CHILD

NEGLECT Dr Samir Parikh

C hild abuse is a much spoken-about topic today; horror stories of child abuse flood television and
print reports every day. What often goes unnoticed is a quieter, more insidious kind of abuse—
child neglect. Abuse is active, characterized by aggression and exploitation, making it easier to identify
and easier to capture. Neglect, on the other hand, is more passive, and often very difficult to recognize.
Unfortunately, child neglect has become one of the most pervasive forms of child abuse in the world
these days; it’s as prevalent as physical abuse, if not more, and its long-term consequences can be
equally damaging. Knowing about the symptoms of neglect is important—for the teacher and parent
community to be able to recognize symptoms of neglect can go a long way in identifying such children
and ensuring that they receive timely help.
Understanding neglect
Child neglect is characterized by a pattern of repeated failure to provide for a child’s basic needs. A
child’s basic needs are not simply food, clothing and shelter. What is equally important is a caring and
nurturing environment. Child neglect is therefore found in many different forms, it can be physical,
educational, or emotional – each of which can be detrimental to the healthy growth and development
of the child.
Neglect can occur when a parent abandons the child or simply does not have enough time to spend
with the child leaving the child all to itself. Physical neglect is the failure to provide food, shelter,
clothing, medical care and supervision. It’s important, however, to distinguish between a failure to
meet these needs due to poverty and a lack of resources or neglect. Parents who physically neglect
their children do have the resources to care for them but are still either unable to do so, or choose not
to do so. Educational neglect involves permitting regular absenteeism from school, failure to provide
basic educational opportunities and not paying attention to a child’s special educational needs. Of all
the various forms of neglect, emotional or psychological neglect is the most difficult to identify. These
are children who are constantly being threatened, ignored, belittled or insulted, isolated and rejected
by their care-givers. Ignoring a child who is feeling anxious, stressed or fearful after they experience a
quarrel is one such example of emotional neglect.

There can be no keener revelation of a society’s soul than the way in which it treats its children. ~ Nelson Mandela

