(NOTE: This is the printable version of Lesson One only. Please go to first page of Lesson Two and Lesson Three to download the printable version of those chapters.)
Researcher James Garbarino refers to the neglectful family as the “family with the hole in the middle.” When a child doesn’t get basic emotional and physical needs met early on in life, it impacts his every day functioning. Foster parents see this impact every day in the life of children. The child who hoards food in his bedroom. The grade school child who doesn’t have basic hygiene skills. A baby who is underweight and underfed, yet shows no interest in snuggling and sucking on a bottle.
Neglect is sometimes hard to define because our basic expectations, our cultural biases, and our opinions of what parents should do influence our definitions. Neglect is usually quite severe before the State of Alaska Office of Children’s Services gets involved or before children are taken into custody solely because of neglect. Yet neglect is the most commonly reported form of maltreatment. Most children who are placed into foster care for reasons of physical or sexual abuse have also been neglected in some way as well.
To determine what defines neglect, we need to look at what a child needs from his or her caregivers in order to survive and grow. This course will look at what children need to be healthy, how children are hurt when basic needs are not being met, and how resource families can help a child heal.
This course includes:
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Understanding Neglect |
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Impact of Neglect |
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Helping a Child Heal |
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Final Questionnaire |
Neglect accounts for more than half of all reports of maltreatment, but it is the form of maltreatment we know the least about. Risk for neglect seems to be greatest among children younger than five years old and children in low-income families. Parental stress and lack of social support are contribute to rates of neglect. In Alaska, neglect and alcohol addiction are often connected in families.
Neglect is the most common form of harm reported to child protective services, both in Alaska and nationwide. In September 2006, of the 2079 Protective Service Reports made to Office of Children's Services in Alaska, neglect accounted for 60% of suspected maltreatment reports.
From State of Alaska Office of Children’s Services Web Page Statistics http://hss.state.ak.us/ocs/Statistics/default.htm
SEPT. 2006
Mental Injury
Neglect
Physical Abuse
Sexual Abuse
Unknown
TOTAL
Allegations
385
1225
315
154
0
2079
In this activity, you will read some actual case examples of children who came into custody of the State of Alaska Office of Children's Services (then called DFYS) . These examples were documented in the State of Alaska Publication More Child Causalities of Alaska's Hidden War. Published in November 2002.
An 11-year-old child was left with her aunt while the child’s mother went to fill out a job application. Later, the mother called from a bar and made threats to the child over the phone. Both of the child’s parents remained in the bar drinking. The aunt called (OCS) to report she could no longer care for the child and could not located the parents, who both have a history of neglecting the child.
A four-year-old girl was observed in a car driven by her intoxicated mother. The child had come to a neighbor’s house earlier that day hungry, filthy, her hair uncombed and wearing dirty oversized clothes. The neighbor said that the child’s mother had been intoxicated nearly every day for the past month.
A grandfather reported that his grandchildren, ages 7 and 8 , were dirty, hungry and unsupervised by his son and that the children’s father was incapacitated by intoxication. Having just come from the family’ house, the grandfather described it as an “absolute disaster” that the night before there had been a big fight and that someone had been beat up (not one of the children). The father won’t buy food, and won’t let the grandfather take food stamps to buy food for the kids.
Nationally, neglect, not physical abuse, accounts for the most number of child deaths every year.
The National Child Abuse and Neglect Data System (NCANDS) reported an estimated 1,400 child fatalities in 2002. Mmore than one-third (38 percent) of these child maltreatment fatalities were associated with neglect alone. Physical abuse alone was cited in more than one-quarter (30 percent) of reported fatalities. (From Child Maltreatment 2002, Child Welfare Information Gateway Website.)
Write out your own definition of neglect either in the text box below or on a separate piece of paper. When defining neglect, ask yourself: what are the basic things that I expect a caregiver to provide for children? Do these things change as a child grows older? What do I think the difference is between poor parenting or different cultural standards and the kind of neglect in which child protective services law may need to get involved?
Write Your Definition of Neglect Here:
Dee Wilson, a foremost researcher on neglect, includes in his definition of neglect "the behavior of a parent or caregiver when he or she fails or refuses to provide basic, necessary care for a child’s safety, health or well-being, such as medical or physical care, nurturance, protection, etc." Some neglect may be situational and specific, such as limited to one form of neglect, but chronic neglect is frequently across all child care domains.
Here are some generally accepted definitions of neglect.
