Child Neglect: Are We Doing Enough?

Science tells us that responsive environments and supportive relationships are essential elements for building healthy brain architecture. When young children reach out for interaction and receive responses that are consistently unreliable, inappropriate, or simply absent, the impact of excessive stress activation combined with this lost opportunity for interaction can affect brain development and result in lifelong consequences. Several decades of research has linked early deprivation with subsequent impairment, yet child neglect receives far less public attention and dedicated mental health resources compared to other types of child maltreatment.

In “The Science of Neglect: The Persistent Absence of Responsive Care Disrupts the Developing Brain,” a Center on the Developing Child at Harvard University working paper authored by the National Scientific Council on the Developing Child, evidence from the fields of neuroscience, molecular biology, epigenetics, and a range of behavioral and social sciences is synthesized to promote a greater understanding of neglect’s threat to child well-being, in addition to highlighting opportunities for policy and program intervention.

Over half a million cases of neglect are reported annually in the US, accounting for nearly 80 percent of all child maltreatment cases nationwide. Referencing 122 papers examining various aspects of neglect, this working paper presents key research findings on the impact of and recovery from neglect. First, the wear and tear of severe neglect has been linked with a host of adverse consequences including academic struggles, difficulties in social adjustment, mental health problems, and chronic physical disease in later life. Exposure to such environments is also associated with impairment of the immune system, increased risk for interpersonal relationship difficulties, and even physical abnormalities. In fact, findings show that severe neglect can cause more harm to a young child’s development than overt physical abuse.

Second, the capacity for recovery from the negative consequences of severe neglect via appropriate and timely interventions is well documented. Recovery rates are strongly tied to severity, duration and timing of the deprivation along with the timeliness and type of intervention provided. Cessation of neglect combined with early intervention of empirically supported strategies is required to support effective healing. Lastly, successful intervention has resulted in a reduction in behavioral difficulties and attachment difficulties, an increase in secure attachments, improved stress-regulatory capabilities and even improved EEG measured brain activity.

This working paper also brings to light the gap between research and practice in addressing neglect and provides readers with implications for policy and programs. Considerable scientific advances reveal the extensive adverse developmental and neurobiological impacts of early childhood neglect and the importance of timely intervention, yet there have been minimal alterations to service delivery and the capacity of child welfare agencies to address the needs of children experiencing reportable neglect.

Furthermore, despite the prevalence of child neglect, there exists no broad based agreement on clear and objective criteria for defining neglect and authorizing public intervention. To this end, the authors provide a framework for improving assessment and developing effective strategies for protecting children from neglect. The science of development and neurobiology of stress is used to delineate four types of decreased responsiveness and their consequences: occasional inattention, chronic under-stimulation, severe neglect in a family context and severe neglect in an institutional setting.

In terms of policy, the paper calls for re-examination of approaches to identify, prevent, reduce, and mitigate neglect and its consequences through the lens of scientific advances. Policymakers are encouraged to re-assess the allocation of resources to and within the child welfare system, and to invest more in the development and implementation of evidence-based programs to address the specific needs of children affected by severe neglect. Emphasis is placed on the importance of prevention efforts and early identification, and measurement of life outcomes for young children affected by significant neglect or chronic under-stimulation.

Powerful and robust findings elucidate the short- and long-term consequences of neglect and the importance of early intervention. Despite such scientific advances, the issue of neglect has received little public attention and few changes have been made to better align child welfare practice with research. Further investment in evidence-based early interventions, expansion of prevention efforts and capturing the economic benefits of interventions targeted to improve life outcomes for young children affected by significant neglect could prove promising in narrowing the science-policy gap.

Feature Photo: cc/(D. Sharon Pruitt)