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Understanding Neglect

When looking at special needs for children and youth it is important to understand the history and experiences they have been through.  This will allow you to gain insight and valuable information about each child or youth and how their past might be affecting their current attitudes and behaviours.  When there is child welfare involvement, a common finding is an over-representation of children and youth with special needs in comparison to the general population (Bruhn, 2003).  Adoption provides hope and a change in that child or youth’s life; however, it does not remove the experiences that child or youth has already lived through.  According to the Public Health Agency of Canada (2008), neglect and exposure to domestic violence are the number one reasons for children’s involvement with child welfare (Blumenthal, 2015).  Understanding the impact of neglect on a child or youth is important.  When learning about a child who has experienced neglect it is important to consider their experiences of attachment and trauma. Secure attachment can be compromised in situations of neglect which can be shored up through reparative relationships.  Neglect can manifest as a non-visible form of trauma, meaning that there are no physical marks or features that show the impacts.  The impacts of neglect are hidden and often unknown to even the child or youth themselves.  Such early childhood experiences can shape a child’s development and outlook of the world. 

Neglect

Neglect occurs when a caregiver is not able to provide the necessary care for a child or youth, such as not providing the basic needs for the child or youth to grow up in a safe, stable and loving home environment.  Neglect can occur from a caregivers’ actions or lack of actions to properly care for the child or youth (Blumenthal, 2015).  A child or youth should be provided with appropriate physical, emotional, developmental and psychological care (Blumenthal, 2015).  Neglect occurs when caregivers are unable to provide this care for a multitude of reasons.  It is important to know that caregivers who were unable to meet their child or youth’s needs are often experiencing difficulties of their own.  For example, neglect is often the result of poverty as there is a high correlation between neglect and class (Lefebvre, Van Wert, Black, Fallon, & Trocmé, 2013). Neglect can vary from mild, or moderate, and to severe.  There are different types of neglect that a child or youth can experience.  These can be experienced either separately or simultaneously.  Severe neglect often results in the removal of the child or youth from their current caregiver’s by a Children’s Aid Society (CAS).  Neglect impacts children and youth in many different ways and learning about each child or youth is important so that you can know and understand them and their personal experiences. 

Types of Neglect

Physical Neglect

Physical neglect occurs when a child or youth does not receive care for their attachment, supervision, or caregiving needs.  It includes lack of nutrition, clothing, and lack of appropriate or reliable housing.

Environmental neglect is also a consideration of physical neglect.  A child or youth’s environment should be safe and free from hazardous or dangerous materials.  This can include homes with improperly stored firearms, exposure to drugs in the home or other inappropriate environments for children or youth.

Inadequate Supervision

There are varying legal requirements regarding the time that a child or youth can be left alone.  A child or youth can experience a lack of appropriate supervision based on many factors including their age, developmental needs, environment and other aspects.  This includes not providing adequate supervision for a child or youth, leaving a child or youth with someone unable to provide care, allowing a child or youth to take part in risky or harmful behaviours or other situations where a caregiver has not made sure that the child or youth is well cared for (DePanfilis,2006). 

Emotional Neglect and Exposure to Domestic Violence

Emotional support and guidance is important during a child or youth’s development.  A child is able to grow healthy emotional relationships with others based on their experience of emotional relationships with their caregivers.  Emotional neglect is when a child is not provided with nurturing, affection or comfort.  Another form of emotional neglect is exposing a child or youth to domestic violence (Alaggia, Gadalla, Shlonsky, Daciuk & Jenney, 2015).  Violence in the home is traumatic and witnessing this can impact that child or youth’s feelings of security, safety and well-being. 

Educational Neglect

In Canada, every child and youth has a right to education.  Educational neglect occurs when a child or youth is not attending school, when parents do not enroll their child or youth in any form of education, or when a child or youth's special education needs are not being met.

Medical Neglect

Medical neglect occurs when a caregiver denies or delays the treatment of a medical condition for a child or youth.  Withholding medical care can result in a child or youth experiencing undue or unwanted medical complications that can sometimes result in fatalities or lifelong developmental, physical or mental impacts. 

All of these types of neglect can leave a long-lasting impact on the child or youth. 

