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S. U. S. Child Neglect. By Celeste R. Wilson, MD John R. Knight, MD Corresponding Educational Materials Reviewed by Hoover Adger, MD Jennifer Smrstik, LICSW Richard Bourne, JD, PhD. Epidemiology.

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child neglect

S

U

S

Child Neglect

By

Celeste R. Wilson, MD

John R. Knight, MD

Corresponding Educational Materials Reviewed by

Hoover Adger, MD

Jennifer Smrstik, LICSW

Richard Bourne, JD, PhD

epidemiology
Epidemiology
  • In 1996, child protective service agencies investigated more than 2 million reports alleging child abuse or neglect.
  • More than 1 million of these cases were substantiated.
epidemiology3
Epidemiology

Child neglect:

  • is the most common form of child maltreatment
  • accounts for about 2/3 of substantiated cases of child maltreatment
definition
Definition
  • The definition of child neglect varies from state to state.
  • In general, child neglect is defined as the caretaker’s failure to provide for the basic needs (e.g., food, clothing, shelter, education, safety) of the child.
poverty
Poverty
  • Poverty does not constitute child neglect.
  • Differentiating poverty from willful child neglect can be extremely challenging.
poverty6
Poverty
  • Detailed history is needed to understand parent’s explanation (e.g., why medication not purchased, why appointment missed)
  • Must determine if limited access to resources is preventing parent from acting in the child’s best interest (e.g., no money, no transportation)
types of child neglect
Types of Child Neglect
  • Physical neglect – failure to provide adequate food, clothing, and shelter
  • Emotional neglect – failure to provide adequate social stimulation in the form of talking, love, and nurturance/affection
types of child neglect8
Types of Child Neglect
  • Medical neglect – failure or delay in seeking medical/dental care or noncompliance with medications or recommended health care
  • Educational neglect – failure to send a child to school regularly
  • Safety neglect – failure to provide adequate supervision
parental factors associated with child neglect
Parental Factors Associated with Child Neglect
  • Substance abuse
  • Depression or other mental health disorders
  • Domestic violence
  • Unrealistic expectations of the child
  • Lack of social support system
  • Personal history of child maltreatment
child factors associated with child neglect
Child Factors Associated with Child Neglect
  • Prematurity
  • Developmental disability
  • Chronic medical condition
  • Difficult temperament (e.g., crying, fussiness)
environmental factors associated with child neglect
Environmental Factors Associated with Child Neglect
  • Family stressors (e.g., unemployment, illness, death of loved one, inadequate finances, divorce)
  • Lack of community resources
signs and symptoms
Missed medical appointments

Failure/delay in seeking medical care for illness

Failure/delay in seeking dental care

Poor growth

Poor hygiene

Developmental delay

Multiple dental caries

Untreated medical conditions

Nonspecific behavior patterns

Signs and Symptoms
identification
Identification

…can be challenging, partly because of the complexity associated with trying to discriminate between “adequate” vs. “inadequate” care of the child.

…in many cases is subjective, which can lead to underreporting.

intervention
Intervention
  • Educate parents about expectations for appropriate pediatric health care.
  • Promote parent understanding of child development through anticipatory guidance.
  • Supply parents with information about community resources and support services.
  • Establish a good rapport with parents and inquire about their childhood.
mandated reporting
Mandated Reporting
  • Pediatric clinicians are mandated reporters, meaning that they are required by law to notify the state child protection agency when they suspect a child is being neglected or abused.
child protection agency
Child Protection Agency
  • Evaluate situation
  • Emphasis on child safety and protection
  • Family plan
  • Direct services for the parents (e.g., parenting classes, substance abuse treatment)
  • Establish services for child (e.g., Early Intervention, daycare)
  • Ability to offer ongoing intervention for family and child
what can you do
What can you do?
  • Recognize signs and symptoms of child neglect and abuse.
  • Realize that intervening benefits the child and family.
  • Energize yourself to stay involved with the family even after a report to child protection services has been made.