Defining Neglect:

Child Neglect is the most prevalent form of child maltreatment.

According to the most recent federal data,¹ as in prior years, of those children reported by states as experiencing neglect and abuse, the greatest percentage of children suffered from neglect (74.9%). Physical abuse was reported far less frequently, at 17.5%.

Federal law does not provide specific definitions for neglect. However, federal legislation that authorizes CBCAP – the Federal Child Abuse Prevention and Treatment Act (CAPTA) (42 U.S.C.A. § 5106g) as amended by the CAPTA Reauthorization Act of 2010 – does provide guidance to states in creating their own legal definitions.

However,  it does include abuse and neglect together, as a set of acts or behaviors. At minimum, these include:

• “Any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation”;
• “An act or failure to act which presents an imminent risk of serious harm.”

This definition of child abuse and neglect refers specifically to parents and other caregivers. A “child” under this definition generally means a person who is younger than age 18 or who is not an emancipated minor.

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Check your own state statutes for definitions that have been created for child neglect or visit Child Welfare Information Gateway’s State Statutes Search page: https://www.childwelfare.gov/resources/states-territories-tribes/state-statutes/?rt=1381

The Children’s Trust Fund Alliance (Alliance), which works to prevent child maltreatment, has developed a practical, fact-based definition of neglect that is considered useful to practitioners and advocates:

“Child Neglect is a failure to meet children’s basic needs – whether the failure is the responsibility of parents, communities or society – and this void, places children in harm’s way.”

The value of the Alliance definition is that it points toward our collective responsibility for child neglect, and away from blaming parents for problems not of their making.

Family issues such as poverty, mental health, homelessness, domestic violence and stress can limit parental capacity and contribute significantly to a child being neglected. Neglect often occurs without intent to harm.

Neglect can be characterized as occurring in different, but often overlapping domains. These include:

• Physical
  (e.g., failure to provide necessary food or shelter, or lack of appropriate supervision)
• Medical
  (e.g., failure to provide necessary medical or mental health treatment)
• Educational
  (e.g., failure to educate a child or attend to special education needs)
• Emotional
  (e.g., inattention to a child’s emotional needs, failure to provide psychological care, or permitting the child to use alcohol or other drugs)

While this list may suggest that neglect is easily observable, this is not necessarily true. In reality, neglect can be hard to identify.

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For more information on defining and identifying neglect, see Child Welfare Information Gateway’s, Child Neglect: A Guide for Prevention, Assessment and Intervention.

¹ Summary p. x, Child Maltreatment 2019, Children’s Bureau, Administration on Children, Youth and Families, Administration for Children and Families, U.S. Department of Health and Human Services. http://www.acf.hhs.gov/programs/cb/research-data-technology/statistics-research/child-maltreatment.

Occasional or situational neglect of children needs to be distinguished from neglect that is severe and ongoing, or ‘chronic.’

In a bulletin for professionals on Chronic Child Neglect, the Child Welfare Information Gateway characterizes chronic neglect as occurring when one or more needs basic to a child’s healthy development are not being met by a parent or caregiver on a recurring or enduring basis.

Chronic neglect can also be understood as the experience of growing up in chronic adversity – living in an environment laden with traumatic events that lacks access to resources, including adequate adult supervision and support.

Long-standing and severe neglect can have serious, long-term consequences for children and impact the development of important self-regulation skills in children. The Center on the Developing Child at Harvard notes chronic neglect as being a major contributor to toxic stress.

“Severe neglect appears to be at least as great a threat to health and development as physical abuse—possibly even greater.”
– Harvard University Center on the Developing Child

Research shows that this kind of prolonged activation of the body’s stress response systems can disrupt the development of brain architecture and other organ systems. These disruptions precipitated by chronic neglect (and/or other sources of toxic stress) can produce damaging effects on learning, behavior, and health across the lifespan.

Living with the toxic stress produced by chronic neglect or adversity links to trauma symptoms that can impact early brain development and later cognitive development and emotional regulation. Long term impacts can include increased risk for stress-related disease and cognitive impairment well into adulthood. For more information in this area, click here.