Impact of Neglect

While children are resilient, the impacts of neglect on children and youth can be significant.  The effects that a child or youth may experience are dependent on many factors.   Some factors to consider are the child’s age, their experience of neglect (duration and severity), and what protective factors existed, if any.  Protective factors can be things like having a strong relationship or bond with an adultor other positive influences on a child or youth’s life(Blumenthal, 2015).  The child or youth’s worker should be able to assist you in learning what specific experiences a child or youth may have undergone which will allow you to understand their needs more specifically and to respond more effectively.  There are different types of impacts based on the types of neglect a child or youth may have experienced.  The major impacts fall within four major categories:

Physiological and Health Impacts

The National Scientific Council on the Developing Child (2012), found that some children and youth who have experienced severe neglect experience physical changes to the brain.  During childhood, the brain is growing and developing; however, neglect causes trauma.  When we experience trauma, our brain’s response is to release hormones and chemicals to assist with the fight, flight or freeze reaction when we are in stressful situations (Perry & Marcellus, n.d.).  When a child or youth is in stressful situations continually, these hormones and chemicals effect the brain’s growth and development. 

For infants, the results of a neglectful parent could mean that the infant does not receive the nutrition and basic care that would allow for them to grow and develop.  This may result in a diagnosis of “failure to thrive”.  This diagnosis means that the infant is not progressing at the same rate as infants their own age.  This can lead to delays in the growth of their brain which can impact the body, mind and level of ability. 

Intellectual, Developmental or Cognitive Impacts

Neglect can cause intellectual, developmental and cognitive impairment.  Some examples of how neglect can impact children and youth are: 

  • A child who is unable to walk or talk due to an absent caregiver –failure to meet their developmental milestones as expected
  • Delayed progress at school because of many school absences

These are a few examples of a host of various neglectful situations and impacts.  It is important to learn about that child or youth’s early history of developmental milestones so that you can understand if there are reasons for certain delays.   

Social and Behavioural Impacts

Neglect often means that a child or youth has missed out on experiencing positive interactions with others.  This can result in them having under-developed relational skills and difficulties in forming positive relationships (DePanfilis,2006).  Children and youth from neglectful backgrounds can have difficulties with impulse control, lowered self-esteem and problems controlling negative thoughts about themselves or other’s intentions (Blumenthal, 2015).  Other manifestations of early neglect may include hoarding of food or stealing due to anxiety of not having enough. These should not be viewed as acting out behaviours but rather as anxiety based. Children and youth who have experienced neglect may view adults as being unreliable and not dependable and it may be difficult for them to shift this way of thinking.

Positive Brain Changes

Despite the challenges of childhood neglect, a child or youth’s brain has the ability to learn and grow until the age of approximately 25 to 26.  A childhood experience of neglect can have negative impacts for a child or youth; however, if given the right supports and resources, along with a stable and loving family environment, children and youth can have positive physical brain changes all the way up to the age of 26 (Perry & Marcellus, n.d.).  The brain is able to change and allow for them to nurture connections in their brain that can impact everything from their development to the way they manage their emotions, academics and relationships. Helpful services and resources for children who have experienced neglect include emotional support, trauma counselling, adoption-informed family counselling, and skills-building support for decision-making, self-esteem and conflict resolution.

The benefit of the brain changing into adulthood is that the child or youth can work towards closing gaps in their development, academics, and other delays. 

Parenting a child or youth who has experienced neglect

When parenting a child or youth who has experienced neglect, it is important and influential to build supportive and loving relationships.  Adoptive families have the opportunity to provide the child or youth with the bond of a positive relationship.  Positive and dependable relationships help them reframe their views of the world so that they can see that the world can be safe because of the trust and love they have developed in other people. These relationships can be emotionally corrective and reparative. 

There are some tips and tools that can assist you in your parenting journey. 

Patience

Many of the children and youth who have lived through a neglectful environment do not know or understand how this may have impacted them.  They may behave in ways that are difficult or confusing to understand.  Feelings of anger, sadness, withdrawal from affection, temper tantrums and other challenging behaviours are a result of their history.  These behaviours do not define the child or youth because the behaviours are a result of their experiences.  Constantly testing limits and boundaries may also be present with these children as they test out their relationships to see if the adults will abandon them or stick by them.  In these situations, it is important to use consistency and predictability around routines and expectations instead of using punitive-based responses or withdrawal from affection.

