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What is Child Neglect

How professionals think about neglect in babies and children

· Psychotherapy

These are the notes from a training I went to in Tower Hamlets City Council. The subject of the training was child and adolescent neglect. These are some of the things I found interesting.

Very often a neglected child doesn't know that what was going on for them was neglectful. This is because we always get used to our environment and we adapt to even rough conditions. When we think about child and adolescent neglect, as professionals, we want to be able to spot the signs and to link with other services for the case management.

It is also important to stress that there are different types of neglect. As professionals, when we discuss the child's development we traditionally think about those 6 categories of neglect:

  • Medical neglect
  • Nutritional neglect. This means that the child is not getting enough food to thrive.
  • Emotional neglect
  • Educational neglect. This means not going to school, it’s more than just not helping with homework.
  • Physical neglect
  • Lack of supervision and guidance

It is difficult to give a definition of neglect, but we can think about it as a persistent failure to meet the child’s physical or psychological needs. For it to be neglect it needs to be a consistent lack of successful support, not just a one-off episode. Neglect is also likely to result in serious impairments in the child’s development. It is difficult to know where the threshold is, and how to define a 'serious impairment'. The Children’s Act (1989/2004) talks about ‘significant impairment’, which is again quite vague. The issue remains: where is the threshold for neglect?

Various elements can indicate child neglect at different times. Some of the factors can also be indicative of other issues, but this is a list of things that professionals look out for:

- The child being withdrawn and quiet. However this might also be due to them being shy.
- They might consistently present as alone or isolated from their peers.

- The child might be often physically still or, the opposite, very fidgety and restless.

- The child might smell (for example of nappy rash).

- They might have clothing not properly fitted to their age.

- The child might have a poor attendance at school, or might not be attending at all.

- They might not be able to say what they like and dislike. This point is interesting, because it might then develop in a consistent lack of sense of identity, when they grow up.

- The child might prefer to approach adults instead of their peers.

- The child might have an unusual way to approach conversations and verbal interactions. For example they might talk when they should be listening.

Other factors usually associated with child neglect are:

- Being born prematurely. This might indicate neglect during pregnancy.

- Having a disability. This makes the child more vulnerable.

- Children who run away from home. This might indicate that they are somehow aware they're not receiving the care they need.

- Being adolescent out of parental control. This might indicate the difficulty in resolving the tasks of adolescence, for example individuation.

Of course those are not just signs of neglect. The child needs to be understood within their context. The assessment needs to consider the environmental factors as well as visible signs. Environmental factors are things such as education, development, culture, parents, and so on.

Poverty might create some of those signs, and poverty is not necessarily neglect. Just because a child comes from a poor or deprived family, it doesn’t necessarily means that they suffer from neglect

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