Not tending to basic needs of food, clothing, shelter and medical care, resulting in failure-to-thrive, malnutrition, untreated serious infections and diseases, and physical harm in form of cuts, bruises and burns due to lack of supervision.
Includes failure to thrive when an infant is not nurtured or cared for or doesn’t receive adequate nurturing, touch or care; allowing a child to be exposed to inappropriate adults, such as witnessing inappropriate sexuality or drug use, withholding of affections, or allowing a child to use drugs or alcohol, or the extreme forms of neglect, abandonment.
Allowing a child to engage in chronic truancy, failure to provide appropriate and responsible care to a child, leaving children in unsafe situations such as the overly responsible care of a younger sibling when unable to do so.
Failure to provide for appropriate health care for a child although financially able to do so. The refusal of or extreme delay in seeking necessary health care.
Failure to assume adequate responsibility for the child such as leaving the child with no plans for return.
Can You Identify the Neglect? This activity will help you learn to identify different kinds of neglect. Each of the following situations is an example of some kind of neglect. Identify what kind of neglect is illustrated in the example by choosing the right answers. There may be several types of neglect in each answer.
1. A child with asthma who has not received appropriate medications over a long period of time and is frequently admitted to the hospital with breathing difficulties and chest pains.
Physical Neglect
Emotional Neglect
Neglectful Supervision
Medical Neglect
Abandonment
2. A child complaining of a bad stomach ache is seen by a doctor who discovers that child has a massive internal infection due to malnutrition and lack of early detection and treatment.
Physical Neglect
Emotional Neglect
Neglectful Supervision
Medical Neglect
Abandonment
3. A couple makes meth in their home and often goes on binges of using the drug and staying up to party all night with friends and strangers, and keeping the children up with the noise. The drug suppresses their appetite so they often don’t eat for days and forget to feed their children, who have to scrounge in the refrigerator and in the cupboards. Dad keeps his meth making chemicals in a two liter Pepsi bottle in the fridge right next to gallon of milk.
Physical Neglect
Emotional Neglect
Neglectful Supervision
Medical Neglect
Abandonment
4. A newborn tested positive for cocaine at birth. The next day, both mother and child were well enough to go home, but the mother had no interest in the baby. She left the hospital without formally being discharged and left the baby in the nursery.
Physical Neglect
Emotional Neglect
Neglectful Supervision
Medical Neglect
Abandonment
5. Two children, ages 2 and 4, were home without supervision. The mother was out and the babysitter had left the children alone. Police found the door unlocked and upon entering found the children asleep on the living room floor. The baby's diaper was very wet, and he seemed to have a nasty, dark red rash that covered his buttocks and thighs.
Physical Neglect
Emotional Neglect
Neglectful Supervision
Medical Neglect
Abandonment
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CORRECT ANSWERS:
1. Medical Neglect
2. Certainly there has been Medical Neglect of this child for infection and possible Physical Neglect for the malnutrition. A case could also be made for Emotional Neglect if the child had been complaining about pain and the parent ignored him.
3. Because the drug use is preventing the parents from tending to the children's basic needs for food, shelter, sleep, and safety, all of the following are present: Physical Neglect, Emotional Neglect, Neglectful Supervision
4. The cocaine in the baby's system is certainly a concern. But the type of neglect we see in this case is Abandonment.
5. The babysitter obviously was not a good choice to care for the children since they were left alone. The severe diaper rash seems to indicate that the child is not being treated for his condition. The children are not being cared for properly for their age and left along sleeping on the living room floor in a potentially dangerous situation with the door unlocked. In this case, all five types of neglect are present.
Neglect can be chronic or it can be an individual event. It is important for the child welfare system to look at the history of neglectful families and not just at a single event. What may not seem all that harmful to a child when looked at as a one time thing, might be very damaging as part of a more chronic pattern.
The majority of neglect, according to researcher Dr. Bruce Perry, is due to ignorance and chaos in the caregiver’s life. Poverty seems to be a common thread in chronically neglecting families, though it is important to point out that many poor families take very good care of their children, so it is not a causal factor. While sexual abuse and physical abuse may occur episodically or as a single event, “neglect tends to be a chronic pattern of inadequate or age inappropriate care.”
Dee Wilson is a researcher and writer who has studied chronic child neglect in families. The actions of chronically neglectful families seems to go beyond simple ignorance of child care practices. Wilson found that chronically neglecting families fell into seven categories:
Substance Abuse with Anti-Social Features: One or both parents have often been in prison, dealing drugs or other criminal activities. Often have underlying anger directed at authority figures, and may try to threaten or intimidate.