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 Why it happens
Child neglect can happen in any kind of family, even one that looks prosperous and happy from the
outside. Child neglect is a complex issue, and no one factor can completely explain why it happens.
Parenting is not an easy task; especially in today’s fast paced socioeconomic and cultural environment.
Bringing up a child is a hands-on, time intensive, and difficult job. Additional challenges such as
financial difficulties, relationship problems and inadequate social support from friends and family can
lead to a parent neglecting some, if not all, basic needs of their child.
Living with an alcoholic parent can lead to neglect as well. Parents who are inebriated can have a
tumultuous home environment with frequent domestic disputes and incidences of rage. Such parents
are often unable to care for their children, spend quality time with them, or make appropriate parenting
decisions. Substance abuse is particularly dangerous because it can lead not only to neglect but physical
abuse as well.
Parents who suffer from a mental illness such as depression or anxiety may appear to be distant and
withdrawn from their children. Over the years it has also been seen that very often, parents who neglect
their children may have experienced neglect or some other form of abuse themselves. In such cases,
parents may simply perpetuate the cycle of child neglect, not having learned the skills necessary for
parenting. They may have incorrect or inadequate information about the kind of care that babies need,
along with inappropriate expectations from their children. They may be overwhelmed by parental
responsibilities and see the child as a burden. Within a society like ours, unfortunately, gender attitudes
and stereotypes also play a role wherein the girl child, deemed unworthy, is often the victim of neglect.
What neglect can do
We are all aware of the dangers of physical neglect and its adverse impact on brain development. If
a baby is malnourished then neural cells in the brain can become weak or damaged causing lowered
brain function, thus effecting their intellectual and academic functioning. Essential deficiencies can
lead to a myriad of physical and psychological difficulties such as tiredness, weakness and emotional
mood swings. Medical neglect can lead to persistent infections and lifelong ailments.
The most severe case of development is when it begins early in a child’s life. The impact of neglect is not
very easy to notice at an early stage but this neglect can have harmful and long-term effects on children
and may even get worse as the child grows older. Common physical and psychological reactions to
neglect include stunted growth, chronic medical problems, inadequate bone and muscle growth, and
lack of neurological development that negatively affects normal brain functioning and information
processing. Neglected children might have poor language abilities and may lead to difficulties
in attention and concentration. Such difficulties arise when children are not provided exposure to
languages and are given fewer opportunities for their cognitive growth. Where there is no medical or
health reason for faltering growth and development, neglect should be looked into as a potential factor.
The consequences of emotional neglect on a child are as detrimental, if not more. Neglect has can have
severe consequences for the child – both short-term as well as long-term. It can affect all domains of
development, be it physical, psychological, intellectual, behavioural or social.
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 Emotionally, neglect can have far-reaching consequences on the well-being of the child. Children are
extremely sensitive to both verbal and non-verbal cues in their environment. Healthy development
requires for the child to be able to form a secure relationship with the care-giver. Doing so allows the
child to form a secure base from which he can then explore his environment. The first two years of
life are also when children establish a basic sense of trust. A lack of this basic trust is bound to create
a sense of insecurity, anxiety and primal fearfulness within children. In the formative years, neglect
conveys to the child that he or she is worthless, flawed, unloved, and unwanted. It depicts a sense of
emotional unavailability, unresponsiveness, and withdrawal of attention. Children growing up this way
therefore tend to have a poor self-image, cognitive delays and difficulties, problems with coping, and
difficulty forming meaningful relationships, or connecting with others.
In fact, studies have shown that children as young as three years of age can suffer from depression
and withdrawal symptoms as a result of neglect. Although the visible signs of neglect in children
can be difficult to detect, the hidden scars resulting from it manifest in numerous behavioural ways,
including destructive behaviour, angry acts (such as fire setting and animal cruelty), withdrawal and
poor development of basic skills.
Neglect is also likely to influence the manner in which these children form relationships with other
people throughout their life, alter the way they behave and perform at school and interact with other
children, and how they would parent their own children. When children grow up in an environment
where their needs are not met, they have not acquired effective parenting skills from their caregivers.
They may not develop appropriate social skills and may feel hopeless, helpless and mistrustful. They may
even have substance abuse problems, experience domestic violence and engage in criminal behaviour.
Neglected children may experience attachment problems, regressive behaviour, learning difficulties,
somatic symptoms, bedwetting, and juvenile delinquency in later years.
Troublesome behaviours may persist long after the neglectful environment has changed. As children
grow older, feelings of being unloved and unwanted can lead to running away, antisocial behaviour,
self-harm and suicide. Neglect in the early years also has consequences for later life – many young
adults who have been neglected suffer from a recognizable psychiatric illness by the age of 21. They
exhibit many problems, including depression, anxiety, eating disorders, and suicide attempts. Other
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PARENTS MANUAL.indd 44 07-10-2013 17:55:47

