglected so that they don’t draw attention to themselves
- blamed by others, including their parents.
Some neglected children also talk about the physical sensations related to their neglect. They may have stomach pains and headaches from constant hunger, or itchiness from skin conditions resulting from poor hygiene. Neglected infants may experience pain associated with severe nappy rash.
How do kids understand neglect?
The lives of neglected children and young people can be chaotic and disorganised. Neglect rarely occurs in isolation and commonly related issues include substance misuse, family violence and poverty. Children and young people often understand that other issues may undermine their parents’ ability to provide a safe and secure environment. However neglected children may seek help based on worry for their parents’ health and wellbeing rather than an explicit description of their own neglect.
Children may find it difficult and uncomfortable to attribute blame to their parents. Children may not view neglect as a deliberate act. For some children, their experiences of neglect may be considered normal and they may struggle to see it as a problem. If children and young people are also experiencing other forms of maltreatment, being neglected may be minimised or even ignored because they attribute the impacts to other forms of maltreatment.
When and how do children and young people talk about their experiences of neglect?
Neglected children and young people may not want to talk about their experiences and may pretend that everything is okay. They may not recognise it themselves. It may take many years before they tell anyone and they might only seek help when they feel they can no longer cope. Neglected children are more likely to talk to their friends about their concerns before approaching family members or professionals. It is often with the support of their peers that they are encouraged to confide in responsible adults.
Children and young people may subtly seek help from others. They may describe other problems or forms of maltreatment in their lives without explicitly referring to neglect. They might talk about problems with their parents (such as their parent’s mental health or substance abuse issues) but not talk about how these problems result in them being neglected. As practitioners, it is important that we pay attention to their stories and remain attuned to the possible signs that children may be being neglected.
What are the barriers to children and young people talking about neglect?
“Because all the parents might neglect you and stuff, at the end of the day you’re always going to love them no matter what they’ve done. No matter is they’ve locked you in a room for ten days by yourself and you’ve not eaten whatever, you still love them no matter what. And you still trust them because they’re yours; they’re your people” (Young participant in Haynes, 2015: 89).
There are a number of barriers and risks preventing children and young people from talking about being neglected. They may not be able or willing to talk about their experiences because of the following reasons:
- They have low self-esteem and self-efficacy and often view themselves as powerless. The experience of being neglected, of feeling unloved and uncared for may erode their capacity to recognise they need assistance or stop them from seeking help from others.
- They may have normalised their experiences of neglect and may not recognise it themselves.
- They may feel they are undeserving of support and that their situation does not warrant the attention of others.
- They may feel there is no possibility of change.
- They may think they will not be believed. In cases of chronic neglect professionals become desensitised to low levels of parental care and not ask children about or question their experiences. Children may feel disempowered because they have raised concerns in the past without seeing any change.
- Children may feel disloyal towards and/or protective of their parents, particularly when they are aware of the presence of other issues such as mental health, domestic violence or substance abuse.They may be fearful of child protection interventions and may be afraid that talking about their problems will implicate their parents.
- Neglected children and young people may have had negative experiences with child protection workers in the past and may feel they cannot trust practitioners. Children are also often concerned that telling adults about their problems will mean that they lose control over what happens to them and their siblings, or that it may make their situation worse.
These barriers may be particularly relevant in cases of chronic neglect where children have assumed responsibility for their siblings and / or may have had repeated encounters and knowledge of the child protection system.
Many of these barriers can be overcome if children have attentive, responsive and trustworthy adults who they can approach without fear. Children and young people want adults who will listen to their views, take action and keep them informed about what is happening. Relationship based practice is integral to effective work with children and young people who have been neglected.
“My mum goes out sometimes and gets back really late. Sometimes she won’t come home at all until the morning. I have to look after myself and my little sister who is only a baby. I do everything for my sister; feed her, bath her and put her to sleep. It’s been happening for a while now. I just wish she would be a mum for once” (Girl, age 12-15 in Haynes, 2015: 9).
The experience of neglected adolescents is often overlooked because they are perceived as being more capable and less vulnerable than younger children and infants. However, their experience of neglect can still be particularly harmful. Adolescent neglect has been linked to negative health and well-being outcomes. Neglected adolescents may be bullied, face increased safety risks, experience mental or emotional health problems and be more likely to run away from home, display antisocial behaviour or offend (Raws, 2016). Adolescents may have experienced neglect and other forms of maltreatment since early childhood and they may have taken on the responsibility for caring for other children in their household. The impact of chronic maltreatment and the stress of caring for their siblings leads to cumulative harm.