Once they feel their environment is safe and their relationships are stable, these behaviours will recede. It is important to be patient while you both work through the emotions and understanding the child’s past.  Counselling services, especially those that are adoption-competent, can often be helpful supports for families working through these challenges.

Demonstrating a stable, loving and solid relationship

Neglect can result in children or youth viewing relationships as harmful and not beneficial because they have not had positive, trusting, reliable relationships with adults in the past.  Ensuring the child or youth can experience a loving and stable family environment will allow their experience of relationships to change.  These reparative relationships will slowly allow them to build confidence and trust in others which will assist them in their relationship building and social skills.

Be Responsive

Attending to a child or youth’s needs is very important.  Remember, a history of neglect means that they potentially received little to no response for their needs.  This may have led them to build mistrust in relationships and others.  Children and youth will benefit from seeing that they can depend on their caregiver. 

Positive Conflict Resolution Skills

Children and youth need to develop positive coping methods and tools around resolving conflict which can be done through witnessing the ways in which you operate and function as a family.  When experiencing conflict, show positive coping behaviours such as reflective listening, taking time to de-escalate and being respectful of each other's views and options.

Using positive language is a good way to build good self-esteem 

Children and youth who have lived through neglect may have a negative view of themselves and others so it important to use positive and affirming language.  Speaking negatively about them or their behaviours may cause them to continue to have negative feelings.  Instead of saying “You were bad”, you could use language like “Do you think that was a good choice”?  This allows for the child or youth to reflect on their behaviours while you assist them in building better decision-making skills.  Teach them that they can make positive choices, and praise them when they do.

Meet them at their level 

Children and youth who have lived through neglect may experience some developmental and social delays.  It is important to be supportive and manage parenting expectations.  Understand their level of ability and work with them to build it up; however, do not place expectations that they find difficult to achieve.  A good way to manage this is to set goals with them instead of for them.  Parents can help them adjust goals if they need to which will allow the child or youth to feel capable and learn how to set and adjust goals.  Incentive based rewards for positive behaviour work with most children. Parenting programs such as “The Incredible Years” or “Triple P” can be of benefit as long as these are coupled with adoptive-competent counselling.

References

Alaggia, R., Gadalla, T., Shlonsky, A., Jenney, A., & Daciuk, J. (2015). Does Differential Response Make a Difference: Examining Domestic Violence Cases in Child Protection Services. Child and Family Social Work, 20(1), 83-95.

Blumenthal, A. (2015). Child neglect I: scope, consequences, and risk and protective factors.  Canadian Child Welfare Research Portal.  Retrieved from: http://cwrp.ca/sites/default/files/publications/en/141E.pdf

Blumenthal, A. (2015). Child neglect II: Prevention and intervention.  Canadian Child Welfare Research Portal.  Retrieved from: http://cwrp.ca/sites/default/files/publications/en/142E.pdf

Bruhn, C.  (2003). Children with disabilities: Abuse, neglect and the child welfare system. Journal of Aggression, Maltreatment & Trauma, 8 (1-2), 173-203.

Center on the Developing Child at Harvard University. (2012). The Science of Neglect: The Persistent Absence of Responsive Care Disrupts the Developing Brain: Working Paper 12. www.developingchild.harvard.edu

DePanfilis, D. (2006). Child neglect: A guide for prevention, assessment, and intervention. U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, and Children’s Bureau Office on Child Abuse and NeglectRetrieved from: https://www.childwelfare.gov/pubPDFs/neglect.pdf#page=11&view=Chapter 2 Definition and Scope of Neglect.

Lefebvre, R., Van Wert, M ., Black, T., Fallon, B., & Trocmé, N. (2013). A profile of exposure to intimate partner violence investigations in the Canadian child welfare system: An examination using the 2008 Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2008).International Journal of Child and Adolescent Resilience, 1 (1), 60-73.

Perry, B.D., Marcellus, J. (n.d.)  The impact of abuse and neglect on the developing brain.  Retrieved from http://teacher.scholastic.com/professional/bruceperry/abuse_neglect.htm

Public Health Agency of Canada.  (2008). Canadian Incidence Study of Reported Child Abuse and Neglect. (National Clearinghouse on Family Violence).  Retrieved from: http://cwrp.ca/sites/default/files/publications/en/CIS-2008-rprt-eng.pdf