What is neglect?

Neglect is the ongoing failure to meet a child’s basic needs and the most common form of child abuse2. A child might be left hungry or dirty, or without proper clothing, shelter, supervision or health care. This can put children and young people in danger. And it can also have long term effects on their physical and mental wellbeing.

Consequences of Neglect according to Short and Long Terms Effects:

  1. Short term effects:
    1. Aggression
    2. Withdrawal and social isolation
    3. Poor physical health, increased in incidences of poor health and infection which could lead to absences from school/nursey.
    4. Child appears hungry, or tired
    5. Cognitive difficulties : language delay, poor intellectual ability to concentrate or express feelings
    6. Does not seek emotional support from adults
  2. Long term effects:
    1. Increased risk of mental health conditions, like anxiety depression eating disorders, self- harm, post-traumatic stress disorder PTSD)
    2. Increased likelihood of substance misuse
    3. Poor physical health, like obesity, aches and pains
    4. Difficulties maintaining relationships
    5. Learning difficulties, low educational attainment and difficulties in communicating
    6. Engagement with antisocial behaviour and crime.

Types of neglect

Neglect can be a lot of different things, which can make it hard to spot. But broadly speaking, there are 4 types of neglect.

  • Physical neglect
    A child’s basic needs, such as food, clothing or shelter, are not met or they aren’t properly supervised or kept safe.
  • Educational neglect. It is a different form of neglect. 
  • IT occurs when a parent or carer wilfully refuses to support or engage with a child’s education, despite request to do so. This results in the harming of the child’s education development.  Education neglect may occur alongside other indicators of neglect, such as inappropriate clothing for the weather, poor hygiene, uncharacteristic tiredness and coming to school hungry.
    A parent doesn’t ensure their child is given an education.
  • Emotional neglect
    A child doesn’t get the nurture and stimulation they need. This could be through ignoring, humiliating, intimidating or isolating them.
  • Medical neglect
    A child isn’t given proper health care. This includes dental care and refusing or ignoring medical recommendations.
  • Normalising Neglect :  be alert that your tolerance level do not drop when regularly working with families vith very low living standards.
    • If you come into contact with families who fall below normally accepted living standards on a regular basis, you need to be aware of the possibility that your own tolerance levels can subconsciously drop towards the levels you witness.  You must avoid this situation at all cost.

Child Poverty.  There have been many studies conducted to examine the impart of child Poverty.

  • Children living in large families are more likely to experience poverty. Child poverty is significant even children belonging to working families live in poverty.
  • Children are more likely to be cold, hungry and isolated
  • More likely to live in poor housing, increasing risk of poor health
  • Parents at increased risk of poor mental health, making emotional neglect more likely
  • May have to move more because of repeart housing evictions, causing emotional unrest. (Study of Rowntree Foundation, 2016)

Assumptions : Although poverty increases the risk of child neglect, practitioners should be careful not to assume a hild is experiencing neglect because they are living in poverty.   (Conditions for neglect are complex and cannot be attributed to one set of social circumstances, NSPCC, 2019).

Signs of neglect

Neglect can be really difficult to spot. Having one of the signs doesn’t necessarily mean a child is being neglected. But if you notice multiple signs that last for a while, they might show there’s a serious problem. Children and young people who are neglected might have:

    • being smelly or dirty
    • being hungry or not given money for food
    • having unwashed clothes
    • having the wrong clothing, such as no warm clothes in winter
    • having frequent and untreated nappy rash in infants.
    • anaemia
    • body issues, such as poor muscle tone or prominent joints
    • medical or dental issues
    • missed medical appointments, such as for vaccinations
    • not given the correct medicines
    • poor language or social skills
    • regular illness or infections
    • repeated accidental injuries, often caused by lack of supervision
    • skin issues, such as sores, rashes, flea bites, scabies or ringworm
    • thin or swollen tummy
    • tiredness
    • untreated injuries
    • weight or growth issues.

 

  • change in behaviour   
    • becoming clingy
    • becoming aggressive
    • being withdrawn, depressed or anxious
    • changes in eating habits
    • displaying obsessive behaviour
    • finding it hard to concentrate or take part in activities
    • missing school
    • showing signs of self-harm
    • using drugs or alcohol.