Substance Abuse with Depression: These families are drinking and drugging to medicate themselves. May have great trouble forming and maintaining relationship with children and with treatment provider. Difficulty in verbal conversations and reacts passively to helping efforts.
Substance Abuse as A Form of Self Destruction: Usually long history of alcoholism or abuse. Behavior is reckless and indiscriminate.
Intergenerational Transmission of Chronic Maltreatment Congruent with Family Values: Extended family full of abused and neglect of children. Views things as just the way things are. Extended family reinforces poor parenting practices.
Mentally Ill Parents with Periodic Breakdowns: Some parents function reasonable well most of the time, but periodically suffer breakdowns related to psychotic episodes, leading to sub-adequate care of the children during these times.
Developmentally Delayed parents with Profound Cognitive Impairment
Emotionally Desperate Parent (failure to protect a child): Parents who are very dependent on a romantic partner and fail to protect a child from abuse or harm. Includes families where domestic violence interferes with a child’s safety needs.
Wilson also notes that in chronically neglectful families, there are often multiple issues faced by a family. These issues may need time to address and in the cases of substance abuse and mental illness, effective treatment and services as well.
What does this mean for you as a foster parent?
The children in your home have come from very chaotic backgrounds, have been exposed to drugs and alcohol abuse in their homes, and have not had a parent who was able to consistently meet their needs and protect them from harmful situations. These children come into your home carrying these experiences in their "emotional suitcases." They may have never had an opportunity to learn what a healthy family is supposed to be.
In the Family Feathers Series video “Multigenerational Grief” produced and distributed by from Tlingit Haida Head Start in Juneau, Alaska, an elder who works with others in recovery talks about how her drinking affected the care of her children.
"I used to brag about the fact that I never hit my children. What hurt the most, was when they needed my support, I was either hung-over or drunk. When they needed a hug because they were afraid, I was in a bar. When they needed a pat on the back for all their accomplishments, I was drunk or hung-over. How can I ask them to be responsible when I was never responsible? How can I ask them to be loving when I was never there?"
In his research, Dee Wilson talks of three different kinds of families where substance abuse is a major cause of child neglect. These include:
What is difficult in chronic neglect cases is that sometime a single incident may not appear to put a child in long term or immediate danger such as an occasion of supervisory neglect or improper clothing or neglecting dental checkups. But when this incident is seen in a recurrence of similar incidents, a clear pattern of chronic neglect emerges.
To explore more about how substance abuse can lead to the abuse and neglect of children, read the three readings below:
"Drug's youngest victims see families torn apart. " Story Excerpted From the Honolulu Advertiser. September 14, 2003.
When police raid the so-called "ice houses," they typically find junked cars in an overgrown yard, auto parts strewn around a house with holes in the walls and light fixtures that don't work. Recovering addicts often recall living in homes long after the electricity was cut off, using candles and bathing in cold water.
"Rotting food on the stove is nothing unusual, the places smell like garbage, disarray, messy places," said a police detective who has participated in many raids in the Hilo area. He asked that he not be identified because he works undercover at times.
"We've had places with last year's turkey rotting in the refrigerator just like soup, you can just see the bones," he said. "The smell is bad, and you turn on the TV like a kid could turn on the TV, there's normally porno in the VCR. That's not unusual."
The children may suffer beatings and sometimes sexual abuse, and watch as virtually everything the family owns is sold or traded off. They look on as people they love are hurt, and they are usually powerless to stop it. Sometimes, these children die, victims of neglect or abuse at the hands of addicts.
"From the point of view of the kids, they end up dealing with irrational people that are impulsive, they have no judgment, and are sometimes paranoid or delusional," said Hilo Family Court Judge Ben Gaddis. "So, you can imagine what effect that has on kids."
Gaddis said these youngsters come to the attention of the authorities in a variety of ways. Often the schools report that two, three or four siblings have been missing from their classes, and authorities discover the reason is the parents' addiction to ice.
