Conceptualising and defining neglect

Acting with urgency: responding to child neglect


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Neglect is simultaneously simple and complex. When seen from the perspective of the child, neglect is quite simply the experience of needs not being met, and for some children this simple fact can lead directly, or indirectly, to their deaths

Neglect is a broad term encompassing a number of maltreatment types that result in a child or young person experiencing deprivation. While child abuse typically involves acts of commission, child neglect involves acts of omission. This includes a lack of care to provide for a child or young person’s basic physical, emotional or educational needs, and failure to protect them from harm. Neglect can broadly be defined as:

the absence of sufficient attention, responsiveness, and protection appropriate to the age and needs of a child

Neglect can also be considered in relation to a child’s rights under the United Nations Convention on the Rights of the Child, including the right to: not be subject to inhuman or degrading treatment (Article 19), good quality health care, clean water, nutritious food and clean environment (Article 24), a standard of living that is good enough to meet their physical and mental needs (Article 28), and to relax, play and join in on a range of activities (Article 31). 

One should not get hung up on the definition of child neglect but rather get on with helping these children, who are being cared for in a manner far below our society’s acceptable standards

Prevalence of neglect 

It is widely recognised that neglect is the most common form of child maltreatment in the Western world. The estimated prevalence of child neglect in Australia is 2.4% overall (0.1-6.6%), and 2% (0.6-4.1%) for males and 3.5% (0-13%) for females. Research suggests that neglect is the second most common form of substantiated maltreatment in Australia, following emotional abuse. Interestingly, some research suggests that the prevalence of child neglect is higher when children and young people are asked to report on their own experiences. 

Co-occurrence of neglect with other maltreatment types 

Children who experience neglect also frequently experience other maltreatment types. In Australia, neglect has been found to co-occur with at least one other maltreatment type in 73.6% of cases. Neglect most commonly co-occurs with emotional and physical abuse.

Cumulative harm

Cumulative harm is particularly relevant to child neglect, due to the often chronic nature of neglect and its frequent co-occurrence with other forms of maltreatment. Neglect has the most damaging impacts for a child or young person when it continues across developmental stages, with harm accumulating over time. An episodic or incident based assessment of neglect may mean that cases fail to reach the threshold for statutory intervention. However, when the long-term impacts are taken into account it becomes evident that frequent and/or persistent low severity maltreatment can result in significant harm.

Types of neglect

There are five widely recognised domains or sub-types of child neglect, as outlined below.  

A note on emotional neglect

Making the distinction between emotional neglect and emotional abuse can be challenging due to the interaction between acts of omission (emotional neglect) and commission (emotional abuse) in parent-child interactions. The term ‘emotional maltreatment’ has been used to capture both of these behaviours. Emotional neglect can be more challenging to assess in comparison to other forms of neglect, however the research indicates that it may have more severe and ongoing consequences than physical neglect.

Dimensions for conceptualising neglect 

Child neglect should be considered along a continuum in order to understand the form and pattern of neglect that is occurring. 

The chronicity of neglect 

Most children experience neglect as repeated and persistent events as opposed to a single acute episode. The following dimensions are important to consider when assessing the chronicity of the neglect.

Situational or enduring neglect 

Neglect may be situational or enduring. Neglect is situational when it is likely to have a short duration (e.g. when a mother is hospitalised and an under-involved father takes on caring duties) and it is enduring when it is likely to be an ongoing situation (e.g. when caregiver(s) lack parenting knowledge and skills and themselves have experienced trauma). 

Thresholds for neglect

Neglect sits on a continuum from developmentally appropriate through to neglectful caregiver behaviours, and practitioners need to “be able to differentiate between what is unacceptable rather than simply undesirable”. Neglectful behaviours change with the needs of the child according to their developmental stage (e.g. it is essential to supervise a 6 month old to bathe, but in most instances not a 16 year old). 

Neglect is a particularly challenging concept due to difficulties in definition, seemingly moveable thresholds for intervention and uncertainty about when a line has been crossed

Conceptualising neglect through a socio-ecological framework

Child neglect is best understood through a socio-ecological framework. This shifts the focus away from concentrating on parental characteristics to a recognition of parental and family functioning, extended family and peer groups, the community within which the family live and the wider social environment including the media, the law or belief systems.

Neglect and culture

It is important to consider the differences that exist across cultures in terms of parenting practices and expectations about adequate parental care. For example, supervisory practices of parents in collectivist cultures may be different to those in non-collectivist cultures. However, it is also important to note that children’s basic development needs are common across cultures. Differing parenting practices just mean that these needs are being provided for differently. Dependent on the family context, different child rearing practices may or may not need to change in order to secure the child's safety from harm (e.g. practitioners may assess an Aboriginal child as having an avoidant attachment because they do not express negative emotion; while in some Aboriginal cultures this expression may be seen as disrespectful of elders and discouraged). 

It is critical that practitioners are aware of the many historical factors that impact on Aboriginal and Torres Strait Islander families and their parenting, including intergenerational trauma, fractured families due to past policies and actions, the impact of poverty, poor access to culturally safe services, and the presence of domestic violence and drug and alcohol abuse. Similarly, practitioners need to be alert to the impacts of migration and settlement, inaccessibility of services, periods of time spent in refugee camps, poverty and language barriers on Culturally and Linguistically Diverse families and their parenting. 

Practitioners need to be culturally sensitive when they are assessing whether a child is being neglected, and consider the families’ background and context. However, cultural understanding should not prevent practitioners from acting to ensure a child is receiving the care and protection they require. 

