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Child neglect is defined as any egregious act or omission by a parent or other caregiver that deprives a child of basic age-appropriate needs and thereby results, or has reasonable potential to result, in physical or psychological harm. Younger children are neglected most, and more girls suffer from neglect than boys.

Child neglect can encompass abandonment; lack of appropriate supervision; failure to attend to necessary emotional or psychological needs; and failure to provide necessary education, medical care, nourishment, shelter, and/or clothing. Neglect is usually typified by an ongoing pattern of inadequate care that may be readily observed by individuals in close contact with a child. School personnel, for example, may detect indicators of neglect such as poor hygiene, low weight gain, inadequate medical care, or frequent absences.

According to the U.S. Department of Health and Human Services, reported rates of neglect in the U.S. tend to be higher than those for other types of child maltreatment. In 2019, reports indicated that there were at least 656,000 maltreated children in the U.S. Of those, 61 percent were solely victims of neglect, compared to 10.3 percent and 7.2 percent who were solely victims of physical abuse and sexual abuse, respectively. Sadly, more than 15 percent of maltreated children suffer from more than one type of maltreatment.

Nationally, the total number of victims of child maltreatment has been on a downward trend, decreasing 4 percent from 2015 to 2019. However, data suggests that within that group, the rate of neglect may be increasing; among all maltreated children, the proportion with reported neglect increased from 49 percent in 1990 to 75 percent in 2016.

Because of these trends, many advocates believe neglect merits more attention from researchers, legislators, and clinicians. However, because it is an act of omission rather than an overt act of violence or harm, neglect may at times be more difficult to identify than physical or sexual abuse.

Symptoms

A number of neglected children present as suffering from medical conditions, failure to thrive, or malnutrition, which in severe cases can be life-threatening. Observable signs of neglect on the child’s person may include:

  • dirty skin
  • offensive body odor
  • unwashed, uncombed hair
  • undersized, oversized, or unclean clothing
  • clothing inappropriate for the weather
  • frequent lack of supervision

School personnel may be well-poised to spot neglect and are advised to consider the possibility when a child:

  • is frequently absent
  • steals or begs for food or money
  • appears to lack needed medical or dental care, immunizations, or glasses
  • is consistently dirty and has severe body odor
  • appears to lack sufficient clothing for the weather
  • abuses alcohol or other drugs
  • states that there is no one at home to provide care

Neglect may also be considered when a parent or caregiver presents as:

  • indifferent to the child
  • apathetic or depressed
  • irrational
  • abusing alcohol or other drugs

There are several types of neglect. Physical neglect is a broad category that includes the refusal to seek necessary medical care; child abandonment, or the desertion of a child without arranging for care or supervision; inadequate supervision; the expulsion of a child from the home; and failing to provide for a child's safety or physical needs. Other forms of physical neglect include inadequate nutrition, clothing, or hygiene; conspicuous inattention to avoidable hazards in the home; and reckless disregard of a child's safety and welfare, such as driving with a child while intoxicated or leaving a young child in a car unattended.

Educational neglect occurs when a child is allowed to engage in chronic truancy or is of mandatory school age but does not receive schooling; the refusal to obtain or allow recommended remedial education services; or the refusal to follow through with treatment for a diagnosed learning disorder or other special education needs without reasonable cause.

Emotional neglect includes inadequate nurturing and affection; spousal abuse in a child's presence; allowing a child to use drugs or alcohol; the refusal, or delay in providing, needed psychological care; and encouraging or allowing maladaptive behavior such as chronic delinquency or assault. Because emotional neglect may not manifest as physical signs like dirty clothes or frequent absences, it may be difficult for outside parties to identify.

Medical neglect is the failure to provide for the appropriate health care of a child. Such a child may exhibit signs of poor health such as fatigue, infected cuts, and constant itching or scratching of the skin.

What is the most common type of child maltreatment?

Neglect is the most common form of child maltreatment. In the U.S., nearly ⅔ of maltreated children are victims of neglect alone.

What are the long-term consequences of child neglect?

Research finds that neglected children are more likely than their peers to experience behavior problems, develop psychiatric disorders and/or engage in substance abuse, or display emotional challenges, such as difficulties connecting with or trusting others. Children who are physically neglected—failing to receive adequate food or medical care, for example—may suffer from developmental problems or other long-term health issues as a result. Children who are neglected in the earliest years of their lives tend to experience more long-term problems than do older children in similar straits. 

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Causes

Some parents, sadly, neglect their children simply because they are disinterested or uncaring. But many parents who neglect children do not do so intentionally. Researchers suggest that neglectful parenting may emerge from a caregiver's own developmental history or psychological well-being, the adult's limited coping strategies or resources, or the particular characteristics or dynamics of a family.

Many neglectful parents, for example, were themselves neglected or abused as children, and may thus consider their parenting approach to be normal or expected. Very young or inexperienced parents, on the other hand, might not fully understand how to care for a baby or what can reasonably be expected of children at different stages of development. Circumstances that place families under extraordinary stress, such as poverty, divorce, sickness, or disability, sometimes result in the neglect or mistreatment of children. And parents who abuse alcohol or other drugs, or who struggle with other mental health disorders, may be more likely to abuse or neglect their children.

Can parental mental health disorders increase the risk of child neglect?

Research suggests that parents with mental illnesses are more likely than other parents to abuse or neglect their children. Seriously depressed parents, for example, may struggle to meet a child’s needs in addition to their own, while parents with antisocial personality disorder may neglect a child out of indifference or cruelty. Substance use disorder in parents also greatly increases the risk of child neglect, along with other types of child mistreatment such as sexual abuse.

Can child neglect lead to PTSD?

Being neglected as a child can indeed be traumatic, and evidence suggests that it can trigger post-traumatic stress in some cases. Some also argue that since neglect tends to be ongoing, rather than a singular incident, it may result in complex PTSD (cPTSD), a condition similar to both PTSD and borderline personality disorder that can manifest as symptoms like hypervigilance, feelings of helplessness, and interpersonal difficulties stemming from insecure attachment.

Treatment

Understanding and addressing neglect requires an awareness of complex, interrelated social problems, including but not limited to poverty, substance abuse, and domestic violence. Interventions to treat children and families affected by neglect require thorough assessments and customized treatment. Parent education classes, substance-abuse treatment programs, respite care services, community center outreach, and informed policies from government agencies may help to protect children by addressing the circumstances that place families at higher risk for abuse and neglect.

Can therapy help neglected children?

Yes. Psychotherapy can help neglected children—as well as adults who were neglected as children—come to terms with what happened, cope with difficult feelings, and learn to trust others again. In some cases, and especially in cases where both neglect and abuse occurred, trauma-informed therapy may be most appropriate. For neglected children and teens, some studies have found group therapy to be particularly effective, if it is available nearby. In cases where the neglectful parent will remain in the child’s life and is open to changing their behavior, family therapy can help address dysfunctional dynamics and help parents learn the skills necessary to meet their child’s needs.

I suspect child neglect. What should I do?

In the U.S., anyone who suspects that a child they know is being neglected can call or text the National Child Abuse Hotline at 1 (800) 422-4453. They can also contact their state’s child welfare agency, which can be found here. Individuals in other countries who suspect neglect may be able to reach out to similar resources in their country, most of which are discoverable via an internet search.

References
National Institutes of Health—National Library of Medicine
U.S. Department of Health and Human Services: Administration for Children and Families and Office of Child Abuse and Neglect.
Acts of Omission: An Overview of Child Neglect, by The United States Children's Bureau
Last updated: 12/06/2021