 psychological conditions ns associated
ass
ssoccia
i tedd with
with abuse
abu
buse
se and
and neglect
neg
egle
lect
ct include
inc
nclulude
de panic
pananic
ic disorder,
dis
isor
orde
der,
r, dissociative
dis
isso
soci
ciat
ativ
ivee
disorders, attention-defificit it hyperactivity
hyp
y er
erac
accti vityy disorder,
tivi dis
isor
orde r and
der, nd reactive
rea
eact ivee attachment
ctiv atta
at tach
chmement nt disorder.
dis
isor
orde
order.
de r Even
r. Eve n through
ven thro
th roug
ugh h
their adult lives, they mayy havehaave d ifficulty
diffi cult
cu ltyy forming
form
forminingg secure
secu
se cure
re aand
nd h ealt
ea lthy
healthy hyy relationships
rel
elat
atio
ions
nsh
hips
p andnd unstable
uns
nstatabl
blee jo
jobb
histories. Where neglectctt iiss ch
chronic,
hro nic, tthe
r ni he eeff
ffec
ff ts of
ects of it on
on the
the mental
ment
me al health
ntal hea
ealtlth
lt h of a child
chi ld can
hild can be
be drastic.
dras
drastitic.
c.
Recognizing the Signss
Teachers are perhaps in th
thee bebestst p
position
osit
os itioon to iidentify
dent
de ntififyy ch
chil
children
ildr
dren e suff
en suff
uffeering
eri
ring
ng from
fro
rom m neglect
neegl
glecectt at home. hom
omee. e. R
Recognizing
ecog
ec ogninizi
ziing
the signs is important too ensure
en tthat
h t su
ha ch cchildren
such hild
hi ldrerenn rereceive
rece
ceiv early
ivee ea
earl intervention
rlyy in
inteterv
rvvene ti on iin
tion order
n or
o derr to
de to m minimize
inim
in imizizee the
thhe
damage. It’s important to o ke
keep
eep in in mind nd that
tha
hatt neglect
negl
ne glec
ectt is not
noto the
the same
samme as p poverty.
ovverrtyy. It It’s’s’s n
not
ot o only
nlyy th
nl thee po
poor orr
who get neglected; even n ch
children
hilildr
dren
en w whohoohhave
avee al
av alll their
thei
th eirr material
mate
ma teri
rial
al needs
neeeeds
ds met
met ccan an feel
feeel pspsychological
syc ychhologi
holo gicacall neglect
negl
ne glecectt
if their basic emotional n needs
eeds
ee ds fororr care
car
a e remain
rema
re main in unmet.
unm
nmet ett.
siica
Children who are physically calllly neglected
neglleccte
ne ted
d might
migh
mi ghtt ap ppe
pear
appear ar tto o be p e en
er enni
perenniallynial
ally
al ly tired
tirred
d oror listless,
list
li stle
less
ss,, oft
ofteeen
n fafall
llin
ingg
falling
asleep in class. Remaininging consistently
consi sist
stenntlly hungry
hung
hu ngryryy and
and malnourished,
mal a no ouris
urishehed,d, tthese
hesee cchildren
he h lld
hi dreen might m gh
mi ghtt steal
stea
st eal food
food or or
ssm
s at
beg for it from their classmates.ates. They w ould typically
ou
would typpic
ical
allly be
be dressed
d es
dr esse
sed d in iill-fi
ll-fi
ll -fittting
tti
ting
ng cclothes
loth
lo thes w
th ith po
it
with poor or p hysi
hy sica
physical call
llness
hygiene and frequent illnesses. sses. They m igght
might h sskip
kip
ki p sccho
hool
school ol ffrequently
requ
re quen entltlyy an
and d in tthe he aadolescent
dole
do lesccen nt yeyearars,
years, s, m ight
ig
might ht
gagin
drop out altogether. Engaging i g in sel elf-
f- d
self- estrtruc
uccti
destructive tive
ve behaviour
beh
ehav avioiour
ur iiss al
also
so a w arni
ar
warningningng ssign
ign
ig n of o p hysica
hysi
physical call neglect.
negl
ne glec
ect.
t.
itttl
tlee less
Emotional neglect is a little s o bvio
bv ious
obvious us tto
o id
iden
entitify
identify,fy,, bu
butt evevenen eemotional
moti
mo tion
onalal n egle
eg
neglectlect
ct ccan
an m an
manifest nififes
estt in p hysi
hy sica
physical call
n ex
indicators. Difficulty in exprpres
esssiive
expressive v llanguage,
anngu
guag age,
e, sspeech
peec
pe echh didiso
sordrder
disorders, ers,
s, d elay
el ayed
delayed ed p hysi
hy sica
physical call gr
ggrowth,
ro owth,, an
owth and d fr
freq
equeuent
frequent nt
ors of
illnesses are all indicators of emotional
emot
em otio
io l neglect.
ional negl
ne glec
ect.t. Habits