Despite the risk of harm facing neglected adolescents, there is often a failure to recognise and act on concerns for neglected adolescents. Research has revealed that the relationship between parental supervision and adolescent risk taking behaviour and wellbeing is not straightforward. Adolescent neglect is multifaceted and complex. It can be helpful to develop skills in recognising the signs of neglect across the different developmental stages and age groups. When practitioners recognise the signs that a young person may be neglected, casework should include working collaboratively with both the young people themselves as well as with other agencies. Casework with neglected adolescents should focus on preventing ongoing neglect occurring, whilst also supporting young people to develop and maintain resilience.
The Horwath Model
Improving outcomes for neglected children means we need to know how, when, where and why neglect is occurring for each child in the household. The Horwath model aims to help practitioners gain a better understanding of what is happening in families where neglect is an issue and what actions may lead to improved outcomes for children.
The model requires practitioners to develop an understanding of what a full day is like in the life of each and every child and carer in the family. By comparing and contrasting the information from each family member, practitioners can begin to understand why neglect is taking place, what is likely to happen if things do not change within the home, and what actions are required and appropriate to improve outcomes for the children.
Using the Horwath model to make sense of the daily lived experience
As indicated by the diagram, the model requires practitioners to talk to children and parents about what a regular day is like in their life across a 24 hour cycle. By talking to each family member and cross-referencing their experiences of the same day, practitioners are able to make the experiences of each neglected children visible and begin to understand their daily lived experience. When using the Horwath model with families, consider the following guidance:
- Children should only be asked to describe their lived experience periodically (no more than every 3 months). This will allow you to develop a picture of how things may have changed for the child but prevents family members feeling fatigued by the process.
- Family life for neglected children can be chaotic. When trying to understand their lived experience, ask open questions, do not take anything for granted and do not presume any degree of routine occurs in the household. Some examples of the sort of questions you might ask are:
Alternative open question
When do you eat dinner?
What happens in the evenings in your house?
How do you get to school?
Can you tell me what the mornings are like? What happens when you wake up?
What time do you get up in the morning?
When do you get out of bed?
- The process of talking about the daily lived experience can take a long time. Try not to let children get bored and disengaged. If you have particular areas of concern, focus on asking what is happening for the child at a particular time of the day. (i.e. if you are worried that the child isn’t going to school, you could ask, “can you tell me what happens in the mornings when you wake up?”).
- The concept of time can be abstract and easily misunderstood by younger children. When asking younger children to recall their daily lived experience, rather than asking “can you tell me about a morning last week?” you could ask “can you tell me about what happened this morning?”
- Children may be guarded about talking about their experiences. Make sure to let them tell their story at their own pace. If they are uncomfortable talking about their life at home, start by asking questions about what happens elsewhere (i.e. “can you tell me what it is like for you at school?”).
- For young, pre-verbal children you will need to rely upon your observations and the details of other family members’ lived experiences, including asking specific questions of parents or other children about their interactions with their infant or toddler.
- Use a range of age appropriate tools and techniques to prompt details about the child’s lived experience. You could try:
When talking to and thinking about neglect, consider a range of domains and be attuned to cumulative harm. What is their daily experience?
Bromfield, L. & Miller, R. (2012), p. 23
Implications for Practice
Understanding how children experience, feel and talk about their experiences of neglect is crucial for our practice. Some of the ways we can talk with children, and integrate a child’s lived experience of neglect into our assessments and case planning include:
Building relationships with children and young people who experience neglect
- Practice with neglected children is strengthened when children have an opportunity to develop a relationship with workers. Neglected children need to be able to trust workers and feel that they are able to take the time to listen, respond and act on their concerns.
- Neglected children and young people are often lonely and socially isolated. It may be particularly challenging for them to trust that you care about their situation. Take time and be patient as they build confidence in your relationship.
- It is particularly important for neglected children who feel alone and ignored to feel as if someone is listening to their concerns. Neglected children appreciate displays on kindness.
- Ask children and young people what they want and be clear about the things you can or cannot provide.
