Child Neglect

A child left alone in a dirty apartment
while his parent sits in a bar drinking — this is
the sort of picture “neglect” often brings to mind.
But child neglect can take many forms, some
blatant, some so subtle as to be nearly undetectable.
The American Medical Association (AMA) defines it as “an
act or failure to act that results in serious harm or
imminent risk of harm.” The AMA categorizes neglect as
one of the four major types of child abuse (along with physical abuse, sexual abuse, and emotional abuse).
Of the four types, it is also the most common. Parents
may neglect children without wishing to, as do poor
parents who don’t have the money for nourishing food.
And neglect spans class lines, as in the case of wealthy
latchkey kids with parents too busy
to provide steady love and affection.

What is neglect?

Failure to meet a child’s basic needs may take any of
the following forms:

  • Physical or medical neglect. This is the most
    common type. It includes failing to seek
    appropriate and timely medical care for your
    child, failing to provide adequate nutrition,
    abandoning your child, and leaving him
    unsupervised at too young an age.
  • Educational neglect. Allowing your child to skip
    school frequently is
    another sort of neglect. Also, if you don’t enroll
    your child in school when he’s reached the
    mandatory age, or you don’t seek special
    educational help if your child needs it, this may
    be considered neglectful.
  • Psychological or emotional neglect. Harder to
    recognize, this type occurs when, for example,
    parents withhold affection from their children or
    ignore them. Occasionally, parents withhold
    affection as a form of discipline, but when indifference and inattention
    become the norm, over an extended period of time,
    then it is considered neglect.

According to the federal government, you are also guilty
of neglect any time you hit or verbally abuse your spouse in
front of your child. Allowing your children to use drugs
and alcohol is another form of psychological neglect.

How common is neglect?

Surprisingly Statistics from the U.S.
government’s National Child Abuse and Neglect Data
System (NCANDS) show that 78 percent of the
more than 700,000 child abuse victims reported suffered
neglect by their
parents or caretakers. The same study found that 36 percent of the
1,770 child abuse-related deaths were a result of

What are some signs of child neglect?

Some varieties of neglect, such as withholding
affection, are tricky to detect, but other kinds —
particularly physical neglect — are easily noticed. The
following is a list of potential signs of neglect:

Physical signs

  • Untreated medical problems. For example, the
    child has a cut that has become badly infected
    because it was never bandaged.
  • Clothing. Signs of neglect include sending a
    child outside in a T-shirt in the middle of
    winter, or without rain gear when it’s pouring
  • Poor hygiene. A dirty face, grubby fingernails,
    strong body odor, matted hair, and chronic
    infestations of lice are all possible tip-offs.
  • Distended stomach. A characteristic of
    malnutrition and constant hunger, this is a sign
    of extreme neglect.

Behavioral Signs

  • Fatigue. Falling asleep in class and other
    symptoms of a tired and listless child can be
    signs of malnutrition or extreme stress.
  • Stealing or hoarding food. A child who steals
    food from classmates’ lunches or eats in needy
    gulps may not be getting enough nutrition at home.
  • Complaining of abandonment. If a child makes
    constant mention of being left alone at the park
    or at home, there is cause for concern.
  • Excessive absence and tardiness at school. A
    parent may be unaware that her child is skipping
    school, but truancy can also signal neglect.

Does child neglect do any long-term harm?

Yes, according to most research. A University of Albany
study found that 30.6 percent of neglected children met
diagnostic standards for lifetime post-traumatic stress
disorder. In addition, according to a study by Dr.
Jeffrey G. Johnson of Columbia University and the New
York State Psychiatric Hospital, victims of childhood
neglect (and/or physical and sexual abuse) are “four
times as likely as those who had not been abused or
neglected to have personality disorders during early
adulthood.” These personality disorders include symptoms
of depression, paranoia, passive-aggression, dependency,
and antisocial disorders.

Many neglected children never learn important basics of
healthy, trusting, and loving relationships, increasing
the likelihood that they’ll struggle with relationships
of all kinds later in life.

However, people who have suffered neglect in childhood
can recover. Individual or group psychotherapy can help
them learn how their personality has adapted and
compensated for the neglect they experienced in
childhood. With help, it’s possible for adults and
children to develop healthy relationships and successful
lives despite past traumas.

What causes parents to neglect their children?

There are many answers to this question. Statistics show
child neglect is often associated with the following
“risk” factors (listed in order of severity):

  • Poverty. Families with incomes under $15,000 a
    year are nine times as likely to experience cases
    of neglect.
  • Poor social skills and unloving relationships.
    Social work researcher Norman Polansky’s (author
    of Damaged Parents) study found that neglectful
    parents were socially deficient and had trouble
    investing themselves emotionally in relationships.
  • Substance abuse. Sadly, an alcohol or drug
    addiction can become the focus of one’s life, at
    the expense of caring for and giving attention to
    a child.
  • Depression. Psychiatric researchers have found
    that depressed mothers are more likely to be
    rejecting and indifferent toward their children,
    as well as being more likely to neglect their
    diets and leave them unsupervised.
  • A large family. The U.S. Department of Health and
    Human Services’ Study of National Incidence and
    Prevalence of Child Abuse and Neglect found that
    families with four or more children were almost
    twice as likely to be neglectful than families
    with three or fewer children.
  • Lack of support for single-parent households.
    Often, a single parent must work long hours in
    order to provide for her children, which can be a
    catch-22: While she is at a job trying to make
    money to keep her children healthy and fed, for
    example, she may be neglecting them by leaving
    them unsupervised.
  • Misconceptions about child development and lack
    of empathy. A parent who doesn’t respond correctly
    to her child’s needs often has unrealistic
    expectations for the child’s stage of development,
    possibly due to the way the parent was raised. For
    example, if you were left at home alone a lot at
    an early age and never seemed to come to any harm,
    you may be inclined to raise your child the same

How can I avoid neglecting my child?

