The impact of child neglect

Acting with urgency: responding to child neglect


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Neglect can have serious and long lasting impacts across a child’s physical, emotional, social wellbeing across their lifespan. It is also important to recognise that neglect can be fatal. 

Children’s experiences of neglect are diverse. The impact of neglect differs depending upon the neglect sub-types including physical, emotional, supervisory, educational and medical neglect. There is growing evidence that the damaging effects of neglect are at least as harmful if not worse than other forms of maltreatment, including physical and sexual abuse. Research suggests that the chronicity, severity, frequency and duration of neglect play a role in the impacts experienced. 

“Of all forms of maltreatment, neglect leads to some of the most profound negative long-term effects on brain and other physical development, behaviour, educational achievement and emotional wellbeing”

The implications of neglect for children are often minimised. The signs and symptoms of harm may not be obvious at the time the child is in contact with the child protection system, but may become apparent later in adolescence or adulthood. It is often over time that the risk of harm to a child/young person becomes significant harm due to the cumulative nature of neglect. This differs from other forms of maltreatment, like physical or sexual abuse, which are often incident based and have more explicit signs of impact. 

To identify the needs of a child or young person the impact of neglect needs to be assessed in relation to developmental stage. While there is some evidence to suggest that it is more detrimental for infants and children to experience neglect earlier in life, the negative consequences of neglect must also be recognised for adolescents. Although there is sometimes a perception that adolescents are more resilient than younger children, research shows that neglect is related to poor mental and emotional wellbeing including internalising and externalising behaviours, decreased safety for example due to engagement in risk taking behaviours, poor relationships and being bullied, running away from home, educational problems including poor school engagement and anti-social behaviours and delinquency or offending amongst adolescents. In addition, in the UK teenagers have been found to have a high level of representation amongst serious case reviews of situations that have tragically resulted in serious harm or death.

“Neglect with the most serious outcomes is not confined to the youngest children, and occurs across all ages”

The impact of neglect on behaviour, mental health and wellbeing

The impact of neglect on relational and social outcomes

The impact of neglect on physical health outcomes

The impact of neglect on learning and development outcomes


Implications for practice

Behaviour, mental health and wellbeing

  • It is important for practitioners to have a good understanding of the serious short and long term impacts of neglect for children and young people. It can be as harmful as other forms of abuse. 
  • Neglect is often chronic and cumulative, and practitioners need to be aware that the impact of neglect is often worsened by other co-occurring forms of maltreatment. If other forms of abuse are present it is important to explore how this may impact on the provision of a child’s physical and emotional needs.
  • When assessing potential impacts of neglect, it is important to consider the unique experience of each child/young person and the pattern of neglect over time, including: 
  • What are the sub-types of neglect that the child is experiencing?
  • Are there other co-occurring maltreatment types, such as physical or emotional abuse?
  • What is the chronicity, severity, frequency and duration of the neglect?
  • What developmental stages has the neglect occurred within and across over time? 
  • Children/young people who have experienced neglect may display behavioural difficulties. Staff need to understand this relationship in order to develop an appropriate support plan for the child/young person.
  • Early intervention to improve behavioural and mental health outcomes is required to prevent and reduce the impacts of neglect on a child/young person’s wellbeing. In particular, strategies to support a child/young person to learn emotional regulation skills and healthy ways of coping are required.
  • Referrals to specialist mental health interventions, including assessments and treatment, may be required.

Relationships

  • It is important to understand the lifelong implications of poor attachment in childhood, and the critical need to support improved parent-child interactions. For more information about attachment please see previous attachment practice notes : http://caseworkpractice.intranet.facs.nsw.gov.au/supporting-practice/seminars-and-conferences/research-to-practice/understanding-attachment 
  • A mother and father’s childhood parenting experiences should be considered when assessing the child-parent relationship and child’s difficulties. 
  • Children who have experienced neglect may benefit from interventions to improve their social skills.
  • Interventions may also be necessary for children exposed to harsh or neglectful parenting in order to prevent or reduce peer victimisation.
  • There is a need for early and effective intervention with children/young people to reduce the risk of later aggression, anti-social behaviour and delinquency.
  • Interventions for neglected children and young people are needed to improve their emotional processing, and must consider the role of IQ. Practitioners should support both caregivers and children to learn how to identify and name their own emotions, and to read the emotions of others. 
  • Interventions for a lack of emotional awareness and expression may improve social outcomes and may also alleviate child internalising problems. 

Physical health

  • Children who experience maltreatment and neglect should be considered at risk of poor physical health outcomes across the lifespan. 
  • It is important to understand that neglected children may experience poor physical health in adulthood and that early intervention is essential. 
  • The negative impacts of child neglect on brain development and neurobiological abnormalities need to be acknowledged. For more information about trauma including neglect please see previous practice notes: http://caseworkpractice.intranet.facs.nsw.gov.au/supporting-practice/seminars-and-conferences/research-to-practice/brainstorm-helpling-to-heal-childhood-trauma 
  • Nutritional support to mothers (including breastfeeding and smoking cessation) may support normal growth and child development in neglected children/young people.
  • Practitioners need to recognise that neglected young people are at increased risk of substance abuse, risky sexual behaviours and getting STD’s, and provide them with education and support. 
  • Given the risks, child protection workers should also make appropriate referrals and collaborate with Health professionals.

Learning and development

  • The seriousness of the impact of neglect on child learning and development must be recognised. The links between language development, social inclusion, subsequent academic performance, and participation in society as adults strongly supports the need for an early response.
  • The impacts of neglect on a child and their developmental risk will vary according to their unique experience, including the presence of different maltreatment and neglect sub-types.
  • The negative impact of neglect on school outcomes demonstrates the need for quality early intervention and prevention support, which may include quality child care and other primary services.
  • It is important for staff to better detect child language and development problems and develop strategies to improve child educational outcomes. 
  • Improving the quality of the parent-child relationship is only one type of intervention. Children experiencing neglect should be referred to services to provide universal and targeted interventions for their cognitive and linguistic development in order to reduce developmental risk and difficulties. 
  • Some children may need targeted support and specialist services, for example speech and language pathology. 
  • It is critical that child protection workers collaborate with the Education system to improve the lifelong outcomes for children/young people who have been neglected.

References 

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. 

Raws, P. (2016) Understanding Adolescent Neglect: Troubled Teens. A study of the links between parenting and adolescent neglect. The Children’s Society, United Kingdom.