- Neglected children often feel invisible and their individual identity is regularly ignored. As you develop a relationship, try to make them feel valued. Pay attention to what they are interested in; what their experience is like at school; who their friends are?
- Recognise the role that your relationship with a neglected child can have in contributing towards their recovery. Strive to develop a relationship based on honesty and respect which encourages their self-worth. Be realistic but focus on strengths and talk about the possibility that things might get better in the future.
Recognising and talking with children and young people about their experiences
- Neglected children may need support to develop their self-esteem so that they believe other people are concerned about their welfare.
- Consider children and young people’s need to feel and be safe by informing them of what you are doing to keep them safe, keeping them in the loop and providing feedback.
- Learn to recognise the signs that a child may be neglected and try to notice when these signs are evident. Use active listening to tune into what children are saying as well as noticing their non-verbal communication.
- Neglected children may feel uncomfortable by people paying attention to them and may be reluctant to engage. Try and make them feel at ease and let them know it is safe to open up. Use reflective language and clarify meaning during conversations to help children and young people take the lead and feel reassured that you understand what they are telling you.
- Children and young people don’t need to understand they are being neglected. When children give examples that indicate that they are being neglected, tell them clearly what your specific concerns are. (i.e. that you are concerned that they are left at home, unsupervised overnight).
- Neglect often co-occurs with other forms of neglect. Children may talk about other forms of harm but may not mention neglect. It is important to reassure children that you are concerned about all of their experiences.
- Children may not be aware of exactly what they are missing. They may feel unloved but not have any real understanding of what safe family relationships look like. Practitioners must engage sensitively to identify what their experiences have been and what they may have missed out on.
- What children identify as problems may not match professional definitions of neglect. Some childrens’ experiences of neglect are therefore likely to be overlooked. When assessing whether a child has been neglected, listen to the child’s perspective and focus on how their parents’ behaviour impacts upon them.
- A child’s demeanour when talking about neglect is not necessarily an indicator of the severity of their experience. Some young people may feel ambivalent about their experience and will need support to understand and process their emotions.
Involving children and young people in decision-making processes
- Children are experts in their own lives. Talk to them about their lives and listen to their opinions about how things need to change.
- Recognise that children are impacted by the experience of neglect differently and each child in the home is likely to have unique perspectives. Make the time to talk to each child separately and do not assume that they will have shared experiences.
- We need to talk to the child and their parent about what they think needs to change in order to improve the child’s outcomes. When we understand how a child experiences neglect our assessment should focus on the parental behaviours that causes this harm.
- Invite children and young people to any meetings in which decisions about their lives are being made such as case plan or care plan meetings. Neglected children may not attend because they feel afraid or embarrassed about their situation. If they do not attend, ask them if there is anything you can do to make it easier for them to attend next time, or what they would like you to say on their behalf.
- If time or locational barriers are restricting your contact with children, talk to them about alternative communication methods they may be comfortable with in between face to face contact. Try using a weekly text message or phone call to check in with each other if they have access to electronic media.
- Acknowledge that neglected children may be embarrassed and try to hide the signs they are neglected from others. Consider how to be discrete in assessments with neglected children, particularly if these must take place at school.
To learn more working with children and young people who are neglected watch Emeritus Professor Jan Horwath’s presentation at the Research to Practice seminar.
Bromfield, L. & Miller, R. (2012) Cumulative harm. Best interests case practice model. Specialist practice resource. Victorian Government Department of Human Services, Melbourne, Australia.
Haynes, A. (2015) Realising the potential. Tackling child neglect in universal services. National Society for the Prevention of Cruelty to Children, United Kingdom. Retrieved from: https://www.nspcc.org.uk/globalassets/documents/research-reports/realising-potential-tackling-neglect-universal-services-report.pdf
Hicks, L. & Stein, M. (2010) Neglect Matters. A multi-agency guide for professionals working together on behalf of teenagers. Department for children, schools and families, United Kingdom.
Horwath, J. (2017) Under the microscope: the lived experience of neglectful families. Video recording presented at FACS Research to Practice seminar – Act with urgency: responding to neglect. Sydney, 9 May 2017.
Raws, P. (2016) Understanding Adolescent Neglect: Troubled Teens. A study of the links between parenting and adolescent neglect. The Children’s Society, United Kingdom.