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Child neglect is the most common form of child maltreatment (a broad category of behavior that also includes sexual, physical, and emotional abuse). The National Child Abuse and Neglect Data System (NCANDS), a review of abuse and neglect data from all states, reported over one million substantiated cases of abuse in its 1994 review (U.S. Department of Health and Human Services [DHHS] 1994). Fifty two percent of these cases were from neglect. The majority of the two thousand or more documented abuse-related deaths each year are due to neglect. These statistics are likely to be an underestimate of the actual occurrence of neglect. Neglect is the least studied and most poorly characterized form of child maltreatment. This is due to multiple factors, including the difficulty in defining and documenting neglect in children.

Definitions

Neglect can occur in several forms. A broad definition of neglect is any failure to provide for the basic needs of the child. In practice, neglect is defined somewhat differently, depending upon local statutory definitions. Common statutory categories include (1) medical neglect—such as failure to provide visits to the doctor for routine checkups, not getting medical attention for injuries, and failure to ensure compliance with necessary medical treatments such as providing insulin for a diabetic child; (2) physical neglect—failure to provide food, water, or adequate sanitation; (3) emotional neglect—failing to provide appropriate attention, nurturing, and support for a child; (4) neglectful supervision—failure to provide appropriate and responsible care to the child; and/or (5) abandonment—failure to assume adequate responsibility for the child, such as leaving the child with no plans for return.

Major Categories of Neglect

Aside from statutory definitions, researchers and clinicians generally define and categorize neglect into four broad areas: physical, emotional, educational, and medical.

Physical Neglect

Physical neglect accounts for the majority of cases of maltreatment. It is estimated that eight of every thousand children experience physical neglect (NCANDS; DHHS 1997). The definition includes the refusal of or extreme delay in seeking necessary health care, child abandonment, inadequate supervision, rejection of a child leading to expulsion from the home, and failing to adequately provide for the child's safety and physical and emotional needs. Physical neglect, often in combination with emotional neglect, can severely affect development by causing failure to thrive, malnutrition, untreated serious infectious diseases (e.g., pneumonia), and physical harm in the form of cuts, bruises, and burns due to lack of supervision. Furthermore, the long-term emotional, social, and cognitive problems caused by physical neglect may be more serious and difficult to treat than the other actual physical problems.

Educational Neglect

Educational neglect occurs when a child is allowed to engage in chronic truancy, or is of mandatory school age but not enrolled in school or receiving school training, and/or is not receiving needed special educational training. Educational neglect can lead to underachievement in acquiring necessary basic skills, dropping out of school, and/or continually disruptive behavior.

Emotional Neglect

Emotional neglect includes such actions as chronic or extreme spousal abuse in the child's presence, allowing a child to use drugs or alcohol, refusal or failure to provide needed psychological care, constant belittling, and withholding of affection. This pattern of behavior can lead to poor self-image, alcohol or drug abuse, destructive behavior, and even suicide. Severe neglect of infants can result in the infant failing to grow and thrive, and may even lead to infant death.

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