Here are a few things that will help any parent to
provide responsibly for a child’s needs:

  • Strength in numbers. A strong support network,
    drawing on relatives, friends, and neighbors, can
    give your family the boost it needs. If you have
    to work late, or just need a night off, have a
    friend take the kids out for ice cream or to a
    movie. And don’t hesitate to call on friends for
    advice. If you’re not sure whether your child is
    ready to be left at home alone, your doctor can
    give you an opinion based on the child’s age and
    maturity level.
  • Shared responsibility. Sometimes the job of
    caring for children falls disproportionately on
    one parent — usually the mother. If you feel that
    your partner isn’t shouldering enough of the load,
    make it clear that you need to work as a team.
    Even if one partner does more of the breadwinning,
    both should take a role in childcare in order to
    run a healthy family.
  • Safeguarding against danger. Take a tour of your
    home to locate potential safety hazards. Fix the
    problem, if possible: Put rubber guards on sharp
    table corners, for example, and child safety
    latches on medicine cabinets. Make sure toxic
    cleaning products are locked up and out of reach.
    If you have a swimming pool, make sure it’s fenced
    in. Have your children take swimming lessons; a
    large number of child deaths due to neglect are a
    result of drowning in pools.
  • Community support. You can help meet the
    challenge of creating a nurturing home environment
    by tapping into programs run through local
    churches, community centers, YMCAs, and schools.
  • Childcare. If you have the money, consider a
    nanny or think about other daycare options.

What can I do to prevent someone else from neglecting a

If you think another parent is neglecting a child, you
can call the Childhelp National Child Abuse Hotline at
(800) 422-4453 (800-4-A-CHILD), for advice. If the
parent is a friend or relative, have a talk and offer
help and emotional support. If the direct approach
doesn’t work — and if you’re certain of the problem —
contact your local Child Protective Services (CPS)
agency to report it. CPS professionals will evaluate the
report and, if they deem it necessary, send someone out
to talk with the alleged neglecter. CPS will keep your
identity confidential, but you can make an anonymous
report if you prefer.

In any case, it is also important to weigh cultural
considerations before you intervene. Notions of
parenting and ideas of “the family unit” may differ
across cultures. For example, some cultures may be used
to a much larger family unit, and they may be accustomed
to sharing childcare among many family members —
grandparents, older siblings, aunts, and uncles. What
looks to you like neglect may just be a different
approach to family, and you should be sensitive to that
possibility when considering taking action.

What actions are taken in cases of confirmed neglect?

Intervention groups and services always aim to preserve
the family core, so removing the neglected child from
the home is an option authorities avoid whenever
possible. The Federal Adoption Assistance and Child
Welfare Act of 1980 inspired a national movement among
state CPS agencies to make “reasonable efforts” to solve
cases of neglect without taking a child from the
household. However, a large percentage of children in
foster care are there because of neglect. The following
are factors that CPS takes into account when deciding
whether to place a child in foster care:

  • Severity of harm or imminent danger. If the child
    is seriously ill, suffering from extreme
    malnutrition, or living in extremely dangerous
    circumstances, CPS may place him in foster care
  • Age and special needs. Most child neglect
    fatalities happen among children under 3. Also,
    children with disabilities are more likely to be
    taken into foster care.
  • Parent-child bond. CPS tries to determine the
    strength of the existing bond between parent and
    child. If a bond seems extremely weak, the child
    is more likely to be removed.
  • History of neglect. CPS is more likely to remove
    a child if the neglect is chronic rather than an
    isolated incident due to recent extreme
  • Caretaker’s motivation to improve care. Sometimes
    a parent acknowledges the situation and genuinely
    wants to reverse it, but isn’t able to take the
    proper steps. Intervention groups can be helpful
    in connecting the parent with community services
    or point her in the direction of affordable
    childcare. However, if the parent doesn’t have the
    mental or physical ability to provide adequate
    care, or has a serious drinking or drug problem,
    CPS may remove the child regardless of an apparent
    desire to change. A parent can challenge this
    decision and may be able to regain custody of her
    children, particularly if she can show she has the
    means to provide a good home for them.

Further Resources

National Child Abuse Hot Line Child Help USA
(800) 422-4453 (800-4-A-CHILD)

National Data Archive on Child Abuse and Neglect


Child Maltreatment 2009, Administration for Children and
Families, U.S. Department of Health and Human Services,

Johnson JG, et al. Associations between four types of
childhood neglect and personality disorder symptoms
during adolescence and early adulthood: findings of a
community-based longitudinal study. J Personal Disord
2000 Summer;14(2):171-87.

Widom CS. Posttraumatic stress disorder in abused and
neglected children grown up. Am J Psychiatry 1999

Child Welfare Information Gateway. What Is Child Abuse
and Neglect? 2006.

Child Welfare Information Gateway. Child Abuse and
Neglect Statistics. 2006.

US Department of Health and Human Services. Figure 4-3
maltreatment Types of Child Fatalities, 2005. March

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