“The Silent Epidemic” – Part 3

“The Silent Epidemic” – Childhood Trauma – Part 3: Child Neglect


Child neglect is the most common type of child maltreatment. The problem with child neglect is that it is often unreported and often not acknowledged as child abuse. Physical abuse tends to leave obvious and visible markings, while neglect are often less obvious. Having consensus on definitions are always challenging. How neglect is defined shapes our responses to it. According to Child Abuse Prevention and Treatment Act (CAPTA; 42 U.S.C.A. § 5106g), child abuse and neglect is defined as:

Any recent act or failure to act on the part of a parent or caregiver, which results in death, serious physical or emotional harm, sexual abuse or exploitation, or an act of failure to act which presents an imminent risk of serious harm.

Neglect can be classified as mild, moderate or severe, depending on the chronicity and amount of risks or actual harm. There are various types of neglect. Physical neglect involves abandonment, expulsion (e.g. banishment of children from homes), shuttling (e.g. leaving children in the custody of others for periods of time), nutritional and clothing neglect, and various other forms. Inadequate supervision is a type of neglect that involves the lack of appropriate supervision such as exposing children to hazards or leaving them in the care of inappropriate caregivers (e.g. another young child or someone with a substance abuse problem) and various other forms. Emotional neglect includes inadequate nurturing or affection, exposure of children to spousal abuse or domestic violence, permitted maladaptive behaviors such as drug or alcohol use and isolation. Educational neglect involves permitted truancy, failure of school enrolment, or the lack of provision of special education as needed. Medical neglect involves the denial and/or delay in healthcare provision. Environmental neglect involves a lack of safety, opportunities and resources in the family and neighborhood settings. Others include the exposure of newborns to drugs (DePanfilis, 2006).

The consequences of neglect often show itself in different areas. These impacts are often dependent on the age of the child, the quality of the child-caregiver relationship, the frequency, duration and severity of the neglect, the presence and strength of other protective factors. Negative impacts of neglect are also often related to the child welfare system. They include higher rates, greater number and longer placements in out-of-home care, and decreased likelihood of children residing with parents after being discharged from foster care (DePanfilis, 2006).

Impact of Neglect on Health and Physical Development

Some health and physical problems associated with neglect include malnutrition, impaired brain development and a failure to thrive. Skin infections, severe diaper rash, and recurrent and persistent minor infections can also occur. The early years are critical periods of development where neural synapses are formed at high rates. After age three, neural pathways that are not used are discarded and synapses are pruned. E.g. in cases where attachment with primary caregivers are disrupted, children may have difficulties forming healthy relationships. Learning can still occur, but becomes more challenging for children who are deprived of appropriate stimulation (DePanfilis, 2006).

Impact of Neglect on Intellectual and Cognitive Development

Neglected children are more likely to have cognitive deficits, severe academic and developmental delays. Children experience language problems when parents-caregivers do not provide necessary verbal interactions. They show greatest delays in expressive and receptive languages (DePanfilis, 2006).

Impact of Neglect on Emotional, Psychosocial and Behavioral Development

Short-term emotional impacts include fear and isolation, low self-esteem, and an inability to trust. These often carry on to form chronic emotional and psychological problems. Children’s relationships with their primary caregivers set the foundation for the way they view themselves and others. If their needs are not met or are met inconsistently, the children may start to disregard their own needs and view them as unimportant. They may learn not to trust themselves, because what the body communicates to them is unreliable. Feeling hunger and expressing the hunger, may not necessarily mean that they will be fed. If the children are exposed to homes with verbal or physical abuse, their environment and the world becomes dangerous. They may feel uncared for, unsupported and unsafe (DePanfilis, 2006).

Attachment is a major component here. Children who experience neglect have higher frequencies of insecure, anxious or avoidant attachments. Throughout the years, they are less trusting of others, and may struggle with intimacy and forming meaningful relationships. Neglected children are also at greater risks for developing conduct disorders and delinquent behaviors. Children who are neglected as a child, are at greater risks for repeating neglectful behaviors with own children. They may not perceive their upbringing to be dysfunctional, and may model their parent’s parenting behaviors (DePanfilis, 2006).


Summary of Emotional, Psychosocial and Behavioral Problems associated with Neglect

  • Poor coping skills and inability to control emotions and impulses – frequent  outbursts
  • Demonstrate helplessness when stressed
  • May present with self-abusive behaviors
  • Unusual eating/sleeping habits


  • May suffer from depression, anxiety and low self-esteem
  • Or exhibit panic, dissociative symptoms, attention-deficit-hyperactive disorder, and posttraumatic stress


  • Highly dependent
  • Appear quiet and submissive, lethargic or show apathy
  • May be less flexible, persistent and enthusiastic
  • Unresponsive to affection


  • Difficulties in school – low academic achievements and few peer interactions
  • Act socially inappropriate for age – engage in sexual activities (teen pregnancy or fatherhood)
  • Abuse alcohol or drugs
  • Exhibit juvenile delinquent behaviours OR engage in adult criminal activities




Child Abuse Prevention and Treatment Act (42 U.S.C.A. § 5106g)

DePanfilis, D. (2006). Child neglect: A guide for prevention, assessment, and intervention. Retrieved from:



Gratitude – Quek Wan Ting