Neglect and gendered parenting roles

Neglect is largely a parental issue or responsibility. However because mothers are most commonly the ‘primary caregivers’ in society, they are more likely to have duty of care for the child. As such mothers are more likely to be held responsible for child neglect and failing to provide adequate care than fathers. 

Solely holding mothers accountable for neglect, especially in two parent households, may represent ‘mother blaming’. Practitioners need to be aware of the parental obligations and duty of care of both caregivers. 

Neglect and poverty

Poverty and child neglect have been found to be linked, with the majority of families experiencing neglect falling under the poverty line in the United States and the United Kingdom. This link is particularly strong for physical neglect which is characterised by a lack of basic needs being met, including housing, clothing and food. However, it is not yet clear whether poverty is a cause or consequence of child neglect. It is important to note that the majority of caregivers experiencing poverty do not neglect their children, and that families experiencing poverty are more likely to be identified by the child protection system. Similarly, wealthier families may not come to the attention of the child protection system because physical and supervisory neglect may be hidden by their access to resources, and emotional neglect is unlikely to be detected. 

As per the socio-ecological framework, it is important that the broader context of neglect is understood including social justice considerations and inequity due to poverty, class, gender or race. Without these issues, interventions focussing on the parent and child may be limited in their effectiveness because the factors underlying the neglect may remain unaddressed. In cases of child neglect practitioners will need to advocate on behalf of the family for access to services and support. 

Caution needs to be applied by social workers that they do not suggest there is neglect where there is only poverty, nor should they ignore neglect by attributing this behaviour to poverty

Implications for Practice

  • Neglect involves acts of omission. This means that practitioners need to be aware of what is missing or lacking for a child or young person in order to identify and substantiate neglect.
  • Although intent to harm is not a requirement for neglect, it is important for practitioners to understand the knowledge and intent of the caregiver(s). This information will help inform a hypothesis about the causes of the neglect, and the selection of appropriate interventions. 
  • Neglect is developmentally defined. Allegations of neglect should be considered in relation to the developmental stage of the child/young person to assess whether their needs are being met.
  • Neglect refers to a broad range of caregiver behaviours resulting in a child or young person experiencing deprivation. Practitioners need to look for the presence of a range of neglect sub-types, because some types of neglect may be more obvious than others. 
  • Emotional neglect can be difficult to identify and as such is often missed in practice. Due to the devastating impact of emotional neglect on a child/young person, practitioners need to be alert to the presence of emotional neglect. It is also important to be aware of the potential for children and young people in residential care to experience emotional neglect. 
  • Neglect should be assessed across a range of dimensions, including the chronicity and severity of the neglect, in order to understand the severity of the neglect and its likely impacts. Practitioners should also consider the frequency and duration of the neglect and the stages of development over which the neglect has occurred.
  • As cumulative harm is particularly relevant to child neglect, practitioners need to move beyond an episodic or incident based assessment of harm to consider the daily lived experience of the child in relation to their developmental stage. Without this, neglect cases may fail to reach the statutory threshold for intervention despite the known devastating impacts of neglect over time.
  • Child neglect is best understood within a socio-ecological framework in recognition of the role of the child, parental characteristics, family functioning and broader community and context play in driving neglect.
  • Cultural sensitivity and respectful practice is required when working with children and families from different cultural backgrounds. Practitioners must be respectful of different parenting practices across cultures, while still assessing the situation in relation to the child and their developmental needs. Practitioners should not prioritise culture over safety from harm. 
  • It is important that caregivers in addition to mothers are seen to have an obligation to provide care for a child, including fathers, biological parents, step parents, foster parents, etc. Holding mothers solely accountable may constitute ‘mother blaming’.
  • While there is a strong interaction between poverty and neglect, not all caregiver(s) experiencing poverty are neglectful. Advocacy for families will be an important part of responding to child neglect.  

References 

Bromfield, L., Lamont, A., Parker, R., & Horsfall, B. (2010). Issues for the safety and wellbeing of children in families with multiple and complex problems: The co-occurrence of domestic violence, parental substance misuse, and mental health problems. NCPC issues paper no. 33. Australian Institute of Family Studies. Retrieved from https://aifs.gov.au/cfca/publications/issues-safety-and-wellbeing-children-families

Daniel, B. (2015). Why have we made neglect so complicated? Taking a fresh look at noticing and helping the neglected child, Child Abuse Review, 24, 82-94. 

Department of Families, Housing, Community Services and Indigenous Affairs. (2011). An outline of national standards for out-of-home care. Canberra: Commonwealth of Australia.

Government of Western Australia Department for Child Protection. (2008). Background paper: Understanding neglect. Retrieved from http://www.nt.gov.au/dcm/inquirysaac/pdf/bipacsa_final_report.pdf 

Long, T., Murphy, M., Fallon, D., Livesly, J., Devitt, P., McLoughlin, M. & Cavanagh, A. (2014). Four-year longitudinal impact evaluation of the Action for Children UK Neglect Project: Outcomes for the children, families, Action for Children, and the UK, Child Abuse & Neglect, 38, 1358-1368. 

Moore, S. E., Scott, J. G., Ferrari, A. J., Mills, R., Dunne, M. P., Erskine, H. E., … Norman, R. E. (2015). Burden attributable to child maltreatment in Australia. Child Abuse & Neglect, 48, 208-220. doi:10.1016/j.chiabu.2015.05.006 

National Scientific Council on the Developing Child. (2012). The science of neglect: The persistent absence of responsive care disrupts the developing brain: Working paper 12. Retrieved from http://www.developingchild.harvard.edu

Scott, D. (2014). Understanding child neglect. CFCA Paper no. 20. Melbourne, VIC: Australian Institute of Family Studies.