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See the Child Welfare Information Gateway’s “Understanding the Effects of Maltreatment on Brain Development” for a full discussion of this important topic.

Two other developing bodies of knowledge are important to understanding chronic neglect:

• One is the Adverse Childhood Experiences (ACEs) research, which, among other findings, documents how the accumulation of ACEs in parents/caregivers can negatively impact their parenting; see the FRIENDS ACEs webpage or the website of the Centers for Disease Control and Prevention for an overview of the topic. The CDC pages include links to its Essentials for Childhood initiative aimed at addressing the broad range of health and developmental problems associated with toxic stress.
• Another is research on the frequency of the Intergenerational Transmission (IGT) of child neglect. For a discussion of the research behind the IGT of neglect and reforms needed to address it, see the article Intergenerational Patterns of Child Maltreatment: What the Evidence Shows.

On Trauma
Because trauma is so frequently a product of the experience of living with chronic neglect/adversity and other forms of abuse and neglect, it is important that CBCAP grantees maintain a trauma-informed perspective on their work.

Early child abuse and neglect can result in lifelong cognitive, behavioral, and mental health problems. Traumatized children and youth may need help overcoming learning difficulties and social-emotional deficits. Find out how to help these vulnerable children and youth with Child Welfare Information Gateway’s Supporting Brain Development in Traumatized Children and Youth.

The National Child Traumatic Stress Network (NCTSN) provides a wealth of resources on trauma, from the basics (e.g., “What it is” and “Why it matters”) to highly specialized topics such as addressing the needs of those who have experienced terrorism or war.

NCTSN also hosts a registry, Empirically Supportive Treatments and Promising Practices, that details programs and interventions scientifically endorsed for dealing with trauma. This registry includes interventions specific to the prevention and treatment of neglect. Among these are:

• Trauma Adapted Family Connections (TA-FC), a neglect prevention intervention for children and youth from 0-18. TA-FC puts significant attention on the daily stressors and crises related to the environmental contexts as well as to family histories that include complex developmental trauma.
• Attachment and Bio-behavioral Catch-up (ABC) ABC is an early intervention program aimed at the needs of neglected children aged birth through 24 months from low-income families.

In addition, when working with American Indian or Alaskan Native populations it’s important to consider the impact of historical trauma. FRIENDS has resources related to working with Tribes and Tribal Governments and this important topic.

To clearly understand child neglect and the protective factors that need to be in place for prevention, it is important to understand the broader environment in which child neglect occurs.

The social-ecological model considers four levels –individual, relationship, community, and societal.

The Children’s Trust Fund Alliance has created an infographic that identifies the protective and risk factors that impact child neglect. These factors are associated with one or more of the four levels of the socio-ecological system – the child/individual, family/relationship, community/neighborhood, and society levels.

As noted by the CDC, this model considers the complex interplay between factors at each level as well as the full range of factors that put children at risk for neglect and other forms of maltreatment. It also suggests that efforts must be made at each level to protect children. The overlapping rings in the model illustrate how factors at one level influence factors at another level.

The social-ecological model should be foundational to the work of CBCAP state lead agencies, as it points to the need for child neglect prevention strategies targeting each of these levels to build safe and healthy children and families and strong, supportive communities.

Consistent with a social-ecological approach, effective child neglect prevention strategies include evidence-based or -informed practices, programs, public awareness, policies, economic development, and support for basic needs. This type of comprehensive approach to neglect prevention ensures impact at each level of the social ecology: individual, family, community, and society. This approach is more likely to sustain prevention efforts over time than any single intervention.

Because of the risks closely associated with neglect, such as substance use disorders, mental health conditions, domestic violence and especially, extreme poverty, neglect prevention is often well served by being woven into other public systems.

The CBCAP program instruction states, “The most effective way to strengthen families and prevent child abuse and neglect is for all family support, prevention and treatment programs, public and private, to work together in partnership with families and other disciplines such as social services, physical health and mental health, substance abuse treatment services, domestic violence, child care, early childhood, education, law enforcement, and other relevant groups in the community to achieve their common goals.”

Public Systems

Public agencies must focus on prevention and early intervention and on developing partnerships with other community and informal support systems to promote effective prevention strategies for neglect. Roles and responsibilities of all service providers must be discussed and adjusted to ensure the goals and objectives are achievable and that children are safe.