Spotting signs of Neglect

  • Food: Lack of appropriate food can lead to a failure to thrive, children stealing food or even raiding bins, to name a few examples.
    • Food should be wholesome, age-appropriate and sufficient for the child, an example of inappropriate feeding is prop-feeding a baby.
  • Shelter and clothing : The child may have torn clothing, poor hygiene and appear underweight.
    • Questions : is shelter adequate? ( For example , a hole in the child’s bedroom window would require attention).
    • If the child left wandering the streets inappropriately? Is the child warm enough?
    • Is clothing appropriate? For example, wearing thin clothes and no socks in winter would be inappropriate.
  • Protection: A child particular a young child must be kept safe inside and outside the home. Be aware of potential hazards both inside and outside the home.
    • The suitability of carers is sometimes a matter of concern, particularly if the carer is very young or when a young person comes along with a recently acquired boyfriend or girlfriend who you, and the child’s parents, know little about it.
    • If you are ever concerned about a carer or their friends, refer immediately to your line manager.

Health Care: Lack of appropriate health care as a child can lead to ongoing health problems throughout their life.   A question you should ask is “does the child have access to health services, such as A GP and hospitals services are used appropriately?

Hygiene :  Lack appropriate Hygiene  can lead to baby nappy rash, social exclusion and , particularly for older children, lack of self –esteem. 

  • Hygiene is very subjective, as each of us will tolerate different levels of dirtiness’/ The benchmark we should use in relation to hygiene should be ‘ is the hygiene good enough?’
  • Whilst people may be in poor surroundings and cleanliness may be difficult, most carers will do their best to ensure good hygiene. You need to assess whether the hygiene is adequate.
  • Being dirty does not mean a child has been neglected, although extreme dirtiness may lead to a child being ostracised and will, if nothing else, psychologically affect the child.

Comfort and Stimulation

Every child needs age –appropriate warmth and comfort.  Comfort should be received though their interaction with others.

A Comfortable environment and appropriate interaction, including simple toys, or age-appropriate conversation with others, will stimulate the child’s imagination.

You will need to note any signs that strike you as worrying and for to your line manager for guidance.

Interaction: The way the child interacts with a parent or carer can signal the possibility of insecure attachment, possibly resulting from some form of neglect or abuse.  Verbal interaction and eye contact are key activities.

A child will learn and be stimulated by verbal communication from a car.

  • Is there spontaneity between the carer and children?
  • Does interaction appear rehearsed?
  • Do children remain silent whenever the carer is present?
  • Are children left in front of a television without any interaction from a carer?
  • Do children appear to think before doing anything? • Do children appear wary of the carer?
  • Are children ignored or are they encouraged to make conversation?
  • Are children shouted at and handled roughly by the carer?

ControlChildren do need to recognise reasonable, consistent and appropriate boundaries.

  • Boundariesare important part of socialisation. Children need to know their boundaries.
  • Appropriatenesspunishment meeds to be appropriate. It should suit the crime’ you need to be alert to a punishment that is excessive and become unacceptable.
  • Consistencya child must know what the consequences are if they misbehave. Misbehaviour must not be challenged on one occasion and allowed to go unchecked on the next.

When can neglect start? It can start even as early as pregnancy.

  1. Mothers substance misuse
  2. Mother’s malnutrition;
  3. Mother not acknowledging the pregnancy
  4. Failure to attend healthcare appointments to monitor the mother’s health and that of her unborn baby.

How Neglect Can affect the life of Children?

A case Reviews finding shows that:

  • Neglect is much more prevalent in serious case reviews than had previously been understood (neglect was present in 60% of the 139 reviews from 2009-2011)
  • Neglect can be life threatening and needs to be treated with as much urgency as other categories of maltreatment
  • Neglect with the most serious outcomes is not confined to the youngest children, and occurs across all ages
  • The possibility that in a very small minority of cases neglect will be fatal, or cause grave harm, should be part of a practitioner’s mind-set. Practitioners, managers, policy makers and decision makers should be discouraged from minimising or downgrading the harm that can come from neglect and discouraged from allowing neglect cases to drift
  • The key aim for the practitioner working with neglect is to ensure a healthy living environment and healthy relationships for children.

Practitioners need to be supported by a system that allows them to make good relationships with children and parents and supports them in managing the risks of harm that stem from maltreatment. This includes the harm from neglect and the way that neglect can conceal other risks and dangers.

This study does not provide easy answers about the difficult judgements and decisions that may need to be made where neglect is present but shows how important it is to be open-minded and vigilant about where and how these risks manifest themselves.