More Child Casualties of Alaska’s Hidden War DFYS November 2002
A six-year-old girl was stranded at school awaiting her mother. The police went to the mother’s residence and found her asleep and hard to wake. The mother admitted to smoking marijuana and also had taken three prescription pain medications. The house was filthy. In an attempt to avoid taking custody of the young girl, the police tried to contact a relative. A grandmother was found, but had a history of DWI and assault. An aunt stated she had to work and was unable to care for the child. Another aunt was found to have had her driving licensing suspended of DWI. At least 13 prior reports of harm were on file for the family. (More Child Casualties of Alaska’s Hidden War DFYS November 2002.)
A two-year-old boy was found wandering alone in a trailer court. Police cared for the child for an hour while investigating child neglect. They canvassed the area looking for a caretaker without success. The boy was unable to tell the police his age, name, who was caring for him, where he lived, or who or where his parents were. Police requested placement in emergency foster care. (More Child Casualties of Alaska’s Hidden War DFYS November 2002.)
A four-month-old baby boy was left by his parents with neighbors for over two weeks. During this time they visited their son once. The mother recently came back to retrieve the baby, but appeared to be under the influence of some type of drug and was in the company of a known perpetrator of physical abuse against another child in protective custody. The neighbors refused to give up the child and contacted DFYS. (More Child Casualties of Alaska’s Hidden War DFYS November 2002.)
The parents of a nine-month-old child, apparently drug shooting junkies, allowed their child to crawl about an unsanitary home, with dirty laundry pile up, dishes left unwashed, and baby feces found on floors and counters. The baby was filthy from crawling on the floor. Domestic violence has been reported but unconfirmed. (More Child Casualties of Alaska’s Hidden War DFYS November 2002.)
(Note: This a classic case of how a single incident of neglect may not be taken as putting the child in immediate danger, but a pattern of chronic neglect emerges when seen in relationship to other incidents.)
"..... In one case, for example, CPS obtained a court order to remove two children, ages seven and eight, from their mother in January 1999. Their mother had been the subject of 17 neglect-related reports to CPS during the preceding six-and-a-half years. During that time, CPS periodically offered the family short-term support services. In another case, CPS filed a petition to take protective custody of three children in September 1999. Their mother had been the subject of nine neglect-related CPS reports in the preceding seven-and-a-half years. CPS did not take any action concerning this family until May 1999, after receiving a report from a hospital indicating that the mother had tested positive for controlled substances while she was pregnant. At that point, the mother agreed to voluntarily place her infant in foster care for a short period. Despite this history, and a June 1999 report to CPS that the children’s father had died of an accidental drug overdose while they were at home, CPS did not take assertive action until September 1999 after a domestic violence incident..."
Wilson states that "substance abuse treatment is most effective as part of a comprehensive set of services, including concrete services and mental health services." Families who chronically neglect their children need parenting skills, housing assistance, child development skills and financial assistance as well as an opportunity for substance abuse treatment. Neglecting parents frequently have serious mental health problems as well, such as depression.
These mental health problems, coupled with addiction, can put a child even more at risk. One study (Wilson) shows that the more chronic neglect is, the more likely that children in the family have been physically abused or sexually abused as well.
When addiction and neglect is coupled with mental illness or poverty, often the neglect is chronic and can have serious effects on a child's development. In the Lesson Two, we will look at how children are affected by neglect.
1. On a national level, what form of maltreatment accounts for the most number of child deaths every year?
a) Physical Abuse
b) Neglect
c) Sexual Abuse
d) Abandonment
2. _______ is defined as a failure to provide appropriate and responsible care to a child and leaving children in unsafe situations such as in the care of a young sibling who is unable to provide adequate care.,
a) Physical Neglect
b) Medical Neglect
c) Emotional Neglect
d) Neglectful Supervision
3. ____________ is defined as failure to assume adequate responsibility for the child such as leaving the child with no plans for return
a) Abandonment
b) Neglectful Supervision
c) Physical Neglect
d) Medical Neglect
4. Dee Wilson talks of three different kinds of families where substance abuse is a major cause of child neglect. Which are the three groups he pairs with substance abuse related neglect?
a) Mental Retardation, Domestic Violence and Depression
b) Lack of Knowledge, Family History, Poverty
c) Depression, Anti-Social Features and Self-Destruction
d) Physical Abuse, Domestic Violence and Cocaine
5. The more chronic neglect is, the less likely that children in the family have been physically abused or sexually abused as well.
a) True
b) False
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CORRECT ANSWERS
1. b) Neglect
2. d) Neglectful Supervision
3. a) Abandonment
4. c) Depression, Anti-Social Features, and Self Destruction
5. b) False. They are MORE likely to be physically or sexually abused.