These partners may include:

• physical health and behavioral health,
• early childhood education and education,
• economic aid/poverty reduction,
• housing/homelessness,
• workforce development,
• financial literacy, and
• domestic violence

As stated in the CBCAP Program Instruction, lead agencies are strongly encouraged to find ways to partner with other public and private organizations serving the same populations and sharing the same goals and objectives. States are encouraged to build upon existing interagency collaboratives with similar goals as CBCAP. Each offer fruitful grounds for potential partnerships aimed at child neglect prevention.

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For information on collaborating with substance use, mental health and domestic violence partners, see the FRIENDS and The Children’s Trust Fund Alliance brief, The Power of Collaboration in Preventing Child Neglect, Partnering with Substance Abuse, Mental Health and Domestic Violence Systems.

Additional Resources

National Resource Center for Healthy Marriage and Families offers free resources for service providers looking to form partnerships here.

The Centers for Disease Control provides information on strategies for preventing child abuse and neglect here, along with their technical package called Preventing Child Abuse and Neglect: A Technical Package for Policy, Norm, and Programmatic Activities.

Community Initiatives

One seminal work on effectively integrating broad-based community initiatives is the Pathways Mapping Initiative, which put together what is known from research and from the experiences of high-quality, results-oriented, initiatives and systems for strengthening efforts to improve community outcomes for children and their families. The initiative included the publication of a guide specific to integrating child maltreatment prevention into such initiatives, the Pathway to the Prevention of Child Abuse and Neglect.

As outlined in this document, examples of the types of widely endorsed public policy child-related goals (outcomes) that can serve as common ground for public sector partnerships include:

Children and Youth:

• Children and youth are safe
• Children develop the cognitive and socio-emotional capacities needed to become self-sufficient adults
• Children experience a reasonable level of mental health.

Family:

• Strong, connected families
• Families have knowledge of child development and skill in parenting
• Families have basic supports families and ready access to needed services
• Families are free from substance use/misuse and mental illness

Community:

• Communities are caring and responsive
• Community environments support healthy child development and family functioning.

In recent years, there has been an upsurge in public sector initiatives that include a focus on outcomes related to child neglect prevention. Examples of initiatives that CBCAP programs can connect to further their neglect prevention goals include Inter-generational approaches and Differential/Alternative Response systems.

Inter-generational Approaches

Inter-generational approaches focus on creating opportunities for and addressing needs of both vulnerable parents and their children. These are sometimes referred to as “Two-Gen” or 2Gen approaches.

Two-generational (Two-Gen) approaches are defined as one which expands the lens to evaluate more than each generations resource and service needs, and intentionally focuses on the innate interdependence of family members – especially parent and child, but also partners, co-partners, siblings, and others who define themselves as “family”.

Two-Gen approaches seek to deal with the inter-generational impacts of poverty on the outcomes level and focus on creating opportunities for and addressing needs of both vulnerable parents and their children. It actively involves parents in the outcomes level service connections and goal-setting for their children and involves children in the same way for parents. It facilitates inner-self level skills and mind-set focused coaching for all family members, and family level alignment around shared goals.

Two-Gen practices hold promise for better outcomes for vulnerable families. As data supports, the efforts to reduce stress and provide support to young children, through two-generation interventions, can reverse the biological effects and behaviors associate with them.

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More information about Inter-generational approaches can be found at Annie E. Casey Foundation and Aspen Institute.

Differential or Alternative Response

As defined by the Child Welfare Information Gateway, Differential or Alternative Response is “a system reform that enables child protective services (CPS) to differentiate its response to reports of child abuse and neglect based on several factors. The CPS system selects the initial response (investigation or assessment) based on several factors. Differential response is an area of CPS reform also referred to as dual track, multiple track, or alternative response.” A state’s Differential or Alternative Response system may bolster service provision to those at risk because of the additional supports offered. These supports, such as assistance in meeting basic needs, address a critical risk factor for neglect.

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More information about Differential or Alternative Response is readily available by searching these terms in the Child Welfare Information Gateway library.