Hababititss such
such as as su
suck kin
sucking ingg anand d rrocking,
ockkin ing,
g, d isru
is ruptptiv
disruptive ivee an
and d
aggressive behaviours, lac ackk of remorse,
lack rem
emor orse, and
and diffi
difficculties
ulti
ul ties
es inin sleeping
slee
sl eepi
pingng might
mig ight
ht also hint hint towards tow
owar ards
ds emotional
emo
moti tion
onalal
migght
neglect. Such children might h also
als
lso harbour
harb
ha bou
ourr a pervasive
perv
pe rvasasiv
ivee sesens
nsee of d
sense istr
istru
distrustust of o aadults
du
dultltss an and d mimigh
mightght exexprpres
express esss
reluctance to go home.. Th Theese
ese cchildren
hild
hi ldreren experience
expeperi
rien nce diffi
difficulties
cult
cu ltie
iess fo
form
rmin
forming inng frffriendships
iend
ie ndsh ship ipss an and d re ela
lati
tion
onsh
relationships hipipss
aren
ar
and often assume the parentalenta t l role tthemselves.
ta hemselvees. Su ubsstatanc
Substance ncce ababususee is aalso
abuse lsso common
comm
co mmon on amongst
amo
m ng ngst st eemotionally
m ti
mo t on
onal ally
ly
neglected children.
Summary
As a parent, it’s not easyy tto
o br
brin
bring
ingg up a childchild.
d. Facing
Faaci
cing
ngg thehe crunch
cru
runcnchh of b both
oth
ot h ti
time
me aand nd rresources,
esou
es ourc
ou rces
rc es,, pa
es pare
parents
rent
re ntss ar
aree
caught in a dilemma of whether
wheheth
ther
her toto provide
provid de for
fo
or their
t ei
th eir family
fami
fa mily ly or
or to spend
spe
pend nd q quality
ualiity time
ua tim
imee with
w th
wi h them.
the
hem.
m. Parents
m. Par
aren
ennts
t
might compensate for theirthe
heirir absence
abs
bsenencecee aatt home
me bbyy sho
sh
showering
hower
owerin ingg th
thei
their
eirr ch
child
hilildd wiwiththh ggift
ift
ftss and
and yielding
yieeldin
ld
din
ingg to
t ttheir
heeir
i
every material wish. Chronic
hron
hr o ic stress
str
tres
esss at w work,
ork,
k o orr in
inte
interpersonal
erpper
erso
sona nall di
diffi
fficulties
culltities
es atat home
home m might
iigght ccause
ause
au se a p parent
aren
arentt
en
to be irritable and dismissive
misissi ve ooff th
sive child’s
thee cch
hilild’ emotions.
d s emmot
o ioons Striking
ns. St
Stri
riki ng tthe
king right
he rig igght
h b balance
allan
ancece isis not
n t al
no always
alwa
w ys
wa y easy.
eas
asy.
y.
It’s important, therefore,e, to
to keep
keep in in mind
m nd tha
mi at a ch
that chil
ild’
d s emotional
d’
child’s emot
em otio
iona
nal needs
need
ne e s for
ed for warmth
warm
wa rmth th and
and attachment
atttac
achm men
entt
are as important as theireiir ne
n ed for
need for safety
saf
afetetyy and
and nutrition.
nutr
nu trit
itio
ion. Neither
Nei
eith
ther cancan n be be compromised
comp
co mpro romimisesed d for
for the
the sake
sake ofof
the other. All children needneeeed
d acceptance,
acc
ccepepta
tance, e love,
lov
ove,
e, encouragement,
enc
ncouourar geme ment, di isc
scip ipli
ip
discipline, line
ne,, coconsnsisiste
tenc
consistency, ncy,y sstability
tabi
ta bili
lity
ty aand
nd
nts might
nt
positive attention. Parents m gh
mi ht not
not always
alwa
al w ys even
eve
ven n realize
r al
re a iz
izee that
that their
the
heir
ir child
chi
hild l is
ld is being
bein
be ingg neglected
negl
ne glec
ecte
ted d in some
som
omee way.
way.
Recognizing this neglect ct isis th
the fi
first
rst st
step
ep. Ge
step. G
Gett he
helplp.. Su
help. Supp
ppor
Supportortt iss aavailable
v ilab
va able lee ffor
o ffamilies
or amil
am ilie
iess at rrisk
iskk of eemotional
is moti
mo tion
onalal
abuse through child welfarel ar
lfare associations,
asso oci
ciat
atio
ionsns,, NG
NGOs
NGOs,Os,, ph
physysic
ys icia
ic ianss, me
physicians, mental al health
heae ltlth
h practitioners
prac
pr acti titi
tion
oner erss and
and schools.
scho
sc hoolols.
s.
ABOUT THE AUTHOR

Dr Samir Parikh
Head, Fortis Mental
Health Program

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